The development of acute liver injury can result in liver cirrhosis, liver failure, and even liver cancer, yet there is currently no effective therapy for it. The purpose of this study was to investigate the protective effect and therapeutic mechanism of Lycium barbarum polysaccharides (LBPs) on acute liver injury induced by carbon tetrachloride (CCl4). To create a model of acute liver injury, experimental canines received an intraperitoneal injection of 1 mL/kg of CCl4 solution. The experimental canines in the therapy group were then fed LBPs (20 mg/kg). CCl4-induced liver structural damage, excessive fibrosis, and reduced mitochondrial density were all improved by LBPs, according to microstructure data. By suppressing Kelch-like epichlorohydrin (ECH)-associated protein 1 (Keap1), promoting the production of sequestosome 1 (SQSTM1)/p62, nuclear factor erythroid 2-related factor 2 (Nrf2), and phase Ⅱ detoxification genes and proteins downstream of Nrf2, and restoring the activity of anti-oxidant enzymes like catalase (CAT), LBPs can restore and increase the antioxidant capacity of liver. To lessen mitochondrial damage, LBPs can also enhance mitochondrial respiration, raise tissue adenosine triphosphate (ATP) levels, and reactivate the respiratory chain complexes I?V. According to serum metabolomics, the therapeutic impact of LBPs on acute liver damage is accomplished mostly by controlling the pathways to lipid metabolism. 9-Hydroxyoctadecadienoic acid (9-HODE), lysophosphatidylcholine (LysoPC/LPC), and phosphatidylethanolamine (PE) may be potential indicators of acute liver injury. This study confirmed that LBPs, an effective hepatoprotective drug, may cure acute liver injury by lowering oxidative stress, repairing mitochondrial damage, and regulating metabolic pathways.

Objective:To establish a competency assessment system for nutritional support specialist nurses, so as to provide reference basis for training reform, functional performance, and improvement of nursing service quality for nutritional support specialist nurses.Methods:Based on the practice standards of nutrition support specialist nurses published by American Society for Parenteral and Enteral Nutrition, the draft of the competency assessment system for nutrition support specialist nurses was developed through literature search and group discussion. From November 2021 to February 2022, two rounds of expert letter consultation were conducted with 15 experts by Delphi method, indicators were screened and modified according to expert suggestions, and the final competency assessment system for nutrition support specialist nurses was formed.Results:The effective response rates of the two rounds of expert inquiry questionnaires were 93.3% (14/15) and 100.0% (15/15) , with expert authority coefficients of 0.922 and 0.917, respectively. In the first round of expert consultation, 50.0% (3/6) of the first-level indicators agreed with a percentage≥80.0%, and 64.9% (24/37) of the second-level indicators agreed with a percentage≥80.0%. In the second round of expert letter consultation, the agreement percentage of the first and second indicators were≥80.0%. The final competency assessment system for nutrition support specialist nurses included 6 first-level indicators (practical ability, communication and coordination ability, education and consultation ability, legal and ethical decision-making ability, scientific research ability, leadership) and 29 second-level indicators.Conclusions:The competency assessment system for nutritional support specialist nurses constructed in this study is scientific, reasonable, and highly reliable, which can be used to standardize the training process of nutritional support specialist nurses, promote personal development.

Objective:To explore the application value of CT measurement of renal depth correction, optimized acquisition and post-processing in the measurement of renal glomerular filtration rate (GFR) by Gates renal dynamic imaging.Methods:From January 2018 to November 2019, 157 patients (102 males, 55 females, age (51.4±14.5) years) including 118 in normal renal area group (adults with normal renal position and morphology, and excluding hydronephrosis, renal occupation, retroperitoneal mass and other factors affecting renal depth) and 39 in abnormal renal area group (19 of transplanted kidney, 11 of horseshoe kidney and 9 of ectopic kidney), were retrospectively enrolled in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The GFR was measured by renal dynamic imaging Gates method. For the normal renal area group, the renal depth was calculated by CT method, the traditional Tonnesen formula or the Li Qian formula. For the abnormal renal area group, the GFR was measured by optimized acquisition and post-processing method (GFR optimization), the traditional post-processing method (GFR tradition), or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula method (eGFR). The differences of the renal depth and corresponding GFR obtained by different methods were analyzed using one-way analysis of variance and the least significant difference (LSD) t test. The correlation was analyzed by Pearson correlation analysis, and the consistency was analyzed by Bland-Altman analysis. Results:In the normal renal area group, the left and right renal depth measured by CT were (7.40±1.43) and (7.51±1.37) cm. Tonnesen formula underestimated renal depth (left kidney: (6.03±0.82) cm, right kidney: (6.06±0.84) cm; F values: 64.145 and 68.567, both P<0.01), and the deviation increased with the increase of CT measured depth ( r values: 0.847 and 0.834, both P<0.01). The GFR measured by Tonnesen formula was (56.93±28.42) ml·min -1·1.73 m -2, and the difference was statistically significant compared with CT method ((73.43±36.56) ml·min -1·1.73 m -2; F=9.423, P<0.01). The renal left and right depth measured by Li Qian formula were (7.55±1.03) and (7.52±0.98) cm, and the total GFR was (73.65±34.50) ml·min -1·1.73 m -2 with no differences compared with CT method (all P>0.05). The GFR obtained by Li Qian formula had better correlation ( r=0.901, P<0.01) and consistency with CT method. In the abnormal renal area group, GFR optimization, GFR tradition and eGFR was (63.11±27.40), (48.40±25.45) and (59.89±32.24) ml·min -1·1.73 m -2, respectively, and the difference between GFR tradition and GFR optimization was statistically significant ( F=2.870, P=0.025). GFR optimization had better correlation ( r=0.941, P<0.01) and consistency with eGFR. Conclusions:Tonnesen formula underestimates the renal depth. Using CT to measure renal depth and perform depth correction can improve the accuracy of Gates method for GFR determination. For the special cases of transplanted kidney, horseshoe kidney, ectopic kidney and retroperitoneal mass, it is important to optimize acquisition scheme and post-processing method to obtain accurate GFR.

Objective:To evaluate the effects of different sphere volumes, target background ratio (T/B) and post-processing correction techniques on the quantitative results of 99Tc m SPECT/CT. Methods:Six spheres with different diameters (37, 28, 22, 17, 13, 10 mm) in National Electrical Manufacturers Association International Electrotechnical Commission (NEMA IEC) models were filled with a mixture of 0.54 MBq/ml 99Tc m and iodixanol. The mixture iodine content was about 0.3%(135 mg), which led to different T/B (32∶1, 16∶1, 8∶1, 4∶1) by changing the radioactivity concentration of the cylinder. Routine imaging was performed on different T/B phantoms which were scanned by SPECT/CT. The CT threshold method was used for the delineation of volume of interest (VOI). Then the same processing correction technique and ordered-subsets expectation maximization (OSEM) parameters were used to calculate the radioactivity concentrations of different spheres, and further compared with the true values, and the accuracies were calculated. Pearson correlation analysis was applied to evaluate the relationships between sphere volume, T/B and quantitative results. The sphere with T/B of 32∶1 and diameter of 37 mm were processed by 3 correction techniques (CT attenuation correction (CTAC)+ scatter correction (SC)+ resolution recovery (RR); CTAC+ SC; CTAC+ RR). One-way analysis of variance and the least significant difference t test were used to analyzed the effects of 3 correction techniques on the quantitative results and image contrasts. Results:There were significant relationships between the sphere volumes, T/B and the quantitative accuracy ( r values: 0.757, 0.409, both P<0.05). There were significant differences of 3 correction techniques on the quantitative results and image contrast ( F values: 139.665 and 38.905, both P<0.001). Among them, the quantitative error of CTAC+ SC+ RR was lower than that of CTAC+ SC ((9.63±8.82)% vs (38.89±2.17)%; P<0.001), and similar to that of CTAC+ RR ((8.70±6.64)%; P>0.05). The quantitative error of CTAC+ RR was lower than that of CTAC+ SC ( P<0.001). The image contrast of CTAC+ SC+ RR was higher than that of CTAC+ SC ((93.45±0.91)% vs (92.41±0.25)%; P<0.001) and the image contrast of CTAC+ SC was higher than that of CTAC+ RR ((91.37±0.87)%; P<0.001). Conclusions:The larger sphere volume and the higher T/B, the more quantitative accuracy. The volume has a more significant effect on quantitative accuracy than T/B. Choosing the appropriate correction technique is helpful to quantitative accuracy improvement. It is suggested to use CTAC+ SC+ RR in quantitative processing.

Extracellular vesicles (EVs) are phospholipid bilayer vesicles actively secreted by cells, that contain a variety of functional nucleic acids, proteins, and lipids, and are important mediums of intercellular communication. Based on their natural properties, EVs can not only retain the pharmacological effects of their source cells but also serve as natural delivery carriers. Among them, plant-derived nanovesicles (PNVs) are characterized as natural disease therapeutics with many advantages such as simplicity, safety, eco-friendliness, low cost, and low toxicity due to their abundant resources, large yield, and low risk of immunogenicity in vivo. This review systematically introduces the biogenesis, isolation methods, physical characterization, and components of PNVs, and describes their administration and cellular uptake as therapeutic agents. We highlight the therapeutic potential of PNVs as therapeutic agents and drug delivery carriers, including anti-inflammatory, anticancer, wound healing, regeneration, and antiaging properties as well as their potential use in the treatment of liver disease and COVID-19. Finally, the toxicity and immunogenicity, the current clinical application, and the possible challenges in the future development of PNVs were analyzed. We expect the functions of PNVs to be further explored to promote clinical translation, thereby facilitating the development of a new framework for the treatment of human diseases.

The development of acute liver injury can result in liver cirrhosis, liver failure, and even liver cancer, yet there is currently no effective therapy for it. The purpose of this study was to investigate the protective effect and therapeutic mechanism of Lyciumbarbarum polysaccharides (LBPs) on acute liver injury induced by carbon tetrachloride (CCl₄). To create a model of acute liver injury, experimental canines received an intraperitoneal injection of 1 mL/kg of CCl₄ solution. The experimental canines in the therapy group were then fed LBPs (20 mg/kg). CCl₄-induced liver structural damage, excessive fibrosis, and reduced mitochondrial density were all improved by LBPs, according to microstructure data. By suppressing Kelch-like epichlorohydrin (ECH)-associated protein 1 (Keap1), promoting the production of sequestosome 1 (SQSTM1)/p62, nuclear factor erythroid 2-related factor 2 (Nrf2), and phase II detoxification genes and proteins downstream of Nrf2, and restoring the activity of anti-oxidant enzymes like catalase (CAT), LBPs can restore and increase the antioxidant capacity of liver. To lessen mitochondrial damage, LBPs can also enhance mitochondrial respiration, raise tissue adenosine triphosphate (ATP) levels, and reactivate the respiratory chain complexes I‒V. According to serum metabolomics, the therapeutic impact of LBPs on acute liver damage is accomplished mostly by controlling the pathways to lipid metabolism. 9-Hydroxyoctadecadienoic acid (9-HODE), lysophosphatidylcholine (LysoPC/LPC), and phosphatidylethanolamine (PE) may be potential indicators of acute liver injury. This study confirmed that LBPs, an effective hepatoprotective drug, may cure acute liver injury by lowering oxidative stress, repairing mitochondrial damage, and regulating metabolic pathways.
Animals ; Dogs ; Antioxidants/metabolism* ; Carbon Tetrachloride ; Chemical and Drug Induced Liver Injury/drug therapy* ; Kelch-Like ECH-Associated Protein 1/metabolism* ; Liver ; Metabolic Networks and Pathways ; Mitochondria/metabolism* ; NF-E2-Related Factor 2/metabolism* ; Oxidative Stress ; Polysaccharides/pharmacology* ; Lycium/chemistry*