Objective To describe symptom experiences and quality of life (QOL) in liver transplant recipients and explore the relationship between them,in order to provide a scientific basis and new directions for clinical assessment and intervention to improve QOL of them. Methods One hundred and thirty-seven liver transplant recipients who received liver transplantation from 1999 to 2008 were recruited in this study. They were investigated with The SF-36 Health Survey Questionnaire and Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD). Results Liver transplant recipients experienced many symptoms (median 17,range 2-30). The most commen symptoms were：fatigue and drowsy,sleeplessness,mood swings,dizzy and headache,abdominal distension,and diarrhea,which distressed more than half of the recipients. Compared with a reference general population,the liver transplant recipients showed a significantly worse QOL score (P＜0.01). The result of stepwise multiple regression analysis showed that the total score of symptom experiences,surviving time after transplantation operation,family income and social support score were significant predictors of QOL. Conclusion Liver transplant recipients suffer from complex symptom experiences after transplantation operation. Symptom management is imperative to be embraced in long-term care planning for liver transplant recipients and effective symptom intervention will result in improved QOL.

Objective To investigate the effect of glucocorticoid on rat lung in a rat model of oleic acid-induced acute respiratory distress syndrome(ARDS)lung injury. Methods Sixty SPF level of healthy male Wistar rats were randomly divided into normal control group(group A),oleic acid model group(group B)and oleic acid and Methylprednisolone group(group C),and each group with 20 cases rats. ARDS model rats were established by injection with oleic acid(0. 14 ml/ kg)intravenously. Twelve hours after injection,aterial blood was drawn for blood gas analysis of blood oxygen partial pressure in order to confirm that acute lung injury model was successful. Then the rats in group C were treated with injection of Methylprednisolone( 4 mg/ kg) intravenously,once a day,from the 1st to 7th day. The rats in A and B groups were given saline(4 ml/ kg). Five rats in each group were randomly sacrificed on the1st,7th,14th,28th day respectively. The left lung of all rats was underwent bronchoalveolar lavage after weighed. Bronchoalveolar lavage fluid( BALF)were obtained for detection of procollagen III(PCⅢ)concentrations with enzyme-linked immunosorbent assay( ELISA). Right lobe of lung specimens was used for histopathological examination. Results Compared with the group A,PaO2 in group B and C were decreased significantly(P < 0. 01),but there was no significant difference between group B and group C(P > 0. 05). The levels of PCⅢ concentrations of BALF in Group A,B and C group were(30. 61 ± 0. 52)μg/ L,(30. 14 ± 0. 41)μg/ L and(30. 71 ± 0. 74)μg/ L respectively on the first day,(29. 15 ± 0. 17)μg/ L,(34. 35 ± 0. 73)μg/ L and(31. 72 ± 0. 46)μg/ L respectively at the 7th day,(30. 23 ± 0. 41)μg/ L, (38. 61 ± 1. 21)μg/ L and(33. 32 ± 0. 57)μg/ L respectively at 14th day and(31. 12 ± 0. 22)μg/ L,(37. 53 ± 2. 46)μg/ L and(34. 45 ± 0. 27)μg/ L respectively at 28th day. Levels of PCⅢ concentrations of BALF at 7th, 14th and 28th day time point in group B and C were decreased in comparison of A group(P < 0. 05),and there was significant difference between B and C group(P < 0. 01). Conclusion A treatment with Methylprednisolone may be useful in inhibiting pulmonary fibrosis in the process of ARDS in rats.

Objective To explore the effects and mechanism of Shentao Ruangan Prescription on hepatocellular carcinoma.Methods MTT assay was used to detect the activity of Shentao Ruangan Prescription against HepG2 cells and the effects of PI3K/Akt/MAPK inhibitors(LY294002,Akti,MEKi,JNKi),apoptosis inhibitor(Z-VAD)and autophagy inhibitor(Wortmanin)in human hepatoma cells.),ferroptosis inhibitor(Ferrostatin-1)and cell necrosis inhibitor(Necrostatin-1)on the inhibition of HepG2 activity of human hepatoma cells by Shentao Ruangan Prescription.LDH method was used to detect the toxicity of Shentao Ruangan Prescription on HepG2 cells;Real-time PCR experiment tested the effect of Shentao Ruangan Prescription on the pyroptosis marker IL-1β in human hepatoma cells HepG2;Western blot experiment explored the effect of Shentao Ruangan Prescription on the Akt/ERK signaling pathway in human hepatoma HepG2 cells and the expression of Akt,ERK,P-ERK,the key proteins of apoptosis signaling pathway Caspase 3,PARP,Bcl2,Bax,and the expression of pyroptosis marker Cleavaged Caspase-1.Results Shentao Ruangan Prescription Can effectively inhibit the activity of human hepatoma HepG2 cells.LY294002,Wortmanin,Akti,MEKi,JNKi,Z-Vad,Ferrostatin-1,Necrostatin-1 had no significant effect on the inhibition of HepG2 activity by total extract(water extract),supernatant and precipitation.Shentao Ruangan Prescription promoted the release of LDH in human hepatoma HepG2 cells,causing cytotoxicity.It inhibited HepG2 pyroptosis markers in human hepatoma cells and the expression of IL-1β and Cleavaged Caspase-1 and decreased the protein expression of Akt in human hepatoma cells HepG2 but inversely increased Caspase3 protein expression.Conclusion Shentao Ruangan Prescription has the effect of inhibiting the activity of hepatocellular carcinoma cells and anti-hepatocellular carcinoma,and its mechanism may be related to inhibiting the expression of Akt and promoting the expression of Caspase3.At the same time,Shentao Ruangan Prescription reduces the expressions of IL-1β and Cleavaged Caspase-1,which may inhibit cell pyroptosis.The inhibitory effect of Shentao Ruangan Prescription on the activity of liver cancer cells is likely to be independent of programmed death modes such as autophagy and necrotizing apoptosis,and PI3K/Akt/MAPK signal transduction.The total extract of Shentao Ruangan Prescription has better anti-hepatoma activity than its water-soluble and alcohol-soluble components,and its water-soluble and alcohol-soluble components may have synergistic effect.

Objective:To explore the effect of family empowerment program combined with deglutition exercises in patients with deglutition disorders.Methods:From February 2019 to February 2021, a total of 107 patients with deglutition disorders admitted to Xinxiang Central Hospital were enrolled by convenience sampling method and divided into the observation group (54 cases) and the control group (53 cases) using random number table method. The control group received routine nursing and deglutition intervention, and the observation group received family empowerment program combined with deglutition intervention on the basis of routine nursing. The standardized swallowing assessment (SSA) , mini nutritional assessment short-form (MNA-SF) , swallowing quality of life questionnaire (SWAL-QOL) scores and the incidence of adverse events of the two groups were compared before and after intervention.Results:After intervention, MNA-SF score and SWAL-QOL score of the observation group were higher than those of the control group, while SSA score, incidence of respiratory aspiration and aspiration pneumonia of the observation group were lower than those of the control group , the differences were statistically significant ( P<0.05) . Conclusions:The family empowerment program combined with deglutition exercises can improve patients' deglutition function and nutrition status, reduce the risk of respiratory aspiration and aspiration pneumonia, and improve patients' quality of life.

Objective: To discuss the clinical effect of small dose of botulinum toxin injection in cricothyroid muscle and thyroarytenoid muscle on patients with incomplete bilateral recurrent laryngeal nerve paresis. Methods: Six patients were selected with Ⅰor Ⅱ or Ⅲ degree of dyspnea diagnosed as bilateral recurrent laryngeal nerve injury by laryngeal electromyography, and small dose of botulinum toxin injection was performed in cricothyroid muscle and thyroarytenoid muscle as a treatment. Degree of dyspnea was assessed one month before and after the treatment, and the stroboscopic laryngoscope results, acoustic parameters and CT image of the patients were collected in the 6 patients. The relevant parameters were also collected one month before and after treatment, including the degree of dyspnea, stroboscopic laryngoscope results, acoustic parameters and CT image of the patients. The angle between bilateral vocal cords in stroboscopy at full inspiratory was calculated, acoustic parameters (F0, jitter, shimmer) were analysed, and vocal length, width and the vocal region were measured. Then, the paired t test was performed for statistical analysis between before and after one month injection, the one way analysis of variance was performed among vocal parameters in CT image. Result: Botulinum toxin injection was successfully completed in the 6 patients, followed without any serious complications. The degree of dyspnea was alleviated to some extent after treatment in all 6 patients; the angle between bilateral vocal cords at the end of a deep inspiration was significantly increased (t=2.44, P<0.05) after the treatment. The changes of F0 and jitter between before and after treatment were not statistically significant (t=0.72, t=1.42, P>0.05). Shimmer was significantly decreased after treatment (t=2.61, P<0.05). Vocal fold length, width and vocal region increased with F0, there was a statistically significant difference between different F0 before injection, and there was no statistically significant difference between different F0 after injection. The follow-up time was respectively seven months, 1 year, 1 year, 18 months, 22 months and 2 years respectively. Conclusion Small dose of botulinum toxin injection in bilateral cricothyroid muscles and thyroarytenoid muscles can relieve the dyspnea caused by bilateral vocal cords paresis to some extent, accompanied without serious complications, despite the sound quality was slightly worse.