Objective To detect the protective effect of sufentanil preconditioning on hepatic ischemia-reperfusion injury in rats and the role of c-Jun N-terminal kinase signal pathway in the mech-enism.Methods One hundred and sixty-two SD rats(in either gender,weighing 250-300 g)were ran-domly divided into seven groups:Sham-operated group (group S,n = 30 ),ischemia-reperfusion group (group IR,n =30),sufentanil preconditioning group (group SF1:1 μg/kg,n =30;group SF5:5 μg/kg,n =30;group SF10:10 μg/kg,n =30),SP600125 group (group SP,n =30),and dimethyl sulphoxide control group (group DMSO,n =6),different doses of sufentanil was administered 30 min before hepatic ischemia in group SF1,SF5 and SF10.Blood and liver samples were collected from each group at 0(T1 ),1 (T2 ),2 (T3 ),4 (T4 ),and 6 (T5 )hours after reperfusion.Serum alanine amin-otransferase (ALT)and aspartate aminotransferase (AST)were measured by an automatic biochemi-cal analyzer.Malondialdehyde (MDA)and superoxide dismutase (SOD)in liver tissue was measured. Liver sample was stained with HE to observe the hepatic pathological changes.Immunohistochemical method was used to determine the expression of JNK and western blotting was used to detect the ex-pression of P-JNK.Results Compared with group S,levels of AST,ALT increased significantly in group IR,SF1,SF5,SF10 at T1-T5 and in group SP,DMSO at T3 (P <0.05 ).Compared with group IR,levels of AST,ALT decreased significantly in group SF1,SF5,SF10 at T1-T5 and in group SP at T3 (P <0.05).Compared with group S,levels of MDA,SOD increased significantly in group IR,SF1, SF5,SF10 at T1-T5 and in group SP,DMSO at T3 (P < 0.05 ).Compared with group IR,levels of MDA,SOD decreased significantly in group SF1,SF5,SF10 at T1-T5 and in group SP at T3 (P <0.05).Compared with group SF1 and SF5,levels of MDA,SOD decreased significantly in SF10 at T4 . Compared with T1 ,the expression of p-JNK in group IR increased significantly at T3 (P < 0.05 ). Compared with group S,the expression of p-JNK in groups IR,SF1,SF5,SF10,SP,DMSO increased significantly at T3 (P < 0.05 ).Compared with group IR,the expression of p-JNK in groups SF1, SF5,SF10,SP decreased significantly and that in groups SF5,SF10 were less than that in group SF1 (P <0.05 ).The expression of p-JNK in group SF10 was less than that in group SF5 (P < 0.05 ). Conclusion Sufentanil preconditioning can reduce the hepatic ischemia-reperfusion injury and the dos-age of 10 μg/kg was the most effective.The protective mechanisms may inhibit JNK pathway and re-duce the expression of JNK.

Objective To study the protective effect of sufentanil preconditioning on hepatic ischemia-reperfusion injury in rats and to investigate the mechanisms whether may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphoryla-tion .Methods Thirty SD rats(in either gender ,weighing 220-270 g) were randomly divided into five groups :Sham-operated group (Ⅰ) ,ischemia-reperfusion group(Ⅱ);sufentanil preconditioning group(5 μg/kg ,Ⅲ) ,SB203580(an inhibitor of p38 MAPK) group (Ⅳ) ,and dimethyl sulphoxide (DMSO) control group(Ⅴ) .Sample specimens were collected from each group at 240 minutes after reperfusion .Serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were measured by an automatic biochem-ical analyzer .Malondialdehyde(MDA) and superoxide dismutase(SOD) in liver tissue was measured .HE staining was used to ob-serve the hepatic pathological changes ,and to examine the expression of phosphor-p38 mitogen-activated protein kinases (p-p38 MAPK)of hepatic tissues by western blotting .Results Compared with group Ⅰ ,levels of AST ,ALT and MDA showed signifi-cantly increased in group Ⅱ-Ⅴ ,but levels of SOD decreased ,and obvious pathological changes were observed in the liver .In GroupⅢ significantly decreased the elevated levels of ASL ,ALT and MDA but increased levels of SOD ,and lessened hepatic pathological changes ,caused promoted p38 MAPK phosphorylation at 240 minutes after reperfusion .The protective effects of sufentanil precon-ditioning were abolished by SB203580 pretreatment .There were no significant differences between group Ⅴ and group Ⅱ .Conclu-sion Sufentanil preconditioning can reduce the hepatic ischemia-reperfusion injury .The protective mechanisms may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphorylation .

Objective To study the influence of treatment communication on negative emotions and self-efficacy of patients with cerebral infarction. Methods A total of 98 unrelated patients with cerebral infarction in neurology department in the period between September 2013 and February 2015, in accordance with the random number table, were divided into treatment group ( 48 cases with treatment communication ) and control group(50 cases with normal communication). The change of negative emotions and self-efficacy at 10 days after intervention were collected and compared.Results High, medium and low self-efficacy status in the treatment group were 31.25%, 54.17% and 14.58%, respectively, which was obviously superior to the control group with 14.00%, 34.00% and 52.00%(P<0.05). The SDS and SAS scores were(43.31±4.37),(43.46± 4.95)in the treatment group, which were significantly lower than(48.16±3.23),(46.34±3.19) of the control group(P<0.05).Conclusions The implementation of treatment communication is conducive to improve the self-efficacy of patients with cerebral infarction and relieve depression and anxiety. It is of great significance to improve the physical and mental health of patients.

Objective To explore the effects of safety swallowing management based on swallowing functional grading in senile Alzheimer disease patients with feeding difficulty.Methods From November 2016 to April 2017,a total of 72 Alzheimer disease patients in Wuxi Second People's Hospital of Jiangsu Province were selected.All of the patients were randomly divided into observation group and control group according to the singular,dual numbers of sequences being admitted to hospital,36 cases in each group.Patients of control group received conventional diet nursing.Patients of observation group were treated with appropriate safety swallowing management on the basis of assessment level.The effect of feeding,nutrition and feeding safety of patients between two groups were compared.Results Three months after intervention,the food-intake each meal of patients was (251.20 ± 24.37) g in observation group,water-intake each meal was (141.50 ± 12.27) ml higher than those in control group with significant differences (t=6.324,8.817;P ＜ 0.01).The serum prealbumin of observation group and control group was (202.44 ± 12.56)mg/L and (186.94 ± 14.80)mg/L respectively with a significant difference (t=4.611,P ＜ 0.01).The incidence of unsafe feeding events of observation group and control group was 8.33％ and 30.55％ respectively with a significant difference (x2=5.675,P ＜ 0.05).Conclusions Application of safety swallowing management based on swallowing functional grading in senile Alzheimer disease patients is favorable for improving food-intake and supplementing nutrition.

Objective:To compare the predictive performance of the Norton Pressure Ulcer Risk Assessment Scale and the OH Pressure Sore Assessment Scale on pressure injury in elderly stroke patients.Methods:From January to December 2021, convenience sampling was used to select 168 elderly stroke patients admitted to the Department of Neurology, Wuxi Second People's Hospital as the research subject. The Norton Pressure Ulcer Risk Assessment Scale and the OH Pressure Sore Assessment Scale were used to assess the risk of pressure injury in elderly stroke patients. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and area under the receiver operating characteristic curve ( AUC) of each scale were calculated. The Kappa value was used to evaluate the consistency. Results:A total of 168 questionnaires were distributed, 160 valid questionnaires were recovered, and the valid recovery rate was 95.24%. The incidence of pressure injury in 160 elderly stroke patients was 9.38% (15/160) . The AUC of the Norton Pressure Ulcer Risk Assessment Scale was 0.805. When the total score was 12.5, the sensitivity, specificity, and Youden index of pressure ulcer prediction were 0.933, 0.559, and 0.492, respectively, with the highest predictive performance. The AUC of the OH Pressure Sore Assessment Scale was 0.803. When the total score was 5.5, the sensitivity, specificity and Youden index of pressure ulcer prediction were 0.933, 0.379, and 0.312, respectively, with the highest predictive performance. The Kappa value between the two scales was 0.588, and the difference was statistically significant ( P<0.05) . Conclusions:The Norton Pressure Ulcer Risk Assessment Scale was superior to the OH Pressure Sore Assessment Scale in predicting pressure injury in elderly stroke patients.