Objective To observe the repair effect and mechanism of Danhuang Powder-containing serum on high glucose-induced vascular endothelial cell injury.Methods Danhuang Powder-containing serum was prepared.Human umbilical vein endothelial cells(HUVECs)were cultured to be divided into control group,recombinant human epidermal growth factor(called"growth factor"for short)group,Danhuang Powder group,high glucose group,high glucose+growth factor group,and high glucose+Danhuang Powder group.After corresponding intervention in each group for 48 hours,the cell ultrastructure and autophagy were observed under transmission electron microscope,apoptosis was detected by flow cytometry,and the protein expression levels of vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and basic fibroblast growth factor(bFGF)in the cells were detected by Western Blot.Results(1)The intra-mitochondrial ridges in the control group were clearly visible,autophagosomes and autolysosomes were fewer;mitochondria in the high glucose group were swollen and irregular,and appeared vacuolated;and the more typical autophagy-like structures were seen in the high glucose+Danhuang Powder group.(2)Compared with the high glucose group and high glucose+growth factor group,the apoptosis rate of cells in the high glucose+Danhuang Powder group was significantly decreased(P<0.05).(3)Compared with the high glucose group and the high glucose+growth factor group,the protein expression levels of VEGF,EGF and bFGF in the cells of the high glucose+Danhuang Powder group were significantly increased(P<0.05).Conclusion Danhuang Powder-containing serum can reduce the high glucose-induced damage in HUVEC cells,and its mechanism may be related to the activation of mitochondrial autophagy,and the inhibition of apoptosis,as well as the up-regulation of the expression of VEGF,EGF and bFGF.

Myocardial injury is a pathological change of myocardium caused by many factors,which can lead to the decline of cardiac function and the occurrence of cardiovascular events.Astragaloside Ⅳ is one of the main pharmacological components in Astragali Radix,which plays an anti-myocardial injury role by regulating various signaling pathways.This article reviewed the anti-myocardial injury mechanism of astragaloside Ⅳ from five aspects:inhibition of oxidative stress,inhibition of apoptosis,anti-myocardial fibrosis,improvement of myocardial energy metabolism and inhibition of myocardium inflammation,in order to provide reference for the mechanism research and clinical application of astragaloside Ⅳ in the prevention and treatment of myocardial injury.

Emphasizing symptom efficacy is an important manifestation of the personalized diagnosis and treatment of traditional Chinese medicine （TCM）. However， in current clinical practice of TCM， there are challenges such as diverse symptom expressions， difficulty in standardization， inconsistent evaluation standards for symptom efficacy， lack of universal quantitative methods， and complexity in collecting complete and accurate symptom information. These issues hinder the full and effective utilization of symptom information. Addressing the current research status and existing problems of symptom terminology standardization， quantification and grading of symptom efficacy， and collection of symptom information， this paper proposes methodological strategies for effectively recording and utilizing TCM symptom efficacy information in the era of big data. These strategies include collecting TCM symptom information based on patient reporting， standardizing the evaluation of TCM symptom efficacy from measurement scales and evaluation dimensions， integrating TCM symptom efficacy evaluation into clinical diagnosis and treatment processes， and utilizing artificial intelligence technology to acquire and process TCM symptom efficacy information. TCM symptom efficacy evaluation strategies based on patient perspectives and artificial intelligence technology will help fully explore the value of data elements， promote the objective demonstration of the specific efficacy of TCM， and facilitate the discovery of effective patterns.

Objective To investigate the relationship between the changes in vasopressin(VP)level and disease severity and prognosis in patients with septic shock(SS).Methods A total of 96 patients with SS in the hospital from December 2021 to December 2022 were selected as the study group,and 95 healthy volun-teers in the hospital during the same period were selected as the control group.The plasma VP levels of the two groups were compared,and their correlation with multiple organ dysfunction syndrome(MODS)score,a-cute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,serum C-reactive protein(CRP),and procalcitonin(PCT)levels were analyzed.The study group received shock treatment,and was divided into a good prognosis group and a poor prognosis group based on the prognosis after 28 days of hospitalization.The clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the factors affecting poor prognosis.A new prediction scheme and a conventional prediction scheme were con-structed,and the predictive efficacy of different prediction schemes was evaluated using area under the curve(AUC),net reclassification index and comprehensive discrimination improvement index.Results Compared with the control group,the plasma VP level in the study group was significantly decreased,and MODS score,APACHE Ⅱ score,the levels of serum CRP and PCT were significantly increased,with statistical significance(P＜0.05).Pearson correlation analysis showed that plasma VP level was negatively correlated with MODS score,APACHE Ⅱ score,serum CRP and PCT level(r=-0.426,-0.519,-0.483,-0.395,P＜0.05).The proportion of diabetes mellitus,acute respiratory distress syndrome(ARDS),acute kidney injury(AKI),MODS score,APACHE Ⅱ score,serum CRP and PCT levels in the poor prognosis group were higher than those in the good prognosis group,while the plasma VP level was lower than that in the good prognosis group,with statistical significance(P＜0.05).Logistic regression analysis showed that concurrent ARDS,concurrent AKI,plasma VP,MODS score,APACHE Ⅱ score,serum CRP and PCT were all influential factors for poor prognosis of SS patients(P＜0.05).The AUC of plasma VP predicting poor prognosis of SS patients was 0.752,and the AUC of the new prediction scheme predicting poor prognosis of SS patients was greater than that of the conventional prediction scheme predicting poor prognosis of SS patients(P＜0.05).Conclu-sion Plasma VP level decrease in SS patients and closely relate to the severity of the condition.Based on the results of Logistic regression analysis,the new predictive model is established,which has certain predictive value for poor prognosis.

Objective To provide the evidence for the development of personalized health education courses for twin pregnant women.We explored the health education and psychosocial demand of twin pregnant women from the perspective of social ecosystem theory.Methods By purposive sampling,18 twin pregnant women hospitalized in the twin medical center of a tertiary A hospital in Shenyang from January to March 2023 to conduct for semi-structured interviews,and Colaizzi's 7-step analysis method was used to sort out and analyze the data.Results 3 themes were extracted from the health education and psychosocial needs of twin pregnant women.Microsystem:the content needs of twin pregnant women's health education(the guidance needs of nutrition intake and weight growth;the needs for fetus health monitoring guidance;the cognitive needs of twin pregnancy complications;the needs for health education knowledge related to puerperium and the diversification of the choice of teaching methods).Mesosystem:the emotional support needs of twin pregnant women during prenatal and puetperal(the needs of family support and peer education support).Macrosystem:seeking social support and network information support(the demand of community support;the needs of information related to twin pregnant women's hierarchical management system and maternal fetal medical referral process and the needs for network health education information).Conclusion The women with twin pregnancy have different needs for health education content in each stage of pregnancy and puerperium,and there are urgent needs for emotional support and social support.Clinical nurses should construct health education courses according to the needs of twin women,and innovate in content and form,so as to improve the self-care ability of twin pregnant women and the knowledge level of family caregivers,and improve the pregnancy outcome.

Objective:To analyze the research hotspots and trends in the field of emergency nursing safety management at home and abroad through bibliometrics, and to provide reference for the research and clinical practice of emergency nursing safety management in China.Methods:The relevant literature in the field of emergency nursing safety management in China National Knowledge Infrastructure and Web of Science databases were searched from January 1, 2014 to December 31, 2023. CiteSpace6.2.R7 software was used for keyword co-occurrence, clustering and mutation analysis, and the hotspot and development trend of the literature were analyzed.Results:A total of 883 literatures were included, including 665 Chinese literatures and 218 English literatures.Nursing safety management had attracted much attention in China, but there were few high-level studies.And the foreign related research had steadily increased. The content of foreign literature was different from that of domestic literature. Chinese literature focused on nursing risk, nursing quality, nursing management, application effectiveness, emergency triage, etc, and focused on critically ill patients.The English literature mainly focused on medical errors, risk management, organizational culture, maternal investment, emergency department, training, depression, emergency care systems,improvement, etc.Conclusions:The research on emergency nursing safety management in China is still in the initial stage. In the future, it is necessary to strengthen safety culture construction, adverse event management, emergency observation, establishment of safety management measures, drug safety management strategies, and patient satisfaction, etc.

The advent of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have brought benefits to patients with EGFR gene mutations, which can not only improve the quality of life of patients, but also prolong their survival. However, most patients develop resistance to EGFR-TKIs after taking them for about one year, leading to disease progression. One of the mechanisms of EGFR-TKIs resistance is the conversion from non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC), with an incidence of 2%-14%, which is a relatively rare resistance mechanism. Currently, the mechanism of SCLS transformation remains unclear, and the median survival of patients with NSCLC converted to SCLC is approximately 17.8 months. Studying the resistance mechanism of EGFR-TKIs, the occurrence mechanism and clinical characteristics of transformed SCLC is of great significance for the treatment plan and prognosis of transformed SCLC.

Objective To investigate the effect of Danhuangsan on high glucose-induced vascular endothelial cell injury based on PINK 1/Parkin signaling pathway,and to explore its specific mechanism.Methods Human um-bilical vein endothelial cells were cultured in vitro and randomly divided into control group,growth factor group,Danhuangsan group,high glucose group,high glucose+growth factor group,high glucose+Danhuangsan group,with 3 cases in each group,treated for 48 hours.Cell scratch test was used to detect cell migration rate,and Transwell test was used to detect cell invasion rate.Immunofluorescence was used to detect the expression of anti-apoptotic protein Bcl-2,Beclin-1 and pro-apoptotic protein Bax.Western blot was used to detect the protein expression levels of PINK 1,Parkin and LC 3-Ⅱ.Results Cell scratch test and Transwell test showed that under normal environment and high glucose treatment,Danhuangsan could reduce the cell migration and invasion rate(P＜0.05).Immunofluorescence assay showed that under normal environment and high glucose treatment,Danhuang-san up-regulated the expression levels of Bcl-2 and Beclin-1 protein in cells(P＜0.05).Western blot results showed that under normal environment and high glucose treatment,Danhuangsan increased the protein expression levels of PINK 1,Parkin and LC 3-Ⅱ in cells and down-regulated the expression levels of Bax protein(P＜0.05),and the effects of Danhuang powder were significantly better than those of blank serum and growth factor(P＜0.05).Conclusion Danhuangsan can alleviate high glucose-induced endothelial cell injury by activating PINK 1/Parkin pathway,and the mechanism may be related to promoting mitophagy and enhancing the repair of damage.

ObjectiveTo compare the characteristics of adult and juvenile callers at high risk of suicide from psychological assistance hotline， to screen factors influencing the crisis intervention effect， so as to develop specific intervention programs for different age groups on psychological assistance hotline. MethodsFrom January 2021 to June 2021， a total of 2 229 callers at high risk for suicide were recruited from Beijing psychological assistance hotline. The selected individuals were divided into adult group （n=1 344） and juvenile group （n=885）. Callers were interviewed by the hotline operators. Their general information， suicidal ideation， socio-psychological characteristics and chief complaints were recorded and compared between two groups. Before and after hotline crisis interventions， psychological distress， suicidal ideation intensity and hope level of the callers were assessed， and the improvements in the three assessed dimensions were compared between two groups. Then Logistic regression was adopted to compare the crisis intervention effects on three dimensions and their associated factors. ResultsCompared with adult group， juvenile group reported higher rates of family relationship problems， learning problems， history of suicide attempts and fear of assault， with statistically significant differences （χ²=55.604， 24.706， 41.944， 106.527， P<0.01）. After hotline crisis intervention， the proportion of callers with increased level of hope was larger in juvenile group than that in adult group （42.74% vs. 30.97%， χ²=26.042， P<0.01）. Multivariate Logistic regression analysis showed that the chances of improvement in psychological distress for major depressive disorder （OR=0.650， 95% CI： 0.510~0.827）， the chances of improvement in the level of hope for those with substance dependents （OR=0.550， 95% CI： 0.327~0.926）， and the chances of improvement in the intensity of suicidal ideation for those with stressful life events （OR=0.565， 95% CI： 0.328~0.973） were all higher in juvenile group than those in adult group after crisis intervention. ConclusionAmong the callers at high risk for suicide from psychological assistance hotline， adult callers are more concerned about extra-familial relationships， work and economic problems， while juvenile callers are more concerned about family relationship and learning problems. Furthermore， the effect of crisis intervention in juvenile callers is less affected by major depressive disorder， substance use problems and stressful life events.

OBJECTIVE: To explore the risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis and to construct a risk nomogram model. METHODS: The clinical data of 234 sepsis patients admitted to the intensive care unit (ICU) of Tianjin Hospital from January 2019 to May 2022 were retrospectively analyzed. The patients were divided into non-ARDS group (156 cases) and ARDS group (78 cases) according to the presence or absence of ARDS. The gender, age, hypertension, diabetes, coronary heart disease, smoking history, history of alcoholism, temperature, respiratory rate (RR), mean arterial pressure (MAP), pulmonary infection, white blood cell count (WBC), hemoglobin (Hb), platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer, oxygenation index (PaO₂/FiO₂), lactic acid (Lac), procalcitonin (PCT), brain natriuretic peptide (BNP), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (SCr), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) were compared between the two groups. Univariate and multivariate Logistic regression were used to analyze the risk factors of sepsis related ARDS. Based on the screened independent risk factors, a nomogram prediction model was constructed, and Bootstrap method was used for internal verification. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the ROC curve (AUC) was calculated to verify the prediction and accuracy of the model. RESULTS: There were no significant differences in gender, age, hypertension, diabetes, coronary heart disease, smoking history, alcoholism history, temperature, WBC, Hb, PLT, PT, APTT, FIB, PCT, BNP and SCr between the two groups. There were significant differences in RR, MAP, pulmonary infection, D-dimer, PaO₂/FiO₂, Lac, ALB, BUN, APACHE II score and SOFA score (all P < 0.05). Multivariate Logistic regression analysis showed that increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score were independent risk factors for sepsis related ARDS [RR: odds ratio (OR) = 1.167, 95% confidence interval (95%CI) was 1.019-1.336; MAP: OR = 0.962, 95%CI was 0.932-0.994; pulmonary infection: OR = 0.428, 95%CI was 0.189-0.966; Lac: OR = 1.684, 95%CI was 1.036-2.735; APACHE II score: OR = 1.577, 95%CI was 1.202-2.067; all P < 0.05]. Based on the above independent risk factors, a risk nomograph model was established to predict sepsis related ARDS (accuracy was 81.62%, sensitivity was 66.67%, specificity was 89.10%). The predicted values were basically consistent with the measured values, and the AUC was 0.866 (95%CI was 0.819-0.914). CONCLUSIONS Increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score are independent risk factors for sepsis related ARDS. Establishment of a risk nomograph model based on these factors may guide to predict the risk of ARDS in sepsis patients.
Humans ; Retrospective Studies ; Alcoholism ; Prognosis ; Respiratory Distress Syndrome ; Pneumonia ; Sepsis ; Intensive Care Units ; Procalcitonin ; Fibrinogen ; ROC Curve