Objective To explore the neuro-protective effect of remimazolam(Rem)on traumatic brain injury(TBI)in rat models.Methods A TBI rat model was constructed.The rats were randomly divided into control group,traumatic brain injury group(TBI group),low-dose and high-dose remimazolam groups(Rem-L,Rem-H groups),and high-dose remimazolam+Jagged1 group(Rem-H+Jagged1 group),with 12 rats in each.All rats were evaluated for neurological deficits.The serum level of inflammatory factors like tumor necrosis factor α(TNF-α)and interleukin-1β(IL-1β)were detected by ELISA.HE staining microscopy was used to observe the changes of brain histopathology.The expression of glial fibrillary acidic protein(GFAP)and ionized calcium-binding adaptation molecule 1(IBA1)were detected by immunohistochemistry.Western blot was applied to detect the ex-pression of Notch,Notch 1 intracellular domain(NICD)and Hes-1 protein in the brain tissue.Results Compared with the control group,the TBI group showed a larger area of brain tissue defect and edema,with more activated glial cells and fragmented,concentrated and deeply stained neuronal nuclei,indistinct nucleoli,deeply stained cy-toplasm,and partial neuronal necrosis The neurological deficit score was higher,level of TNF-α and IL-1β and the expression of GFAP,IBA1,Notch,NICD,and Hes-1 all elevated(P＜0.05).Remazolam reduced brain tissue defect area,alleviated edema,inhibited glial cell activation and neuronal apoptosis,and reduced nerve function deficit score,the level of TNF-α and IL-1β,and the expression of GFAP,IBA1,Notch,NICD and Hes-1(P＜0.05).Jagged1 could aggravate brain tissue injury,increase neural function deficit score,levels of TNF-α and IL-1β and expressions of GFAP,IBA1,Notch,NICD and Hes-1(P＜0.05).Conclusions Remimazolam may have neuroprotective effects as shown by TBI rat models,and the underlying mechanism is potentially related to the inhibition of the Notch/Hes-1 signaling pathway.

Objective To understand the research status,hotspots and trends of Wuzhuyu Decoction;To provide reference for relevant research.Methods The literature related to Wuzhuyu Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM databases from the establishment to February 28,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,organization and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 822 articles were included,and the number of publications showed a wave upward trend;the top journals were New Chinese Medicine,Henan Traditional Chinese Medicine and Sichuan Traditional Chinese Medicine;the main research institutions were Beijing University of Chinese Medicine,China Academy of Chinese Medical Sciences and Shandong University of Traditional Chinese Medicine;a total of 566 authors were involved,and the authors with more publications included Wang Zhimin(12),Gong Muxin(9)and Bi Kaishun(5);high-frequency keywords included"headache","Shang Han Lun","TCM therapy"and so on.Conclusion Wuzhuyu Decoction is effective in treating chronic gastritis,hypertension and other primary diseases,which is a research hotspot in this field.It is a research trend in this field to explore its active components by high performance liquid chromatography and explain its action mechanism and target at the molecular level.

Objective To understand the research status,hotspots and trends of animal medicinal materials;To provide reference for future research.Methods The literature related to animal medicinal materials was retrieved from CNKI,VIP,Wanfang Data and CBM from January 1,2000 to April 30,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,institution and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 1 169 articles were included,and the overall publication quantity in this field showed a stable fluctuation trend;the top journals were Lishizhen Medicine and Materia Medica Research,China Journal of Chinese Materia Medica and Modern Chinese Medicine;the main research institutions were China Academy of Chinese Medical Sciences,Changchun University of Chinese Medicine and Chinese Academy of Medical Sciences;a total of 676 authors were involved,and the authors with more publications included Zhang Hui(22),Liu Rui(15),Lin Zhe and Ma Shuangcheng(14);high-frequency keywords included"identification","TCM resources","clinical application"and so on.Conclusion Resource survey of animal medicinal materials,standardized breeding of medicinal animals,development of alternatives to rare medicinal animal resources,and construction of quality standard system for animal medicinal materials are the research hotspots in this field.The basic research of pharmacodynamic substances of animal medicinal materials based on the integrated analysis strategies of proteomics,peptideomics and transcriptomics,and the revelation of the signaling pathways and targets of animal medicinal materials from the molecular biology level are the research trends in this field.

BACKGROUND:With the progress of minimally invasive procedures of the spine,endoscopic lumbar decompression has been widely used in the treatment of lumbar disc herniation.The indications of different endoscopic surgical approaches are different,and the decision of the specific operation plan needs to be combined with the actual situation and the choice of clinical surgeons. OBJECTIVE:To investigate the short-term effect in treatment of single-level lumbar disc herniation by percutaneous endoscopic visual trephine arthroplasty. METHODS:Ninety patients with single-level lumbar disc herniation admitted to Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021 who met the inclusion criteria were included in this study.According to different approaches of percutaneous endoscopic visual trephine arthroplasty,they were divided into transforaminal approach group(control group,n=48 cases)and translaminar approach group(trial group,n=42 cases).The general information of patients in the two groups was recorded,including sex,age,disease course,body mass index,incision length,operation time,intraoperative fluoroscopy times,length of hospital stay,and amount of blood loss.Visual analog scale score of pain and Japanese Orthopaedic Association score at different follow-up stages were assessed.The modified MacNab standard was used to evaluate the clinical outcome at the last follow-up,and the postoperative complications and recurrence rate were measured. RESULTS AND CONCLUSION:(1)The operation time and intraoperative fluoroscopy times of the trial group were less than those of the control group,and the difference was statistically significant(P<0.05).However,there were no significant differences in intraoperative blood loss,incision length,and hospital stay between the two groups(P>0.05).(2)There was no significant difference in visual analog scale score of pain and Japanese Orthopaedic Association score between the two groups before surgery(P>0.05).However,visual analog scale of pain and Japanese Orthopaedic Association score were significantly improved 1 week,3,6,and 12 months after surgery(P<0.05).(3)At the last follow-up,the good and good rate of modified MacNab standard was 94%in the control group and 95%in the trial group.(4)In the control group,one patient still felt back and leg pain after surgery,underwent open surgery,and recovered well after surgery without obvious sequelae.There were no postoperative complications or recurrent cases in the trial group.(5)It is concluded that both percutaneous transforaminal approach and interlaminar approach have good short-term clinical efficacy and high patient satisfaction in the treatment of single-level lumbar disc herniation,but the time of the interlaminar approach is shorter and has less intraoperative fluoroscopy times.

Objective:To investigate the mediating effect of spiritual health between emotional intelligence and humanistic care ability of nursing undergraduates, and to provide reference for cultivating humanistic care ability of nursing undergraduates.Methods:From May to July, 2023, the nursing undergraduates from Hunan University of Traditional Chinese Medicine, Hunan Normal University, Xi'an Medical College were selected as the research objects by convenient sampling method, and they were investigated by general information questionnaire, spiritual health scale, emotional intelligence scale and humanistic care ability scale.Using AMOS 29.0 to construct a structural equation model, this paper explored the mediating effect of spiritual health between emotional intelligence and humanistic care ability of nursing undergraduates.Results:Finally, 1 126 valid questionnaires were collected. Among 1 126 nursing undergraduates, there were 229 males and 897 females. The total scores of spiritual health, emotional intelligence and humanistic care ability of nursing undergraduates were (90.60 ± 11.02), (126.01 ± 11.90), (174.27 ± 15.16) points, respectively. The humanistic care ability of nursing undergraduates was positively correlated with spiritual health and emotional intelligence ( r=0.441, 0.417; both P<0.01), emotional intelligence and spiritual health were positively correlated ( r=0.397, P<0.01). Spiritual health had some mediating effects between emotional intelligence and humanistic care ability, and the amount of mediating effects was 32.24%. Conclusions:The humanistic care ability of nursing undergraduates is at a medium level, and emotional intelligence can influence humanistic care ability through spiritual health. Therefore, it is suggested that nursing educators should add courses and practical activities related to spiritual health in the training plan of nursing students to promote their emotional intelligence and humanistic care ability.

Objective:To systematically evaluate the hospice care needs of end-stage AIDS patients.Methods:Qualitative research on the hospice care needs of end-stage AIDS patients was electronically searched on China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, PubMed, Cochrane Library, PsychINFO, Web of Science, Embase, and so on. The search period was from database establishment to November 20, 2023. Quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center was used to evaluate the quality of literature. The Meta-synthesis method was used to integrate the results.Results:A total of 14 articles were included. Sixty-nine results were extracted and classified into six categories, resulting in five integrated results, including personalized support and care needs, psychological counseling and dignity maintenance, social assistance, spiritual sustenance, and information and decision-making needs.Conclusions:The end-stage AIDS patients have multi-dimensional needs for hospice care. Hospital and community staff should pay attention to the hospice care needs of end-stage AIDS patients and provide adequate care for patients.

Objective:To systematically evaluate the hospice care needs of end-stage AIDS patients.Methods:Qualitative research on the hospice care needs of end-stage AIDS patients was electronically searched on China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, PubMed, Cochrane Library, PsychINFO, Web of Science, Embase, and so on. The search period was from database establishment to November 20, 2023. Quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center was used to evaluate the quality of literature. The Meta-synthesis method was used to integrate the results.Results:A total of 14 articles were included. Sixty-nine results were extracted and classified into six categories, resulting in five integrated results, including personalized support and care needs, psychological counseling and dignity maintenance, social assistance, spiritual sustenance, and information and decision-making needs.Conclusions:The end-stage AIDS patients have multi-dimensional needs for hospice care. Hospital and community staff should pay attention to the hospice care needs of end-stage AIDS patients and provide adequate care for patients.

Objective:To construct the evaluation index system of "early clinical contact" education of undergraduate medical students, and to provide guidance for the evaluation of "early clinical contact" education in medical teaching.Methods:The evaluation index system of "early clinical contact" education of undergraduate medical students was constructed by literature research, Delphi expert consultation and analytic hierarchy process, and the weight of each index was determined. Excel 2010 and SPSS 25.0 were used to make data entry and statistical analysis.Results:The enthusiasm of experts in the two rounds of expert consultation were 100.00%(26/26) and 96.15%(25/26) respectively, the expert authority coefficients were 0.900 and 0.920, and the coordination coefficients were 0.255 and 0.175 respectively ( P < 0.05). The evaluation index system included 4 first-class indexes, 12 second-class indexes and 47 third-class indexes. Conclusion:The index system has high scientificity and reliability. After further verification, it can be used as an evaluation tool for the teaching quality of "early clinical contact" education of undergraduate medical students.

Objective:To investigate the clinical value of Octreotide plus Ulinastatin in the treatment of severe acute pancreatitis(SAP)in elderly patients.Methods:From May 2016 to February 2019, 124 elderly SAP patients admitted to the gastroenterology department of our hospital were enrolled and divided into the combination therapy group and the control group, with 62 patients in each group.The combination therapy group was treated with Octreotide and Ulinastatin, while the control group was treated with Octreotide alone.Serum leukocyte count, C-reactive protein(CRP), interleukin(IL)-6, tumor necrosis factor(TNF)-α and amylase levels were monitored before and 1, 3, 5, 7 and 14 days after treatment by automated biochemical analysis and enzyme-linked immunosorbent assays.The pain grade scale, APACHE-Ⅱ score and efficacy evaluation were analyzed for the two groups 7 days after treatment.The time to oral refeeding and length of hospitalization were compared between the two groups, and related complications during the treatment were recorded.Complications and the recurrence of pancreatitis within 1 year were followed up in both groups.Results:There was no statistically significant difference in serum white blood cell count, CRP, amylase, IL-6 and TNF-α levels between the two groups before treatment(all P>0.05). Serum white blood cell count, CRP and TNF-α levels had significant differences( t=3.735, 2.851 and -2.147, P=0.036, 0.029 and 0.043)and serum amylase and IL-6 levels had no significant difference( P>0.05)between the two groups 3 days after treatment.All the above parameters had significant differences between the two groups 7 days after treatment( t=3.624, 2.918, -2.166, 2.684 and -2.593, P=0.023, 0.011, <0.001, 0.015 and <0.001). Serum amylase, IL-6 and TNF-α levels had significant differences( t=-3.515, 4.627 and -3.189, all P<0.001)and serum white blood cell count and CRP had no significant difference(all P>0.05)between the two groups 14 days after treatment.There were significant differences in visual analogue scale(VAS)and APACHE-Ⅱ score between the two groups 7 days after treatment( t=-2.346 and -3.245, P=0.021 and 0.002). On the 7th day after treatment, the effectiveness rate was 79.0%(49/62)in the combination therapy group and 61.3%(38/62)in the control group, with a significant difference between the two groups( χ2=4.661, P=0.031). Compared with the control group, time to oral refeeding and hospitalization length were shorter in the combination therapy group than in the control group(6.72±1.87 d vs.7.65±1.69 d, 11.23±2.98 d vs.13.85±3.42 d, t=-2.868 and -4.565, both P<0.05). There were significant differences in the incidences of infectious pancreatic necrosis, gastrointestinal adverse reactions and organ failure between the combination therapy group and the control group(11.3% or 7/62 vs.25.8% or 16/62, 43.5% or 27/62 vs.21.0% or 13/62, 1.6% or 1/62 vs.11.3% or 7/62, χ2=4.324, 7.233 and 4.810, P=0.038, 0.007 and 0.028). There were significant differences in mean length of time without complications and recurrence between the combined group and the control group(10.25±3.26 months vs.8.72±3.73 months, 10.69±2.51 months vs.9.62±2.92 months, Log Rank χ2=7.463 and 4.589, P=0.006 and 0.032). Conclusions:Octreotide combined with Ulinastatin can effectively alleviate local symptoms, slow clinical progression, reduce the risk of complications, decrease the recurrence rate and promote early recovery in elderly SAP patients.

Objective To summarize the experience of peri-operative emotion management of male patients with breast cancer. Methods The clinical data of 11 male patients with breast cancer were analyzed to summarize methods for the emotion management before, during and after chemo-radiotherapy. Result All the patients took a good attitude and complete the therapy after implementation of emotion management. Conclusion Peri-operative psychological management is of help for their alleviating the negative moods of helplessness, strengthening their confidence, stabilizing and improving the emotions, and finally making them cooperative in the treatment and nursing.