OBJECTIVE To study the effects of bergapten in the treatment of liver fibrosis and its mechanism based on serum metabolomics. METHODS Forty mice were divided into normal control group （0.5% carboxymethyl cellulose sodium solution）， model group （0.5% carboxymethyl cellulose sodium solution）， and BP low-dose and high-dose groups （50， 100 mg/kg）， with 10 mice in each group. Except for the normal control group， the other three groups were all treated with carbon tetrachloride to induce liver fibrosis model； they were given relevant medicine/solution intragastrically， once a day， for consecutive 8 weeks. After the last medication， the levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in serum were detected， and liver pathological changes were observed； the expressions of α-smooth muscle actin （α-SMA） and Collagen Ⅰ were detected in liver tissue； the serum of the mice was collected for metabolomics analysis. RESULTS Compared with the model group， serum levels of ALT and AST and protein expressions of α-SMA and Collagen Ⅰ in liver tissue were decreased significantly in BP high-dose and low-dose groups （P＜0.05）， while liver fibrosis was improved significantly. Meanwhile， metabolomics analyses showed that there were a total of 175 serum differential metabolites in the BP high-dose group and model group， of which 18 substances were upregulated and 157 substances were downregulated； the main metabolic pathways involved in bergapten intervention were pyrimidine metabolism， butanoate metabolism， fatty acid synthesis， tyrosine metabolism， β-alanine metabolism， nicotinic acid and nicotinamide metabolism， glutathione metabolism， etc. CONCLUSIONS BP is effective in the treatment of liver fibrosis by regulating pyrimidine metabolism， butanoate metabolism， glutathione metabolism and so on in rats with liver fibrosis.

Objective To investigate the status quo of pain catastrophizing(PC)in the patients with di-abetic peripheral neuropathic pain(DPNP),and to analyze the influencing factors to provide reference for for-mulating clinical preventive intervention strategies.Methods A total of 206 patients with DPNP admitted and treated in the People's Hospital of Guangxi Zhuang Autonomous Region were selected as the research sub-jects by convenience sampling method.The general data questionnaire,Numerical Rating Scale(NRS),Pain Catastrophizing scale(PCS),Perceived Social Support Scale(PSSS)and diabetes distress scale(DDS)were used to conduct the investigation.Results The incidence rate of PC in 206 cases of DPNP patients was 44.66％(92/206),and the total score of PCS was(30.10±5.16)points.The results of multiple linear regres-sion analysis showed that the gender,duration of diabetes(≥10 years),multiple drug use,number of compli-cations(＞5),NRS score,PSSS score and scores of DDS dimensions were the main influencing factors of PC(all P＜0.05),which could explain 92.3％of the total variation of PC.Conclusion The PC incidence rate in the patients with DPNP is high.Clinical healthcare workers should pay attention to the evaluation of PC in these patients,and formulate the scientific and effective targeted intervention measures according to the main influen-cing factors to help the patients to reduce the pain burden in order to reduce the level of PC.

Objective:To summarize the evidence of diet management in patients with chronic kidney disease (CKD) in stage 3-5 D, so as to provide a reference for clinical nursing.Methods:After establishing evidence-based nursing questions, according to the "6S evidence model", the evidence on diet management of patients with CKD in stage 3-5 D was searched by computer, including computer decision support system evidence, guidelines, best evidence summary and systematic review. The search time limit was from the establishment of the database to September 2020. The guideline quality assessment was independently completed by two research nurses and a doctor of nephrology. The quality assessment of non-guideline article was independently completed by two research nurses, and an evidence-based instructor participated in decision-making. The evidence was extracted, evaluated and graded using the Joanna Briggs Institute (JBI) 2014 version of the intervention research evidence pre-grading system.Results:A total of 19 articles that met the requirements were included, including 5 guidelines, 8 systematic reviews, 4 randomized controlled trials, 1 clinical decision, and 1 national standard. A total of 22 pieces of the best evidence on diet management of patients with CKD in stage 3-5 D were summarized from three aspects, namely, diet/nutrition assessment, diet management, teamwork and education.Conclusions:The best evidence of diet management in patients with CKD in stage 3-5 D provides a certain reference for clinical practice, so as to improve the quality of diet management in patients with CKD and the clinical outcomes of patients.

Objective:To elucidate the correlation between peripheral blood levels of pentraxin 3 (PTX3) and fibroblast growth factors 2 (FGF2) and clinical manifestations, immunological indexes and disease activity of systemic lupus erythematosus (SLE) patients.Methods:The correlation between peripheral blood levels of PTX3 and FGF2 and clinical manifestations, immunological indexes and disease activity of SLE pa-tients was determined. T test, Mann-Whitney U test and Spearman's rank correlation coefficient were analyzed statistically. Results:Plasma PTX3 levels were significantly higher in SLE patients than in healthy controls (3 191±2 423) pg/ml vs (755±432) pg/ml, t=5.595, P<0.01) . The titer of PTX3 in patients with hematologic in-volvement was higher than that in the patients without [(3 810±2 840) pg/ml vs (2 493±1 830) pg/ml, t=2.008, P=0.049). Plasma PTX3 concentration in SLE patients was positively correlated not only with the level of 24 h urine protein ( r=0.498 6, P=0.005 9), but also with ESR ( r= 0.376, P=0.007) and systemic lupus erythematosus disease activity index (SLEDAI) scores ( r=0.405, P=0.003). On the contrast, plasma PTX3 concentration in SLE patients was negatively correlated with complement 3 ( r=-0.405, P=0.005). Increased serum PTX3 levels accompanied by increased serum FGF2 levels was observed. Plasma FGF2 concentration in SLE patients was positively correlated with SLEDAI scores ( r=0.326, P=0.019), but negatively correlated with level of comple-ment 3 ( r=-0.414, P=0.004) and complement 4 ( r=-0.451, P=0.007). Levels of FGF2 were higher in patients with positive anti-NuA antibody [(138±91) pg/ml vs (59±68) pg/ml, t=2.996, P=0.004 2), anti-dsDNA antibody [(120±96) pg/ml vs (56±58) pg/ml, t=3.583, P=0.000 7] and anti-rRNP antibody (151±109) pg/ml vs (63±61) pg/ml, t=3.757, P=0.000 4) than in patients with negative of these antibodies. Conclusion:The levels of PTX3 and FGF2 in peripheral blood may play a role in determining the disease activity and clinical phenotype of SLE, and can help doctors to make diagnosis and treatment decisions.

Objective:To explore the lesion characteristics and predictors of invasive coronary angiography (ICA)-verified obstructive lesions with fractional flow reserve (FFR)>0.80, that is, anatomy-function mismatch.Methods:A total of 515 obstructive vessels in 419 coronary disease patients from 11 Chinese medical centers undergoing coronary CT angiography and ICA and FFR were retrospectively analyzed. All vessels had one target lesion with diameter stenosis ≥50 % by ICA. There were 229 vessels in the match group (FFR≤0.80) and 286 vessels in the mismatch group (FFR>0.80). The lesion characteristics including lesion territory, the distance of the coronary artery ostium to the proximal end of the lesion, minimum lumen area, reference lumen area, plaque length and burden, plaque volume and component volume, remodeling index and plaque morphological complexity were measured and compared between the two groups. Optimal thresholds of quantitative plaque characteristics were defined by Yoden index. Logistic regression analysis was used to analyze the predictors of anatomy-function mismatch. Area under receiver operating characteristic curve (AUC) was used to analyze the ability of different lesion features to predict mismatched lesions.Results:The coronary stenosis, plaque burden and length, plaque volume (including each component volume) in the mismatch group were smaller than those in the match group, and FFR, minimum lumen area were larger (all P<0.05). Left anterior descending artery (LAD) lesion and severe complex plaque were more common in the match group than the mismatch group with a statistically significant difference. Univariate logistic regression analysis showed that LAD lesion, minimum lumen area>4 mm 2, plaque burden and length, plaque calcification volume<27 mm 3, plaque lipid volume<30 mm 3, plaque fiber volume<150 mm 3 and plaque morphological complexity were predictiors of anatomic function mismatched lesions; Multivariate logistic regression showed that the minimum lumen area>4 mm 2 (OR=3.371, 95%CI 1.903-5.973, P<0.001), plaque lipid volume<30 mm 3 (OR=3.014, 95%CI 1.691-5.373, P<0.001), plaque morphological complexity (mild OR=17.772, 95%CI 8.072-39.128, P<0.001, moderate OR=6.383, 95%CI 3.739-10.896, P<0.001) were independent predictors of mismatched lesions. The AUC of the model based on the minimum lumen area, plaque lipid volume and morphological complexity was 0.824, which was superior to either of the plaque feature alone ( P<0.001). Conclusions:The minimum lumen area, lipid volume and plaque morphological complexity are independent predictors of the anatomical-functional mismatch lesions, and the combination can significantly improve the prediction value.

Objective:To correlate homocysteine (Hcy) and blood lipid levels with neurological function in patients with progressive ischemic stroke.Methods:A total of 400 patients with ischemic stroke who received treatment between June 2018 and June 2020 in Linhai Second People's Hospital were included in this study. Progressive ischemic stroke ( n = 126) and non-progressive ischemic stroke ( n = 274) groups were designated. Hcy level was determined by enzyme-linked immunosorbent assay. High-density lipoprotein cholesterol, triacylglycerol, low-density lipoprotein cholesterol and cholesterol levels were measured using a biochemical analyzer. Hcy and blood lipid levels as well as National Institute Health of Stroke Scale (NIHSS) score were determined in each group. Hcy and blood lipid levels were correlated with NIHSS score. Results:Hcy level in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(28.39 ± 4.36) μmol/L vs. (20.17 ± 3.24) μmol/L, t = 18.894, P < 0.05]. Low-density lipoprotein cholesterol , triacylglycerol and TC levels in the progressive ischemic stroke group were (3.29 ± 0.45) mmol/L, (2.08 ± 0.34) mmol/L and (4.82 ± 0.79) mmol/L, respectively, which were significantly higher than those in the non-progressive ischemic stroke group [(2.48 ± 0.37) mmol/L, (1.56 ± 0.29) mmol/L and (4.08 ± 0.43) mmol/L, t = 17.644, 14.859, 9.860, P < 0.05]. High-density lipoprotein cholesterol level in the progressive ischemic stroke group was significantly lower than that in the non-progressive ischemic stroke group [(1.03 ± 0.13) mmol/L vs. (1.19 ± 0.14) mmol/L, t =11.158, P < 0.05]. NIHSS score in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(21.72 ± 4.35) points vs. (15.52 ± 2.89) points, t = 14.582, P < 0.05]. Hcy, low-density lipoprotein cholesterol, cholesterol and triacylglycerol levels were linearly and positively correlated with NIHSS score ( r = 0.846, 0.724, 0.718, 0.765, all P < 0.05), while igh-density lipoprotein cholesterol level was linearly and negatively correlated with NIHSS score ( r = -0.710, P < 0.05). Conclusion:In patients with progressive ischemic stroke, Hcy level is increased and blood lipid level is obviously abnormal. Hcy and blood lipid levels are greatly correlated with neurological function.

Objective:To analyze the effect of family involvement in nursing on the recovery effect of children with thrombocytopenic purpura (ITP).Methods:A total of 55 children with ITP in our hospital who were not given family involvement in nursing between January and December 2017 were included in the control group and 63 children with ITP who were given family involvement in nursing between January and December 2018 were included in the observation group. The hospital stay, platelet count (PLT) recovery time, compliance (emotional control, diet, medication), mastery of health knowledge of family members and short-term prognosis were compared between the 2 groups.Results:The recovery time of PLT count (30-50)×10 9/L and (51-100)×10 9/L in the observation group was (1.97±0.56) d, (3.41±0.45) d, which was shorter than those of the control group [(2.79±0.59) d, (4.02±1.22) d] ( t value was 7.739, 3.693, P < 0.05). The scores of emotional control, dietary compliance and medication compliance and total score of compliance of the observation group on the day of discharge were 7.25 ± 1.17 , 8.18 ± 1.19 , 7.47 ± 1.35 , 21.26 ± 4.92, which were higher than those of the control group (5.11 ± 1.34, 5.79 ± 1.25, 4.86 ± 1.75, 15.76 ± 4.34) ( t value was -10.630- -6.397, all P < 0.05). On the day of discharge, the scores of condition monitoring, prevention of complications, dietary guidance, medication guidance, mastery of health knowledge and total score of family members of the observation group were higher than those of the control group ( t value was -7.705-5.949, all P< 0.05). Conclusions:Family involvement in nursing can improve the mastery of health knowledge about ITP of family members and children′s compliance, which is conductive to the recovery of PLT count in children with ITP. It may improve the short-term prognosis.

Objective To investigate the associations of cognitive function with apolipoprotein E (APOE) gene polymorphism and chronic diseases among long-lived people in Zhongxiang City of Hubei Province.Methods A total of 110 long-lived elderly residents aged 90 years and over were collected.Their cognitive function was determined face-to-face using questionnaires by trained interviewers.According to mini-mental state examination(MMSE) scores,subjects were divided into a no dementia risk group and a high dementia risk group.General demographic characteristics,activities of daily living,depression state and nutrition status were compared between the two groups.Correlations of dementia with APOE gene polymorphism and chronic diseases were analyzed.Results The average MMSE score was 22.3±4.8.Among the 110 long-lived people,18 cases had a high risk for dementia,accounting for 16.4％,and 92 cases had no risk of dementia,accounting for 83.6％.The risk of dementia in long-lived elderly people was correlated with activities of daily living,mental state,nutritional status and falls(all P＜0.05).There were 8 cases with the APOE gene ε4/ε3 genotype in the high dementia risk group and 16 cases with the APOE gene ε4/e3 genotype in the no dementia risk group,with the former group showing a higher frequency of the APOE ε4/ε3 genotype (44.4％ vs.17.4％,x2 =6.46,P＜0.05).The former group also seemed to have a higher APOE ε4 frequency,but the difference was not statistically significant(22.2 ％ vs.10.3 ％,x2 =3.96,P =0.055)Chronic diseases prevalent in the long-lived people were hypertension(86 cases,78.2 ％),hearing loss (72 cases,65.5％),hyperlipidemia(56 cases,50.9％),anemia(43 cases,39.1％),impaired vision(39 cases,35.5 ％),chronic kidney diseases(25 cases,22.7 ％),chronic heart diseases (18 cases,16.4 ％) and osteoarthritis(18 cases,16.4％).No correlation was found between the risk of dementia and chronic diseases(P＞0.05).Conclusions Cognitive function is highly correlated with activities of daily living,mental state and nutritional status among long-lived elderly people in Zhongxiang City.The risk of dementia has a correlation with the APOE gene e4/e3 genotype but not with chronic diseases in long-lived people.

Metabolic syndrome is closely related to target organ injury such as heart, brain, and kidney. And bilirubin is an effective antioxidant. At present, there is a lack of research data on metabolic syndrome and serum total bilirubin in longevity elderly people. This study aimed to study the prevalence of the metabolic syndrome and its correlation with serum total bilirubin level in nonagenarians and centenarians living in Hubei Zhongxiang Province. According to the demographic information provided by Zhongxiang Civil Affairs Bureau, 128 elderly people were interviewed and 11 of them were excluded. A total of 117 population were included in the study. Questionnaires, physical examination, and blood test were made. 117 subjects aged 90-113 years with an average age of (98.6±4.8) years old were analysed. The prevalence of metabolic syndrome and its diagnostic components were obesity 19.7%, hyperglycemia 29.9%, hypertension 94.0%, hypertriglyceridemia 33.3%, low high density lipoprotein-cholesterol (HDL-C) levels 17.1%, and metabolic syndrome 23.9%. Logistic regression analysis found that the total bilirubin level was negatively correlated with metabolic syndrome and triglyceride levels(P<0.05), but not with obesity, hyperglycemia, hypertension, and total cholesterol (P>0.05). The nonagenarians and centenarians have a low prevalence of metabolic syndrome in Zhongxiang, Hubei Province, total bilirubin was negatively correlated with metabolic syndrome and triglyceride.

Objective To investigate the calcium dobesilate tablets combined with mecobalamin injection in treatment of diabetic peripheral neuropathy and effects on oxidative stress and neurotrophic factor.Methods 82 cases of diabetic peripheral neuropathy(DPN) patients from February 2015 to October 2016 in our hospital were selected and randomly divided into observation group and control group with 41 cases in each group.The control group was treated with mecobalamin injection, the observation group were treated with calcium dobesilate tablets.The course of treatment was two weeks in two groups.Results The total efficiency of the observation group (90.24%) was higher than the control group (68.29%) , the difference was statistically significant ( P<0.05 ) , patients in the observation group after the treatment of common peroneal nerve and median nerve SCV and MCV higher than the control group, the difference was statistically significant (P <0.05), the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control group and the level of superoxide dismutase ( SOD) in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05), the levels of serum NGF and BDNF in the observation group were higher than those in the control group, the difference was statistically significant (P<0.05), the two groups were no obvious adverse reactions.Conclusion Calcium dobesilate tablets and mecobalamin injection curative effect in the treatment of diabetic peripheral neuropathy , and patients could improve oxidative stress and neurotrophic factors, and the safety is good, has the important research significance.