The paper gives an account of the basic methods for assessing the intrinsic quality of patient nursing by nursing procedures. These include: ①monitoring the accuracy of nursing assessment via evaluating the integrity of patients health; ②evaluating the soundness of nursing diagnosis via analyzing and judging the individuality of patients; ③evaluating the rationality of nursing goals and the appropriateness and operability of nursing measures through patients changes in behavior, function, cognition and emotion; and ④evaluating the timeliness and cyclicity of nursing result assessment through the improvement of patients overall conditions. The paper also analyses the problems involved in employing nursing procedures and countermeasures, pointing out that timely transformation of the nursing management model can markedly enhance the intrinsic quality of nursing.

Objective To observe the effects of vitamin E(VE) on the changes of the intercellular adhesion molecule-1(ICAM-1)and free radicals in ischemic-reperfused myocardium(MIR) of diabetic rats Method The diabetic rat model was established by i.p.streptozotocin injection.Four weeks later,MIR models were established,and 30 rats were divided into three groups with each group 10 rats(sham group,MIR group and VE group).The ICAM-1 protein expressions were evaluated by immunocytochemistry.The contents of malonialdehyde(MDA) in serum and myocardial tissues were detected.The activities of superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in serum and myocardial tissues were measured.The activities of Na+,K+-ATPase,Mg++-ATPase,Ca++-ATPase in myocardial mitochondria were measured.Results Compared with sham group,the activities of Na+,K+-ATPase,Mg++-ATPase,Ca++-ATPase in myocardial mitochondria were decreased,the contents of MDA in serum and myocardium increased,the levels of SOD and GSH-Px in serum and myocardium decreased,and the levels of ICAM-1 in myocardium increased significantly in MIR group.Compared with MIR group,the activities of Na+,K+-ATPase,Mg++-ATPase in myocardial mitochondria were increased,the levels of MDA in serum andmyocardium decreased the activities of SOD and GSH-Px in serum and myocardium increased,and the levels of ICAM-1 in myocardium decreased significantly in VE group.Conclusion VE could relieve myocardial ischemic reperfusion injury and the damage of lipid peroxidation and free radical induced by MIR in diabetic rats,and this effect was mediated by reduction of the expression of ICAM-1 protein.

Purpose To exp1ore the expression and c1inica1 significance of epiderma1 growth factor receptor( EGFR)and human epi-derma1 receptor-2(HER-2)in co1orecta1 carcinoma. Methods Immunohistochemistry(IHC)PV-9000 was used to detect the expres-sion of EGFR and HER-2 in 78 cases of co1orecta1 carcinoma. Si1ver in situ hybridization( SISH)was used to detect HER-2 amp1ifica-tion in co1orecta1 carcinoma. Results The positive rates of EGFR in 78 co1orecta1 carcinomas were 69. 23%( 54/78 ). The differ-ences of the expression of EGFR between different depth of invasion group and 1ymph node metastasis group were statistica11y signifi-cant. The differences of the expression of EGFR between different aging group,gender group,tumor size,different histo1ogica1 grading group and Dukes stage were insignificant. The positive rates of HER-2 in 78 cases of co1orecta1 carcinoma were 25. 64%(20/78). The differences of the expression of HER-2 between different depth of invasion group and 1ymph node metastasis group were statistica11y sig-nificant. The differences of the expression of HER-2 between different aging group,gender group,tumor size,histo1ogica1 grading group and Dukes stage were insignificant. The expression of EGFR and HER-2 was positive1y corre1ated. Among the 20 cases of HER-2 protein overexpression,10 cases showed HER-2 gene amp1ification,15 cases showed HER-2 protein overexpression(~)by IHC and 10 cases showed HER-2 gene amp1ification by SISH. The rate of HER-2 gene amp1ification was 66. 67%. 5 cases with 1ow HER-2 protein overexpression( +)and no case showed HER-2 gene amp1ification. Conclusions EGFR and HER-2 are high1y ex-pressed in co1orecta1 carcinoma. EGFR and HER-2 expression is connected to invasion and metastasis process of co1orecta1 carcinoma. The both may be synergy. The corre1ation between HER-2 protein overexpression(~)and HER-2 gene amp1ification is statisti-ca11y significant. Therefore,immunohistochemistry can be regarded as an initia1 screening method for HER-2 gene amp1ification,and then SISH testing shou1d be done as we11 to confirm the resu1t. It is usefu1 for mo1ecu1ar target therapy to detect HER-2 status in co1or-ecta1 carcinoma.

Objective To investigate the effects of tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis (RA) curative effect and peripheral blood of patients with IL-6, effects of IL-10 and TNF- alpha. Methods 80 patients with RA from February 2014 to August 2016 in our hospital were retrospectively analyzed. According to the different treatment methods by for the observation group, the control group (40 cases). To compare and analyze the curative effect before and after short-term treatment and treatment of patients in the 2 groups were the main clinical symptoms and signs of change and ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index. Results The total effective rate of observation group (92.50％) was significantly higher than the control group (77.50％), the difference was statistically significant (P<0.05), 2 groups of patients before treatment of main clinical symptoms and signs, there was no significant difference, after treatment, clinical symptoms and signs of 2 groups of patients were compared with those before treatment was statistically significant to alleviate the differences (P<0.05), and the observation group of main clinical symptoms and signs were lower than the control group and the remission (down), the difference was statistically significant (P<0.05).Before ESR, the treatment of 2 patients with RF, CRP, TNF- IL-6, alpha, IL-10 index level, no statistical significance, the 2 groups after treatment in patients with ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index level than before treatment with significant difference (P<0.05), and the observation group ESR, RF, CRP, TNF- alpha, IL-6 average index of water compared with the control group decreased significantly, IL-10 index increased significantly than the control group. The difference was statistically significant (P<0.05). Conclusion Tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis And it can effectively inhibit the expression of peripheral serum L-6 and TNF- alpha, promote the expression of IL-10 and alleviate the inflammatory reaction

Objective:To explore the application value of laparoscopic contrast enhanced ultrasound in laparoscopic surgery for patients with hepatocellular carcinoma combined with cirrhosis.Methods:The clinical data of 71 patients with hepatocellular carcinoma combined cirrhosis from February 2018 to February 2020 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. The patients underwent preoperative enhanced CT and multi-parameter MRI examination, followed by laparoscopic partial hepatectomy, and intraoperative laparoscopic contrast enhanced ultrasound examination. Based on histological examination and follow-up results, the diagnostic efficacy of preoperative imaging and preoperative imaging combined with intraoperative laparoscopic contrast enhanced ultrasound in patients with hepatocellular carcinoma combined with cirrhosis was compared.Results:Among the 71 patients, 69 completed laparoscopic surgery and 2 converted to open surgery. One hundred and ten HCC lesions were diagnosed by preoperative imaging examination, 105 lesions were detected by intraoperative ultrasound among them, of which 98 lesions were diagnosed as HCC by intraoperative laparoscopic contrast enhanced ultrasound. There were no statistically significant difference in sensitivity, specificity, accuracy, positive predictive value and negative predictive value between preoperative imaging and preoperative imaging combined with intraoperative laparoscopic contrast enhanced ultrasound in the diagnosis of malignant liver lesions: 94.4% (102/108) vs. 99.1% (107/108), 81.0% (34/42) vs. 66.7% (28/42), 90.6% (136/150) vs. 90.0% (135/150), 92.7% (102/110) vs. 88.4% (107/121) and 85.0% (34/40) vs. 96.6% (28/29), P>0.05. Laparoscopic contrast enhanced ultrasound revealed an additional 11 suspected malignant lesions, of which 5 lesions were histologically confirmed as HCC. Seven patients underwent surgical strategy changes. Conclusions:Laparoscopic contrast enhanced ultrasound in patients with HCC combined with cirrhosis during laparoscopic surgery can be used to detect, identify, accurately locate of the lesions and modify the surgical plan.

Objective:To investigate the expression of INHBA in colorectal cancer and its relationship with microsatellite status and clinicopathological features.Methods:Bioinformatics analysis was conducted based on Gene Expression Omnibus (GEO) database and Gene Expression Profiling Interaction Analysis (GEPIA) database, and the differentially expressed prognosis-related target genes in colorectal cancer were selected. Wax mass tissues of 107 patients with colorectal cancer who underwent surgery from January 2016 to June 2022 in the Third Affiliated Hospital of Jinzhou Medical University were collected, and the tissue microarrays were prepared. The clinicopathological microsatellite status [positive expressions of the mismatch repair (MMR) proteins MLH1, MSH2, MSH6, and PMS2 were mismatch repair proficient (pMMR), which represented low microsatellite instability or microsatellite stabilization; if any of these indexes was negative, it was judged to be mismatch repair deficient (dMMR), which represented high microsatellite instability] and INHBA expression in colorectal cancer tissues were detected by immunohistochemistry, data of the patients were retrospectively analyzed. The relationship between INHBA and microsatellite status as well as clinicopathological features was analyzed.Results:Three data sets of colorectal cancer were selected from GEO database: GSE110223 (13 cancer tissues, 13 paracancerous tissues), GSE110224 (17 cancer tissues, 17 paracancerous tissues), GSE113513 (14 cancer tissues, 14 paracancerous tissues), and the top 50 genes that were differentially up-regulated and down-regulated between cancer tissues and paracancerous tissues were screened. Intersection genes of 3 data sets were analyzed by Venn diagram, and 12 up-regulated genes and 17 down-regulated genes were screened out. According to GEPIA database, AQP8, ZG16 and INHBA genes among the up-regulated and down-regulated differential genes were associated with the prognosis of colorectal cancer. INHBA was higher expressed in colorectal cancer tissues than in paracancerous tissues (≥5 cm from the tumor margin) ( P < 0.05), and INHBA gene was selected for analysis. Immunohistochemical detection of collected colorectal cancer wax samples showed that the proportion of patients with high INHBA expression in colorectal cancer tissues was higher than that in paracancerous tissues [85.05% (91/107) vs. 67.29% (72/107), P < 0.05]. The high expression of INHBA in cancer tissues was related to the lesion site [right colon vs. left colon: 94.00% (47/50) vs. 77.19% (44/57)], maximum tumor diameter [>5 cm vs. ≤5 cm: 92.73% (51/55) vs. 76.92% (40/52)] and the depth of invasion [stage T 3-4 vs. stage T 1-2: 96.43% (54/56) vs. 72.55% (37/51)], differentiation degree [low and medium differentiation vs. high differentiation: 91.04% (61/67) vs. 75.00% (30/40)], lymph node metastasis [yes vs. no: 93.02% (40/43) vs. 78.13% (50/64)] (all P < 0.05), but had no correlation with age, sex, thrombus and nerve invasion (all P > 0.05). The proportion of patients with high expression of INHBA in colorectal cancer tissues in pMMR group was higher than that in dMMR group [93.22% (55/59) vs. 75.00% (36/48), χ2 = 6.91, P = 0.008]. Conclusions:INHBA is highly expressed in colorectal cancer tissues, and the highly expressed INHBA is closely related to clinicopathological features and microsatellite status of colorectal cancer. INBHA may be a new target for diagnosis, treatment and prognosis of colorectal cancer.

OBJECTIVE：To study the effects and active ingr edients of Tibetan medicine Lamiophlomis rotata against rheumatoid arthritis （RA）. METHODS ：Fifty-six SD rats were randomly divided into normal control group （0.5％ sodium carboxymethylcellulose），model group （0.5％ sodium carboxymethylcellulose ），methotrexate group （positive control group ，3 mg/kg），L. rotata water extract low-dose ，medium-dose and high-dose groups （0.5，1，2 g/kg，by crude drug ），L. rotata total flavonoid group （200 mg/kg，by flavonoid extat ），with 8 rats in each group. Except for normal control group ，other groups were given Freund ’s complete adjuvant （FCA）on the rat ’s right hind footpad to induce adjuvant-induced arthritis model. The next day after injection of FCA ，rats in all groups were given relevant medicine intragastrically ，once a day （once every 3 days for methotrexate group ）for 30 days. At 15th and 30th day of administration ，the degree of paw swelling of left hind foot was measured，and the arthritis index ，spleen index were calculated. At the end of 30th day of administration ，the levels of TNF-α，IL-1β， IL-6 and IL- 10 in rat serum were determined by ELISA assay ，the thymus index and spleen index were calculated ，the pathological changes of the ankle joints were observed by HE staining. RESULTS ：Compared with normal control group ，degree of paw swelling，arthritis index at 15th and 30th day of administration as well as the spleen index and the levels of TNF-α，IL-1β， msxmX0146） IL-6 in serum at 30th day of administration were significantly com increased in model group （P＜0.01）；while the thymus indexyunbinji- and IL- 10 level at 30th day of administration were ang@swu.edu.cn significantly decreased（P＜0.01）；synovial cell proliferation and infiltration of articular cavity were observed in ankle joint. Compared with model group ，degree of paw swelling ，arthritis index at 15th and 30th day of administration as well as the spleen index and the levels of TNF-α，IL-1β，IL-6 in serum at 30th day of administration were significantly decreased in each medicine group （P＜0.01）；while the thymus index and IL- 10 level at 30th day of administration were significantly increased （P＜0.01）；the pathological changes of arthritis were significantly improved. Compared with L. rotata water extract high-dose group ，there were no significant differences in degree of paw swelling at 15th day of administration as well as the arthritis index ，spleen index ，levels of inflammatory cytokines and pathological changes of ankle joint in L. rotata total flavonoid group （P＞0.05）. CONCLUSIONS ：Tibetan medicine L. rotata shows well anti-RA activity ，and total flavonoids may be the active ingredients of its efficacy.