Purpose/Significance To quantitatively analyze and evaluate 26 health informatization construction policies issued at the national level,so as to provide basis for improving related policies.Method/Process Based on the policy modeling consistency(PMC)index model,a health informatization construction policy evaluation index system is constructed,which includes 9 first-level indicators and 36 second-level indicators.Appling it to the evaluation of various policy texts,and the health informatization construction policies are analyzed in a holistic and concrete way.Result/Conclusion The overall score of the health informatization construction policies is ex-cellent.2 policies are at the perfect level,80.6％of policies are at the excellent level,and there are no bad level policy texts.However,the driving force of the policy and the balance of policy recipients need to be further improved.

Dacryocystitis is a common ophthalmic disease, and the main treatment of it is to abandon the obstructed nasolacrimal duct and create a new lacrimal drainage pathway through implanting a tube.For now, its pathogenesis is understood very limitedly.It is widely accepted that many factors take part in its occurrence, among which obstruction and infection play important roles.Recent researches have shown that there is lacrimal drainage-associated lymphoid tissue (LDALT) which changes remarkably in dacryocystitis, and significant differences in cytokines expression levels in tears between dacryocystitis patients and normal control have been found.In addition, the lacrimal duct has reactions similar to immune rejection to the silicone tube.All of these indicate that immune factors participate in the pathogenesis of dacryocystitis.Changes of immune tissue and macromolecular substances including the LDALT, cytokines, local tissue and cytokines after tube implantation were reviewed to analyze the changes and possible roles of immune factors in the pathogenesis of dacryocystitis.

In recent years, the effective use and scientific management of specialist nurses has become an important strategy for the sustainable development of specialized nursing and the progress of the nursing industry in China, and it is a new topic facing nursing managers in the new era. This article reviews the research progress on the use and management of specialist nurses at home and abroad, in order to provide a theoretical basis and reference for the formulation of a system for the use and management of specialist nurses in China.

Objective:To investigate the use and management of intensive care nurse specialists in ClassⅡ and ClassⅢ hospitals in Jiangsu Province.Methods:From July to August 2021, convenience sampling was used to select 421 intensive care nurse specialists in Class Ⅱ and Class Ⅲ hospitals in Jiangsu Province as the research object. A self-designed Jiangsu Provincial Intensive Care Nurse Specialists Use and Management Questionnaire was used for investigation. A total of 421 questionnaires were distributed, and 414 valid questionnaires were recovered, with a valid recovery rate of 98.3%.Results:Among 414 intensive care nurse specialists, 65.7% (272/414) of nurses still worked in their original positions after obtaining the specialist certificate, and 47.8% (198/414) of the nurses had slightly different job content after obtaining the specialist certificate than before obtaining the certificate. In terms of salary, only 31.6% (131/414) of nurses had increased their salary after obtaining the specialist certificate. In terms of retraining and scientific research, 56.5% (234/414) of the nurses had not participated in intensive specialist nursing retraining after obtaining the specialist certificate, and 65.5% (271/414) of the nurses had not undertaken nursing research projects. In terms of recertification, 50.7% (210/414) of nurses did not recertify after earning a specialist certificate. In terms of core competency training needs, nurses had the strongest need for scientific research and innovation ability training (81.4%, 337/414) .Conclusions:The roles and responsibilities of intensive care nurse specialists in Jiangsu Province need to be clarified, the scientific research ability of nurses needs to be improved, and the salary and qualification re-certification system needs to be further improved. Nursing managers should establish a standardized management system to promote the professional development of intensive care nurse specialists.

Objective:To investigate the predictive value of heparin binding protein (HBP) for sepsis.Methods:From June 2019 to December 2020, 188 patients admitted to the department of emergency of Hunan Provincial People's Hospital were enrolled. The patients were divided into non-sepsis group (87 patients) and sepsis group (101 patients) according to Sepsis-3 criteria. Gender, age, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), HBP, sequential organ failure assessment (SOFA) score, quick SOFA (qSOFA) score, modified early warning score (MEWS) and patients' recent medication history were recorded, the differences in the above indicators between the two groups were compared. The risk factors of sepsis were analyzed by Logistic regression. Spearman correlation analysis was used to analyze the correlation between HBP, PCT, CRP and SOFA score to evaluate the predictive value of HBP, PCT and CRP for the severity of septic organ failure. Receiver operating characteristic curve (ROC curve) were drawn to evaluate the diagnostic value of HBP, PCT and CRP for sepsis.Results:Compared with the non-sepsis group, the sepsis group had significantly higher levels of HBP, PCT, CRP, WBC, SOFA score, qSOFA score, and MEWS [HBP (μg/L): 55.46 (24.57, 78.49) vs. 5.90 (5.90, 9.01), PCT (μg/L): 6.83 (1.75, 30.64) vs. 0.23 (0.12, 0.75), CRP (mg/L): 67.35 (26.23, 123.23) vs. 4.45 (2.62, 47.22), WBC (×10 9/L): 11.84 (7.18, 16.06) vs. 6.58 (5.47, 8.99), SOFA score: 6 (4, 8) vs. 0 (0, 0), qSOFA score: 2 (1, 3) vs. 0 (0, 1), MEWS: 4 (3, 6) vs. 1 (0, 2)], the length of hospital stay was significantly prolonged [days: 10 (4, 17) vs. 0 (0, 7)], and the mortality was significantly increased [29.7% (30/101)vs. 4.6% (4/87)], with statistical significance (all P < 0.05). Correlation analysis showed that HBP, PCT and CRP were significantly positively correlated with SOFA score ( r values were 0.60, 0.33, and 0.38, respectively, all P < 0.01), among which HBP had the strongest correlation, CRP was the second, and PCT was the weakest. Logistic regression analysis showed that HBP, PCT and CRP levels were independent risk factors for sepsis [odds ratio ( OR) were 1.015, 1.094, 1.067, 95% confidence intervals (95% CI) were 1.007-1.022, 1.041-1.150, 1.043-1.093, all P < 0.01]. ROC curve analysis showed that HBP, PCT and CRP all had some diagnostic value for sepsis [the area under ROC curve (AUC) were 0.92, 0.87, 0.80, 95% CI were 0.88-0.97, 0.82-0.92, 0.74-0.87, respectively, all P < 0.01]. Among them, the diagnostic efficacy of HBP was higher when the cut-off value was ≥15.11 μg/L, its sensitivity and specificity were 86.14% and 89.66%, respectively, which were higher than the sensitivity (81.19%) and specificity (80.46%) when the PCT cut-off value was≥ 1.17 μg/L. However, CRP had the best sensitivity of 94.06% for the diagnosis of sepsis but lacked of specificity (63.22%). Conclusion:HBP can be used as a biological indicator for predicting sepsis and can assess the severity of organ failure in septic patients.

Objective: To investigate the association of periodontal diseases in pregnant women with preterm birth and low birth weight. Methods: 213 pregnant women aged 22-40 years were enrolled while receiving periodontal examination by 26 weeks of gestation. Periodontal measurements included plaque index(PLI),bleeding on probing (BOP),probing pocket depth(PD) and clinical attachment loss(CAL) were used as the criteria to classify the groups: healthy group(HG; n = 63),gingivitis group(GG; n = 74) and periodontitis group(PG; n = 76). At delivery,birth date and birth weight were recorded. Results: Preterm birth ratio in PG group is higher than that in HG group and GG group(P ＜ 0. 05). Conclusion: Periodontal disease may lead to preterm birth in pregnant women.

BACKGROUND:A short-peptide small molecule hydrogel (SMH) developed in the previous study has more obvious advantages than other hydrogels to improve local microenvironment, carry bioactive substances and interfere with stem cell signal transduction pathways. OBJECTIVE:To explore the effect of SMHs on bone marrow mesenchymal stem cells (BMSCs) proliferation, apoptosis and differentiation into myocardial cells. METHODS: (1) Passage 9 rat BMSCs in vitro were divided into control group and experimental group, followed by routine culture and culture in SMHs, respectively. At 7 days of culture, cell proliferation and apoptosis were detected. Cells in the two groups were exposed to anaerobic environment for 12 hours, and expression levels of Bcl-2, Bax and Caspase-3 in BMSCs were detected. (2) Passage 9 BMSCs were divided into four groups and then cultured in 5-azacytidine, SMHs, SMHs+5-azacytidine, and L-DMEM (normal control), respectively. After 4 weeks of induction, expression of CTnT, desmin and Cx-43 proteins was detected and expression levels of early cardiac transcription factors, NKX2.5 and GATA-4, were also measured. RESULTS AND CONCLUSION: (1) Compared with the control group, better proliferation and lower apoptosis of BMSCs were found in the experimental group. Under anaerobic conditions, the number of survival cells was reduced in both groups, but less apoptosis or necrosis was found in the experimental group than the control group (P < 0.05). Moreover, the level of Bcl-2 was higher in the experimental group than the control group (P < 0.01), while the levels of Bax and Caspases-3 protiens were lower in the experimental group than the control group (P < 0.01). (2) NKx2.5 and GATA-4 mRNA expression was found in both 5-azacytidine and SMHs+5-azacytidine groups, and moreover, the mRNA levels of early cardiac transcription factors were significantly higher in the SMHs+5-azacytidine group than in the 5-azacytidine group (P < 0.05). In the normal control group, cTnT expressed negatively, and desmin and Cx-43 expressed weakly. The expression of cTnT, desmin and Cx-43 proteins was higher in the SMHs+5-azacytidine group than in the 5-azacytidine and SMHs groups, while there was no significant difference between the latter two groups. To conclude, SMHs as a culture medium is conducive to the proliferation of BMSCs, reduces cell apoptosis, and promotes myocardial differentiation of BMSCs.

Objective To observe the effect of severe heatstroke on intestinal mucosal barrier function,and explore its correlation with systemic inflammatory reaction.Methods The SPF male BALB/c mice were randomly divided into normal control group,40 ℃ heat stress group and 42 ℃ heat stress group,with 6 mice in each group.The mice in normal control group were observed at normal temperature with (25.0 ± 0.5)℃,and the mice in heat stress groups were challenged with a temperature of (35.5 ± 0.5) ℃ and a humidity of (60 ± 5)％ until body temperature increase up to 40 ℃ or 42 ℃ followed by recovering the surroundings temperature to normal temperature for 12 hours.The blood of medial angle of eye of mice in each group was collected for determination of plasma lipopolysaccharide (LPS),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) levels,and diamine oxidase (DAO) activity with enzyme linked immunosorbent assay (ELISA).The level of D-lactic acid was determined with ultraviolet spectrophotometer.Then the mice in each group were sacrificed,and mesenteric lymph node (MLN),liver,spleen,lung,kidney tissues,and the blood from portal vein and caval vein were collected for colony count to observe the intestinal bacterial translocation.The ileum tissue was collected for observation of changes in histomorphology and ultrastructure of small intestine mucous membrane with microscope.Pearson linear regression analysis was used to explore the correlation between intestinal mucosal barrier dysfunction and systemic inflammatory response.Results Compared with normal control group,plasma LPS,inflammatory parameters such as TNF-α and IL-6,and gut barrier function parameters such as DAO and D-lactic acid levels as well as the rate of bacterial translocation after heat stress were significantly increased,and the differences were more obvious in 42 ℃ heat stress group [LPS (EU/L):740±50 vs.340±40,TNF-α (ng/L):148.06±36.61 vs.12.89 ± 1.67,IL-6 (ng/L):110.91 ± 9.97 vs.18.02 ± 2.20,DAO (U/L):1 760 ± 400 vs.670± 50,D-lactic acid (mg/L):9.60 ± 1.48 vs.5.08 ± 0.28,rate of bacterial translocation:78.6％ (33/42) vs.9.5％ (4/42),all P ＜ 0.01].It was shown by Pearson linear regression analysis that plasma LPS,TNF-α,IL-6 were positively correlated with DAO activity (r values were 0.834,0.808,0.836,respectively) and D-lactic acid (r values were 0.811,0.811,0.800,respectively) in 42 ℃ heat stress group (all P =0.000).It was showed by microscope that the changes in histomorphology and ultrastructure changes in intestinal mucosa were found after heat stress,and was obvious in 42 ℃ heat stress group as following:villus atrophy and falling off,infiltration of neutrophils and lymphocytes,the microvillus on the surface of mucosa cells were short and small,arranged in disorder,the tight junction between epithelial cells became widen,the mitochondrion and endoplasmic reticulum swelled obviously.Conclusion During the early stage of severe heatstroke,the damage of intestinal mucosal was obvious,and it has close correlation with systemic inflammatory response.

Triple-negative breast cancer(TNBC)is a special subtype of breast cancer which is invalid to endocrine therapy.Anti-Her2 targeted therapies such as herceptin and lapatinib are not suitable to TNBC.At present,conventional chemotherapy is the only way for the medical therapy of TNBC.Thus,searching for novel therapeutic agents for TNBC is one of hot researches of breast cancer.New targeted therapy drugs such as PARP-1 inhibitors,EGFR inhibitors,CXCR4 inhibitors,anti-angiogenesis drugs,Src tyrosine kinase inhibitor,and mTOR inhibitor are being researched.

Objective To investigate the optimal therapy for patients with acute-on-chronic liver failure induced by hepatitis B.Methods A total of 302 patients with acute-on-chronic liver failure induced by hepatitis B in the Affiliated Infectious Diseases Hospital of Fujian Medical University were enrolled during January 2008 to January 2010.Patients were divided into group A ( medical treatment,n =57 ),group B (medical + antiviral treatment,n =80),group C ( medical + antiviral + artificial liver support system (ALSS),n =124) and group D (medical + antiviral + ALSS + traditional Chinese medicine treatment,n =41 ).Liver and renal function,prothrombin activity (PTA) and HBV DNA load were observed at the baseline,week 1,4,8,12 and the end of the treatment.All groups were followed up for 48 weeks to observe the survival rates.Kruskal-Willis H test was used to compare the efficacies in four groups,and Cox proportional hazards regression model was used for survival analysis. Results There was no difference among four groups in curative effects at week 4 ( H =3.213,P =0.360 ),but there was significant difference at week 12 (H =8.722,P =0.033).The one-year mortality rates for groups A,B,C,D were 36.84％ (21/57),32.50％ (26/80),26.61％ (33/124) and 24.39％ ( 10/41 ),respectively.The death risks of group C and D were 0.566 and 0.396 times of that in group B ( P =0.036 and 0.016).Conclusion Nucleoside analogue and ALSS plus medical treatment can effectively increase the survival rates of the patients with acute-on-chronic liver failure induced by hepatitis B.