Objective To explore the situation and the impact of early postnatal sucking and health educa-tion on early maternal lactation physical rehabilitation of primipara.Methods 100 primiparas were randomly divided into two groups,50 cases in each group.The control group received routine care,the observation group was given suck and health care education on the basis of the control group.The maternal lactation and physical rehabilitation was compared between the two groups.Results The good rate of the maternal health knowledge in the observation group was 92.00%,the good rate of ability of nursing master was 86.00%,the lactation time was (16.46 ±2.43)h,which were significantly better than the control group(χ2 =14.03,14.89,t =10.22,all P <0.05).The postpartum rehabil-itations of the observation group were better than those of the control group(t =3.86,4.42,4.68,5.67,677,5.46, 571,4.27,3.98,508,all P <0.05).The incidence rate of complication of the observation group was 6.00%,which was significantly lower than 22.00% of the control group(χ2 =5.24,P <0.05).Conclusion First mothers receive early postnatal sucking and health education can increase their milk production capacity,promote physical rehabilitation.

Background and purpose:Advanced pancreatic cancer is characteristic of poor treatment eff icacy and short survival time. Gemcitabine is considered as front-line therapy for advanced pancreatic cancer. Gemcitabine combinations have shown a favorable impact on survival. We compared gemcitabine-based combination cheme therapy and gemcitabine(GEM) alone in patients with advanced pancreatic cancer through Meta analysis in phase Ⅲ clinical trials. Methods:MEDLINE and EMBASE searches were supplemented by information from trial registers of phase Ⅲ randomized controlled trials(RCTs) for GEM-based combination therapy and GEM alone for advanced pancreatic cancer. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The Meta-analysis involved 6-months and 1-year survival rate and objective remission rate(ORR) . Results:The Meta-analysis included 20 RCTs. The result of our Meta-analysis showed that there was signifi cant improvement in the GEM combination group with regard to the 1-year survival rate(RR:0.87,95%:(0.78,0.96) ,P=0.008) . The other result of our meta-analysis showed no signifi cant difference between two groups. Conclusion:GEM-based combination therapy may be effective with regard to the survival rate compared with GEM alone.

Objective:To compare the neonatal end tidal carbon dioxide pressure(PetCO 2) and its correlation with arterial carbon dioxide pressure(PaCO 2) monitored by non-invasive mask, accessory flow nasal catheter and invasive mechanical ventilation. Methods:From October 2017 to January 2020, 53 cases of newborn who were needed respiratory support treatment in our hospital were selected.PetCO 2was detected at admission, respiratory support and after weaning, including nasal catheter, non wound mask and invasive ventilation, and at the same time matching analysis of the corresponding with PaCO 2artery blood gas analysis. Results:(1) PetCO 2monitored by mask was lower than PaCO 2[(40.41 ± 10.21) mmHg vs.(42.85 ± 10.32) mmHg(1 mmHg=0.133 kPa), t=11.88, P<0.01], and there was a significant positive correlation between PetCO 2and PaCO 2( r=0.97, P<0.01); the mean bias of PetCO 2monitored by mask was(1.20 ± 2.31) mmHg, only 4.5%(5/110) was outside the 95% confidence interval.(2) PetCO 2monitored by nasal catheter was also lower than the mean PaCO 2[(40.93 ± 10.55) mmHg vs.(42.01 ± 10.50) mmHg, t=4.12, P<0.01], showing a significant positive correlation( r=0.96, P<0.01); the mean bias of PetCO 2monitored by nasal catheter was(2.44 ± 2.56) mmHg, and only 4.6%(7/150) was beyond the 95% confidence interval.(3) PetCO 2of neonates with endotracheal intubation and mechanical ventilation was also lower than PaCO 2[(43.33±10.26) mmHg vs. (49.37±11.34) mmHg, t=13.83, P<0.01], and there was also a significant positive correlation between the two groups, which was lower than that of neonates with non-invasive ventilation( r=0.94, P<0.01). The mean PetCO 2bias for neonates with invasive positive pressure ventilation was(0.90±0.82) mmHg, and only 3.9%(2/51) were outside the 95% confidence interval.(4) According to gestational age, the PetCO 2of early and late preterm infants was(37.25±11.32) mmHg and(39.58±10.37) mmHg, respectively, which were lower than that of full-term infants[(42.69±10.66) mmHg], and there was a positive correlation between PetCO 2and PaCO 2in all three groups.The correlation between PetCO 2and PaCO 2in early preterm infants was the lowest among the three groups( r=0.89, P<0.01). Conclusion:The monitoring of PetCO 2through nasal catheter, mask and invasive ventilation has a good correlation and consistency with the level of PaCO 2in neonates, which can accurately reflect the level of PaCO 2in neonates.The correlation between PetCO 2and PaCO 2in neonates with non-invasive ventilation is better than that in neonates with invasive ventilation.The correlation between PetCO 2and PaCO 2in late preterm infants and term infants is better than that in early preterm infants.

Objective·To explore the effects and possible molecular mechanisms of nanoplastics(NPs)on severe asthma.Methods·A mouse model of severe asthma was established by using house dust mite(HDM)and lipopolysaccharide(LPS)co-stimulation.Polystyrene nanoplastics(PS-NPs)were instilled into the severe asthma mice's airways.Subsequently,bronchoalveolar lavage fluid(BALF)was collected and lung tissue sections were prepared.Flow cytometry,hematoxylin-eosin(H-E)staining,periodic acid-Schiff(PAS)staining,immunohistochemistry,and terminal dexynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)staining,were used to observe the effects of PS-NPs on airway inflammation,mucus secretion,alveolar structure,and the proliferation and apoptosis of alveolar type Ⅱ epithelial cells(AT2 cells)in severe asthma mice.The CCK-8 assay and Annexin Ⅴ/PI double staining were performed to evaluate the effects of PS-NPs on the proliferation and apoptosis of the mouse AT2 cell line MLE-12.DNA damage in AT2 cells caused by PS-NPs was detected by using anti-γ-H2A.X immunofluorescence staining.The expression of genes in the ATR/Chk1/p53 signaling pathway was detected by real-time fluorescent quantitative polymerase chain reaction(qPCR),Western blotting,Tyramide signal amplification(TSA)multiplex immunofluorescence staining,and immunofluorescence co-localization,respectively.The ATR-specific inhibitor Ceralasertib(AZD6738)was administrated to MLE-12 cells in combination with PS-NPs to evaluate the recovery effect on cell proliferation and apoptosis.Results·Flow cytometry revealed that exposure to PS-NPs increased the total number of inflammatory cells and the number of each type of inflammatory cells in the BALF of mice with severe asthma,with a predominance of neutrophils.H-E and PAS staining showed significant increase in airway inflammatory cell infiltration and mucus secretion,as well as disruption of alveolar structure.In vitro,the CCK-8 assay demonstrated significant,dose-dependent inhibition of MLE-12 cell proliferation by PS-NPs.The Annexin V/PI double staining assay indicated a higher apoptosis rate of(56.20±3.84)%in PS-NP-exposed cells compared to(23.22±2.52)%in the control group.Immunofluorescence staining demonstrated that PS-NPs were phagocytosed by MLE-12 cells and localized around the nucleus.TUNEL staining confirmed enhanced apoptosis in AT2 cells in vivo.The immunofluorescence assay revealed that compared to the control group,the expression of the DNA damage marker γ-H2A.X increased in the experimental group.qPCR,Western blotting,and TSA multiplex staining results showed that PS-NP-induced elevated expression of mRNA and proteins was related to the ATR/Chk1/p53 pathway in MLE-12 cells.Moreover,immunofluorescence co-localization also confirmed the induction of ATR and p53 proteins in AT2 cells in vivo.The ATR-specific inhibitor Ceralasertib partially restored the PS-NP-induced inhibition of cell proliferation and enhancement of apoptosis in MLE-12 cells.Conclusion·NPs exposure leads to DNA damage in AT2 cells,activating the ATR/Chk1/p53 signaling pathway and exacerbating airway inflammation and alveolar damage in mice with severe asthma.

Ulcerative colitis is a common disease of the digestive system in China,which seriously affects the quality of life of patients due to its disease characteristics,such as easy recurrence,repeated course of disease and carcinogenic tendency.Neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are considered as new inflammatory biomarkers,which have been found to be related with ulcerative colitis.This article reviewed the clinical value of NLR and PLR in ulcerative colitis.

So far, liver cancer is still a highly malignant tumor with a high incidence rate in China, and it seriously affects the life and health of Chinese people. Previous studies have shown that the development of liver cancer is associated with various factors such as virus, smoking, drinking, and nonalcoholic fatty liver disease. With continuous exploration, more and more studies have pointed out that nutritional factors and living environment are associated with the development and progression of liver cancer. Folic acid is a necessary nutrient for cell growth and reproduction, and its level in human body has an impact on the growth of tumor cells and is closely associated with liver cancer. This article reviews the research advances in the association between folic acid and liver cancer in recent years, so as to provide new reference and basis for the prevention and treatment of liver cancer.