Objective To observe the effects of liver-discharging and stomach-harmonizing therapy on quality of life in senile patients with reflux esophagitis and to evaluate the therapeutic effect of traditional Chinese medicine (TCM) on chronic diseases. Methods Sixty patients with senile reflux esophagitis selected from in-patients and out-patients of Henan Province Hospital of TCM from March 2012 to October 2013 were randomly divided into experimental group and control group(each,30 patients). The experimental group was treated with Xiaoyao powder (its ingredients could be added or subtracted according to the patient's individual situation)combined with omeprazole and domperidone,while in the control group,only western drugs,omeprazole and domperidone were applied. The therapies in both groups lasting for 8 weeks constituted one therapeutic course. The MOS 36-item short form healthy survey(SF-36)was used to evaluate the degree of improvement of patients,quality of life,and clinical effects and adverse drug reaction were observed. Results The total scores of SF-36,physical and mental health scores of both groups were increased significantly,and the degree of elevation in scores in the experimental group was markedly higher than that in the control group(total scores of SF-36:124.2±11.5 vs. 117.1±10.9,physical health scores:67.9±5.3 vs. 62.9±6.2,mental health scores:56.1±6.7 vs. 55.0±6.6,all P<0.05). The total effective rate of experimental group was much superior to that of control group(96.7%vs. 80.0%,P<0.05). No obvious adverse reactions happened in the two groups. Conclusion Liver-discharging and stomach-harmonizing therapy can improve the quality of life in aged patients with reflux esophagitis.

Objective To explore the effect of Baogan Jiedu Granule on liver cell ultrastructure of model mice with acute liver injury induced by tetracycline.Methods Totally 60 mice were randomly divided into tetracycline model group,large-dosage,medium-dosage and small-dosage groups of Baogan Jiedu Granule,Ganlixin group and control group.Each group was respectively perfused with corresponding drug for 5 days and tetracycline was perfused once to make the model.The tissues were observed by electron microscope,and the liver cell ultrastructure was measured and analyzed by three-dimensional metrology.Results The amount of mitochondria Vv,heterochromatin Vv,mitochondria ?m,endoplasmic reticulum ?m and Golgi's apparatus ?m all obviously decreased in model group,while that of euchromatin Vv and lipid droplet Vv increased.Baogan Jiedu Granule could remarkably increase the amount of indexes referred above,and decrease the amount of euchromatin Vv and lipid droplet Vv.Conclusion Baogan Jiedu Granule can significantly ameliorate the pathologic change of liver cell ultrastructure,thus having a good hepatoprotective effect.

Objective To study the effect of Punica granatum( pomegranate) see d oil( PSO) on proliferation and apop-tosis behaviors of breast cancer cells.Methods Fatty acid composition was detected by gas chromatography,breast cancer cells, MCF-7 and MDA-MB-231 were treated with PSO, cell proliferation was observed by MMT, cell apoptosis was analyzed by flow cytometry,and expression levels of proliferation and apoptosis-related proteins were detected by Western blot.Results Punicic acid (PA) was the major fatty acid in PSO(74.41%).PSO could inhibit the proliferation while in-ducing apoptosis in both cell lines in a dose-and time-dependent manner, significantly decrease the expression level of Cox-2 and Bcl-2, increase the expression level of Bax and caspase-3 (cleaved),remarkably upregulate the expression of P53 in MCF-7, and downregulate p53 expression in MDA-MB-231.Conclusion PA may be one of the functional ingredients of PSO which can inhibit proliferation and induce apoptosis in breast cancer cells.These effects are probably mediated by regu-lating the expression of Cox-2, Bcl-2, Bax, caspase-3 (cleaved) and p53.

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

Background:Accumulating evidence links colorectal cancer (CRC) with the gut microbiota.Fusobacterium nucleatum (F.nucleatum) has been revealed to be involved in the development of CRC, however, the mechanism of F.nucleatum in mediating colorectal tumorigenesis is still poorly understood.Aims:To investigate the effect and potential mechanism of F.nucleatum on CRC.Methods:Wild type C57BL/6 mice and APC(Min/+) mice characterized by multiple intestinal neoplasia were used in this animal study.After administered with F.nucleatum intragastrically and/or 1,2-dimethylhydrazine (DMH, a carcinogen) subcutaneously, the aberrant crypt foci (ACF) and colonic tumor were counted at 8th and 20th week, respectively.Structural alteration of intestinal microbiota and mucosal immune factors were detected in wild type C57BL/6 mice receiving different interventions by using Roche 454 GS FLX pyrosequencing and Bio-Plex ProTM cytokine assay, respectively.Results:In DMH-treated wild type C57BL/6 mice or APC(Min/+) mice, number of ACF and colonic tumor in those administered with F.nucleatum were significantly higher than those without (P<0.05).F.nucleatum colonization significantly altered the lumen microbial structure, with decreased Cyanobacterium and increased Tenericutes and Verrucomicrobia (P all <0.05).Furthermore, F.nucleatum up-regulated expressions of tumor-related immune factors in colonic mucosa, such as IL-21, IL-22, IL-31 and CD40L (P<0.05).Conclusions:F.nucleatum colonization in intestine may prompt colonic tumorigenesis in mice via inducing intestinal dysbiosis and modulating tumor-related immune factors expression.

Objective:To compare the effectiveness of Logistic regression, BP neural network and support vector machine models in the prediction of 30-day risk of readmission in elderly patients with an exacerbation of chronic obstructive pulmonary disease (COPD) and to provide a scientific basis for the screening and prevention of high-risk patients with readmission.Methods:The COPD patient survey questionnaire was made, including the general data questionnaire, modified Medical Research Council dyspnea scale (mMRC), activities of daily living (ADL), the geriatric depression scale, the mini nutritional assessment-short form (MNA-SF) and COPD assessment test (CAT). Elderly COPD patients were selected from the department of respiratory medicine of 13 general hospitals in Ningxia from April 2019 to August 2020 by convenience sampling method, and they were followed up 30 days after discharge. To explore the risk factors of patient readmission, Logistic regression model, BP neural network model and support vector machine models were constructed based on the risk factors. According to the ratio of the training set to the testing set of 7∶3, the model was divided into the training set sample and the testing set sample. The prediction efficiency of the model was compared by the precision rate, recall rate and accuracy rate, F1 index and the area under the receiver operator characteristic curve (AUC).Results:A total of 1 120 patients were investigated, including 879 non-readmission patients and 241 readmission patients. Univariate regression analysis showed that there were statistically significant differences in age, education level, smoking status, proportion of diabetes and coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors and long-term home oxygen therapy, regular medication, proportion of rehabilitation exercise, course of disease, ADL, depression status, mMRC, nutritional status between non-readmission patients and readmission patients. Binary Logistic regression analysis showed that education level, smoking status, coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors, whether long-term home oxygen therapy, whether regular medication, nutritional status were the risk factors for 30-day acute exacerbation of readmission in elderly patients with COPD. The training set showed that the accuracy rate of Logistic regression model, BP neural network model and support vector machine models were 70.95%, 76.51% and 84.78%, respectively. The recall rates were 79.55%, 86.36% and 88.64%, respectively. The accuracy rates were 87.81%, 90.81% and 93.82%, respectively. F1 indexes were 0.75, 0.81 and 0.87, respectively. The AUC were 0.850, 0.893 and 0.921, respectively. The testing set showed that the precision rate of Logistic regression model, BP neural network model and support vector machine model were 78.38%, 80.65% and 88.57%, respectively. The recall rates were 70.73%, 60.98% and 75.61%, respectively. The accuracy rates were 85.82%, 84.40% and 90.07%, respectively. F1 indexes were 0.74, 0.69 and 0.82, respectively. The AUC were 0.814, 0.775 and 0.858, respectively.Conclusion:Comparing with Logistic regression and BP neural network, support vector machine model has better prediction effect, and can effectively predict the risk of acute exacerbation of readmission in elderly patients with COPD within 30 days.

Objective To study the validity of RAND-UCLA (Rand Corporation and University of California at Los Angeles) consensus panel method in developing guidelines of referral indications for low back pain (LBP).Methods Evidence-based clinical guidelines for LBP management at community level and its referral guidelines published since 2001 and other tools were retrieved with varied tools.All clinical guidelines met inclusion criteria were evaluated with clinical studies and evaluation tools (AGREE).An pool of indication items was established based on evidence for developing referral indications for LBP, which were added by RAND-UCLA consensus panel method, and alternative referral indications were selected and clinical guidelines for LBP referral were established.Results A total of 15 copies of clinical guidelines from nine countries or regions were included in it after critical appraisal.Four copies of referral guidelines from two countries were included.Referral indications for LBP were derived directly from the RAND-UCLA consensus panel process, consisting of 44 referral indications for three groups (immediate, urgent and routine referral).Conclusions The RAND-UCLA consensus panel method is a more useful and practical tool in developing clinical guidelines, referral guidelines, which is worthwhile being recommended and spread.

Objective:To investigate the value of superb micro-vascular imaging (SMI) in evaluating carotid neovascularization in patients with Takayasu arteritis (TA).Methods:SMI was used to analyze the wall thickness and neovascularization in a total of 38 common carotid arteries in 23 patients with TA diagnosed in Shengjing Hospital of China Medical University, and the results were compared with contrast-enhanced ultrasound (CEUS).Results:SMI could clearly show the thickening wall of the common carotid artery in TA patients, and could show very tiny blood flow channels in the thickening wall. Neovascularization was detected in a total of 34 common carotid arteries by SMI, 23 of which showed 1 point of score with scattered low-velocity blood flow and the rest of which showed 2 points of score with diffused spots or strips with low-velocity blood flow. Correspondingly, neovascularization was detected in a total of 34 common carotid artery by CEUS, 22 of which showed 1 point of score and the rest of which showed 2 points of score. The scores of the two groups were consistent ( Kappa=0.641, P<0.01). Conclusions:SMI can be used as one of the important screening methods for neovascularization assessment in thickened carotid wall in patients with TA, which shows potential application value in the diagnosis, treatment and follow-up for TA patients.

Objective:To understand the current situation of nurses′ implementation of oral care for elderly patients, so as to improve oral care practice standard and quality of oral care constantly.Methods:Using convenient sampling method, 190 nurses in the general ward of the General Hospital of Ningxia Medical University were selected as the research object from September to November 2020. The self-designed questionnaire was used to investigate and analyze the implementation of oral care among elderly patients.Results:A total of 190 questionnaires were collected in this survey, 84.74%(161/190) of the nurses reported that the hospital or department had oral care practice standard; The proportion of nurses who evaluated the oral status of elderly patients by the oral care assessment tool was 17.89%(34/190).Only 14.74%(28/190) and 16.84%(32/190) of the nurses could always set the expected rehabilitation goals and formulate the corresponding nursing plans for the oral problems of elderly patients, respectively. When the elderly patients had special oral problems, 26.32% (50/190) of the nurses would proactively communicate with doctors or search literature; the oral knowledge and oral hygiene habits of the elderly patients would be known to nurses accounting for 5.26% (10/190).Conclusions:Nurses′ cognition of oral care for elderly patients is at a low level on the structure, process and outcome.Relevant nursing managers still need to further improve the oral care operation norms and the training of nurses′ knowledge and skills, so as to continuously promote the oral health of elderly patients.

Objective:To explore the correlation between abdominal aortic calcification and serum cell division cycle 42 (CDC-42) in maintenance hemodialysis (MHD) patients, and to explore the influencing factors of them.Methods:A cross-sectional study was conducted in the Blood Purification Center of Qingdao Municipal Hospital,112 patients who underwent MHD for more than 6 months from October 2019 to March 2021 were selected. The abdominal aortic calcification score (ACCs) was calculated by reference to the abdominal lateral X flat tablets. According to AACS, 50 cases were divided into no and mild calcification group (0≤AACS<5 points) and 62 cases were divided into moderate and severe calcification group (AACS≥5 points). The level of serum CDC-42 was detected by enzyme linked immunosorbent assay (ELISA). Taking the median serum CDC-42 level as the boundary, 56 cases were divided into low CDC-42 group and high CDC-42 group. Spearman correlation analysis was used to analyze the correlation between indicators. The risk factors of elevated CDC-42 and abdominal aortic calcification in MHD patients were explored by multivariate logistic regression analysis, and the variables were included by entry method.Results:In 112 patients, 91 cases (81.25%, 91/112) had abdominal aortic calcification, and the median serum CDC-42 level was 466.56 (335.56,623.57) ng/L. CDC-42, AACs, age, dialysis age, diabetic nephropathy, glycosylated hemoglobin, alkaline phosphatase, parathormone and calcium in the no and mild calcification groups were 347.77 (291.20, 419.53) ng/L, 1.00 (0.00, 3.00) points, (57.18±6.25) years, 31.50 (15.00, 49.25) months, 34.00%(17/50), (6.63±0.97)%, 116.22 (87.32, 152.13) U/L, 258.57 (143.40, 433.31) ng/L, (2.18±0.26) mmol/L, and in the moderate to severe calcification group were 602.69 (489.61, 762.73) ng/L, 10.00 (7.00, 16.25) points, (60.81±7.12) years, 49.00 (18.00, 67.00) months, 53.23%(33/62), (7.07±1.20)%, 144.34 (99.71, 201.76) U/L, 336.57 (230.63, 506.00) ng/L,(2.28±0.26) mmol/L, with statistically significant differences between the two groups(The statistical values were 6.99, 9.11, 2.83, 2.45, 4.14, 2.08, 2.04, 2.16 and 1.99, respectively, all P<0.05). CDC-42, AACs, glycosylated hemoglobin and parathormone in the low CDC-42 group were 336.50 (295.10, 395.25) ng/L, 2.00 (0.00, 4.00) points, (6.62±1.06) %, 250.60 (140.20, 462.02) ng/L,and in the high CDC-42 group were 622.92 (558.11, 836.65) ng/L, 10.00 (6.25, 15.75) points, (7.13±1.13) %, 347.21 (240.40,501.20) ng/L, with statistically significant differences between the two groups (The statistical values are 6.51, 5.21, 2.43 and 2.54, respectively,all P<0.05). Abdominal aortic calcification has positive correlations with CDC-42 ( r s=0.704, P<0.001), age ( r s=0.308, P=0.001), dialysis years ( r s=0.198, P=0.036), glycosylated hemoglobin ( r s=0.358, P<0.001), alkaline phosphatase ( r s=0.187, P=0.048), parathormone ( r s=0.437, P<0.001), serum calciu m( r s=0.323, P=0.001) and serum phospho-rus ( r s=0.251, P=0.007), and negative correlation with serum albumin( r s=-0.276, P=0.003). This study has confirmed that high serum CDC-42 ( OR=1.010, 95%CI:1.004-1.016, P=0.001) and senior dialysis age ( OR=1.033, 95%CI:1.006-1.061, P=0.018) were independent risk factors for moderate to severe abdominal aortic calcification.Serum CDC-42 levels has positive correlation with AACs ( r s=0.704, P<0.001), age ( r s=0.240, P=0.011), dialysis age ( r s=0.191, P=0.044), glycosylated hemoglobin ( r s=0.350, P<0.001), parathormone ( r s=0.380, P<0.001) and serum calcium ( r s=0.235, P=0.013). This study learned that,high AACs ( OR=1.185, 95%CI:1.037-1.354, P=0.013) and high parathormone ( OR=1.005, 95%CI:1.001-1.009, P=0.009) were independent risk factors for high CDC-42. The area under the receiver operating characteristic curve (ROC-AUC) of serum CDC-42 in predicting moderate and severe abdominal aortic calcification in MHD patients was 0.885. When the cut-off point was 466.56 ng/L, the predictive sensitivity and specificity were 79% and 86% respectively. Conclusion:The degree of abdominal aortic calcification in MHD patients was positively correlated with the level of serum CDC-42. High serum CDC-42 and high dialysis age were independent risk factors for abdominal aortic calcification in MHD patients. High AACS and high parathyroid hormone were independent risk factors for the increase of serum CDC-42 in MHD patients .