Objective To investigate the diagnosis,treatment and follow-up experience of patients with diffuse large B cell lymphoma,explore their preferences and needs,and improve their treatment experience and effectiveness.Methods From August to November 2023,17 patients and their family members were interviewed in one-hour semi-structured interviews,which were organized and analyzed by Excel.Results The preference,diagnosis stage and diagnosis time were mainly related to the complexity of symptoms and knowledge storage.Patients selected hospitals according to their medical habits and geographical location,and the departments were recommended by the guidance desk or judged by experience.In the treatment stage,the choice of hospital mainly considers the comprehensive strength,recommendation of relatives and geographical location,trust doctors and choose treatment plan according to their own conditions;In the follow-up stage,all patients were followed up according to the doctor's advice.About the need,diagnosis stage,hope to improve the level and speed of pathological diagnosis.During the treatment phase,patients and family members expressed their needs for drug policy assurance,accessibility and convenience of chemotherapy,and easy-to-communicate physician and patient education guidelines;In the follow-up stage,it hopes to have easy-to-use follow-up management tools.Conclusion It is suggested that the government should pay more attention to drug guarantee,issue patient education guidelines and pay more attention to popular science education of major diseases.It is recommended that hospitals improve the level and speed of pathological diagnosis,increase the opening rate of daytime chemotherapy area,use smart bed reservation system and actively popularize the latest research results of diseases.

Objective To investigate the diagnosis,treatment and follow-up experience of patients with diffuse large B cell lymphoma,explore their preferences and needs,and improve their treatment experience and effectiveness.Methods From August to November 2023,17 patients and their family members were interviewed in one-hour semi-structured interviews,which were organized and analyzed by Excel.Results The preference,diagnosis stage and diagnosis time were mainly related to the complexity of symptoms and knowledge storage.Patients selected hospitals according to their medical habits and geographical location,and the departments were recommended by the guidance desk or judged by experience.In the treatment stage,the choice of hospital mainly considers the comprehensive strength,recommendation of relatives and geographical location,trust doctors and choose treatment plan according to their own conditions;In the follow-up stage,all patients were followed up according to the doctor's advice.About the need,diagnosis stage,hope to improve the level and speed of pathological diagnosis.During the treatment phase,patients and family members expressed their needs for drug policy assurance,accessibility and convenience of chemotherapy,and easy-to-communicate physician and patient education guidelines;In the follow-up stage,it hopes to have easy-to-use follow-up management tools.Conclusion It is suggested that the government should pay more attention to drug guarantee,issue patient education guidelines and pay more attention to popular science education of major diseases.It is recommended that hospitals improve the level and speed of pathological diagnosis,increase the opening rate of daytime chemotherapy area,use smart bed reservation system and actively popularize the latest research results of diseases.

Objective:To explore the effect of inhibiting miR-203a-3p gene expression on proliferation and apoptosis of rheu-matoid arthritis(RA)synovial fibroblasts.Methods:Divided fibroblast-like synovial cells MH7A into Control group(untransfected cells),anti-miR-NC group(transfected with anti-miR-NC),anti-miR-203a-3p group(transfected with anti-miR-203a-3p),anti-miR-203a-3p+LiCl group(transfected with anti-miR-203a-3p+signal pathway activator LiCl).qRT-PCR was used to detect expression level of miR-203a-3p;clone formation experiment,MTT experiment were used to detect cell proliferation;flow cytometry was used to de-tect cell apoptosis;Western blot was used to detect protein expressions of PCNA,Bcl-2,Bax,Wnt1,β-catenin.Results:Transfec-tion of miR-203a-3p reduced the number of clones and survival rate of MH7A cells,increased rate of apoptosis,reduced expression levels of PCNA,Bcl-2,Wnt1,β-catenin protein,increased expression level of Bax protein.The signaling pathway activator LiCl in-creases the number of clones and survival rate of MH7A cells transfected with miR-203a-3p,reduces the rate of apoptosis,increases the expression level of Wnt1,β-catenin,PCNA,Bcl-2 protein,and reduces expression level of Bax protein.Conclusion:miR-203a-3p may promote proliferation of RA synovial fibroblasts and inhibit cell apoptosis by activating Wnt/β-catenin.

Objective:To explore the correlation among SMAD4 gene polymorphisms, early life traumatic experience and their interactions with clinical feature of obsessive-compulsive disorder (OCD). Methods:Totally 484 OCD patients who met the DSM-Ⅳ diagnostic criteria and 368 health controls who met the enrollment criteria were recruited from September 2013 to September 2018. The Yale-Brown obsessive-compulsive scale (Y-BOCS) was used to assess the severity of obsessive-compulsive symptoms, the Beck depression inventory Ⅱ (BDI-Ⅱ) was used to assess the severity of depressive symptoms, the Beck anxiety inventory (BAI) was used to assess the severity of anxiety symptoms, and early trauma inventory-short form (ETI-SF) was used to assess early traumatic experience. SMAD4: rs12452684, rs2276163, rs17663887 and rs3819122 were genotyped using the Taqman genotyping technique. Data were analyzed using SPSS 20.0 software, and comparisons among groups were performed using chi-square test, t-test, Mann-Whitney U non-parametric test and analysis of covariance. Correlation was analyzed using Spearman correlation analysis, and interactions were analyzed using general linear model. Results:All sites except rs17663887 met the Hardy-Weinberg equilibrium (rs12452684: χ2=0.29, P=0.59; rs2276163: χ2=2.58, P=0.11; rs3819122: χ2=0.22, P=0.64).Allele, genotype frequencies of SMAD4: rs12452684, rs2276163 and rs3819122 were not statistically significant between the OCD and the health control groups ( χ2=0.02, 1.20, 0.04, all P>0.05; χ2=1.85, 3.98, 1.45, all P>0.05). The results of covariance analysis (corrected for age and gender) showed that there were significantly differences in compulsion (CC: 12.47±4.23, CT: 12.53±4.15, TT: 13.97±3.11; AA: 12.63±4.08, AC: 12.49±4.19, CC: 13.87±2.93) and total Y-BOCS scores(CC: 25.31±6.42, CT: 25.68±5.90, TT: 27.75±6.01; AA: 25.54±6.52, AC: 25.56±5.98, CC: 27.63±5.75) among the three genotypes of the SMAD4: rs2276163 and rs3819122 between the two groups ( F=3.58, 3.87, 3.48, 3.73, all P<0.05). Emotional abuse in the ETI-SF was positively correlated with obsession and total Y-BOCS scores( r=0.14, 0.14, both P<0.05). The interactions of rs2276163, rs3819122 and emotional abuse were associated with obsession scores ( F=4.65, 3.63, 2.93, all P<0.01). Conclusions:The more emotional abuse experienced in early life, the more severe obsessive-compulsive symptoms, and the interaction between the SMAD4 gene and early traumatic experience is involved in the development of OCD.

Objective:To explore the correlation among SMAD4 gene polymorphisms, early life traumatic experience and their interactions with clinical feature of obsessive-compulsive disorder (OCD). Methods:Totally 484 OCD patients who met the DSM-Ⅳ diagnostic criteria and 368 health controls who met the enrollment criteria were recruited from September 2013 to September 2018. The Yale-Brown obsessive-compulsive scale (Y-BOCS) was used to assess the severity of obsessive-compulsive symptoms, the Beck depression inventory Ⅱ (BDI-Ⅱ) was used to assess the severity of depressive symptoms, the Beck anxiety inventory (BAI) was used to assess the severity of anxiety symptoms, and early trauma inventory-short form (ETI-SF) was used to assess early traumatic experience. SMAD4: rs12452684, rs2276163, rs17663887 and rs3819122 were genotyped using the Taqman genotyping technique. Data were analyzed using SPSS 20.0 software, and comparisons among groups were performed using chi-square test, t-test, Mann-Whitney U non-parametric test and analysis of covariance. Correlation was analyzed using Spearman correlation analysis, and interactions were analyzed using general linear model. Results:All sites except rs17663887 met the Hardy-Weinberg equilibrium (rs12452684: χ2=0.29, P=0.59; rs2276163: χ2=2.58, P=0.11; rs3819122: χ2=0.22, P=0.64).Allele, genotype frequencies of SMAD4: rs12452684, rs2276163 and rs3819122 were not statistically significant between the OCD and the health control groups ( χ2=0.02, 1.20, 0.04, all P>0.05; χ2=1.85, 3.98, 1.45, all P>0.05). The results of covariance analysis (corrected for age and gender) showed that there were significantly differences in compulsion (CC: 12.47±4.23, CT: 12.53±4.15, TT: 13.97±3.11; AA: 12.63±4.08, AC: 12.49±4.19, CC: 13.87±2.93) and total Y-BOCS scores(CC: 25.31±6.42, CT: 25.68±5.90, TT: 27.75±6.01; AA: 25.54±6.52, AC: 25.56±5.98, CC: 27.63±5.75) among the three genotypes of the SMAD4: rs2276163 and rs3819122 between the two groups ( F=3.58, 3.87, 3.48, 3.73, all P<0.05). Emotional abuse in the ETI-SF was positively correlated with obsession and total Y-BOCS scores( r=0.14, 0.14, both P<0.05). The interactions of rs2276163, rs3819122 and emotional abuse were associated with obsession scores ( F=4.65, 3.63, 2.93, all P<0.01). Conclusions:The more emotional abuse experienced in early life, the more severe obsessive-compulsive symptoms, and the interaction between the SMAD4 gene and early traumatic experience is involved in the development of OCD.

Objective:To explore the effect of inhibiting miR-203a-3p gene expression on proliferation and apoptosis of rheu-matoid arthritis(RA)synovial fibroblasts.Methods:Divided fibroblast-like synovial cells MH7A into Control group(untransfected cells),anti-miR-NC group(transfected with anti-miR-NC),anti-miR-203a-3p group(transfected with anti-miR-203a-3p),anti-miR-203a-3p+LiCl group(transfected with anti-miR-203a-3p+signal pathway activator LiCl).qRT-PCR was used to detect expression level of miR-203a-3p;clone formation experiment,MTT experiment were used to detect cell proliferation;flow cytometry was used to de-tect cell apoptosis;Western blot was used to detect protein expressions of PCNA,Bcl-2,Bax,Wnt1,β-catenin.Results:Transfec-tion of miR-203a-3p reduced the number of clones and survival rate of MH7A cells,increased rate of apoptosis,reduced expression levels of PCNA,Bcl-2,Wnt1,β-catenin protein,increased expression level of Bax protein.The signaling pathway activator LiCl in-creases the number of clones and survival rate of MH7A cells transfected with miR-203a-3p,reduces the rate of apoptosis,increases the expression level of Wnt1,β-catenin,PCNA,Bcl-2 protein,and reduces expression level of Bax protein.Conclusion:miR-203a-3p may promote proliferation of RA synovial fibroblasts and inhibit cell apoptosis by activating Wnt/β-catenin.

Objective:To evaluate the effects of comprehensive rehabilitation nursing based on guided education and training on rehabilitation treatment in school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection.Methods:Fifty movement disorders school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection in Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University from January 2017 to December 2019 were enrolled in this study. The child patients were divided into the control group and the observation group according to the order of admission, with 25 cases in each group, and the control group was from January 2017 to June 2018 while the observation group was from July 2018 to December 2019. In the control group, routine nursing after epileptogenic focus resection and functional exercise were conducted. The observation group was treated with comprehensive rehabilitation nursing based on guided education and training. On the third day after operation, the day of discharge respectively, the motor function and activity of daily living of the two groups were evaluated. The satisfaction of children′s parents on nursing was compared between the two groups.Results:The scores of motor function on the third day after operation and the day of discharge were (57.0 ± 6.8), (73.0 ± 5.4) points respectively in the observation group, and those in the control group were (55.0 ± 5.6), (65.6 ± 5.9) points. There were significant differences intra group comparison ( t=-9.26, -6.48, both P<0.05). The activity of daily living scores on the third day after operation and the day of discharge were (45.2 ± 5.9), (74.2 ± 8.3) points respectively in the observation group, and those in the control group were (44.0 ± 5.8), (60.2 ± 7.6) points. There were significant differences intra group comparison ( t=-14.33, -8.51, both P<0.05). There were significant differences between the scores of motor function and the ability of daily living scores on the day of discharge in the observation group and the control group ( t values were -4.65, -6.25, both P<0.05). The satisfaction of children′s parents on nursing in the observation group and the control group were 96.0% (24/25), 72.0% (18/25) respectively. There was significant difference between the two groups ( χ 2=8.78, P<0.05). Conclusions:Rehabilitation nursing based on guided education and training can improve motor function and ability of daily living in movement disorders school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection, promote the functional recovery of children after surgery and increase the satisfaction of children′s parents on nursing.

OBJECT IVE To evaluate the application effect of the whole cour se medication management mode led by pharmacists in rheumatic immune diseases. METHODS A total of 122 patients treated with tacrolimus or cyclosporine in the department of rheumatology and immunology of Wuhan No. 1 Hospital from 2018 to 2020 were selected as the study subjects. Among them ，44 cases in the control group were under the traditional supervision mode ；78 patients in the observation group adopted the whole course medication management mode led by pharmacists ，that was ，individual pharmacists and specialist clinical pharmacists cooperated and led ，and not only participated in the whole process of drug treatment but also involved in the whole process of therapeutic drug monitoring （TDM）. On the basis of the control group ，the division of labor and cooperation among medical，pharmaceutical and nursing parties were strengthened ，and the homogeneous supervision was carried out for the outpatients and inpatients from admission to discharge . The daily dose of medication ，the rate of reaching the standard of blood drug concentration ，the incidence of problematic samples （the sample was calculated by the number of times ），the average hospitalization days ，the re-admission rate within 6 months after discharge ，the medication compliance score and the patient ’s satisfaction rate were compared between the two groups. RESULTS In the control group ，53 times of TDM were performed ， including 18 times of tacrolimus monitoring and 35 times of cyclosporine monitoring ；in the observation group ，123 timesof TDM were performed ，including 55 times of tacrolimus monitoring and 68 times of cyclosporine monitoring. The daily dose of tacrolimus ，the daily dose of cyclosporine ，the rate of reaching the standard of cyclosporine blood drugconcentration，the inc idence of problematic samples ，the rate of re-admission within 6 months after discharge ， the medication compliance score and the patient ’s satisfaction rate in the observation group were significantly better than those in the control group （P＜0.05）. CONCLUSIONS It can effectively improve the effect of the quality of pharmaceutical care to implement whole course and homogeneous medication management led by pharmacists and provide precise drug guidance for patients with rheumatic and immune diseases.

OBJECTIVE： To isolate and identify the coumarins from the seeds of Clausena lansium， and to study their inhibitory activity of α-glucosidase and nematicidal activity against Panagrellus redivivus. METHODS： Column chromatography， reversed phase silica gel column chromatography and HPLC method were used to separate and purify the coumarins from the seeds of C. lansium. The structures of compounds were identified according to physicochemical properties， 1H-NMR and 13C-NMR spectral data. Using acarbose and avermectin as positive control， PNPG and Berman funnel methods were used to investigate the α-glucosidase inhibitory activity and nematicidal activity against P. redivivus， respectively. RESULTS： Seven coumarins compounds were isolated from the seeds of C. lansium， and were identified as 7-hydroxy-1-benzopiran-2-one （Ⅰ）， Wampetin （Ⅱ）， Lansiumarin-C （Ⅲ）， Claucoumarin A （Ⅳ）， Clausenalansimin A （Ⅴ）， （E，E）-8-（7-hydroxy-3，7-dimethylocta-2，5-dienyloxy） psoralen （Ⅵ）， Dihydroindicolactone （Ⅶ）. Under 0.25 mg/mL， the α-glucosidase inhibitory rates of compounds Ⅰ， Ⅲ， Ⅴ were （32.4±1.9）％，（37.1±6.0）％， （39.5±1.1）％， respectively. Under 2.5 mg/mL， corrected mortality of compounds Ⅰ， Ⅳwere 50.5％ and 47.9％. CONCLUSIONS： Compounds Ⅰ， Ⅲ， Ⅴ show α-glucosidase inhibitory activity， and compounds Ⅰ，Ⅳ display nematicidal activity against P. redivivus.  α-Glucosidase inhibitory activity of compounds Ⅲ， Ⅴ， and nematicidal activity of compound Ⅳ are found for the first time.

Objective:To research the curative effect of liuwei dihuang pill and metformin on the serum levels of apolipoprotein of patients with type 2 diabetes.Methods:106 cases with type 2 diabetes were selected and randomly divided into the control group and the observation group,with 53 cases in each group.The patients in the control group were treated with metformin,and the patients in the observation group were treated with liuwei dihuang capsules on the basis of the control group.Then the serum levels of apolipoprotein A and B (ApoA,ApoB),ApoA/ApoB,fasting plasma glucose (FPG),2 h postprandial blood glucose (2 HPG),fasting insulin (FINS),in sulin resistance index (HOMA IR),interleukin 6 (IL-6),hypersensitive c-reactive protein (hs-CRP),endothelin-1 (ET-1) and nitric oxide (NO),the curative effect and safety in the two groups were observed and compared before and after the treatment.Results:After treatment,the serum levels of ApoA,ApoA/ApoB and NO of the both groups were higher than those before,treatment,which were higher in the observation group than those of the control group (P＜0.05).After treatment,the serum levels ofFPG,2hPG,FINS,HOMA IR,IL-6,hs CRP and ET-1 of both groups were lower than before treatment,which were lower in the observation group than those of the control group(P＜0.05).The total effective rate of observation group was higher than that of the control group(P＜0.05).There was no statistically significant difference in the drug safety between the two groups (P＞0.05).Conclusion:Liuwei dihuang capsules and metformin had reliable curative effect on the treatment type 2 diabetes,which could regulate the serum levels of apolipoprotein,and improve the blood glucose,inflammatory factors and endothelial function.