OBJECTIVE：To explore the possible mechanism of astragalus in improving cardiac function.METHODS：To observe the effects of astragalus,added to basic anti-heart-failure therapy,on cardiac function and TNF in 45 cases of thronic heart failure.RESULTS：In comparison with basic therapy group,the improvement of cardiac function was more obvious and the level of serum TNF-α was lower in astragalus group.CONCLUSION：Astragalus probably has the action of decreasing TNF resulting in improvement of cardiac function.

Objective? To explore the status quo of thirst distress in patients with heart failure and its influencing factors and to provide a basis for developing intervention measures. Methods? Totally 445 patients with heart failure were selected from 3 ClassⅢ Grade A hospitals in Jiangsu and He′nan Provinces by convenient sampling, and investigated with the general information questionnaire, Thirst Distress Scale-Heart Failure (TDS-HF), Minnesota Heart Failure Quality of Life Scale (MLHFQ) and 24-hour Input and Output Record between August and December 2018. The influencing factors to thirst distress in patients with heart failure were also analyzed. Results? A total of 445 questionnaires were sent out, and 401 questionnaires were effectively recovered. The TDS-HF and MLHFQ scores of the patients with chronic heart disease were (21.98±9.70) and (57.77±28.34), and there was a positive correlation between the two (P=0.003). Univariate analysis revealed that there was a statistically significant difference in TED-HF scores between the patients with different body surface area, BMI,drinking alcohol or not,7 d fluid intake, 7 d fluid output, 7 d input-output difference, proportion of morning input, proportion of afternoon input, proportion of night input, cardiac function, left ventricular ejection fraction (LVEF), NT-proBNP, estimated plasma volume status (ePVS), with or without edema and estimated glomerular filtration rate (eGFR) (P＜0.05). Multiple linear regression analysis was conducted taking TDS-HF scores as dependent variables and the statistically significant variables found in univariate analysis as independent variables. The results showed that patients′ BMI, body surface area, 7 d fluid intake, 7 d input-output difference, proportion of morning input, proportion of afternoon input, cardiac function, ePVS, edema grading and eGFR were the main influencing factors to thirst distress in patients with heart failure (P＜ 0.05). Conclusions? The thirst distress is severe in patients with heart failure, which is affected by limited water, individual variation between patients and disease conditions. It is necessary for medical and nursing workers develop targeted intervention measures, reduce thirst distress while achieving the best outcomes, and improve the patients′ quality of life.

Objective:To construct the different functional graded care programs for elderly patients with chronic heart failure (CHF) .Methods:In March 2019, convenience sampling was used to select 24 nursing experts from 14 ClassⅢ Grade A hospitals in Northeast, North China, East China, South China, Central China and Northwest China as the subjects of correspondence. Based on the "International Classification of Functioning, Disability and Health" (ICF) , we took the function as the starting point to construct the different functional graded care programs for elderly CHF patients through systematic reviews, expert meeting and expert consultations.Results:In three rounds of questionnaires, the recovery rates were 100.00%, 100.00% and 95.83%; the authority coefficients of experts were 0.912, 0.914 and 0.913; the coordination coefficients were 0.348, 0.451 and 0.752, respectively; the differences were all statistical ( P<0.001) . The finally constructed different functional graded care programs for elderly CHF patients included heart function, respiratory function, water and electrolyte function, energy and drive function, emotional function, skin protection function, sleep function, and activity and participation function, totaling 8 ICF functions, 14 nursing measures and 161 nursing activity. Conclusions:The different functional graded care programs for CHF patients is comprehensive and systematic, which can not only improve nurses' nursing decision-making, standardize nursing behaviors, but also can be dynamically adjusted. It is scientific and feasible, and can satisfy the individualized and differentiated care demands of CHF patients with impaired function in different disease stages. At the same time, it also provides a theoretical framework for the future development of nursing information systems.

Objective:To deeply explore the comprehensive function impairment of chronic heart failure (CHF) patients and analyze its influencing factors.Methods:From November 2018 to January 2019, this study selected medical workers (doctors and nurses) , CHF patients or their family members in Department of Cardiovascular at a Class Ⅲ Grade A hospital in Jiangsu Province as subjects by purposive sampling. Semi-structured interview was carried out for the subjects with the phenomenological method. Colaizzi analysis was used to extract concepts. Two researchers matched the concept with the international classification of functioning, disability and health (ICF) based on Cieza link rules. This study took ICF category no more than 5% of the former after two interviews as the sample size saturated standard.Results:Finally, a total of 28 interviewees were included. A total of 80 ICF categories were linked, 31 (38.8%) of them in body function, 5 (6.2%) in body structure, 28 (35.0%) in activity participation and 16 (20.0%) in environmental factors. Other 482 concepts could not be linked with ICF categories with health status (30.7%) for the most followed by personal factors (27.4%) .Conclusions:ICF could be used to describe the comprehensive function impairment of CHF patients and its influencing factors. Being linked with multitudinous ICF categories indicates the complex function impairment and the numerous influencing factors. This study will be beneficial to carry out the individualized, detailed and dynamic treatment and nursing based on comprehensive evaluation for CHF patients.

OBJECTIVETo investigate the protective effects of beta-carotene in rats against the development of chronic bronchitis induced by cigarette smoking.

METHODSForty-two Male Wistar rats were randomly divided into three study groups: (1) control (n = 15), animals underwent no treatment; (2) cigarette smoking (n = 15), animals developed chronic bronchitis through long-term cigarette smoking twice a day for 75 d; (3) beta-carotene plus cigarette smoking animals (n = 12) were given 1 ml or 15 mg/kg beta-carotene orally every day just before cigarette smoking. The levels of IL-6, IL-8, NO, superoxide dismutase (SOD) and lipoperoxide (LPO) in serum, bronchoalveolar lavage fluid (BALF) and lung tissue were measured and the pathological changes to lung tissue were analyzed using light microscopy.

RESULTSLong-term cigarette smoking caused an obvious increase in the amount of IL-6, IL-8 and LPO and a sharp decrease in the levels of NO and SOD in smoking animals compared to controls. beta-carotene intake reversed all the changes induced by smoking and alleviated the pathological changes caused by chronic bronchitis.

CONCLUSIONSQuantitative oral intake of beta-carotene had protective effects against chronic bronchitis induced by long-term cigarette smoking, which was associated with the increased production of NO, the clearance of some oxidative free radicals (OFR) and the alleviation of chronic inflammation.

Animals ; Bronchitis ; blood ; etiology ; prevention & control ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; Nitric Oxide ; blood ; Rats ; Rats, Wistar ; Smoking ; adverse effects ; Superoxide Dismutase ; blood ; beta Carotene ; pharmacology

Objective To investigate the characteristics of imprinted differentially methylated regions (iDMRs) in placentas and their correlation with preeclampsia (PE). Methods A total of 43 healthy pregnant women (control group) and 33 pregnant women with PE (PE group) at Shanghai Putuo Maternity and Infant Hospital and International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine from September 2021 to September 2023 were selected. A total of 3 362 CpG sites in 62 iDMRs were analyzed in 76 placenta and 5 maternal blood samples using BisCap targeted bisulfite resequencing (BisCap-seq) assays. The CpG sites in the CpG islands of the iDMRs were assessed for their methylation levels and methylation linkage disequilibrium (MLD). Imprinted methylation haplotype blocks (iMHBs) were constructed based on MLD. The methylation levels and variablility of CpG sites and iMHBs were compared among the healthy placenta, PE placenta and blood samples. Results The CpG sites in the CpG islands of the iDMRs exhibited intermediate methylation, with adjacent sites displaying high MLD (methylation levels: 0.35-0.65, D’ ＞ 0.8). A total of 185 iMHBs were constructed using these coupled CpG sites, 60 placenta-specific iMHBs and 38 somatic iMHBs were found to be differentially methylated in the placenta compared with maternal blood (P_adj＜0.05). Twenty-seven iMHBs were identified with differentially variable methylation patterns in the placenta. The iMHBs methylation was unchanged in the PE placentas compared to the healthy placentas. Twenty-seven differentially methylated cytosines (DMCs) were identified outside the iMHBs structure, among which the methylation levels of 19 CpG sites showed statistically significant differences between the PE group and the control group (P_adj＜0.05). The quantitative results of placental compositions of maternal plasma cell-free DNA (cfDNA) using placenta-specific haplotype (PSH) were highly correlated with those estimated by a deconvolution methodology (r＝0.973, P＜0.01). Conclusions The genomic imprinting features in the PE placentas were obvious, and PSH could be a potential marker of the placenta to quantify the placental compositions of maternal plasma cfDNA.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.