Objective To investigate the status quo and influencing factors of self-management ability in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods Totally 339 CAPD patients with clinical follow-up regularly were investigated for the situation of self-management with general information questionnaire and Self-management Scale for CAPD.Results The total score of patients' self-management ability was (66.03±15.57).Multiple linear regression analysis showed that education level,marital status,occupation and duration of dialysis were influencing factors of patients' self-management ability.Conclusions Patients undergoing CAPD have certain degree of self-management ability.Nurses should promote their self-management ability according to different education level,marital status,occupation and duration of dialysis.

Objective To explore the mechanism of lupeol in the treatment of rheumatoid arthritis(RA)based on network pharmacology and molecular docking.Methods The target of lupeol was obtained by Swiss and TCMSP analysis platform,and the RA related target was obtained by searching"rheumatoid arthritis"in GeneCards database,which was transformed into the corresponding standardized gene name by UniProt database.The common targets of lupeol and RA were mapped by R-package,and the cross genes were obtained.The cross genes were introduced into the string database to construct protein protein interactions(PPI)network.The clusterProfiler database was used to analyze the enrichment of GO and KEGG pathways.The binding of lupeol with AR,CASP3 and CCNB1 was evaluated by molecular docking.The RA mouse model was established and the foot volume of each group was measured.HE staining for pathological changes,ELISA kit for detecting mouse serum TNF-α,IL-1β and IL-6 expression levels.The protein expression levels of Bcl-2,Bax,CASP3 and CASP9 were detected by Western blot.Results Forty targets of lupeol,4734 related targets of RA disease and 27 common targets of lupeol RA were obtained.The top three genes of PPI network were AR,CASP3 and CCNB1.291 GO and 20 KEGG pathways were enriched.Molecular docking showed that lupeol had good affinity with AR,CASP3 and CCNB1.The foot volume of the model group was significantly higher than that of the normal control group on the 8th,12th,16th and 20th day(P<0.05).Compared with the model group,the foot volume ofthe lupeol group was significantly lower on the 8th,12th,16th and 20th day(P<0.05),andthat ofthe diclofenac group was significantly lower onthe 12th,16th and 20th day(P<0.05).The HE staining results showed that compared with the model group,the lupine alcohol drug group significantly improved the pathological state.Compared with the model group,the level of TNF-α,IL-1β and IL-6 in serum of mice in the Lupeol drug group decreased(P<0.01).WB results showed that compared with the normal group,the protein expressions of Bax,CASP3 and CASP9 in the model group were significantly decreased(P<0.05),and the protein expression of Bcl-2 was significantly increased(P<0.05).Compared with the model group,the protein expression of Bax,CASP3 and CASP9 in the positive control group and drug group were significantly up-regulated(P<0.05),and the protein expression of Bcl-2 was significantly down regulated(P<0.05).Conclusion Lupeol plays a therapeutic role in RA by regulating Bax,Bcl-2,Casp3 and Casp9 in the p53 signaling pathway.

OBJECTIVE:To investigate the clinical efficacy and bacteriological efficacy of biapenem in the treatment of acute bacterial infection,and its effects on serum IL-6 and hs-CRP levels. METHODS:A total of 241 patients with acute bacterial infec-tion of respiratory system and urinary tract system selected from our hospital during Apr. 2015-Apr. 2016 were divided into control group(119 cases)and observation group(122 cases)according to random number table. Control group was given Meropenem for injection 0.5 g added into 100 mL 0.9% NaCl injection intravenously,tid. Observation group was given Biapenem for injection 0.3 g added into 100 mL 0.9% NaCl injection intravenously,bid. Treatment course of 2 groups lasted for 7-14 d. Clinical effica-cies,bacteriological efficacies,serum interleukin-6(IL-6)and hypersensitive C-reactive protein(hs-CRP)levels,the occurrence of ADR were compared between 2 groups. RESULTS:The total response rate,bacterial culture positive rate,bacterial clearance rate and the incidence of ADR were 88.24%,56.30%,87.14%,13.45% in control group and 93.44%,55.74%,93.06%,10.66% in observation group,without statistical significance(P>0.05). Before treatment,there was no statistical significance in serum IL-6 or hs-CRP levels between 2 groups(P>0.05). Compared with before treatment,serum IL-6 and hs-CRP levels of 2 groups were decreased significantly after treatment,with statistical significance(P<0.05);there was no statistical significance between 2 groups(P>0.05). CONCLUSIONS:Biapenem in the treatment of acute bacterial infection of respiratory system and urinary tract system has excellent efficacy,and can significantly reduce inflammatory factor level with good safety. Response rate and safety of biapenem are similar to those of meropenem,so drugs should be selected according to specific condition of patients.

Objective To observe the effects of iguratimod ( IT) combined with methotrexate ( MTX) in patients with refractory rheumatoid arthritis ( rRA) . Methods Sixty patients with rRA were randomly divided into 2 groups ( n=30 each group) . The cases in treatment group received 50 mg.d-1 of iguratimod and 10 mg of MTX for 16 weeks. The cases in control group were treated by 10-15 mg of MTX. DAS28 was analyzed. Levels of VEGF and endostatin ( ES) were quantified. Results In the treatment group,after 16-week treatment,DAS28,levels of VEGF and ES were (3.0±1.2),(818.9±178.8) pg.mL-1, (337.8±132.6) ng.mL-1,and those in the control group were (5.7±1.9),(1000.2±245.9) pg.mL-1,(253.8±77.8) ng.mL-1,respectively. In the treatment group,DAS28 and VEGF after the treatment were significantly decreased as compared with those before the treatment ( P<0.01) . The decrement was more significant in the treatment group than in the control group ( P<0.01) . At the 16th week of treatment,ES was significantly increased as compared with that before the treatment ( P<0.01) , and there was a significant difference between the treatment group and the control group (P<0.01). Conclusion Iguratimod combined with MTX have a prominent effect on rRA with high safety. The efficacy of IT on RA might be related with decreasing VEGF release,increasing ES production and alleviating synovium angiogenesis.

Objective To explore effect of psychological intervention based on clinical nursing pathway on neurogenic bladder training in patients with spinal cord injury.Methods A total of 107 patients with spinal cord injury were selected,and were given psychological nursing measures based on clinical nursing pathway.Results After psychological intervention,the symptoms of suspicion,depression,and psychasthenia were all relieved,and patients can cope with positive and optimistic emotions through the whole treatment,and had a better recovery.Conclusion Scientific and reasonable psychological interventions can reduce the psychological stress of the patients,and improve the quality of life for patients with spinal cord injury.

Objective To explore effect of psychological intervention based on clinical nursing pathway on neurogenic bladder training in patients with spinal cord injury.Methods A total of 107 patients with spinal cord injury were selected,and were given psychological nursing measures based on clinical nursing pathway.Results After psychological intervention,the symptoms of suspicion,depression,and psychasthenia were all relieved,and patients can cope with positive and optimistic emotions through the whole treatment,and had a better recovery.Conclusion Scientific and reasonable psychological interventions can reduce the psychological stress of the patients,and improve the quality of life for patients with spinal cord injury.

Objective To investigate the effect of apatinib on the migration ability of nasopharyngeal carcinoma NPC cells after X-ray irradiation and involved protein expressions. Methods The migration abilities of human immortalized nasopharyngeal epithelial cells ( NP69) and nasopharyngeal carcinoma cells ( CNE-1, CNE-2 ) treated with different concentrations of apatinib ( 0, 5, 10 and 15 μmol/L) were compared by wound healing assay. The effect of apatinib on the activity of NPC cells was detected by CCK-8 for determining the suitable intervention concentration of apatinib. Then NPC cells were divided into control group, apatinib group (15 μmol/L), X-ray irradiation group and apatinib combined with X-ray irradiation group, and the migration ability of each group was compared by wound healing assay. The expressions of pVEGFR2, pSTAT3, STAT3, MMP-9 and EMT related proteins were detected by western blot. Results Compared with the NP69, the migration abilities of CNE-1 and CNE-2 were significantly enhanced ( t=-5. 759, -16. 578, P<0. 05) . Compared with the control group ( 0 μmol/L) , the migration ability of NPC cells after treatment with apatinib(5, 10 and 15 μmol/L) was significantly decreased in a concentration dependent manner ( t=2. 804-13. 362, P<0. 05) . Compared with the X-ray irradiation group, the wound healing rate of NPC cells in the apatinib combined with X-ray irradiation group was decreased ( t=5. 932, 2. 791, P<0. 05) , indicating that apatinib can significantly inhibit the migration of NPC cells after X-ray irradiation. Western blot assay showed that the expressions of pVEGFR2 and pSTAT3 were significantly decreased in NPC cells treated with apatinib, meanwhile, the expression of MMP-9 protein was significantly decreased, and the EMT-related protein was changed. Conclusions Apatinib inhibits migration of X-ray irradiated NPC cells by inhibiting EMT through down-regulating VEGFR2/STAT3/MMP-9 signaling pathway.

Objective:To resolve the issue of poor automatic segmentation of the bowel in women with pelvic tumors, a Dense V-Network model was established, trained and evaluated to accurately and automatically delineate the bowel of female patients with pelvic tumors.Methods:Dense Net and V-Net network models were combined to develop a Dense V-Network algorithm for automatic segmentation of 3D CT images. CT data were collected from 160 patients with cervical cancer, 130 of which were randomly selected as the training set to adjust the model parameters, and the remaining 30 were used as test set to evaluate the effect of automatic segmentation.Results:Eight parameters including Dice similarity coefficient (DSC) were utilized to quantitatively evaluate the segmentation effect. The DSC value, JD, ΔV, SI, IncI, HD (cm), MDA (mm), and DC (mm) of the small intestine were 0.86±0.03, 0.25±0.04, 0.10±0.07, 0.88±0.05, 0.85±0.05, 2.98±0.61, 2.40±0.45 and 4.13±1.74, which were better than those of any other single algorithm.Conclusion:Dense V-Network algorithm proposed in this paper can deliver accurate segmentation of the bowel organs. It can be applied in clinical practice after slight revision by physicians.

With the emergence of new respiratory virus, it is more apparent for the vulnerability of population to respiratory viral infection.Non-pharmaceutical interventions (NPIs) for respiratory virus infection have become the main way to prevent corona virus disease 2019.Some studies had proven its effectiveness.In addition, the NPIs also significantly reduced the incidence and hospitalization rate of other respiratory disease in children.NPIs for respiratory virus infection in children have its particularity and challenge.In daily life, it is important to guide children how to do the NPIs, so as to protect susceptible children and reduce the disease burden in children′s health system.Therefore, the aerosol transmission, the specificity of the NPIs in children, and the impact on childhood respiratory diseases are described in this article, to improve the prevention of common respiratory diseases in children.

Objective:To analyze the prevalence of malnutrition in stable-phase elderly patients with chronic obstructive pulmonary disease (COPD) using the Global Leadership Initiative on Malnutrition (GLIM) criteria.Methods:Using cross-sectional survey, 60 elderly patients with COPD in stable phase were investigated, with 72 elderly patients without COPD in the same age group selected as controls. Differences in basic characteristics, anthropometric indicators, hematology indicators and body composition were compared between the two groups. According to the GLIM diagnostic criteria for malnutrition, the first step is nutritional risk screening, the second step is to diagnose malnutrition, and the third step is to determine severe malnutrition. The prevalence of malnutrition and severe malnutrition were investigated.Results:The levels of total protein, albumin, creatinine, and lymphocyte percentage in the elderly stable COPD group were significantly lower than those in the control group. The nutritional risk and the prevalence of malnutrition in elderly COPD patients were significantly higher than those in the control group, and the prevalence of severe malnutrition was higher .Conclusions:Elderly stable COPD patients of different age groups have a higher nutritional risk. The onset age of malnutrition is younger than that of non-COPD patients and early intervention is required.