Objective To evaluate the effect of magnetic stimulation on sleep disorder of patients with sequela of brain damage.Methods 60 patients with sequela of stroke or brain injury were divided into the control group and treatment group with 30 cases in each group.All patients in two groups were treated with regular rehabilitation training,and treatment group was added with magnetic stimulation,7±2 MT,20～30 min every time,once or twice a day.The period of treatment was 12 weeks.Results After treatment,the sleep disorder of patients of the treatment group improved significantly(P<0.05).Conclusion Magnetic stimulation could improve sleep disorder of patients with sequela of brain damage.

The different levels and clinical significance of high sensitivity C reactive protein(hs-CRP) , tumor necrosis factor-a ( TNF-α) , erythrocyte sedimentation rate ( ESR) , and urinary monocyte chemoattractant protein-1 (uMCP-1) in 84 type 2 diabetic patients with different urine albumin excretion (UAE) were observed. The results indicated that the levels of hs-CRP,TNF-α,urinary MCP-1 ,and ESR in diabetic patients were significantly higher than those in control group,and the first three indexes increased with the levels of UAE. The results suggest that diabetic nephropathy seems to be correlated with inflammatory reactions.

A total of 185 patients with type 2 diabetes mellitus (T2DM) were consisted of male group (n =95) and postmenopausal female group (n =90).The parameters of fasting plasma glucose,HbA1c,fasting insulin,fasting C peptide,homeostasis model assessment insulin resistant index (HOMA-IR) and β-cell function (HOMA-β),blood lipid,body mass index,and waist to hip ratio were collected and analyzed by Pearson correlation analysis and stepwise multiple regression analysis.The relationships between osteocalcin and these parameters were investigated.The results revealed that osteocalcin was negatively correlated with HbA1C (P＜0.05),and osteocalcin was an independent relevant factor affecting HbA1Clevels.Osteocalcin may be involved in the regulation of glucose metabolism in T2DM.

Objective To study the effect of fasudil on inhibiting the Rho/ROCK signaling pathway under high glucose in human mesangial cells (HMCs) inflammation and fibrosis. Methods Synchronized HMCs were divided into following groups: (1) Normal glucose control group ( NG, 5. 5 mmol/L glucose) ;(2) High glucose group (HG, 30 mmol/L glucose) ; (3) Mannitol group (Man, 5.5 mmol/L glucose + 24. 5 mmol/L mannitol) ; (4) High glucose + fasudil group ( HG + F, the concentrations of fasudil were 25 ,50 and 100 μmol/L, respectively). Collect the supernatant and cells at 0, 12, 24, 36, 48 and 72 h respectively, and determine the concentration changes of the RhoA, ROCK- Ⅰ, connective tissue growth factor (CTGF)mRNA with real-time PCR method in the cells, then used the ELISA method to check the protein content of the fibronectin ( FN) , CTGF, TNFα in the supernatant. Results ( 1) RhoA, ROCK- Ⅰand CTGF mRNA of the HMCs cultured under the high glucose expressed significantly higher than those in the normal group, and there was certain time-dependence. Besides, there was no statistic significance by comparing Man and NG. (2) Under the high glucose situation, after the fasudil pretreatment with different concentrations and 24 h or 48 h culture with high glucose, RhoA, ROCK- Ⅰ , CTGF mRNA expression was significantly decreased in HG + F, compared with HG, and there was certain concentration-dependence. (3) High glucose increased the FN, CTGF, TNFα protein secretion of HMCs in a time-dependent manner, but normal glucose and mannitol had no such effect. (4) After the fasudil pretreatment with different concentrations and culture with high glucose for 12, 24, 36, 48, 72 h, the FN, CTGF, TNFα protein secretion was significantly reduced compared with HG. Conclusion Fasudil can reduce the secretion of downstream inflammatory factors and cytokines by inhibiting high glucose-activated HMCs Rho/ROCK signaling pathway, and reduce the inflammation and fibrosis of HMCs. This provides a new basis for the therapeutic target in the treatment of diabetic nephropathy.

Objective To investigate the role of Rho/ROCK signaling pathway in the process of human mesangial cells (HMCs) inflammation and fibrosis induced by high glucose. Methods Synchronized HMCs were divided into following groups: ( 1 ) Normal glucose control group ( NG, 5.5 mmol/L glucose); ( 2 ) High glucose group ( HG, 30 mmol/L glucose); (3) Mannitol group( Man,5.5 mmol/L glucose+ 24.5 mmol/L mannitol); (4) NG +Y-27632 group( 10 μ mmol/L Y-27632 ); ( 5 ) HG Y-27632 group ( 10 μmmol/L Y-27632 ). The supernatant and cells were collected at 0,12,24,36,48, and 72 h. Western blot was used to detect the active RhoA and total RhoA,while RhoA, ROCK-Ⅰ, CTGF, and TNF-α mRNA expressions were determined with realtime PGR method in the cells, then ELISA method was used to check protein levels of FN, CTGF, and TNF-α in the supernatant. Results ( 1 ) RhoA activation was stimulated after treatment for with 30 mmol/L glucose, peaked at 1 h, and then decreased ( P = 0. 02). (2) RhoA, ROCK-Ⅰ, CTGF, and TNF-α mRNA expressions in HMC cultured under high glucose were higher than those in the normal group ( P ＜ 0.05 ), and there was certain time-dependence. Besides, there was no statistical significance between Man and NG groups( P＞0. 05 ). ( 3 ) After Y-27632 pretreatment and being cultured with normal glucose and high glucose for24 h or48 h, RhoA, ROCK-Ⅰ, CTGF, and TNF-α mRNA expressions were significantly decreased ( P＜0.01 ) as compared with groups without treatment. (4) High glucose increased FN, CTGF,and TNF-α protein secretion of HMC in a time-dependent manner( P＜0. 05 ). ( 5 ) After Y-27632 pretreatment and being cultured with normal and high glucose for 12,24,36,48,72 h, FN, CTGF, and TNF-α protein secretions were significantly reduced( P＜0.05 ). Conclusion Rho/ROCK signaling pathway may mediate inflammation and fibrosis induced by high glucose in HMCs, supporting a potential role for inhibitors of Rho/ROCK in the treatment of diabetic nephropathy.

267 newly-diagnosed patients with type 2 diabetes were divided into normoalbuminuria group [group N-UAlb, urinary albumin to creatinine ratio (UACR)<30 mg/g, n=103], microalbuminuria group(group M-UAlb, UACR 30~300 mg/g, n=88 ) , and macroalbuminuria group ( group L-UAlb, UACR>300 mg/g, n=76). The control group(group NC) consisted of 114 healthy individuals. Serum betatrophin, adiponectin(APN), and interleukin-1β( IL-1β) levels were determined with ELISA methods and the parameters of body mass index (BMI), estimated glomerular filtration rate(eGFR), HbA1C, fasting plasma glucose(FPG), OGTT 2h plasma glucose(2hPG), fasting insulin(FINS), OGTT 2h postprandial insulin(2hPINS), fasting C-peptide(FCP), homeostasis model assessment insulin resistant index(HOMA-IR), and blood lipid were collected. Compared with group NC, the serum betatrophin levels in patients with type 2 diabetes were obviously increased. In patients with type 2 diabetes, betatrophin levels increased along with the increase of UACR and there were significant differences in betatrophin among the three groups(P<0. 01). Betatrophin positively correlated with UACR, HbA1C, FPG, 2hPG, FINS, 2hPINS, HOMA-IR, TC, LDL-C, and TG( r were 0. 785, 0. 225, 0. 136, 0. 241, 0. 386, 0. 223, 0. 411, 0.216,0.193,and0.298,allP<0.05),and betatrophin were also positively correlated with APN and IL-1β(rwere 0. 643 and 0. 710, both P<0. 01). Stepwise multiple regression analysis showed that UACR, HbA1C, FINS, and TG were independent relevant factors affecting betatrophin levels.

Endometrial cancer has been identified by The Cancer Genome Atlas program with four molecular subtypes by genome sequence analysis. Clinical trials to select suitable immunotherapeutic agents based on the different immune characteristics of each subtype have been conducted in several countries and have made important progress. The main clinical applications of immune checkpoint inhibitors include anti-programmed cell death protein-1/programmed death-ligand 1 antibodies and poly ADP-ribose polymerase inhibitors. Optimizing drug selection and drug combination based on the target characteristics of different immune checkpoint inhibitors may provide new opportunities for immunotherapy of endometrial cancer and bring new light to improve survival rates.

Objective:To systematically review the experience of nurses′ in providing home-based hospice care, so as to provide a basis for improving the quality of home-based hospice care and the nursing service system.Methods:Qualitative researches on nurses′ experience of providing home-based hospice care were retrieved from the Cochrane Library, PubMed,Web of Science, EBSCO, Medline, China National Knowledge Internet, China Biomedical Literature Database, Wanfang Database, VIP Database from inception to April 1, 2022. Adopting Joanna Briggs Institute Critical Appraisal Tool (2016) to evaluate the quality of included studies, the Meta-synthesis was used to explain and integrate the research results.Results:A total of 9 articles were included. This study extracted 23 clear results, 8 new categories, and 3 integrated results, including the significance of nurses′ acceptance of home-based hospice care; positive and negative emotions coexist when nurses provide home-based hospice care; challenges in implementing home-based hospice care.Conclusions:The development of home-based hospice care service is helpful to provide continuous care for the terminally ill patients and improve their quality of life, but at the same time, the ability of home-based hospice care of nurses should be further improved and the related policy guarantee should be perfected to promote the steady development of home-based hospice care in China.

Objective To measure the occupation-sex stereotype, studying value and emotional stability of undergraduate nursing students (male), so as to provide further reference for exploring approaches of weakening or eliminating occupation-sex stereotype on male nursing students.Methods From November 2015 to November 2016, with method of convenience sampling, 54 undergraduate male nursing students from Grade I, II and III, from School of Nursing, of Kunming Medical University, were selected and were measured by Implicit association test (IAT), Studying value doubt scale and Eysenck emotional stability test.Results There were 34 male nursing students whose results of D-algorithm >0.5; 73.08% of the male nursing students had intensity of implicit sex stereotype>200 ms; 40.74% of the undergraduate male nursing students considered studying at the university valueless; more than 85% of the undergraduate male nursing students experienced inferiority complex or depression; over 65% were with obsession, hypochondriasis or low autonomy; a few were with anxiety or delusion of sin.Conclusions Occupation-sex stereotype is common among male nursing students. Several of the male nursing students considered studying at the university valueless. Emotional problems exist, like inferiority complex, depression, obsession and hypochondriasis.

The superiority of the cumulative outcomes of day 5/6 embryo transfer to those of day 2/3 embryo transfer in infertile couples has been debated.This retrospective study included data collected from 1051 patients from July 2011 to June 2014.Multiple maternal baseline covariates were subjected to propensity score matching analysis,and each day 5/6 group woman was matched to one day 2/3 group woman.A systematic meta-analysis was conducted to validate the results.After matching was completed,217 patients on the day 2/3 group were matched with those on the day 5/6 group,and no significant differences in the baseline characteristics were observed between the two groups.The cumulative pregnancy rate (57.14％ vs.53.46％,OR 1.16,95％ CI 0.79-1.70) and cumulative live birth rate (53.00％ vs.49.77％,OR 1.14,95％ CI 0.78-1.66) of day 5/6 embryo transfers were higher than those of day 2/3 embryo transfers,but this difference was not significant.The mean cycles per live birth and mean days per live birth in the day 5/6 group were significantly lower than those in the day 2/3 group.This study demonstrated that day 5/6 embryo transfer is a more cost-effective and time-efficient policy than day 2/3 embryo transfer to produce a live baby.