The importance of clinical nursing is briefly discussed in this article and the significance of enhancing professional ethics is emphasized.In addition,the importance of cultivating the thought of "being disceet when alone" and improving the quality of nursing ethics are also stressed.

Objective To clarify evaluation methodology of the accuracy of differential diagnosis of meningioma and glioma,taking magnetic resonance imaging (MRI) and vascular endothelial growth factor (VEGF) into account.Methods According to the unified standard of design,114 cases were selected,which were diagnosed by postoperative pathological in Shanxi Cancer Hospital from March 2010 to October 2012.On the basis of hospital routine inspection,all patients needed MRI scan,enhancement scan,VEGF,ALP and LDH,with pathological diagnosis of glioma or meningioma.Using ROC curve analysis which took VEGF,T2WI into account,the accuracy of differential diagnosis could be evaluated.Results The results showed that the differential diagnosis accuracy were high relatively,the area under the ROC curve was 91.34 ％.When the T2WI were equisignal,low signal or high signal respectively,the area under the curve ROC were 97.62 ％,90.00 ％,88.34 ％.Conclusion To consider the MRI T2WI and VEGF,ROC curve regression model analysis can enhance the differential diagnosis accuracy of meningioma and glioma.

BACKGROUND: Scar hypertrophy is always followed by the wound healing in burn and trauma. Endothelial cells play a key role in scar hypertrophy, so inhibitory growth of endothelial cells can relieve scar hypertrophy to a certain degree. OBJECTIVE: To construct a recombinant adenovirus vector expressing human endostatin (Ad/hEnd), and to investigate the cooperative effect of Ad/hEnd and keratinocyte on endothelial cell proliferation. DESIGN, TIME AND SETTING: Observational study, which was performed in the State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital of the Third Military Medical University of Chinese PLA between September 2006 and May 2007. MATERIALS: pAdTrack-CMV and pAdEasy-1 were obtained from Stratagene Company, USA; 293 cell and Ecoli.DH5α were stored in our laboratory. METHODS: The endostatin gene sequence was obtained by reverse transcription-polymerase chain reaction (RT-PCR) and polymerase chain reaction (PCR) based on mRNA of human fetal hepatic tissue and inserted into the adenovims shuttle plasmid pAdTrack-CMV to obtain recombinant plasmid pAdTrack-ES. After identification, positive recon was transformed into pAdeasy 1 recipient virus to screen positive clones. The adenovirus Ad/hEnd was generated from 293 cells and identified by PCR and fluorescence microscope. Then the keratinocytes were infected with Ad/hEnd, and co-cultured with endothelial cells by nest dish culture method. The content of endostatin was detected, and the non-transfection keratinocytes were used as the controls. MAIN OUTCOME MEASURES: Homologous recombination and identification of pAd/hEnd; generation and identification of Ad/hEnd; endostatin expression after 293 cell transfection; purification and titer measurement of Ad/hEnd; content of endostatin in culture solution; apoptotic percentage of endothelial cells; inhibitory ratio of endothelial cells. RESULTS: Ad/hEnd was constructed and the virus titer was generally up to 1.65×1012 PFU/L. Ad/hEnd-infected keratinocytes could effectively express and secrete endostatin of which the content reached 226 μg/L after 3 days of co-culture. The apoptotic percentage and inhibitory ratio of the endothelial cells co-cultured with Ad/hEnd-infected keratinocytes were significantly higher than those in control group (P<0.05). CONCLUSION: Ad/hEnd-infected keratinocytes co-cultured with endothelial cells can promote apoptosis and inhibit proliferation of endothelial cells through excretion of endostatin.

Objective: To explore the application of the King′s theory for the standardized training of new recruited nurses based on Tower platform. Methods: Totally 167 new recruited nurses were randomly divided into the intervention group (n=84) and the control group (n=83). The nurses in the intervention group were taught with the teaching mode of King′s theory based on Tower platform while the control group were taught with routine teaching. Results: After training, the scores of autonomous learning ability, self-motivated belief, task analysis, self-monitoring and regulation, self-evaluation in the intervention group were 124.30±19.34, 52.47±7.01, 23.01±4.03, 34.24±6.17, 14.58±3.83, higher than those in the control group 116.81±15.52, 50.78±6.01, 21.07±3.72, 31.64±5.38, 13.32±3.01, and the differences were significant (t=-5.540-3.134, P<0.05). The theoretical scores in the intervention group (91.37±3.47) were higher than those in the control group (82.68±6.21), and the differences were significant (t=5.172, P<0.05). The scores of the competency of registered nurses in the intervention group (154.75±32.45) were higher than those in the control group (147.82±27.63), and the differences were significant (t=7.68, P<0.05). The total score of nurses in intervention group was 27.79±3.50, which was significantly higher than 20.75±2.54 in the control group, and the difference was statistically significant (t=-8.682, P<0.05). Conclusions The King′s theory for the standardized training of new recruited nurses based on Tower platform helps to promote the quality of teaching. The training method is well accepted and recognized by the new recruited nurses.

Objective:To evaluate the effect of different interventions in post-percutaneous coronary intervention (PCI) patients with kinesiophobia using network Meta-analysis.Methods:Computerized search of randomized controlled trials and quasi-experiment related to kinesiophobia interventions for post-PCI patients in WanFang database, China National Knowledge Infrastructure, China Biology Medicine, VIP database, Web of Science, PubMed, Cochrane Library and Embase was conducted with a time frame of searching from the establishment of the library to August 3, 2023. Literature screening, data extraction and literature quality evaluation were carried out independently by two researchers. Network Meta-analysis was performed using Stata 17.0 software.Results:A total of 13 literatures were included, including 9 randomized controlled trials and 4 quasi-experiments.Network Meta-analysis showed that cognitive behavioral therapy ( SMD = -4.08, 95% CI -6.49 --1.67), cognitive behavioral therapy combined with cardiac rehabilitation ( SMD = - 3.02, 95% CI -5.43 -- 0.61), dual heart medical intervention ( SMD = - 2.48, 95% , - 4.87 - - 0.09) can reduce the level of exercise fear in patients after PCI, and the difference were statistically significant compared with routine nursing (all P< 0.05). Ranked probability plots showed that the effects of the nine interventions in reducing kinesiophobia in post-PCI patients were cognitive behavioral therapy, cognitive behavioral therapy combined with cardiac rehabilitation, adaptive leadership theory-based intervention, dual heart medical intervention, COX health behavior interaction model, health education based on the behavioral change wheel, graded exposure therapy, mindfulness intervention, and high-intensity interval training in descending order of effectiveness. Conclusions:Cognitive behavioral therapy was the most effective intervention for kinesiophobia in post-PCI patients, but more high-quality randomized controlled trials are needed to further verify this conclusion.

Objective To evaluate the effect of propofol on high-mobility group box 1 protein (HMGB1)/Toll-like receptor 4 (TLR4) signaling pathway during hepatic ischemia-reperfusion (I/R) injury in rats.Methods Thirty-six clean-grade healthy male Sprague-Dawley rats,aged 3 months,weighing 250 -300 g,were divided into 3 groups (n=12 each) using a random number table method:sham operation group (group S),hepatic I/R group (group I/R) and propofol group (group P).Hepatic I/R injury was induced by occluding the portal vein and hepatic artery supplying the left and middle lobes of the liver for 1 h followed by 6-h reperfusion in anesthetized rats.Propofol was infused via the tail vein at a rate of 12 mg ·kg-1 · h-1 starting from 20 min before ischemia until 6 h of reperfusion in group P.The rats were sacrificed at 6 h of reperfusion,and the left lobe of the liver was removed for microscopic examination of the pathological changes which were scored and for determination of the expression of HMGB1,TLR4,tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-6) in liver tissues (by Western blot).Results Compared with group S,pathological scores of liver tissues were significantly increased,and the expression of HMGB1,TLR4,TNF-α and IL-6 was up-regulated in I/R and P groups (P＜0.05).Compared with group I/R,pathological scores of liver tissues were significantly decreased,and the expression of HMGB1,TLR4,TNF-α and IL-6 was down-regulated in group P (P＜ 0.05).Conclusion The mechanism by which propofol reduces liver I/R injury is associated with blocking HMGB-1/TLR4 signaling pathway and inhibiting inflammatory responses in rats.

Objective:To determine the median effective dose (ED 50) of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block. Methods:Patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status I or Ⅱ, with body mass index of 20-30 kg/m 2, scheduled for elective open reduction and internal fixation for patella fracture or removal of patella fracture by internal fixation, were enrolled in this study.Ultrasonic localization of femoral nerve was performed for measurement of the femoral nerve cross-sectional area, and 0.5% ropivacaine was injected based on the area.ED 50 was determined by Dixon′s up-and-down sequential method.The initial dose was 0.22 ml/mm 2, and the difference between the two successive doses was 0.02 ml/mm 2.The effective block was defined as complete loss of pain sensation in the areas of anterior skin of knee joint, skin on the inner side of the calf and dorsal medial skin of the foot and the degree of motor block was in stages 1-3 assessed using Brunnstrom motor function within 30 min after nerve block.Nerve block was considered ineffective if pain occurred in any nerve distribution area mentioned above.The study was terminated if 7 effective and ineffective alternating waves occurred.ED 50 and 95% confidence interval (CI) were calculated using Probit analysis. Results:Twenty-seven patients were enrolled in the study with the femoral nerve cross-sectional area (75±5) mm 2.ED 50 (95%CI) of 0.5% ropivacaine for ultrasound-guided femoral nerve block was 0.106 (0.069-0.125) ml/mm 2. Conclusion:ED 50 of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block is 0.106 ml/mm 2.

Objective:To investigate the predictive value of differential distribution of peripheral lymphocyte subsets before and after the first 131I treatment on the therapeutic response to 131I treatment in patients with papillary thyroid cancer (PTC). Methods:A retrospective study was conducted on 46 PTC patients (16 males, 30 females, age 20-77 years) who underwent total thyroidectomy and received 131I treatment between January 2021 and August 2021 in First Hospital of Shanxi Medical University. Peripheral blood lymphocyte subsets (T, B, CD4 + T, CD8 + T, natural killer (NK), helper T (Th)1, Th2, Th17, and regulatory T (Treg) cells) were measured 1-2 d before and 30 d after 131I treatment. Based on serological and imaging evidence, therapeutic response at 6-12 months post- 131I therapy was categorized as either excellent response (ER) or non-excellent response (NER). Differences of preablative stimulated thyroglobulin (psTg) and clinical baseline characteristics between two groups were assessed by using independent-sample t test, paired t test, or Mann-Whitney U test. Predictive value of lymphocyte subsets before and after 131I treatment for therapeutic response was assessed through logistic regression analysis, ROC curve analysis, and decision curve analysis (DCA). Results:In ER group ( n=33) and NER group ( n=13), most lymphocyte subsets showed different degrees of reduction 30 d after 131I treatment compared to before 131I treatment, such as T, B, CD4 + T and Th1 cells in ER group, as well as T, B, CD4 + T, Th1, Th2, Th17, and Treg cells in NER group ( t values: 2.41-9.57, all P<0.05). Before 131I treatment, NER group had significantly higher levels of psTg, Th2, Th17, and Treg cells compared to the ER group ( t values: from -3.32 to -2.48, U=29.00, all P<0.05). After 131I treatment, most of lymphocyte subsets in NER group (T, B, CD4 + T, CD8 + T, Th1 and Treg cells) showed higher trend than those in ER group but without statistical significances ( t values: from -1.12 to -0.06, all P>0.05). Th2 cells before 131I treatment (odds ratio ( OR)=25.00, 95% CI: 1.36-459.10, P=0.030) was identified as a risk factor for NER. ROC curve analysis indicated that AUCs of psTg and Th2 cells for predicting therapeutic response were 0.932 and 0.790, respectively, which was 0.958 for the combined psTg and Th2 cells. DCA showed that within the threshold probability range of 10%-60%, the curves for psTg, Th2 cells, and the combined psTg and Th2 cells were all higher than the extreme curve, suggesting good effect. Conclusions:Most lymphocyte subsets decrease to varying degrees, and NER group shows a significant decrease 30 d after 131I treatment. Th2 cells may be a risk factor for poor response to 131I treatment, providing a certain value in predicting the therapeutic response to 131I treatment.

ObjectiveTo analyze the effects of Danggui Shaoyaosan （DSS） on the gut microbiota of the Alzheimer's disease （AD） model in SAMP8 mice based on 16S rDNA sequencing. MethodTwenty-four SAMP8 mice aged seven months were randomly divided into low-， medium-， and high-dose DSS groups （14.4， 28.8， 57.6 g·kg^-1·d^-1） and a model group according to a random number table， with six rats in each group. Six SAMR1 mice of the same age were assigned to the normal group. After intragastric administration for eight consecutive weeks， 16S rDNA sequencing was performed to detect the gut microbiota of feces in mice. Morris water maze was employed to assess the directional navigation and space exploration ability of mice. Nissl staining was performed to observe the pathological changes of neurons in the hippocampal CA1 area. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the protein content of hippocampal amyloid β-protein （Aβ） and hyperphosphorylated Tau （p-Tau）. ResultCompared with the normal group， the model group presented a declining α diversity （P<0.05）， markedly altered β diversity， prolonged escape latency （P<0.05）， reduced number of platform crossings and cumulative duration in the targeted quadrant （P<0.05）， decreased neurons and Nissl bodies in the CA1 hippocampal area， and up-regulated Aβ and p-Tau expression （P<0.05）. However， DSS intervention enhanced the α diversity， and medium- and high-dose DSS， especially the medium-dose DSS， could result in α diversity similar to the control group. Moreover， at the phylum level， the abundance of Firmicutes increased （P<0.05）， while the abundance of Bacteroidetes and Proteobacteria decreased （P<0.05）. At the genus level， the abundance of Lactobacillus and other genera increased （P<0.05）， while the abundance of Bacteroides， Helicobacterium， Rikenella， Parabacteroides， Sutterella， and Mucilaginibacter decreased （P<0.05）. The DSS groups also showed shortened escape latency （P<0.05）， increased number of platform crossings and cumulative duration in the targeted quadrant （P<0.05）， increased Nissl bodies （P<0.05）， and reduced Aβ and p-Tau content （P<0.05）. Pearson correlation analysis showed that the abundance of Mucilaginibacter， Bacteroides， and Sutterella was negatively correlated with the cognitive ability of SAMP8 mice， while the abundance of Lactobacillus and Butyricimonas was positively correlated with the cognitive ability of SAMP8 mice. ConclusionDSS can improve the cognitive ability of SAMP8 mice， and its mechanism may be related to the regulation of gut microbiota diversity and community composition.

Alzheimer's disease （AD） is a deleterious neurodegenerative disorder， which has become a significant public health concern and economic burden. The pathogenesis of AD is complex and involves several hypotheses such as amyloid β-protein （Aβ） deposition， Tau protein hyperphosphorylation， oxidative stress， and inflammation. There is an urgent need for a holism-based comprehensive intervention with multi-pathway， multi-level， and multi-target characteristics， which demonstrates the unique advantage of traditional Chinese medicine （TCM）. Therefore， it is of great significance to conduct and promote research on TCM treatment of AD. Danggui Shaoyaosan （DSS） from the Synopsis of Golden Chamber （《金匮要略》） by ZHANG Zhongjing （150 AD-219 AD） was originally designed for reliving gynecological ailments. It is a classic TCM formula that modulates liver and spleen and dispels blood stasis and water retention. Since the late 1980s when Japanese researchers reported its therapeutic effect on AD， it has been widely used in the clinic with clear effects. The elucidation of the mechanism of this formula helps exert its effects. Hereby， this paper reviewed relative research progress and made an analysis in terms of attenuating aberrant accumulation of Aβ and hyperphosphorylated Tau protein， anti-inflammatory and antioxidant activities， mediating neurotransmitters， ameliorating lipid metabolism， modulating gut microbiota， reduced neuron apoptosis， decreasing intracellular Ca²⁺ overloading， and increasing the expression of estradiol. This paper is expected to provide references for understanding the scientific connotation of DDS in the treatment of AD and lay a solid foundation for further investigation.