Objective To investigate the observation and nursing for patients with atria] fibrillation (AF)after left atrial linear ablation surrounding ipeilateral pulmonary veins (PVs). Methods Thirty patients with persistent AF underwent left atrial linear ablation surrounding ipsilateral PVs guided by CARTO electroanatomic mapping system and double Lasso catheters technique. The end point of ablation was defined as absence of all PV spikes after isolation and bidirectional conduction block between left atrial and PVs. Results After a median of (245±65)days of follow-up, twenty-one patients were free of AF. Eight patients subjected recurrent atrial tachyarrhymias, including 5 typical AFL, 2 atrial taehycardia and 1 paroxysmal AF. Two patients with persistent AF remaining PV spikes in left superior PV failed to be translated to sinus rhythm. Nine patients underwent repeated ablation and 8 of them were free of atrial taehyarrhythmia after (192±92) days follow-up. Total success rate after two procedures was 92.8%. Conclusions Nurses should perform effective care according to the symptom of patients before, during and after ablation procedure and relieve the patients from pain.

Objective To investigate of the tissue TGF-β changes at early stage of hypertrophic scar formation and the value of scar blisters in hypertrophic scar.Methods The TGF-β1 content in the blister fluid and the blood were quantified with ELISA,patients(n=15)with hypertrophy scar after depth burn were included,three time point(each n=5)on early　stage(<3 months)of hypertrophy scar formationwere monitored.and normal skin blister fluid and the blood(n=5)was used as control.Results The serum TGF-β1 in the both hypertrophic scar patients and normal skin group was not elevated(P>0.01),the TGF-β1 in the blister of normal skin was also not elevated(P>0.01),but TGF-β1 level in the scarblisters hypertrophic scar was elevated significantly[<60 d(158.5±69.8)pg/L,60-90 d,(181.1±40.1)pg/L,>90 d,(534.4±125.9)pg/L,P<0.01] and higher than the normal skin blister and the blood(P<15.6 pg/L.P<0.01),the increased TGF-β1 1evel in the hypertrophic scar blisters were persisted for at least three months.the TGF-β1 level of scar blister on the 3th month of hypertrophic scar formation reached a peak [(534.4±125.9)pg/L,P<0.01].Conclusions The data in this study indicates that TGF-β production at the early stage of hypertrophic scar formation is increased and may play an important role in scar formation;scar blisters is a valuable approach in hypertrophic scar study.

Objective To study the chemical constituents of Hedyotis tenelliflora. Methods The compounds were isolated by chromatographic separation technology. The structures were identified on the basis of chemical and spectral data. Results Four iridoid glycosides were isolated from the whole plant of H. tenelliflora. On the basis of the chemical and spectral methods, their structures were elucidated as teneoside C (1), harpagoside (2), harpagide (3), and asperulosidic acid (4). Conclusion Compound 1 is a new compound, and compounds 2 and 3 are isolated from H. tenelliflora for the first time.

Key word: Hedyotis L ; triterpenoids; spectroscopic characteristics

A sesquiterpene synthase (AsSS4) full-length open reading frame (ORF) cDNA was cloned from wounded stems of Aquilaria sinensis by RT-PCR method. The result showed that the ORF of AsSS4 was 1,698 bp encoding 565 amino acids. Prokaryotic expression vector pET28a-AsSS4 was constructed and transformed into E. coli BL21 (DE3) pLysS. Recombinant AsSS4 protein was obtained after induction by IPTG and SDS-PAGE analysis with a MW of 64 kD. Enzymatic reactions using farnesyl pyrophosphate showed that recombinant AsSS4 protein purified by Ni-agarose gel yielded five sesquiterpene compounds, cyclohexane, 1-ethenyl-1-methyl-2, 4-bis(1-methylethenyl)-, β-elemene, α-guaiene, α-caryophyllene and δ-guaiene. This paper reported the first cloning and functional characterization of AsSS4 gene from A. sinensis, which will establish a foundation for future studies on the molecular mechanisms of wound-induce agarwood formation in A. sinensis

Objective To analyze the holistic nursing value of heart transplant patients during the rehabilitation period. Methods Atotal of 72 patients undergoing heart transplant in our hospital from January 2016 to December 2017 were selected and were randomly divided into observation group and control group, with 36 cases in each group. The control group received conventional nursing. The observation group received holistic nursing on the basis of routine nursing. The SAS, SDSscores, quality of life, and nursing satisfaction were compared between the two groups after nursing. Results There was no significant difference in SASscore, SDSscore and quality of life between the two groups before nursing (P＞0. 05). There was significant difference in SASscore, SDSscore and quality of life between the two groups after nursing, the difference was significant(P＜0. 05). The satisfaction rate was 97. 2％ in the treatment group, which was significant higher than 83. 3％ in the control group (P＜0. 05). Conclusion The use of holistic nursing in recovery period of heart transplant can relieve the bad mood, improve nursing satisfaction and postoperative quality of life.

Objective To investigate the role of network platform for treatment and rescue of acute and severe cerebrovascular diseases in improving treatment level of patients with acute ischemic stroke.Methods The differences of number of patients accepted venous thrombolysis, number of patients accepted emergency intravascular interventional treatment, and time from admission to intravenous thrombolysis (door to needle time [DNT]) were analyzed in patients with acute ischemic stroke admitted to our hospital in the first year (2016) and the second and third years (2017 and 2018) of construction of network platform for treatment and rescue of acute and severe cerebrovascular diseases in Yunfu city. The National Institutes of Health Stroke Scale (NIHSS) scores were compared in 120 patients selected randomly from online referral (study group,n=60) and non-online referral (control group,n=60) within the same time periods in 2018.Results In 2017 and 2018, the number of patients accepted intravenous thrombolysis was 85 and 103, respectively, and the rate of intravenous thrombolysis was 9.92％ and 9.83％; they were all significantly larger/higher than those in 2016 (n=50, 6.97％,P<0.05). In 2017 and 2018, the number of patients accepted emergency endovascular treatment was 56 and 129, respectively, and the emergency endovascular treatment rate was 6.53％ and 12.31％; they were all higher than those in 2016 (n=44 and 6.14％), and the differences between those in 2018 and 2016 were statistically significant (P<0.05). The DNT ([82.00±18.75] min in 2017 and [77.00±32.17] min in 2018) was significantly shorter than that in 2016 ([109.00±30.58] min,P<0.05). The NIHSS scores of the study group and control group were 4.70±3.64 and 8.90±5.62, respectively, after one week of treatment, both of which were lower than those before treatment (14.30±6.29 and 13.60±6.37); and after treatment, the NIHSS scores of the treatment group were statistically lower than those of the control group (P<0.05). Conclusion Construction and effective operation of network platform for treatment and rescue of acute and severe cerebrovascular diseases is an effective guarantee to improve the success rate of treatment for patients with acute ischemic stroke.

Objective:To illuminate a method for establishment of a cost-efficient atopic dermatitis (AD) mouse model by topical application of ovalbumin (OVA),super-antigen staphylococcal enterotoxin B (SEB),and calcipotriene ointment (CO) on the back of BALB/c mice.Methods:Experimental mice were topically treated with OVA/SEB or OVA/SEB/CO every other day during 15 days of induction.Clinical alterations on the skin area were monitored every other day.Epidermal thickness were measured by reflectance confocal microscope (RCM) before harvest.Inflammatory cells in skin biopsies were marked by hematoxylin-eosin (HE) staining.Blood sample and skin biopsies were measured by ELISA and quantitative real-time PCR to detect the expression of IL-2,IL-4,IL-31,interferon (IFN)-γ,tumor necrosis factor (TNF)-α pruritus-associated nerve growth factor (NGF),and serum IgE.Results:Human AD-like cutaneous local inflammatory reaction was characterized by the accumulation of inflammatory cells,increased epidermal thickness and serum IgE levels as well as Th1 cell-associated cytokines (IFN-γ,TNF-α),Th2 cell-associated cytokines (IL-4,IL-31),and NGF in the OVA/SEB/CO group compared with that in the normal control group or the OVA/ SEB group.Conclusion:OVA/SEB/CO can induce an AD-like mouse model with lower economic and time consumption.

Objective:To investigate the clinical value of isolated fetal echogenic bowel (FEB) as an indicator for invasive prenatal diagnosis.Methods:This retrospective study enrolled 183 pregnant women who were diagnosed with isolated FEB and underwent invasive prenatal diagnosis in Fujian Maternity and Child Health Hospital from August 2013 to January 2021. Clinical data including the results of conventional karyotyping and chromosomal microarray analysis (CMA), cytomegalovirus (CMV) DNA loads in amniotic fluid and pregnancy outcomes were reviewed analyzed. Chi-square test was used for statistical analysis Results:Karyotyping was performed on all of the 183 fetuses and three (1.64%) aneuploidies (one case of trisomy 21, one trisomy 18 and one 47,XYY syndrome) were detected. One trisomy 21 and four pathogenic (P)/likely pathogenic (LP) copy number variation (CNV) were detected among 108 fetuses who received CMA. The detection rate of P/LP chromosomal abnormalities by CMA was higher than that by karyotyping, but there was no significant difference between them [4.63% (5/108) vs 0.93% (1/108), χ 2=1.54, P>0.05]. In addition, three cases of variants of uncertain significance (VOUS) were detected by CMA. CMV DNA loads of fetal cells in the amniotic fluid samples of the 166 cases were determined, and only one (0.6%) was positive (CMV DNA up to 7.01×10 6 copies/ml), and no abnormalities were found in karyotype analysis and CMA detection. A total of 176 cases were followed up, and among them only one case of intrauterine infection and seven cases (three aneuploidies and four P/LP CNV) of chromosomal abnormalities were terminated after genetic counseling. Three fetuses with VOUS and other 165 fetuses without chromosomal abnormalities had a good prognosis after birth. Conclusions:Isolated FEB may be the abnormal ultrasound finding in fetuses with chromosomal abnormalities or CMV infection. Prenatal genetic testing and the exclusion of intrauterine infection are important for management during pregnancy and prognosis assessment of FEB.

ObjectiveTo investigate the clinical diagnostic value of extra-spindle pole-like protein 1 （ESPL1） in the progression of hepatitis B virus （HBV）-related liver fibrosis. MethodsA total of 228 patients with HBV infection who were admitted to The First Affiliated Hospital of Guangxi Medical University from June 2017 to August 2023 were enrolled. The transient elastography system FibroScan was used to determine liver stiffness measurement （LSM） for all patients， and according to the LSM value， they were divided into non-liver fibrosis group with 80 patients， mild liver fibrosis group with 83 patients， advanced liver fibrosis group with 30 patients， and liver cirrhosis group with 35 patients. ELISA was used to measure the serum level of ESPL1. The Kruskal-Wallis H test was used for comparison of the serum level of ESPL1 between the four groups； the Spearman correlation analysis was used to investigate the correlation between ESPL1 and LSM； the receiver operating characteristic （ROC） curve was used to analyze the value of serum ESPL1 in predicting the progression of liver fibrosis. ResultsThe liver cirrhosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group and the mild liver fibrosis group （both P<0.05）， and the advanced liver fibrosis group and the mild liver fibrosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group （both P<0.05）. The correlation analysis showed that there was a positive correlation between serum ESPL1 and LSM in the patients with HBV infection and varying degrees of liver fibrosis （r=0.515， P<0.001）. Serum ESPL1 had an area under the ROC curve （AUC） of 0.809 in predicting liver cirrhosis and an AUC of 0.638 in predicting advanced liver fibrosis， with a sensitivity of 87.5% and 100%， respectively， and a specificity of 59.7% and 31.3%， respectively. ConclusionThere is a certain correlation between serum ESPL1 and HBV-related liver fibrosis， and higher serum ESPL1 may indicate a higher degree of liver fibrosis. Serum ESPL1 is expected to become one of the serum markers for assisting in the diagnosis of liver cirrhosis and an important clinical method for dynamically monitoring the progression of liver fibrosis in patients with HBV infection.