OBJECTIVE To explore the impact and mechanism of curcumin on endometriosis （EMS） model rats based on Notch1 signaling pathway. METHODS Female SD rats with synchronized estrous cycles were implanted with autologous endometrium on the abdominal wall to construct EMS model. EMS rats were randomly divided into model group， low-， medium- and high-dose groups of curcumin （60， 120， 240 mg/kg）， and Notch 1 inhibitor DAPT group （7 mg/kg）. The sham surgery group was also established， with 10 rats in each group. Rats in each group received intragastric administration or injection via caudal veins with the corresponding drugs for 4 weeks. Endometriotic lesions were observed and measured using ultrasound and visual inspection， and their volumes were calculated. Histopathological morphology of the lesion tissues was observed. The levels of interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） in the abdominal cavity fluid， as well as the mRNA and protein expression levels of Notch1， matrix metalloproteinase-9 （MMP-9）， and vascular endothelial growth factor （VEGF） in the endometriotic lesions were measured. RESULTS Compared with the model group， the volume of endometriotic lesions in the low- ， medium- and high-dose groups of curcumin and the DAPT group was significantly decreased （P＜0.05）； atrophy or disappearance of columnar epithelium， cyst disappearance； the levels of IL-1β， IL-6， and TNF- α （except for the low-dose curcumin group） in the abdominal cavity fluid， as well as the mRNA （except for MMP-9 and VEGF in the low-dose curcumin group） and protein （except for MMP-9 in the low-dose curcumin group） expression levels of Notch1， MMP-9， and VEGF in the endometriotic lesions were significantly decreased （P＜0.05）. The curcumin high-dose group and DAPT group showed superior results in most indicators compared to the curcumin low- and medium-dose groups. CONCLUSIONS Curcumin has an improving effect on EMS， and its mechanism may be related to inhibiting Notch1 signaling pathway， reducting local inflammatory responses， and inhibiting ectopic endometrial invasion and angiogenesis.

Objective To investigate the characteristics of Clostridioides difficile infection(CDI)in patients hospitalized for diarrhea and analyze the risk factors for CDI.Methods Stool samples were collected from 306 patients with diarrhea hospitalized in 3 university hospitals in a mid-south city of China from October to December,2020.C.difficile was isolated by anaerobic culture,and qRT-PCR was used to detect the expressions of toxin A(tcdA)and B(tcdB)genes and the binary toxin genes(cdtA and cdtB).Multilocus sequence typing(MLST)was performed for the isolated strains without contaminating strains as confirmed by 16S rDNA sequencing.Etest strips were used to determine the drug resistance profiles of the isolated strains,and the risk factors of CDI in the patients were analyzed.Results CDI was detected in 25(8.17%)out of the 306 patients.All the patients tested positive for tcdA and tcdB but negative for the binary toxin genes.Seven noncontaminated C.difficile strains with 5 ST types were isolated,including 3 ST54 strains and one strain of ST129,ST98,ST53,and ST631 types each,all belonging to clade 1 and sensitive to metronidazole and vancomycin.Hospitalization within the past 6 months(OR=3.675;95%CI:1.405-9.612),use of PPIs(OR=7.107;95%CI:2.575-19.613),antibiotics for≥1 week(OR=7.306;95%CI:2.274-23.472),non-steroidal anti-inflammatory drugs(OR=4.754;95%CI:1.504-15.031)in the past month,and gastrointestinal disorders(OR=5.050;95%CI:1.826-13.968)were all risk factors for CDI in the patients hospitalized for diarrhea.Conclusion The CDI rate remains low in the hospitalized patients with diarrhea in the investigated hospitals,but early precaution measures are recommended when exposure to the risk factors is reported to reduce the risk of CDI in the hospitalized patients.

Objective To investigate the characteristics of Clostridioides difficile infection(CDI)in patients hospitalized for diarrhea and analyze the risk factors for CDI.Methods Stool samples were collected from 306 patients with diarrhea hospitalized in 3 university hospitals in a mid-south city of China from October to December,2020.C.difficile was isolated by anaerobic culture,and qRT-PCR was used to detect the expressions of toxin A(tcdA)and B(tcdB)genes and the binary toxin genes(cdtA and cdtB).Multilocus sequence typing(MLST)was performed for the isolated strains without contaminating strains as confirmed by 16S rDNA sequencing.Etest strips were used to determine the drug resistance profiles of the isolated strains,and the risk factors of CDI in the patients were analyzed.Results CDI was detected in 25(8.17%)out of the 306 patients.All the patients tested positive for tcdA and tcdB but negative for the binary toxin genes.Seven noncontaminated C.difficile strains with 5 ST types were isolated,including 3 ST54 strains and one strain of ST129,ST98,ST53,and ST631 types each,all belonging to clade 1 and sensitive to metronidazole and vancomycin.Hospitalization within the past 6 months(OR=3.675;95%CI:1.405-9.612),use of PPIs(OR=7.107;95%CI:2.575-19.613),antibiotics for≥1 week(OR=7.306;95%CI:2.274-23.472),non-steroidal anti-inflammatory drugs(OR=4.754;95%CI:1.504-15.031)in the past month,and gastrointestinal disorders(OR=5.050;95%CI:1.826-13.968)were all risk factors for CDI in the patients hospitalized for diarrhea.Conclusion The CDI rate remains low in the hospitalized patients with diarrhea in the investigated hospitals,but early precaution measures are recommended when exposure to the risk factors is reported to reduce the risk of CDI in the hospitalized patients.

Objective:To conduct a scoping review of studies on the assessment content and early functional exercise of various functional disorders occurring in the limbs on the operated side after cardiac implantable electronic device implantation, so as to provide a reference for the future early identification of different functional disorders in the limbs on the operated side and the guidance of early rehabilitation and exercise in the postoperative period.Methods:According to the scoping review methodology,we systematically searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CNKI, VIP, Wanfang and CBM. The retrieval time limit was from the establishment of the database to October 31, 2023. The included studies were summarized and analyzed.Results:Totally 15 studies were included. These included 7 randomized controlled trials and 6 cohort studies, and 2 case-control studies. Postoperative series of limb-related dysfunction on the operative side after cardiac implantable electronic device implantation including shoulder pain, limited range of motion of the shoulder, decreased grip strength, and scapular dyskinesia. Shoulder range of motion limitations included flexion, abduction, and internal and external rotation angle limitations. Shoulder pain and impaired active forward flexion had the highest prevalence, reaching 61% and 60% respectively. The most restricted population was ICD implanted patients. The assessment tools included subjective and objective tools. These tools included 3 types of scales to assess shoulder pain and goniometer for assessing shoulder range of motion and hydraulic hand dynamometer for evaluating grip strength, and tests and tape measures to assess scapular dyskinesia and 5 types of scales to assess overall limb function on the operative side.The various dysfunctions associated with the limb on the operated side basically appeared at 2 weeks postoperatively, and these dysfunctions began to improve at 3 months postoperatively and normalized at 12 months and fully recovered at 5 years.The longest duration was in patients with ICD implants. The rehabilitation exercise program consisted of five types, of which the pendulum exercise was a single program and the remaining four were comprehensive rehabilitation exercise programs, all of which were effective.Intervention time points included postoperative days 1 and 2, as well as postoperative weeks 1 and 2.Conclusions:We need to focus on the presence of serial related dysfunction in the operated limb after cardiac implantable electronic device implantation. Assessment tools are diverse and we need to choose appropriately based on measurement priorities. All of these dysfunctions are self-limiting, however, they still have a long time to heal themselves. All of these individuals need to be included in screening and comprehensive interventions at regular outpatient follow-up visits for one year after surgery. Conducting a comprehensive functional exercise program is beneficial in reducing the incidence and duration of different dysfunctions in the patient′s operated limb. These exercise programs have value for further clinical application. However, these exercise programs are not uniform.In order to provide early intervention for patients, the further validation of which types of activity programs or a combination of certain types of activity programs need to be further investigated. The timing of early functional exercise is not uniform and further work is needed to determine these times.

Objective To study the effectiveness of pro-abdominal exercise in improving the quality of gastroscopy,and provide patients with a better preoperative preparation for gastroscopy.Methods 307 patients who underwent painless gastroscopy from March to July 2023 were selected and divided into three groups according to the random number table method.There were 106 cases in the abdominal massage group,103 cases in the bed turning group and 98 cases in the control group.On the basis of routine medication,different preoperative activity guidance was used to compare and analyze the preoperative preparation time,examination time and gastric mucosal visual field clarity score in each group.Results The gastroscopy time in the abdominal massage group and the bed-turning group was significantly shorter than that in the control group,and the clarity score of the gastric mucosal visual field was significantly lower than that of the control group,with statistically significant differences(P<0.05).However,there were no statistically significant differences in the gastroscopy time or visual field clarity score for gastric body,gastric fundus,and gastric antrum between the abdominal massage group and the bed-turning group(P>0.05).The satisfaction rate of endoscopists in the abdominal massage group and the bed turning group was higher than that in the control group,and the differences were statistically significant.Conclusion Abdominal massage and turning over in bed as preoperative preparation methods for gastroscopy can improve the quality of gastroscopy,while abdominal massage can shorten the preparation time before gastroscopy,which is helpful for the efficient operation of digestive endoscopy center and is worthy of clinical application.

Objective To investigate the best evidence application of exercise prescription in patients with chronic heart failure in clinical practice and evaluate its effectiveness.Methods The best evidence of exercise prescription for patients with chronic heart failure was summarized,and the evidence-based practice plan was developed,and it was implemented in the cardiology department of a tertiary hospital in Zhejiang Province from August to October,2022.Nurses'exercise prescription knowledge-attitude-practice level,implementation rate of review indicators,the length of hospital stay,exercise endurance,daily living ability and grip strength of both groups before and after the intervention were compared.Results After the application of the best evidence,the score of knowledge dimension was(9.34±0.98)points;the score of attitude dimension was(63.29±1.37)points;the score of practice dimension was(25.49±1.51)points,which were statistically significant compared with the scores before the application of evidence(P<0.05).After the application of the best evidence,the implementation rate of 16 review indicators was higher than that before the application of evidence(P<0.001).The length of hospital stay in the evidence application group was shorter than that in the baseline examination group(Z=-2.610,P<0.001).After intervention,the exercise endurance,daily living ability and grip strength of patients in the evidence application group were improved compared with the baseline review group,and the difference was statistically significant(P<0.05).Conclusion After the application of the best evidence of exercise prescription in patients with chronic heart failure,it can improve the level of knowledge,attitude and practice of nurses on exercise prescription,standardize the compliance of nurses'exercise prescription,reduce the number of days in the hospital,and improve patients'exercise endurance,daily living ability and grip strength.

Objective:To evaluate the role of glutathione S-transferase μ1 (GSTM1) expression in mild hypothermia-induced mitigation of cerebral ischemia-reperfusion (I/R) injury and the relationship with microglial polarization.Methods:Eighty clean-grade healthy male Sprague-Dawley rats, aged 8 weeks, weighing 260-280 g, were divided into 4 groups ( n=20 each) using a random number table method: sham operation group (S group), cerebral I/R group (I/R group), mild hypothermia group (H group), and GSTM1 inhibitor + mild hypothermia group (IH group). The rat model of cerebral I/R injury was prepared using the filament occlusion method. The filament was removed to restore blood flow after the left middle cerebral artery was blocked for 2 h, and the rats′ brain and rectal temperature were maintained at 36-37 ℃ during the period. The vessels were only isolated and ligated without occlusion in S group. In H group, the entire body was wiped with 75% ethanol immediately after removing the filament, and the brain and rectal temperatures were maintained at 32-33 ℃ for 3 h, and the other procedures were the same as those previously described in I/R group. In IH group, GSTM1 inhibitor itaconic acid 8.6 mg/kg was intraperitoneally injected at 24 and 1 h before developing the model, and the other procedures were the same as those previously described in H group. Neurological deficits were evaluated using a modified neurological severity score (mNSS) at 24 h of reperfusion, and then the animals were sacrificed and the brains were removed for observation of cerebral infarction (by TTC staining) and for determination of the expression of GSTM1, M1-type microglial marker inducible nitric oxide synthase (iNOS), and M2-type microglial marker arginase-1 (Arg-1) (by Western blot), expression of GSTM1, iNOS and Arg-1 mRNA (quantitative real-time polymerase chain reaction) and contents of interleukin-6 (IL-6), IL-10, tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) (by enzyme-linked immunosorbent assay). Results:Compared with S group, the mNSS and percentage of cerebral infarct size were significantly increased, and the expression of iNOS and Arg-1 protein and mRNA was up-regulated, the expression of GSTM1 and mRNA was down-regulated, and the contents of IL-6, TNF-α, IL-10 and TGF-β were increased in the other three groups ( P<0.05). Compared with I/R group and IH group, the mNSS and percentage of cerebral infarct size were significantly decreased, and the expression of iNOS protein and mRNA was down-regulated, the expression of Arg-1 protein and mRNA and GSTM1 was up-regulated, the contents of TNF-α and IL-6 were decreased, and the contents of TGF-β and IL-10 were increased in H group ( P<0.05). Conclusions:Up-regulated expression of GSTM1 is involved in mild hypothermia-induced mitigation of cerebral I/R injury, which is associated with inhibition of microglial polarization toward the M1 phenotype and promotion of polarization toward the M2 phenotype.

AIM:To explore whether down-regulation of peroxisome proliferator-activated receptor γ coactivator (PGC)-1α induces podocyte apoptosis and its mechanism.METHODS:The podocytes were cultured under high glucose (HG) condition and the cell apoptosis was analyzed by flow cytometry.The methods of real-time PCR and Western blot were used to analyze the mRNA and protein expression of related molecules in the control, HG-treated or siRNA-treated podocytes.RESULTS:The expression PGC-1α at mRNA and protein levels was significantly decreased in HG-injured podocytes.Down-regulation of PGC-1α expression in vitro by siRNA resulted in podocyte apoptosis.The nuclear protein expression of nuclear factor of activated T-cells (NFAT) was significantly increased in HG injured podocytes, indicating the NFAT activation.Down-regulation of PGC-1α expression also decreased the nuclear protein expression of NFAT.Moreover, silencing of NFAT expression by siRNA significantly abolished PGC-1α deficiency-induced podocyte apoptosis.CONCLUSION: Down-regulation of PGC-1α induces podocyte apoptosis.NFAT mediates PGC-1α deficiency-induced podocyte apoptosis.

Objective To explore the intervention effect of evidence-based nursing on the health behavior of elderly hypertensive patients in the community.Methods 187 elderly hypertensive patients who were hospitalized in December 2015 and met the inclusive criteria were divided into observation group (n=93) and control group (n=94).The observation group received evidence-based nursing according to the evidence-based medical system evaluation while the control group was given regular nursing both for 6 months.The clinical efficacy of two nursing modes was observed and the differences between pre-intervention and pose-intervention and groups were recorded and analyzed with a self-designed questionnaire, drug compliance questionnaire and health behavior scale.Results In the observation group, the blood pressure was effectively controlled or reduced, treatment compliance was significantly increased and body mass index (BMI) was within the ideal range 6 months later.Scores of unhealthy behaviors such as those in living habits and mental stress were lower than those in the control group, which showed significant difference (P<0.05).There was no significant difference in activity participation between the two groups (P>0.05).Conclusion Evidence-based nursing intervention can effectively control the hypertension, improve the treatment compliance of the community elderly hypertension patients and help lead them to a more positive and healthier life style.

Objective To investigate auricle index difference in Henan residents,and to provide an additional reference for otoplasty.Methods Subjects were made up 266 healthy young of Henan residents.Their height,weight,total head height,maximum head length,maximum head breadth,vertex to tragion height,physiognomic ear breadth,morphological ear breadth,physiognomic ear length and morphological ear length were measured and calculated.All the data were analyzed by SPSS 15.0 software.Results We obtained the means,standard deviation of each items,and data were treated statistically.Height (162.9±4.1) cm,weight (55.3±6.5) kg,total head height (18.6±1.0) cm,maximum head length (17.0±0.7) cm,maximum head breadth (14.1±0.8) cm,vertex to tragion height (11.9±0.7) cm,physiognomic ear length (6.2±0.4) cm,morphological ear breadth (4.9±0.6) cm,physiognomic ear breadth (3.3±0.3) cm and morphological ear length (2.9±0.3) cm were determined.The differences among the indices mentioned above were of statistical significance (P＜0.05);the indices of female subjects of different height were significantly different (P＜0.05);the indices of female subjects of different weight were also statistically different (P＜0.05).The auricle index subjects of different height and weight were of no stistical difference.(P＞0.05).Conclusions Subjects of different height and weight have different total head height;hence,the indices are related to body height and weight.Subjects of different height have different vertex to tragion height,length-height index of the head and breadth-height index of the head.This study has certain reference values on analyzing the characteristics of the human and auricle cosmetology of henan young females.