Objective To describe depression in liver transplant(LT)recipients and explore their coping styles.Methods One hundred transplant recipients were divided into three groups according to the time after LT:one to six months after the operation(group1),six months to one year(group2)and one to three years after the operation(group3).A self-rating depression scale(SDS)was used to measure their depression levels,and a Medical Coping Modes questionnaire(MCMQ)Was used to investigate their coping styles.The results were compared with those from a general population,and the relevance of depression symptoms and coping styles was analysed. Results The average SDS score of all the LT recipients was 41.03±7.14(42.90±7.18 for group 1.40.71±7.97 for group 2 and 39.69±6.00 for group 3).The average depression scores of the three groups were all significantly higher than in the normal population,but there was no statistically significant difference among the three groups.The depression scores were negatively correlated with the confrontation aspect of coping style,while positively correlated with avoidance and resignation.Conclusion LT recipients tend to be depressed,and the level of depression is strongly related with their coping styles.

Objective:To observe the effects of Shexiang Baoxin Pill (SBP) on isoprenaline (Iso)-induced changes in myocardial cell volume,shape,and connexin 43 (Cx43) expression.Methods:HgC2 myocardial cells were randomly divided into a control group,a Iso group and a Iso+SBP group.After 72 h of culture,the average surface area of HgC2 cells was measured under phase contrast microscope.Bicinchoninic acid (BCA) protein assay was carried out to determine the concentration of proteins.The survival rate of myocardial cells was measured by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay,and the Cx43 expression was detected by Western blot.Results:The mean surface area and Cx43 concentration in Iso-treated myocardial cells were increased under the phase contrast microscope (P<0.05).Compared with the Iso group,the mean surface area was decreased,and the Cx43 concentration was reduced in the Iso+SBP group (both P<0.05).Compared with the control group,the Cx43 expression was obviously down-regulated in the H9C2 cells of the Iso group (P<0.05);while compared with the Iso group,the Cx43 expression was obviously up-regulated in the Iso+SBP group (P<0.05).Conclusion:Shexiang Baoxin Pills can prevent Iso-induced myocardial hypertrophy and down-regulate Cx43 expression.

Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.

AIM To observe the therapeutic effects of Shengjiang Xiexin Decoction (Zingiberis recens Rhizoma,Zingiberis Rhizoma,Coptidis Rhizoma,etc.) on irinotecan (CPT-11)-induced delayed diarrhea in colorectal carcinoma mice and to discuss its possible action mechanism.METHODS The AOM/DSS-induced female colorectal carcinoma mice were randomly divided into normal group,model group and Shengjiang Xiexin Decoction group.The Shengjiang Xiexin Decoction group was intragastrically administered with Shengjiang Xiexin Decoction,the normal group and the model group were intragastrically administered with normal saline.The diarrhea index and rectum pathologic morphology were measured,and the β-glucuronide activity,IL-15 content and UGT1A1 expression were detected.RESULTS The diarrhea index of Shengjiang Xiexin Decoction group was significantly lower than that of the model group,which might be related to the significant inhibition of β-glucuronide activity,and sig-nificant improvement of IL-15 content and UGT1A1 expression.CONCLUSION Shengjiang Xiexin Decoction shows therapeutic effects on irinotecan-induced delayed diarrhea in AOM/DSS-induced colorectal carcinoma mice.

Aim To study the effect of ginsenoside F1 on the enzyme activity and expression of gene of CYP3 A4 through activation of pregnane X receptor ( PXR ) . Methods With different concentrations of ginsenoside F1 treated on LS174T cells, the expression of CYP3A4 mRNA was determined by Q-PCR, and the enzyme activity was measured by P450-GloTM CYP3A4 assay according to the manufacturer′s instructions, fur-ther PXR-CYP3 A4 stable translation HepG2 cell lines were used to test ginsenoside F1 activates PXR by re-porter gene screening assay. Results The results re-vealed that the levels of CYP3 A4 gene and protein ex-pression were significantly increased by ginsenoside F1 in a concentration-dependent manner. At the same time, reporter gene screening showed that ginsenoside F1 could also enhance the transcriptional activity of PXR. Conclusion Ginsenoside F1 can significantly up-regulate the gene expression and enzyme activity of CYP3A4 via the PXR-CYP3A4 pathway.

Objective To investigate the relationship between plasma homocysteine on admission and the outcome at discharge of acute ischemic stroke.Methods A non-concurrent cohort study was performed and a total of 1 3 1 9 patients with acute is-chemic stroke were continuously included in this study.According to tertile range of plasma homocysteine,patients were di-vided into three group.Logistic regression analysis was used to assess the independent association between plasma homocys-teine on admission and poor outcome at discharge of acute ischemic stroke.Results The difference of plasma homocysteine on admission between the poor outcome and those with good outcome had statistical significance (P<0.000 1).Without the adj ustment of multiple factors,when comparing to the first group,the second and third tertile seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 2.111 (1.297~3.437,P<0.05),2.113 (1.361~3.279,P<0.05).After adjustment for multivariate,the second and third tertile also seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 1.876 (1.160~3.036,P<0.05),2.396 (1.414~4.062,P<0.05).Conclusion The current study indicated that higher plasma homocysteine level was an independent risk factor for poor outcome at discharge in ischemic stroke patients.It would increase the risk of the outcome at discharge in patients with acute ischemic stroke,and suggests that there is a dose-response relationship between plasma homocysteine level on admis-sion and the poor outcome at discharge.

Acute-on-chronic liver failure (ACLF) is a common critical and severe syndrome in patients with chronic liver diseases in China and other countries in the Asia-Pacific region. In recent years, both the Eastern and Western experts have defined ACLF as a new type of liver disease manifesting as a high 28-day mortality rate (>30%) and extensive systematic inflammatory response. ACLF has become a hot topic in the field of liver diseases. This article reviews the research advances in the definition and etiological spectrum of ACLF and discusses the inspirations of such new knowledge for future research.

Objective To examine the association between uric acid (UA)levels of patients with acute ischemic stroke at ad-mission and discharged outcome.Methods The acute ischemic stroke patients of Xinganmeng People’s Hospital in Inner Mongolia,from June 1,2009 to May 31,2012 were continuity included in the present study,the included analysis sample size were 3 440 cases.Poor discharged outcome was defined as the occurrence of disability or death.With reference to the Modi-fied Rankin's Scale (MRs)Stroke Scale,Scores were recorded in the questionnaires,score of 3 or more (MRs≥3)was de-fined as disability.The patients were all grouped by P20,P60,P90 of UA,binary logistic regression were used in studying of risk factors,calculated the odds ratios (Odds ratio,OR)and 95% confidence interval (95% Confident interval,95%CI).All tests were two-sided test and a significance level of 0.05.Results A total of 359 people occurred poor outcomes in the stud-y,accounting for 10.44%.Univariate logistic regression analysis of poor outcome occurred showed that relative to the lowest group(P20,UA≤222.6 mmol/L),the second and third group (UA:222.7 ~ 310.9 mmol/L and 311.0~419.7 mmol/L) OR (95% CI)were:0.70(0.53~0.91)(P <0.05)and 0.66(0.49~0.88)(P <0.05).After adjusted age,body tempera-ture,high blood pressure,hyperglycemia,history of stroke,high triglycerides,high LDL-C and smoking,relative to the low-est level group,the second and third group occurred poor outcoming OR (95% CI)were:0.70(0.53~0.93)(P <0.05)and 0.66(0.48~0.90)(P <0.05).Conclusion Higher levels of uric acid levels in patients with acute ischemic stroke may inde-pendently related with occurred poor discharged outcome.

Objective To investigate the protective effect of total flavonoids of Salvia divinorum extract against acetaminophen(APAP)-induced acute liver injury(ALI)and its molecular mechanism.Methods The main chemical constituents of total flavonoids of Salvia divinorum were obtained through literature search,and their pharmacological mechanisms were predicted using bioinformatics analysis.In a mouse model of APAP-induced ALI,the protective effects of 100,200 and 400 mg/kg total flavonoids of Salvia miltiorrhiza and 150 mg/kg bifidus were evaluated by observing changes in blood biochemistry and liver histopathology and detecting expressions of the key proteins in the Nrf2/HO-1 signaling pathway.Results Network pharmacology analysis suggested that the main active components in total flavonoids of Salvia divinorum for regulating APAP-induced liver injury included quercetin,lignocerol,caruric acid,and kaempferol,for which GO function enrichment analysis yielded 632 GO entries,including 472 involving biological processes,42 involving cellular composition,and 118 involving molecular function.KEGG enrichment analysis showed that the total flavonoids of Salvia divinorum regulated APAP-induced liver injury mainly through ferroptosis-related signaling pathway.In mice with APAP-induced ALI,treatment with the total flavonoids significantly lowered ALT and AST levels,improved liver histopathology and inflammatory cell infiltration,reduced iron deposition in liver tissues,improved lipid peroxidation-related indexes,promoted the expressions of Nrf2,HO-1,SLC7A11,and GPX-4 proteins,and inhibited the expression of keap1 protein.Conclusion The total flavonoids of Salvia divinorum alleviate APAP-induced ALI in mice possibly by suppressing hepatocyte ferroptosis via activating the Nrf2/SLC7A11/GPX-4 signaling pathway.

Objective To investigate the protective effect of total flavonoids of Salvia divinorum extract against acetaminophen(APAP)-induced acute liver injury(ALI)and its molecular mechanism.Methods The main chemical constituents of total flavonoids of Salvia divinorum were obtained through literature search,and their pharmacological mechanisms were predicted using bioinformatics analysis.In a mouse model of APAP-induced ALI,the protective effects of 100,200 and 400 mg/kg total flavonoids of Salvia miltiorrhiza and 150 mg/kg bifidus were evaluated by observing changes in blood biochemistry and liver histopathology and detecting expressions of the key proteins in the Nrf2/HO-1 signaling pathway.Results Network pharmacology analysis suggested that the main active components in total flavonoids of Salvia divinorum for regulating APAP-induced liver injury included quercetin,lignocerol,caruric acid,and kaempferol,for which GO function enrichment analysis yielded 632 GO entries,including 472 involving biological processes,42 involving cellular composition,and 118 involving molecular function.KEGG enrichment analysis showed that the total flavonoids of Salvia divinorum regulated APAP-induced liver injury mainly through ferroptosis-related signaling pathway.In mice with APAP-induced ALI,treatment with the total flavonoids significantly lowered ALT and AST levels,improved liver histopathology and inflammatory cell infiltration,reduced iron deposition in liver tissues,improved lipid peroxidation-related indexes,promoted the expressions of Nrf2,HO-1,SLC7A11,and GPX-4 proteins,and inhibited the expression of keap1 protein.Conclusion The total flavonoids of Salvia divinorum alleviate APAP-induced ALI in mice possibly by suppressing hepatocyte ferroptosis via activating the Nrf2/SLC7A11/GPX-4 signaling pathway.