Objective To explore the short-term influences of conventional internal medical treatment combined with escitalopram on cognitive function and cardiac function in elderly patients with chronic heart failure (CHF) complicated with depression disorder.Methods A total of 97 patients with CHF complicated with depression disorder in Chongqing Ninth People's Hospital,from October 2014 to October 2015,were selected and randomly divided into the antidepressant group and control group.Both groups were undergoing conventional internal medical treatment.Additionally,patients in the antidepressant group were administrated with escitalopram,while patients in the control group were treated with placebo.The degree of depression and anxiety and cognitive function were assessed by using 24-item Hamilton depression scale (HAMD-24),14-item Hamilton anxiety scale (HAMA-14) and Montreal cognitive assessment(MoCA) scale,and the plasma level of NT-proBNP,left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were measured before and after 6-week treatment.Results After 6-week treatment,the HAMD-24 and HAMA-14 scores and plasma level of NT-proBNP in antidepressant group were lower than those in the control group,while the attention score and LVEF were greater than those in the control group,there were statistically significant differences(P＜0.05).After 6-week treatment,no statistically significant difference was found in other observed indicators between the two groups(P＞0.05).Conclnsion For elderly patients with chronic heart failure complicated with depression disorder,it is indicated that escitalopram could not only relieve their anxiety and depression,but also improve their cardiac function and attention.

Objective To establish the method of the GC fingerprints for Ligusticum chuanxiong essential oil and its quality control.Methods The temperature at both feed inlet and detector was 250℃,the carrier gas was nitrogen,and the flow rate was 2 mL/min.GC of the essential oil in ten batches of L.chuanxiong was analyzed by adopting temprature programmer and the fingerprint peaks were identified by GC-MS.Results To set up the GC fingerprints for L.chuanxiong essential oil,13 peaks were marked out altogether and the GC fingerprints were analyzed by similarity analysis.Conclusion The method is of high degree of presion,reproducibility,and stability.The resolving of each component in the essential oil is good.The established fingerprints could be used as one of the quality control index for L.chuanxiong essential oil.

OBJECTIVE:To analyze the safety of linezolid (LZD) for elderly patients,and probe into the regularity of adverse reaction (ADR).METHODS:In retrospective study,elderly patients treated with LZD injection or tablets were selected from our hospital during Jan.2014-Dec.2015.The occurrence of ADRs were analyzed statistically.RESULTS:A total of 126 patients were included,the age was from 65 to 94 year-old,and the mean duration of treatment was (9.47 ± 6.31) d (ranged 1-35 d).Forty-five cases suffered from ADR after medication (35.71％),followed by 39 cases of thrombocytopenia (30.95％),9 cases of leukocytopenia(7.14 ％),7 cases of hemoglobin reduction (5.55 ％),6 cases of nausea and vomiting (4.76 ％),4 cases of transaminase elevation (3.17％),4 cases of diarrhea (3.17％),2 cases of lactic acidosis (1.59％),2 cases of skin rash (1.59％) and 1 case of drug fever (0.79％).The incidence of thrombocytopenia in ICU patients was significantly higher than non-ICU patients,with statistical significance (P=0.019).There was no significant difference among different dosage forms of LZD without statistical significance (P=0.218).CONCLUSIONS:Clinicians and pharmacists should closely monitor the application of LZD in elderly patients,pay more attention to ADR induced by LZD,especially in ICU,it induces the high incidence of thrombocytopenia.Meanwhile,it is suggested to monitor serum lactate concentrations regularly during treatment.

OBJECTIVE: To detect the effect of p38 mitogen activated protein kinase (p38MAPK) and cyclooxygenase-2 (COX-2) on the expression of mucin5AC (MUC5AC) in human nasal mucosa induced by histamine in vitro, and to investigate the pathogenesis of mucus hypersecretion in allergic rhinitis (AR). METHOD: Western blot was performed to detect the protein expressions of p38MAPK, COX-2 and MUC5AC in nasal mucosa induced by histamine or blocked by selective inhibitors of p38MAPK and COX-2 of different concentration gradient. RESULT: Weak expressions of p38MAPK. COX-2 and MUC5AC were detected in normal nasal mucosa in vitro. The protein expressions of p38MAPK. COX-2 and MUC5AC increased in nasal mucosa induced by histamine in a dose-dependent manner. The histamine induced protein expressions of COX-2 and MUC5AC were dose-dependently attenuated by selective inhibitor of COX-2, namely NS-398. No apparent influence of NS-398 on the expression of p38MAPK was observed. The histamine induced protein expressions of p38MAPK, C()X-2 and MUCbAC dose-dependently decreased after nasal mucosa was treated by selective inhibitor of p38MAPK, namely SB203580. And no significant change of MUC5AC protein expression induced by NS-398 or SB203580 was observed. CONCLUSION Our findings indicated that the histamine-induced increased expression of MUC5AC by activated p38MAPK/COX-2 may be a possible pathogenesis of mucus hypersecretion in AR.
Adult ; Female ; Humans ; Male ; Middle Aged ; Mucin 5AC ; metabolism ; Nasal Mucosa ; metabolism ; Rhinitis, Allergic, Perennial ; metabolism ; Signal Transduction ; p38 Mitogen-Activated Protein Kinases ; metabolism

Regional medical alliances help distribute high-quality medical resources to primary healthcare institutions.Under the guidance of " Internet-plus Healthcare" and " Hierarchical Medical System"policies, pharmacists are also exploring new management approaches for discharged patients with chronic diseases.The authors developed a Chronic Care Management(CCM)platform based on mobile App Yi Xing, and carried out full-range CCM for discharged patients in cooperation with pharmacists within the alliance. This CCM practice can contribute to an innovative transformation of pharmaceutical care, deliver high-quality pharmaceutical care to primary institutions, improve patients adherences and efficacy of medication, reduce adverse reactions, and save costs.

Objective? To investigate the readability evaluation of the printed health education materials by working nurses, to understand the perception of readability of health education materials and to lay the basis for future research on readability evaluation. Methods? In July 2017, 310 students from 147 hospitals (secondary and above) from all over Anhui Province were trained at Anhui Medical University. This study utilized the first stage of this training opportunity (July 3-14, 2017) to conduct an investigation of all participants. Surveys were conducted using a general survey, a printed health education material quality questionnaire, and a readability perception questionnaire. A total of 310 questionnaires were distributed in this study, and 283 valid questionnaires were returned. The effective response rate was 91.3%. Results? The results of the readability evaluation of the printed health education materials showed that 36 participants reported that there were no health education resources for the patients in their departments. 247 participants reported that they provided printed health education materials in their departments, 56.7% of them believed that the health education materials of their departments had too many medical terminologies, 53.8% thought that the key information was not summarized or emphasized, and 61.9% thought that the content was too old. Compared with the tertiary hospitals, the nurses working in the secondary hospitals thought that the health education materials in their hospitals had "too many medical terms" and "old content", and the difference was statistically significant (P＜0.05). The results of the evaluation of the application of health education materials showed that 247 clinical nurses reported that the existing health education materials were mainly obtained from the following channels, of which 64.8% were self-designed, 79.4% were from external institutions, and 68.4% were from online resources. Compared with the nurses in the tertiary hospitals, the nurses in the secondary hospitals reported more of the fact that their departments provided the same health education materials to patients with different stages, and the difference was statistically significant (P＜ 0.05); Regarding the perception of readability, 48.8% of the participants had heard of the concept of readability; 94.7% considered it necessary to assess the readability of health education materials; but only 20.5% understand the readability assessment method and have readability evaluation ability. Conclusions? At present, the health education materials used in clinical practice have to be improved in terms of readability and application methods, but the ability to evaluate readability is low. Developers of clinical education materials should pay attention to the readability evaluation of materials, learn from the methods and experience of foreign readability research, actively explore the evaluation methods suitable for the readability of health education materials in China, and improve the material based on the readability evaluation results. Hospital administrators should also strengthen the training of first-line health education nurses, improve their ability to assess the readability of health education materials and optimize the health education outcomes.

Objective To investigate the popularization of cardiopulmonary resuscitation(CPR)knowledge and science popularization needs among urban and rural residents in Tonghai County,Yuxi City,Yunnan Province,so as to explore the establishment of an efficient and appropriate science popularization model.Methods A total of 300 residents aged 15-60 years old were selected from Tonghai County,Yuxi City,Yunnan Province using stratified and simple random sampling methods.A self-designed questionnaire was used to conduct an anonymous questionnaire survey.Results Only 20.3%of Tonghai County residents master CPR skills,and 26.2%of Tonghai County residents have never heard of CPR.There is a statistically significant difference in the awareness rate of CPR between rural residents and non-rural residents(P<0.01).There are differences in residents'age and CPR awareness(P<0.01),the age and CPR are inversely proportional.The residents have a higher willingness to perform chest compressions and mouth-to-mouth resuscitation on strangers,66.2%and 68.6%respectively.63.79%of residents have never attended relevant training.But 92.76%of the people said they were willing to participate in the relevant training when they learned the training news.Conclusion Residents in Tonghai County generally lack knowledge of CPR first aid,but the demand for first aid knowledge of residential CPR is high and the attitude towards rescue is positive.It is recommended that relevant departments increase CPR science popularization and training efforts,and popularize CPR into villages.

Objective To investigate the effectiveness of team-based learning(TBL)combined with research-based learning(RBL)in enhancing evidence-based nursing practice skills of undergraduate nursing interns.Methods A total of 114 undergraduate nursing students who interned in the operating room of a ⅢA hospital in Guangzhou from July 2021 to April 2022 were selected as study subjects.A randomized cluster sampling method based on a random number table was used to divide the students into a control group and a trial group.The control group received traditional teaching methods,while the trial group was taught using a combination of TBL and RBL.The two groups were compared in terms of evidence-based practice skills,critical thinking abilities,and their evaluations on the teaching methods.Results The differences in evidence-based practice skills and critical thinking abilities before and after the internship were significantly higher in the observation group compared to the control group(t=35.108,35.897;both P<0.05).Additionally,post-internship evaluation scores for the teaching methods in the trial group were significantly higher than those in the control group(t=-17.580,P<0.05).Conclusion TBL combined with RBL effectively enhances the evidence-based nursing practice skills and critical thinking abilities of undergraduate nursing interns.This approach also improves students'evaluations on the teaching methods and fosters the cultivation of excellent clinical evidence-based nursing professionals.

Objective:To explore the value of convalescent somatosensory evoked potentials (SEPs) in formulating a prognosis for children with severe disorders of consciousness (DOC) caused by brain trauma, infection or hypoxia.Methods:This was a retrospective cohort study of 286 children with DOC children treated between 2013 and 2021. They were divided into a trauma group ( n=103), an intracranial infection group ( n=101), a hypoxia group ( n=42) and an other-causes group ( n=40). Their consciousness status and functional recovery were obtained in follow-up appointments, and their functional condition 1 year after discharge was assessed using the modified Glasgow Outcome scale (GOS). Results:During 8-year follow-up, 16 had died, with 4 deaths within 1 year. Among the 191 cases followed up to 1 year, children with a bilateral N20 SEP had significantly better functional outcomes than those with unilateral or bilateral N20 absence. For the trauma group, the presence of a bilateral N20 signal was a strong indicator of good functional outcome at the 1-year follow-up, with a specificity of 90.9%, sensitivity of 55.6%, positive predictive value (PPV) of 92.6%, negative predictive value (NPV) of 50% and a positive likelihood rate (PLR) of 6.111. However, for the intracranial infection group, the presence of N20 had a low specificity for predicting good outcomes, though the absence of an N20 potential predicted poor functional outcome at 1 year with a specificity of 82.4%, sensitivity of 62.1%, PPV of 75%, and PLR of 3.517. For the hypoxic group, bilateral N20 could not predict a good prognosis, though its absence meant a poor outcome, with a specificity of 87.5%, sensitivity of 63.6%, PPV of 93.3%, and PLR of 5.818.Conclusion:SEPs during the recovery period can help to formulate a prognosis for children with severe DOC. Traumatic brain injury and the presence of bilateral N20 potentials can be used as a good prognostic indicator. For intracranial infection and hypoxic-ischemic brain injury, the absence of an N20 potential indicates a poor prognosis.

Objective:To explore the dynamic changes of donor derived T cells at different time points in the aplastic anemia mouse model.Methods:The aplastic anemia mouse model was induced and then the proportion of infiltrated donor derived T cells in spleen and bone marrow, expression of activation molecular markers, cell cycle and functional subsets were measured by flow cytometry at different time points to evaluate the functional status of T cells in different periods.Results:①T cell immune-mediated aplastic anemia mouse model was successfully established by half lethal dose irradiation combined with major histocompatibility antigen (MHC) haploidentical lymph node cells infusion. ②The donor derived T cells began to infiltrate significantly in the spleen of aplastic anemia mouse from the 3rd day after transplantation and the ratio of CD4 +/CD8 + gradually inverted. After the 5th day, they gradually entered the bone marrow, predominated by CD8 + cells. ③The expression peak of CD69 in donor CD4 + cells was later than that in CD8 + cells. The trend of CD25 expression in CD4 + cells was the same as that in CD8 + cells, but the expression level in CD8 + cells was higher than CD4 + cells. ④The proportion of donor CD4 + cells in S/G 2/M phase reached the peak in spleen, about 12%, within 3 days after transplantation, while a higher level in CD8 + cells, which was about 20%. And the proportion of both CD4 + and CD8 + cells in S/G 2/M phase increased again after entering bone marrow, which was continued to be higher in CD8 + cells than that in CD4 + cells after 3 days of transplantation. ⑤Immune activated T cells in the spleen rapidly differentiated into effector memory T cells (T EM) after a short central memory T cell (T CM) stage. After entering the bone marrow, some T EM differentiated into effector cells to further function. Conclusion:In the aplastic anemia mouse model, donor derived T cells activated rapidly after entering the allogenic recipient, reached its proliferation booming period and differentiated into T EM cells within 5 days. After 5 days, they began to enter the bone marrow to continue proliferate and damage hematopoiesis.