Objective To retrieve, evaluate, and summarize evidence on preventive management of high output and dehydration in ileostomy patients from both domestic and international sources. Methods Based on the "6S" evidence model, a top-down approach was employed to retrieve evidence on prevention and management of high output and dehydration in ileostomy patients. Databases searched included BMJ best practice, UpToDate, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Wound Ostomy and Continence Nurses Society (WOCNS), World Council of Enterostomal Therapists (WCET), Medlive Clinical Guidelines website, Joanna Briggs Institute (JBI), Cochrane Library, Embase, PubMed, Web of Science, CNKI, Wanfang Data, China Biology Medicine (CBM), and VIP Database. The search period was from January 2019 to April 2024. Results A total of 13 articles were included after retrieval and screening, comprising 2 guidelines, 2 expert consensuses, 4 systematic reviews, 4 evidence summaries, and 1 clinical decision aid. After translation, summarization, and organization of the included articles, 19 pieces of evidence across 11 categories were formulated, focusing on four items: definition and risk factors of high output in ileostomy, prevention and management strategies related to high output in ileostomy, prevention and management strategies related to dehydration in high-output ileostomy, and follow-up strategies for prevention of high output and dehydration after ileostomy surgery. Conclusion The evidence summarized based on the "6S" evidence model for prevention and management of high output and dehydration in ileostomy patients can provide a reference for clinical practice among healthcare professionals and medical decision-makers, thereby enhancing nursing quality and reducing patient rehospitalization rates.

OBJECTIVETo investigate the effect of curcumin on oligomer formation and mitochondrial ATP-sensitive potassium channels (mitoKATP) induced by overexpression or mutation of α-synuclein.

METHODSRecombinant plasmids α-synuclein-pEGFP-A53T and α-synuclein-pEGFP-WT were transfected into PC12 cells by lipofectamin method, and intervened by application of curcumin (20 μmol/L) and 5-hydroxydecanoate (5-HD). Oligomer formation in the cultured cells was identified by Western blotting and Dot blotting. Cytotoxicity and apoptosis of the PC12 cells were measured by lactate dehydrogenase (LDH) and JC-1 assays. mitoKATP were identified by Western blotting and whole cell patch clamp.

RESULTSCurcumin has significantly reduced the oligomer formation induced by overexpression or mutation of α-synuclein in the cultured cells. LDH has decreased by 36.3% and 23.5%, and red/green fluorescence ratio of JC-1 was increased respectively by 48.46% and 50.33% after application of curcumin (P<0.05). Protein expression of Kir6.2 has decreased and mitoKATP channel current has significantly increased (P<0.05).

CONCLUSIONCurcumin can inhibit α-synuclein gene overexpression or mutation induced α-synuclein oligomers formation. It may block apoptosis induced by wild-type overexpression or mutation of α-synuclein. By stabilizing mitochondrial membrane potential. Opening of mitoKATP channel may have been the initiating protective mechanism of apoptosis induced by wild-type overexpression or mutation of α-synuclein. Curcumin may antagonize above cytotoxicity through further opening the mitoKATP channel.

Animals ; Apoptosis ; drug effects ; Cell Line ; Curcumin ; pharmacology ; Humans ; KATP Channels ; chemistry ; genetics ; metabolism ; Mitochondria ; drug effects ; genetics ; metabolism ; Mutation ; drug effects ; PC12 Cells ; Parkinson Disease ; drug therapy ; genetics ; metabolism ; physiopathology ; Rats ; alpha-Synuclein ; genetics

Objective To survey the current status of professional value among health workers in grass-roots medical institutions of Wenzhou city and to analyze the influencing factors.Methods A survey on professional value was conducted from October to December 2017 among health workers from 14 primary medical institutions in 4 urban districts of Wenzhou City selected by stratified random sampling method.The self-designed questionnaires were used for the survey.A total of 350 questionnaires were distributed and 331 were returned,of which 302 were valid.The status and influencing factors of professional value were analyzed.Results The overall score of professional value was (96.66 ± 14.94).The univariate analysis showed that the professional value scores were associated with educational level (F=3.851),income(F=2.660),professional title(F=8.030),position(F=11.658) and specialty (F=4.667) of the health workers(all P＜0.05).The multivariate analysis showed that the gender(male:OR=0.53,95％ CI:-1.077--0.192,P=0.005),educational level (high school and below:OR=3.06,95％ CI:0.007-2.233,P=0.049),income (2 000-4 000 Yuan:OR=0.07,95％ CI:-4.783-0.627,P=0.011),professional title (no title:OR=0.27,95％CI:-2.397--0.232,P=0.017;Junior title:OR=0.31,95％CI:-2.197--0.153),P--0.024;intermediate title:OR=0.23,95％ CI:-2.533--0.366,P--0.009),position (doctor:OR=0.13,95％ CI:-3.235--0.815,P=0.001;nurse:OR=0.20,95％ CI:-2.883--0.368,P=0.011;technician:OR=0.15,95％ CI:-3.076--0.723,P=0.002)were influencing factors of professional value(all P＜0.05).Conclusion The professional values among health workers in Wenzhou grass-roots medical institutions are relatively low.The male gender,low educational level,low income,low professional title or no title and positions are influencing factors of professional value.

Objective:To explore the technical feasibility of CT feature tracking (CT-FT) technique in evaluating left ventricular myocardial strain and evaluate the change of myocardial strain in patients with coronary heart disease.Methods:Eighty-one patients with coronary heart disease (lesion group) and 33 patients with normal coronary artery (control group) matched with age and sex were collected retrospectively from the Second Affiliated Hospital of Nanchang University from April 2019 to October 2020. The lesion group was first divided into single vessel stenosis group (42 cases) and multi vessel stenosis group (39 cases) according to the number of coronary artery stenosis branches, and the global myocardial strains of the left ventricle between the groups were analyzed. Lesion site included the left anterior descending branch (LAD), right coronary artery (RCA) and left circumflex branch (LCX), respectively. According to the degree of vascular stenosis, the lesion groups were divided into normal group, mild stenosis group, moderate stenosis group and severe stenosis group. The segmental myocardial strains of the branch segment of LAD, RCA or LCX were analyzed between groups. All CCTA examinations were performed with retrospective electrocardiogram gating. CVI 42 cardiac postprocessing software was used to obtain myocardial strain parameters, including global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS), and the segmental myocardial strains of the branch segment of LAD, RCA or LCX. The segmental myocardial strains included the peak longitudinal strain (PLS), peak circumferential strain (PCS) and peak radial strain (PRS). One way ANOVA or Kruskal Wallis H test were used for multi group analysis. Results:With the increased number of coronary artery stenosis branches, the absolute value of GPLS gradually decreased. The GPLS of the control group, single vessel stenosis group and multi vessel stenosis group were -14.1%±2.7%, -11.5%±2.3% and -8.8%±2.0%, respectively. The difference of GPLS between the 3 groups or any 2 groups was statistically significant (all P<0.001). The absolute values of GPRS and GPRS in multi vessel stenosis group were significantly lower than those in control group and single vessel stenosis group (all P<0.001). There was no significant difference in GPRS or GPRS between single vessel stenosis group and control group ( P=0.083, 0.118). And there were significant differences in the segmental myocardial strains of the branch segment of LAD, RCA or LCX among 3 groups ( P<0.001). In severe stenosis group, the absolute values of PRS, PCS and PLS in LAD, RCA or LCX were significantly lower than those in moderate stenosis group, mild stenosis group and normal group (all P<0.05). In the moderate stenosis group, the absolute value of PLS in each branch segment was lower than that of the mild stenosis and normal group (all P<0.05), and there was no significant difference in any 2 other myocardial strain parameters of each branch (all P>0.05). Conclusions:CT-FT technique was feasible to evaluate left ventricular myocardial function. With the increased number or degree of coronary artery stenosis, the global and segmental myocardial strain parameters of left ventricle gradually decreased, and the longitudinal strain was more sensitive.

Objective To investigate the nursing effects of Thymosin α1 for injection dilution ( Zadaxin dilution) on the patients with oral ulcers caused by oral endotracheal intubation .Methods One hundred patients with oral ulcers caused by oral endotracheal intubation in the ICU of the Second Affiliated Hospital of Wenzhou Medical University from May 2014 to September 2015 were randomly divided into the observation group ( n=50 ) and the control group ( n=50 ) according to random number table .For the oral care , the patients with oral ulcers were treated with Thymosin α1 for injection dilution and compound chlorhexidine gargle in the observation group and the control group respectively .Therapeutic effects and ulcer healing time were observed and compared between the two groups .Results The clinical therapeutic effects in the observation group was significantly better than that in the control group (P<0.05).The healing time in the observation group was significantly shorter than that in the control group (P<0.05).Conclusions Thymosinα1 for injection dilution has a better effects than compound chlorhexidine gargle on the treatment of oral ulcers in the patients with oral endotracheal intubation .Thymosin α1 for injection dilution is worthy of clinical promotion .

Objective:To investigate the clinical phenotype and genotype characteristics of lipoyltransferase 1 deficiency (LIPT1D).Methods:A retrospective analysis of the clinical data was conducted for one case of LIPT1D, admitted to the Department of Neonatology at Shanghai Children's Hospital on May 7, 2023. Key terms "lipoyltransferase 1 deficiency", " LIPT1", and "lipoic acid" were used to search national databases including CNKI, Wanfang Data, VIP, and Yiigle; and international databases PubMed, Embase, and Web of Science until September 15, 2023, to summarize the clinical presentations, biochemical phenotypes, and genotypic characteristics of LIPT1D. Descriptive statistical analysis was employed. Results:(1) The case concerned: At 1.5 h after birth, the infant exhibited cyanosis and poor responsiveness, presenting with uncorrectable metabolic acidosis (blood pH value 6.9, base excess -27 mmol/L, bicarbonate 5.7 mmol/L), and hyperlactatemia (the highest was 24 mmol/L). The condition progressed rapidly, and the infant died 9 h after birth. Whole exome sequencing performed 6 h postnatally identified compound heterozygous variants in the LIPT1 gene (NM_001204830.1) in the infant. Variants c.986C>A (p.Ser329*) from the mother and c.405_406del (p.Arg135Serfs*18) from the father were detected, both suspected to be pathogenic. (2) Literature review: A review of the literature identified seven cases of LIPT1D caused by LIPT1 gene mutations, totaling eight cases including the current one. The main presentations of LIPT1D in these infants were hyperlactatemia, metabolic acidosis, neurodevelopmental delay, and epilepsy, with four cases presenting in the neonatal period and resulting in death. Conclusions:The primary clinical manifestations of LIPT1D are severe hyperlactatemia, metabolic acidosis, and neurological involvement, potentially leading to early neonatal death. Whole-exome sequencing is instrumental in diagnosing this condition.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective : To investigate the effect of sinomenine on proliferation and migration of multiple myeloma (MM) cells by regulating STAT3 and NF-κB signaling pathway． Methods : The cultured U266 cells were treated with different concentrations of sinomenine (0，0．5，1，2 mmol / L) ．The control group was added DMSO with 0．5% concentration．CCK-8 assay was used to detect the proliferation of U266 cells．Flow cytometry was used to detect the apoptosis of U266 cells．Western blot assay was used to detect the expression levels of apoptosis-related proteins， STAT3 and NF-κB signaling pathway proteins in the each group. Results : Compared with CON group，the apopto- sis of U266 cells increased after Sinomenine treatment，the proliferation was inhibited ; B lymphoma-2 (Bcl-2) mye- loid and cell leukemia-1 (Mcl-1) expression level decreased ; activated Caspase-3 (cleaved Caspase-3) and PARP (Cleaved Caspase-3) expression levels increased ; the activity of STAT3 and NF-κB signaling pathway decreased. Conclusion Sinomenine can down-regulate the activity of STAT3 and NF-κB signaling pathway，promote the apop- tosis of U266 cells and inhibit the proliferation of U266 cells.