Objective To explore the serum placental growth factor (PlGF) and triggering receptors expressed on myeloid cell-1 (TREM1)levels in patients with diabetes foot,and the correlation between them and clinical grading and prognosis of patients. Methods From January 2021 to January 2023,97 patients with diabetes foot who were admitted to Affiliated Hospital of Guilin Medical University were collected as the study object (diabetes foot group),and 102 healthy people who were examined in the hospital were collected as the healthy control group. The patients with diabetic foot were categorized into 33 cases of grade 0～1,39 cases of grade 2～3,and 25 cases of grade 4～5 according to Wanger grading criteria. Patients with diabetes foot were followed up for 6 months and divided into good prognosis group (n=72) and poor prognosis group (n=25).Serum PlGF and TREM1 levels were compared between groups. Spearman correlation analysis was applied to explore the correlation between serum PlGF and TREM1 levels and clinical grading in patients,factors influencing the prognosis of patients with diabetic foot was analyzed by Logistic regression . Receiver operating characteristic (ROC) curve was applied to investigate the predictive effect of serum PlGF and TREM1 on the prognosis of patients with diabetes foot. Results The expression level of serum PlGF in the diabetes foot group was lower than that in the healthy control group (53.86±15.13 pg/ml vs 87.57±18.28 pg/ml),and the level of TREM1 was significantly higher than that in the healthy control group (279.56±32.25 ng/L vs 195.37±26.28 ng/L),and the difference was statistically significance (t=14.133,20.232,all P<0.05).Serum PlGF expression (39.41±13.28 pg/ml vs 66.13±16.30 pg/ml,52.75±15.32 pg/ml) was lower in patients with clinical grades 4～5 than in patients with grades 0～1 and 2～3. TREM1 expression (326.66±35.75 ng/L vs 248.21±29.83 ng/L,275.89±32.06 ng/L) was higher than in patients with grades 0～1 and 2～3. Serum PlGF expression was lower in patients with clinical grades 2～3 than in patients with grades 0～1. TREM1 expression was higher than in patients with grades 0～1,and the differences were statistically significant (q=5.120～12.945,all P<0.05).Spearman correlation analysis,the serum PlGF expression level in diabetes foot patients was negatively correlated with their clinical grading (r=-0.696,P<0.001) and the TREM1 expression level was positively correlated with their clinical grading (r=0.657,P<0.001).Multivariate Logistic regression anaalysis,PlGF was an independent protective factor[OR(95％CI):0.725(0.531～0.990)]and TREM1 was an independent risk factor[OR(95％CI):2.308(1.284～4.147)]affecting the prognosis of diabetic foot patients.The AUC(95％CI) of PlGF,TREM1 levels and their combination to predict the prognosis of diabetes foot patients was 0.898(0.820～0.950),0.817(0.725～0.888)and 0.949 (0.885～0.984),respectively. The clinical efficacy of the combination of the two in predicting the poor prognosis of patients with diabetes foot was better than that of serum PlGF and TREM1 alone (Z=2.150,2.713,P=0.032,0.007). Conclusion The expression of PlGF in serum of patients with diabetes foot is significantly reduced,and the expression of TREM1 is significantly increased. Both of them are closely related to the clinical grading of patients,and they have good clinical efficacy in predicting prognosis.

Objective To investigate the risk factors and intervention measures for surgical site infec-tion following posterolateral approach lumbar fusion surgery.Methods A total of 1 078 patients who under-went posterolateral approach lumbar fusion surgery in the department of spine surgery from January 1,2022 to December 31,2023 were included.Patient related information was collected through the real-time nosocomi-al infection monitoring system,while medical visit information was obtained via the outpatient electronic med-ical record system.Multivariate logistic regression analysis was performed to identify risk factors for surgical site infection.Results Among the 1 078 patients,34 cases(3.15%)developed surgical site infections,while 1 044 cases did not.Multivariate logistic regression analysis revealed that age,smoking,hypertension,diabetes,concurrent hospital stay,operative time,duration of postoperative antimicrobial use after initial surgery,and total antimicrobial use duration were significant risk factors for surgical site infection(P＜0.05).Among the 34 infected patients,the duration of antimicrobial use varied significantly across different infection sites(P＜0.05),with the longest duration observed in patients with deep space infections.Conclusion Targeted surveil-lance of surgical site infections should be reinforced based on these risk factors.Perioperative infection control measures must be strictly implemented to improve the scientific,precise,and standardized management of sur-gical-related nosocomial infections.

Objective To explore the serum placental growth factor (PlGF) and triggering receptors expressed on myeloid cell-1 (TREM1)levels in patients with diabetes foot,and the correlation between them and clinical grading and prognosis of patients. Methods From January 2021 to January 2023,97 patients with diabetes foot who were admitted to Affiliated Hospital of Guilin Medical University were collected as the study object (diabetes foot group),and 102 healthy people who were examined in the hospital were collected as the healthy control group. The patients with diabetic foot were categorized into 33 cases of grade 0～1,39 cases of grade 2～3,and 25 cases of grade 4～5 according to Wanger grading criteria. Patients with diabetes foot were followed up for 6 months and divided into good prognosis group (n=72) and poor prognosis group (n=25).Serum PlGF and TREM1 levels were compared between groups. Spearman correlation analysis was applied to explore the correlation between serum PlGF and TREM1 levels and clinical grading in patients,factors influencing the prognosis of patients with diabetic foot was analyzed by Logistic regression . Receiver operating characteristic (ROC) curve was applied to investigate the predictive effect of serum PlGF and TREM1 on the prognosis of patients with diabetes foot. Results The expression level of serum PlGF in the diabetes foot group was lower than that in the healthy control group (53.86±15.13 pg/ml vs 87.57±18.28 pg/ml),and the level of TREM1 was significantly higher than that in the healthy control group (279.56±32.25 ng/L vs 195.37±26.28 ng/L),and the difference was statistically significance (t=14.133,20.232,all P<0.05).Serum PlGF expression (39.41±13.28 pg/ml vs 66.13±16.30 pg/ml,52.75±15.32 pg/ml) was lower in patients with clinical grades 4～5 than in patients with grades 0～1 and 2～3. TREM1 expression (326.66±35.75 ng/L vs 248.21±29.83 ng/L,275.89±32.06 ng/L) was higher than in patients with grades 0～1 and 2～3. Serum PlGF expression was lower in patients with clinical grades 2～3 than in patients with grades 0～1. TREM1 expression was higher than in patients with grades 0～1,and the differences were statistically significant (q=5.120～12.945,all P<0.05).Spearman correlation analysis,the serum PlGF expression level in diabetes foot patients was negatively correlated with their clinical grading (r=-0.696,P<0.001) and the TREM1 expression level was positively correlated with their clinical grading (r=0.657,P<0.001).Multivariate Logistic regression anaalysis,PlGF was an independent protective factor[OR(95％CI):0.725(0.531～0.990)]and TREM1 was an independent risk factor[OR(95％CI):2.308(1.284～4.147)]affecting the prognosis of diabetic foot patients.The AUC(95％CI) of PlGF,TREM1 levels and their combination to predict the prognosis of diabetes foot patients was 0.898(0.820～0.950),0.817(0.725～0.888)and 0.949 (0.885～0.984),respectively. The clinical efficacy of the combination of the two in predicting the poor prognosis of patients with diabetes foot was better than that of serum PlGF and TREM1 alone (Z=2.150,2.713,P=0.032,0.007). Conclusion The expression of PlGF in serum of patients with diabetes foot is significantly reduced,and the expression of TREM1 is significantly increased. Both of them are closely related to the clinical grading of patients,and they have good clinical efficacy in predicting prognosis.

Rheumatoid arthritis (RA) is an autoimmune disease with a complex etiology. Monocyte-derived macrophages (MDMs) infiltration are associated with RA severity. We have reported the deletion of G-protein-coupled receptor kinase 2 (GRK2) reprograms macrophages toward an anti-inflammatory phenotype by recovering G-protein-coupled receptor signaling. However, as more GRK2-interacting proteins were discovered, the GRK2 interactome mechanisms in RA have been understudied. Thus, in the collagen-induced arthritis mouse model, we performed genetic GRK2 deletion using GRK2^f/fLyz2-Cre^+/- mice. Synovial inflammation and M1 polarization were improved in GRK2^f/fLyz2-Cre^+/- mice. Supporting experiments with RNA-seq and dual-luciferase reporter assays identified peroxisome proliferator-activated receptor γ (PPARγ) as a new GRK2-interacting protein. We further confirmed that fms-related tyrosine kinase 1 (Flt-1), which promoted macrophage migration to induce angiogenesis, was inhibited by GRK2-PPARγ signaling. Mechanistically, excess GRK2 membrane recruitment in CIA MDMs reduced the activation of PPARγ ligand-binding domain and enhanced Flt-1 transcription. Furthermore, the treatment of mice with GRK2 activity inhibitor resulted in significantly diminished CIA pathology, Flt-1⁺ macrophages induced-synovial inflammation, and angiogenesis. Altogether, we anticipate to facilitate the elucidation of previously unappreciated details of GRK2-specific intracellular signaling. Targeting GRK2 activity is a viable strategy to inhibit MDMs infiltration, affording a distinct way to control joint inflammation and angiogenesis of RA.

Postprandial hypotension is an abnormal regulation of blood pressure, which is common in the elderly. Due to insidious symptoms, postprandial hypotension is easily neglected by patients and medical staff in clinical practice, but it has a high degree of harm. There are many factors related to the occurrence of postprandial hypotension, including demographic factors, disease-related factors, lifestyle factors, postprandial postural factors and so on. Among demographic factors, age is positively associated with the occurrence of postprandial hypotension. Among disease-related factors, the existence of some basic diseases such as hypertension and diabetes, and the use of most kinds of anti-hypertensive drugs can increase the risk of postprandial hypotension. Among lifestyle factors, smoking is a risk factor for postprandial hypotension: while reducing the intake of staple foods, drinking large amounts of water or drinking green tea before meals may reduce the risk of postprandial hypotension. By taking different postures after meals, postural factors affect the rate of gastrointestinal emptying and then affect the occurrence of postprandial hypotension. Among the above factors, it is feasible to prevent postprandial hypotension by changing postprandial posture.

Objective:To investigate the effect of virtual-simulation laparoscopic training system in the training of basic skills of endoscopic surgery in trainees with different clinical experience.Method:s Eight refresher physicians, eight residents who received standardized residency training, and eight undergraduate interns in five-year clinical medicine were selected. All of them received the training of endoscopic operations with the laparoscopic training box and the virtual-simulation laparoscopic training system for 30 minutes every day for 4 weeks. Data analyses were performed using SPSS 19.0 and t-test was adopted to compare the scores before and after training among the three groups.Result:s Before training, there were significant differences in endoscopic operations between the undergraduate intern group and the other two groups ( P<0.05); after 4 weeks of training, all three groups had significant increases in the scores and spent less time on training items ( P<0.05). There was no significant difference in simple operations among the three groups ( P>0.05), and the undergraduate intern group had a significantly higher score of complex operations than did the standardized residency training group and the refresher physician group ( P<0.05). Conclusion:The virtual-simulation laparoscopic training system can improve the laparoscopic skills of clinical trainees at different levels, therefore, it is worth being promoted in the teaching of clinical skills.

Objective: To show development status of postprandial hypotension studies comprehensively and intuitively in order to provide a reference for nursing research on postprandial hypotension. Methods: The data was from the literatures included in Web of Science database from 1986 to 2019 related to postprandial hypotension, and CiteSpace information visualization software was used to analyze the issuing country and institution, cited authors, Cited journals, keywords and cited references to postprandial hypotension. Results: A total of 1 140 literatures were obtained. 187 papers were finally included after screening. University of Adelaide in Australia has the most of published articles and the most of cited authors; The cited journals mainly include international high-impact journals such as Annals of Internal Medicine and Journal of the American Geriatrics Society. Through keywords clustering, a total of 5 research hotspots were obtained, including falls, insulin, autonomic nervous system, aged cared, gastrointestinal. Conclusions Postprandial hypotension is one of the convergence points of interdisciplinary fusion. At present, preliminary results have been obtained, but the research on its mechanism is still in the exploratory stage. Falls, insulin, autonomic nervous system, aged cared, gastrointestinal are currently the main focus of postprandial hypotension researches. The prevention of postprandial hypotension has made some achievements, but there are also some risks. It is necessary to conduct further studies on more convenient and safe measures to prevent postprandial hypotension.

Objective To determine the triterpenoid content in Loquat leaf by using HPLC method and to explore the feasibility of ursolic acid and oleanolic acid as the quantitative markers for determination of Loquat leaf and its preparations.Methods Two desugaring methods of Loquat leaf extracts were compared.The contents of ursolic acid and oleanolic acid in Loquat leaf as well as preparations were measured based on a system of HPLC,with a Dumas Diamonsil C18 column (250 mm×4.6 mm,5 μm) was used as analytical column.The mobile phase was consisted of acetonitrile-0.1% phosphoric acid (95∶5) with the flow rate of 0.5 mL·min-1.The column temperature was 30 ℃,the injection volume was 10 μL, the detective wavelength was 210 nm.Results Ursolic acid and oleanolic acid were measured in both Loquat leaf and its preparations,and their contents were fairy stable and comparable.Conclusion Ursolic acid and oleanolic acid can be served as quantitative markers for the determination of Loquat leaf and its preparations.

Objective To explore the effect of nursing support on negative emotion and quality of life in patients with brain tumor. Methods A total of 139 cases of brain tumor in Shandong Provincial Cancer Hospital of Shandong University from September 2014 to February 2016 by convenient sampling , according to the random number table, they were divided into the control group and the intervention group. The patients in the control group were given routine discharge follow-up, while the patients in the intervention group were given emote team nursing support on the basis of the control group. We used anxiety self rating scale (SAS), depression self rating scale (SDS) and quality of life assessment scale (QLICP-BN) evaluation two groups of patients with anxiety, depression and quality of life level in the patients when they were discharged from hospital and discharged after 1 month, 3 months. Results Comparing the two groups of patients with anxiety and depression level and quality of life in the hospital, there was no statistically significant difference (t=0.187,0.174, P > 0.05);1 month after discharge, the scores of SAS and SDS respectively (62.97 ± 485), (63.83 ± 5.24) points in the intervention group, the scores of SAS and SDS respectively (64.58 ± 5.15), (65.17 ± 5.11) points in the control group, the difference is statistically significant (t=2.753, 2.321, P<0.05);3 month after discharge, the scores of SAS and SDS respectively(61.04±4.13),(62.25±3.95)points in the intervention group, the scores of SAS and SDS respectively(63.91 ± 4.73),(64.83 ± 4.29)points in the control group, the difference is statistically significant (t=4.621,5.196, P < 0.01); 1month, 3 months after discharge, the total quality of life scores respectively (65.28 ± 12.53), (68.71 ± 12.78) points in the intervention group, the total quality of life scores respectively (62.07 ± 11.27), (63.86 ± 12.13) points in the control group, the difference is statistically significant (t=2.439, 3.803, P < 0.01). The intervention effects and time effects of anxiety, depression and quality of life were statistically significant (W Mauchly's were 0.823, 0.782, 0.757, P <0.05). Conclusions Remote team nursing support can effectively reduce the negative emotions of patients with brain tumor, improve the quality of life, can be used in the department to promote the quality of clinical care.