Objective To investigate the clinical diagnostic value of extra-spindle pole-like protein 1(ESPL1)in the progression of hepatitis B virus(HBV)-related liver fibrosis.Methods A total of 228 patients with HBV infection who were admitted to The First Affiliated Hospital of Guangxi Medical University from June 2017 to August 2023 were enrolled.The transient elastography system FibroScan was used to determine liver stiffness measurement(LSM)for all patients,and according to the LSM value,they were divided into non-liver fibrosis group with 80 patients,mild liver fibrosis group with 83 patients,advanced liver fibrosis group with 30 patients,and liver cirrhosis group with 35 patients.ELISA was used to measure the serum level of ESPL1.The Kruskal-Wallis H test was used for comparison of the serum level of ESPL1 between the four groups;the Spearman correlation analysis was used to investigate the correlation between ESPL1 and LSM;the receiver operating characteristic(ROC)curve was used to analyze the value of serum ESPL1 in predicting the progression of liver fibrosis.Results The liver cirrhosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group and the mild liver fibrosis group(both P<0.05),and the advanced liver fibrosis group and the mild liver fibrosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group(both P<0.05).The correlation analysis showed that there was a positive correlation between serum ESPL1 and LSM in the patients with HBV infection and varying degrees of liver fibrosis(r=0.515,P<0.001).Serum ESPL1 had an area under the ROC curve(AUC)of 0.809 in predicting liver cirrhosis and an AUC of 0.638 in predicting advanced liver fibrosis,with a sensitivity of 87.5%and 100%,respectively,and a specificity of 59.7%and 31.3%,respectively.Conclusion There is a certain correlation between serum ESPL1 and HBV-related liver fibrosis,and higher serum ESPL1 may indicate a higher degree of liver fibrosis.Serum ESPL1 is expected to become one of the serum markers for assisting in the diagnosis of liver cirrhosis and an important clinical method for dynamically monitoring the progression of liver fibrosis in patients with HBV infection.

Objective:To establish an index system for the construction of cardiovascular nursing discipline based on the internal and external integration model of organ system, and to provide reference for the construction of cardiovascular nursing discipline with patients as the center and circulatory system as the core.Methods:Based on the health science cluster system theory, embodying the integrated nursing concept and the characteristics of cardiovascular discipline, the content of the cardiovascular nursing discipline construction index system and the weight of each index were determined through literature review, semi-structured interview and expert consultation. SPSS 23.0 was used to statistically analyze the obtained consultation data.Results:The positive coefficient of the experts was 92.308%, the authority coefficient was 0.812, and the coordination coefficients of the first-, second- and third-level indicators were 0.412, 0.421 and 0.347, respectively. The final indicator system consisted of 4 first-level indicators, 17 second-level indicators and 66 third-level indicators.Conclusion:The index system of cardiovascular nursing discipline construction is scientific and reliable, which has certain guiding significance to the construction of cardiovascular nursing discipline and the cultivation of talents under the integrated medical model.

Objective:To explore the effect of nursery-led multidisciplinary evidence-based intervention in the management of anticoagulation in inpatients with oral warfarin.Methods:In this study, Quasi-experimental research was adopted. 478 patients were selected as the baseline review group on August 1st, 2019 and December 31th, 2019, and 494 patients were selected as the after-effect evaluation group on February 1st, 2020 and May 31th, 2020 in cardiovascular surgery and cardiovascular medicine. Established a multidisciplinary team, according to theoretical framework basing on the evidence of continuous quality improvement model, combining with evidence and clinical practice to develop evidence-based solutions, the comparison of international normalized ratio (INR) before and after the intervention in the percentage of time in therapeutic range (TTR) and anticoagulant related the incidence of complications.Results:Before and after the multidisciplinary evidence-based intervention, the mean TTR of the patients were (51.67±31.04)% and (64.34±26.37)%, with statistically significant differences ( tvalue was 6.958, P<0.01); the incidence of bleeding and embolization was not statistically significant ( χ 2values were 0.294 and 0.268, P>0.05). Conclusion:Nursing-led multidisciplinary evidence-based interventions can improve the intensity and stability of oral warfarin anticoagulant therapy in inpatients.

Human acute leukemia (AL) is a clonal malignancy with abnormal hematopoietic stem cells. Clinically, AL is very difficult to cure due to its sudden onset and short course of disease progression. Previous studies have shown that eukaryotic initiation factor 4B (eIF4B) plays a critical role in the development of chronic leukemia. However, the involvement of eIF4B in human acute leukemia is still largely unknown. Therefore, we studied eIF4B function and its regulatory mechanism in human acute leukemia. We found that phosphorylation levels of eIF4B in acute leukemia cells were significantly reduced in response to treatment with either LY294002 (PI3K inhibitor), AKTi (AKT inhibitor) or SMI-4A (Pim inhibitor). Co-treatment with inhibitors targeting JAK/STAT5/Pim and PI3K/AKT/mTOR signaling dramatically promoted apoptosis of acute leukemia cells by downregulating eIF4B phosphorylation. Furthermore, in vitro and in vivo functional experiments showed that eIF4B played an important anti-apoptosis role in the acute leukemia cells by regulating the expression of anti-apoptotic proteins Bcl-2 and Bcl-XL. In contrast, silencing eIF4B inhibited the growth of acute leukemia cells as engrafted tumors in nude mice. Taken together, our results indicate the synergistic role of JAK/STAT5/Pim and PI3K/AKT/mTOR signaling pathways in regulating eIF4B phosphorylation in acute leukemia, and highlight eIF4B as a candidate therapeutic target for treatment of acute leukemia.
Animals ; Apoptosis ; Cell Line, Tumor ; Leukemia ; Mice ; Mice, Nude ; Phosphatidylinositol 3-Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; STAT5 Transcription Factor/metabolism*

Objective: To explore the effect of occupational exposure to glyphosate on hepatorenal function. Methods: 526 workers who were occupationally exposed to glyphosate from 5 glyphosate-producing factories were selected as cases; and another 442 administrative staffs who were not exposed to glyphosate were selected as controls from April to November, 2014. All the subjects accepted occupational health examination. The concentration level of glyphosate in the air of workshop was detected and the time weighted average concentration (TWA) was calculated. And analyze the difference of hepatorenal fuction between case group and control group. Result: The age of the subjects in the case and control groups were separately (35.6±10.3), (34.3±9.7) years old, with the length of working for (6.5±5.7), (7.7±6.8) years. The TWA of glyphosate in the case group was between <0.03-48.91 mg/m³, with the geometric mean at 3.78 mg/m³. The overall rates of abnormal hepatic and renal function in the case group were 14.4% (76 cases) and 16.2% (85 cases), respectively; while those were 5.0% (22 cases) and 4.8% (21 cases), respectively in control group, and the difference showed statistical significance (P<0.05). When TWA reached <0.03-6.00 mg/m³, the difference of hepatorenal fuction between case group and control group showed statistical significance, and the rates of abnormal hepatic and renal function was 8.0% (36/447) and 9.8% (44/447) respectively in case group. When cumulative exposure level reached <1.56-68.64 g, the difference of hepatorenal fuction between case group and control group showed statistical significance, and the rates increased to 9.2% (37/404) and 10.4% (42/404) respectively in group of cases. Conclusion Glyphosate can affect the hepatic and renal function among occupational exposure population, and there was an association between the effect and the exposure dose.

Objective To formulate standardized procedure of incontinence-associated dermatitis (IAD) in ICU and evaluate the outcomes.Methods The standardized procedure of IAD,including training program,risk assessment workflow,grading intervention process and physician-nurse communication style,was formulated based on the best evidences combined with the experience of clinical team and patients needs.Then,IAD standardized procedure was applied to the quality improvement project of ICU,and the incidence and severity degrees of IAD were evaluated.Results The total incidence of IAD was on the decline before,during and after improvement,22.43％(96/428),16.06％(71/442),13.90％(51/367),the difference was statistically significant (x2=11.06,P＜ 0.01).The incidence of severe IAD was 2.57％ (11/428),0.45％ (2/442),0.27％(1/367) before,during and after improvement,the difference was statistically significant (x2=11.67,P＜0.01).The incidence of fungal infection was 5.14％ (22/428),2.04％ (9/442),1.63％ (6/367) before,during and after improvement,the difference was statistically significant (x2=10.53,P ＜ 0.01).Conclusions Application of evidence-based practice with specification of IAD,can improve nursing quality and promote patient safety.

The formation mechanisms of rare intracranial aneurysms are various, which lead to various kinds of treatment methods. The present article summarized the pathogenesis, pathologic changes in vascular walls and imaging features of rare intracranial aneurysms including segmental ectasia, aneurysms with dissection, aneurysms with intramural hemorrhage, mycotic aneurysms, aneurysms related to HIV, neoplastic aneurysms and traumatic aneurysms through literature review.
Diagnostic Imaging ; Dilatation, Pathologic ; Humans ; Intracranial Aneurysm ; diagnosis ; pathology ; therapy

Objective To evaluate the correlation of the baseline clinical and laboratory test index with death,and to discuss the independent risk factors for long-term prognosis in elderly HIV/ AIDS patients who had accepted highly active antiretroviral therapy (HAART).Methods 1671 cases of HIV/AIDS patients were included in retrospective cohort study,divided into death group (183 cases) and non-death group (1488 cases) according to HIV/AIDS related death event,and followed up for 2 days to 120 months,an average of 427 days.Results During the period of followup,the proportion of male (12.45％) was higher than that of women (6.9％) in death group(x2 =10.42,P＜0.01).The mortality ratio of the WHO stage Ⅲ and Ⅳ was higher than that of the WHO stage Ⅰ and Ⅱ (x2 =18.67,P＜0.01).The mortality ratio was significantly higher in HIV/AIDS patients with baseline CD4+ T lymphocyte cell ＜100 cells/mm3 than ＞100 cells/mm3 (x2 =52.59,P＜0.01).The platelet (PLT),hemoglobin (HB),and blood glucose levels were lower in death group than in non-death group (P ＜ 0.05),but serum creatinine (SCR) and AST (aspartate aminotransferase) levels were higher than that in the non-death group (P＜0.05).There was no significantly differences between the death group and the non-death group in the index of white blood cell (WBC),blood urea nitrogen (BUN),total cholesterol (CH),triglyceride (TG),alanine aminotransferase (ALT) and total bilirubin (TB) levels (all P＞ 0.05).Multiple logistic regression analysis revealed that the WHO stage (OR=0.777,95％ CI:0.612～0.987,P＜0.05) and the baseline level of CD4+ T lymphocytes cell (OR=1.345,95％ CI:1.089～1.662,P＜0.01) were independent risk factors for long-term outcomes in elderly HIV/AIDS patients.Conclusions The WHO stage and baseline CD4+ T lymphocyte cell level are the independent risk factors for long-term prognosis in HIV/AIDS patients over 60 years of age.Early discovery and early beginning HAART can effectively improve the prognosis of elderly HIV/AIDS patients.

Female ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; diagnosis ; Rhabdoid Tumor ; diagnosis

OBJECTIVETo develop a method for determination of 2, 4-dichlorophenoxyacetic acid (2, 4-D) in the air of workplace by high-performance liquid chromatography.

METHODS2, 4-D was collected by ultrafine glass filters, desorbed by methanol, separated by a C18 column, and detected by a UV detector. Identification and quantification of 2, 4-D were performed by retention time and peak areas, respectively.

RESULTSThe linear range of the test was 2∼200 µg/ml; the elution efficiency was 94.6%- 95.9%; the limit of detection (S/N = 3) was 0.034 µg/ml (injection volume of 20 µl eluant); the lower limit of quantification (S/N = 10) was 0.11 µg/ml; the minimum detectable concentration was 0.011 mg/m(3); the minimum quantifiable concentration was 0.037 mg/m(3) (with sampled air volume of 45 L).

CONCLUSIONThis method is convenient and simple in sample collection and preparation, and satisfies all methodological requirements. Therefore, this method is useful for the determination of 2, 4-D in the air of workplace.