ObjectiveTo study the effects of perindopril on myocardial energy metabolism and ultrastructural changes in rats with chronic heart failure (CHF) induce by isoproterenol. MethodsTotally 55 male SD rats were randomly (random number) divided into two groups, namely control group (Group C) and CHF model group. The CHF rat models were made by subcutaneous injection of isopreteronol (ISO) in doses of 20 mg · kg-1 · d-1, 10mg · kg-1 · d-1 and 5 mg/kg/d for successive 3 days and then 3 mg· kg-1· d-1 for9 days. Four weeks later, the rats in CHF model group were randomly further divided into two subgroups, namely untreated subgroup (group M ) and perindopril treated subgroup (group P). After treatment for five weeks in average, echocardiography and myocardial pathology examination carried out to assess the cardiac function and structure changes of these rats. The levels of ATP, ADP, AMP, lactic acid (LA) and sarcoplasmic reticulum Ca2+ -ATPase (SERCA) activity in myocardium were determined by enzymatic reaction. ResultsCompared with rats in group M, the ejection fraction of left ventricle (EF) and fractional shortening of short axis of left ventricle (FS) of the rats in group P increased by 3.25％ and 7. 33％, respectively. Compared with rats in group C, the myocardial ATP, AMP, TAN (total adenosine) and LA significantly decreased in rats of group M. There were no significant differences in the levels of ADP, AMP, ATP/ADP and TAN between group C and group P (P ＞0. 05). Compared with rats in group M, the myocardial SERCA activity increased by 16. 41％ in rats of group P. The myocardial injury found under microscope and electronic microscope was ameliorated by treatment with peidolapril in rats of group P in comparison with rats of group M. ConclusionsPerindopril can improve myocardial energy metabolism,and lessen the pathological changes of ultrastructure, enhancing the cardiac function of rats with CHF induced by ISO.

OBJECTIVE:To systematically evaluate the effectiveness and safety of escitalopram and duloxetine in the treatment of depression, and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Wanfang database,VIP,CNKI and CBM,randomized controlled trials (RCTs) about escitalopram (trial group) and duloxetine (control group) in the treatment of depression were collected. Meta-analysis was conducted by using Rev Man 5.3 software after data extraction and quality evaluation according to bias risk assessment tool recommended by system evaluator manual 5.3. RESULTS:Finally 25 RCTs were included,involving 2621 patients. The results of Meta-analysis showed that there was no statistical significance in total response rate between 2 groups after 1,2,4,6,8 weeks of treatment or cure rate between 2 groupsafter 4,6,8 weeks of treatment (P>0.05). There was no statistical significance in total response rate [RR=0.96,95％CI(0.88, 1.05),P=0.42] or cure rate [RR=0.91,95％CI(0.78,1.06),P=0.24] of female patients,as well as total response rate [RR=0.96, 95％CI(0.84,1.11),P=0.61] or cure rate [RR=0.90,95％CI(0.54,1.49),P=0.69] of elderly patients between 2 groups. The incidence of constipation [RR=0.59,95％CI (0.42,0.81),P=0.001],dry mouth [RR=0.65,95％CI(0.51,0.82),P=0.0004], nausea [RR=0.68,95％CI(0.56,0.83),P=0.0002] and decreased appetite [RR=0.74,95％CI(0.55,0.99),P=0.04] in trial group were significantly lower than control group,with statistical significance. CONCLUSIONS:The effectiveness of escitalopram is similar to duloxetine in the treatment of depression,but the safety of escitalopram is better than duloxetine.

Objective: To analyze the disease burden and risk factors of colorectal cancer in Zhejiang Province from 1990 to 2019, so as to provide the basis for prevention and control of colorectal cancer. Methods: Based on data of 2019 Global Burden of Disease (GDB 2019), disease burden and risk factors of colorectal cancer in Zhejiang Province from 1990 to 2019 was assessed using years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALY). Results: In 2019, the YLL rate, YLD rate and DALY rate caused by colorectal cancer in Zhejiang Province were 496.15/105, 31.81/105 and 527.96/105, respectively. From 1990 to 2019, the YLL rate, YLD rate and DALY rate caused by colorectal cancer in Zhejiang Province increased by 114.90%, 482.60% and 123.38%, respectively, showing increasing trends (average annual percent change values were =2.663, 6.283 and 2.800, respectively,all P<0.05). From 1990 to 2019, the YLL rate, YLD rate and DALY rate in the age groups of 15 to 49 years, 50 to 69 years and 70 years and older showed increasing trends (all P<0.05). In 1990, the top ten risk factors for colorectal cancer in Zhejiang Province were diet low in calcium, diet low in milk, diet low in whole grains, smoking, alcohol use, low physical activity, high fasting plasma glucose, diet high in red meat, diet low in fiber and high body mass index. In 2019, the top ten risk factors for colorectal cancer in Zhejiang Province were diet low in milk, diet low in whole grains, diet low in calcium, alcohol use, diet high in red meat, high body mass index, high fasting plasma glucose, low physical activity, diet low in fiber and diet high in processed meat. Conclusions The disease burden of colorectal cancer in Zhejiang Province showed an upward trend from 1990 to 2019. The top ten risk factors for colorectal cancer remained between 1990 and 2019, while there was a slight change in ranking.

Objective To explore the real user experiences of patients with PICC catheter for PICC maintenance network in Shandong province.Methods Descriptive phenomenological methodology was adopted in this study.A semi-structured interview was conducted with 18 patients of PICC-line maintained in different hospitals from PICC maintenance network in Shandong province.We analysed the data by Colaizzi's phenomenological research method.Results The experiences of patients with PICC catheter for PICC maintenance network in Shandong province contain positive and negative aspects.The positive aspects were convenient medical treatment,cooperation in various level hospitals,progress of basic hospitals,and enthusiastic services;the negative aspects were personnel shortage,different levels of nurses and imperfect supporting system.Conclusions Patients with PICC maintenance network possessed positive experience,but the accessibility of PICC maintenance network should be further enhanced,specialized development should be promoted.Meanwhile,for the questions proposed by patients,some measures should be taken to improve the overall PICC maintenance service from various level hospitals in Shandong province and make the experience of patients better.These measures include strengthening the standardized training and quality control of PICC,improving the supporting system,and promoting the implementation of continuous nursing mode in the primary hospitals.

Objective: To explore the status of care quality evaluation in the built-in type institution that integrating pension and health care service and analyze the focus on nursing service and management,it aims to provide theoretical basis for nurse managers to implement scientific nursing management. Methods: Descriptive phenomenological methodology was adopted in this study,a semi-structured interview was conducted with 8 nurse managers from 7 built-in type institutions that integrating pension and health care service.Data were analyzed based on Colaizzi′ s phenomenological research method. Results: Two themes were extracted, including the status of care quality evaluation in the built-in type institution that integrating pension and health care service; key indicators of nursing quality in the built-in type institution that integrating pension and health care service. Conclusions Through in-depth interviews with 8 nurse managers, we suggest that state should attach importance to the quality inspection of nursing care in the built-in type institution that integrating pension and health care service, and explore the evaluation criteria for nursing quality,in order to ensure the safety of elderly care, and it also can provide a basis for the comparison between inter-agency nursing quality and promote healthy competition among institutions.

The liver is one of the most important organs which regulate lipid metabolism in the body. Hepatic steatosis is a major manifestation of metabolic syndrome and is associated with an imbalance between lipid synthesis and decomposition. There are gender and age differences in the prevalence of fatty liver, suggesting that sex hormones may play a crucial role. This review summarizes current literatures on the regulation of hepatic lipid metabolism by sex hormones and their receptors. In females, estradiol binds to estrogen receptors to reduce liver fat production and fatty acid intake, while enhancing lipolysis and cholesterol secretion. In males, testosterone reduces adipogenesis and promotes fat breakdown through androgen receptors. These findings suggest that sex hormones and their receptors can serve as potential targets for preventing hepatic steatosis.

Objective:To investigate the status quo of a mobile nursing application acceptance of nurses, and analyze the influencing factors, so as to promote the application of a mobile nursing APP in clinic.Methods:On the principle of convenience sampling, 1207 participants from Shandong province were recruited to complete the self-designed questionnaire, including demographic data, smartphone use behavior and acceptance evaluation of the mobile nursing APP.Results:Average score of nurses' acceptance of a mobile nursing APP was 4.16±0.69. Multiple regression results showed that duty, use experience, recognition, smartphone self-efficacy and daily use time were the main factors affecting the acceptance of a mobile nursing APP for nurses ( t value was -7.132-22.678, P<0.05 or 0.01) and explained 39.1% of the total variation of the acceptance of mobile nursing app ( P<0.01). Conclusions:The acceptability of mobile nursing APP of clinical nurses is at a medium and high level, and it is influenced by the use experience, smartphone self-efficacy and other aspects, suggesting that nursing managers attach importance to the behavioral differences of nurses in using a mobile nursing APP.

Objective To explore the effect and mechanism of estrogen on endothelial progenitor cells（EPCs）function in diabetic rats. Methods EPCs were isolated from bone marrow of rats and characterized by fluorescence microscopy and flow cytometry. Rat diabetic model was established via streptozotocin induction. The bone marrow was taken to culture EPCs. EPCs of diabetes were incubated with Estrogen 10 nmol/L for 24h. The functions and proliferation of EPCs in vitro were detected. The levels of MnSOD and NO in EPCs and TSP-1 in supernatant were assayed. Results Compared with control group, EPCs proliferation, adhesion and angiogenesis functions were impaired in diabetic rats. The level of MnSOD and NO in diabetic EPCs were significantly decreased, while TSP-1 protein level in the supernatant increased. The above changes can be reversed with estrogen incubation. Conclusion Estrogen improved the EPCs migration and tubule formation in diabetic rats. The mechanism may be related to the reduction of oxidative stress and downregulation of TSP-1 expression in diabetic EPCs.

Objective To understand the epidemiological characteristics and variation of H3N2 influenza virus hemagglutinin (HA) gene in Changzhou from 2017 to 2018. Methods Throat swab specimens of the influenza-like cases were collected from Changzhou Influenza Monitoring Sentinel Hospital from April 2017 to March 2018. RNA was extracted from the specimens for influenza diagnosing and genotyping using real-time RT-PCR．H3N2 positive samples were isolated, and extracted RNA was used for amplification, sequencing and phylogenetic analysis of HA gene. Results From April 2017 to March 2018, 28 strains of influenza A (H3N2) virus were isolated. After gene sequencing, a phylogenetic tree was constructed. It was found that all of the strains belonged to Group3C.2a, which was similar to the vaccine strain A/Hong Kong/4801/2014. The HA amino acid sequence difference was analyzed and compared between the H3N2 influenza virus strains isolated in Changzhou and the vaccine strain A/Hong Kong/4801/2014. It was found that the epidemic strain isolated in Changzhou was in the HA epitope (A-E) region. Ten amino acid site mutations in the HA epitope (A-E) region and two amino acid site mutations in the stem region of HA antigen were found. Conclusion From April 2017 to March 2018, the influenza virus H3N2 prevalent in Changzhou was distributed on the same evolutionary branch with the vaccine strain A/Hong Kong/4801/2014 (group 3C.2a), rendering the popular trend of one subgroup. However, some amino acid sites of the HA epitope had variations, suggesting that mutations may occur, which may affect the immune effect of the vaccine. Monitoring needs to be strengthened in the future work.

Objective To explore the therapeutic effects of estrogen-intervened endothelial progenitor cells( EPCs) transplantation on diabetic ischemic stroke rats. Methods PKH26-labeled diabetic EPCs and estrogen-intervened diabetic EPCs were injected into rats via the tail vein 24 h after cerebral ischemia. Cerebral ischemic volume, behavioral changes, ischemic site vascularization and homing of EPCs were measured 3 d after EPCs injection. Results Compared with diabetic ischemic rats, estrogen-intervened EPCs transplantation had reduced infarct volumes, improved behavioral scores and ischemic site revascularization and promoted homing of EPCs to sites of injury(P<0.05). Conclusion Estrogen-intervened EPCs transplantation had a better therapeutic effect on diabetic ischemic stroke by promoting EPCs homing to injury site and EPCs-medicated neovascularization .