Objective To investigate the expression of serum microRNA(miR)-494 and miR-155 in chil-dren with Enterovirus type 71 hand-foot-mouth disease(EV71-HFMD),and to analyze the clinical significance of serum miR-494 and miR-155 in EV71-HFMD.Methods A total of 145 children with EV71-HFMD treated in this hospital from May 2021 to May 2023 were selected.According to the severity of the disease,they were divided into mild group(n=81)and severe group(n=64).In addition,73 healthy and disease-free children in the hospital were included in the health group.Serum expression levels of miR-494 and miR-155 as well as helper T cell 17(Th17),regulatory T cell(Treg)and Th17/Treg in the three groups were detected and com-pared.Pearson correlation analysis was used to analyze the correlation between the expression levels of serum miR-494,miR-155,Th17 and Treg,as well as Th17/Treg.The clinical data of children with EV71-HFMD were collected,and the factors influencing the severity of EV71-HFMD were analyzed by multivariate Logistic regression model.Results Compared with healthy group,serum miR-494,miR-155,Th17 and Th17/Treg in mild and severe groups were increased,and Treg were decreased(P＜0.05).Compared with mild group,ser-um miR-494,miR-155,Th17 and Th17/Treg in severe group were increased,and Treg was decreased(P＜0.05).Pearson correlation analysis showed that Th17 and Th17/Treg were positively correlated with the ex-pression levels of serum miR-494 and miR-155,while Treg was negatively correlated with the expression lev-els of serum miR-494 and miR-155(P＜0.05).The peak temperature,duration of fever ≥3 d proportion and eruption of isthmus in severe group were higher than those in mild group(P＜0.05).Multivariate Logistic re-gression results showed that the duration of fever ≥3 d,eruption in the isthmus,the high expression level of miR-494 and the high expression level of miR-155 were risk factors for severe EV71-HFMD(P＜0.05).Conclusion Se-rum miR-494 and miR-155 are abnormally elevated in children with EV71-HFMD,and the changes in their levels are closely related to Th17/Treg imbalance.Increased expression levels of serum miR-494 and miR-155 are risk factors for severe EV71-HFMD.

Objective To observe the effect of Shenfu injection on lung injury caused by hemor-rhagic shock(HS)in rats and explore the related potential mechanism.Methods Thirty-six SPF healthy male SD rats,aged 16-17 weeks,weighing 400-600 g,were randomly divided into three groups:sham op-eration group(group SH),HS group(group HS),and Shenfu injection group(group SF),12 rats in each group.In group SH,only the right femoral vein and femoral artery were separated after anesthesia,and ve-nous catheterization was not performed.HS model was established in groups SF and HS.In group HS,liquid resuscitation was performed through an intravenous catheter,and the resuscitation fluid consisted of the auto-blood lost and the compound sodium chloride injection equivalent to 1.5 times the blood loss and 10 ml/kg normal saline.In group SF,the resuscitation fluid consisted of the lost autoblood and the compound sodium chloride injection equivalent to 1.5 times the blood loss and Shenfu injection 10 ml/kg.The whole perfusion time was about 60 minutes.Six rats in the three groups were randomly anesthetized 24 and 48 hours after op-eration.The wet/dry weight ratio(W/D)of lung tissues was detected.The concentrations of interleukin-6(IL-6),IL-17,IL-10,and transforming growth factor-β(TGF-β)were detected by ELISA,the mRNA ex-pression of retinoic acid-related orphan nuclear receptor γt(RORγt),transcription factor forkhead box pro-tein 3(Foxp3),and hypoxia-inducible factor-1α(HIF-1α)in lung tissues were detected by PCR.The pro-tein contents of RORγt,Foxp3,HIF-1α,aquaporin 1(AQP1),and AQP5 in lung tissue were detected by Western blot.Pathological changesunder HE staining light microscope and lung injury scores were observed.Results Compared with 24 hours after operation,W/D,the concentrations of IL-6 and IL-17,mRNA ex-pression and protein content of RORγt and HIF-1α,and lung injury score were significantly decreased(P＜0.05),the concentrations of IL-10,and TGF-β,Foxp3 mRNA expression and protein content,and AQP1 protein content were significantly increased in group SF 48 hours after operation(P＜0.05).Compared with group SH,W/D,the concentrations of IL-6,IL-17,IL-10,and TGF-β,mRNA expression and protein content of RORγt,Foxp 3,and HIF-1α,and lung injury score were significantly increased(P＜0.05),AQP1 and AQP5 protein contents were significantly decreased in groups HS and SF 24 and 48 hours after operation(P＜0.05),and alveolar structure was damaged under light microscope and alveolar interstitium was filled with a large amount of edematous fluid,during which a large number of inflammatory cells infiltra-ted.Compared with group HS,W/D,the concentrations of IL-6 and IL-17,mRNA expression and protein content of RORγt and HIF-1α,and lung injury score were significantly decreased(P＜0.05),the concen-trations of IL-10 and TGF-β,Foxp3 mRNA expression and protein content,AQP1 and AQP5 protein con-tents were significantly increased in group SF 24 and 48 hours after surgery(P＜0.05),and the alveolar structure was improved under light microscope,and edema was reduced,and the number of inflammatory cells was reduced.Conclusion Shenfu injection can regulate the balance between pro-inflammatory factors IL-6 and IL-17,and anti-inflammatory factors IL-10 and TGF-β,increase the protein content of AQP1 and AQP5 in lung tissue,and decrease the W/D and injury score in lung tissue,thus alleviating lung injury in HS rats.The mechanism may be related to the regulation of HIF-1α-RORγt/Foxp3 balance.

Objective:To explore the changes in biological characteristics of adipose-derived stem cells (ASCs) in obese patients post successful weight loss, so as to provide a reference for the clinical application of these ASCs in refractory wound repair.Methods:This study was an experimental study. Twelve obese patients (8 females and 4 males, aged (50±9) years) who underwent abdominal skin tightening surgery after successful weight loss and were admitted to the First Affiliated Hospital of Zhengzhou University from April 2021 to April 2023 were included in weight loss group, and 12 healthy volunteers (10 females and 2 males, aged (50±9) years) who underwent abdominal liposuction and facial fat grafting surgery during the same period in the same institution were included in healthy group. Adipose tissue was collected from patients in weight loss group and volunteers in healthy group, and ASCs were extracted. Experiments were conducted using ASCs at passages 4 and 5. Cell proliferation levels were assessed using the methyl thiazolyl tetrazolium assay at 0 (immediately), 24, 48, and 72 hours of culture. The cell scratch test was performed and the cell migration rates at 12 and 24 hours after scratching were calculated. The cell Transwell assay was performed and the number of migration cells at 24 hours after culture was counted. Adipogenic and osteogenic induction assays were carried out, and the adipogenic and osteogenic differentiation levels of cells were detected after 18 and 21 days of induction, respectively. Real-time fluorescence quantitative reverse transcription polymerase chain reaction was employed to measure the mRNA expressions of lipoprotein lipase (LPL), peroxisome proliferator-activated receptor gamma (PPARγ), Runt-related transcription factor 2 (Runx2), osteopontin, alkaline phosphatase (ALP), matrix metalloproteinase 9 (MMP-9), and transforming growth factor beta (TGF-β). The sample number of each experiment was 12.Results:At 0 hour of culture, the cell proliferation levels of patients in weight loss group and volunteers in healthy group were 1.022±0.056 and 1.000±0.144, respectively, with no statistically significant difference between the groups ( P>0.05). At 24, 48, and 72 hours of culture, the cell proliferation levels of patients in weight loss group were 1.366±0.030, 1.353±0.012, and 1.390±0.016, respectively, which were significantly lower than 1.755±0.077, 1.737±0.014, and 1.700±0.023 of volunteers in healthy group (with t values of 16.27, 71.35, and 38.56, respectively, P values all <0.05). In the cell scratch test, at 12 and 24 hours after scratching, the cell migration rates of patients in weight loss group were lower than those of volunteers in healthy group, but the differences were not statistically significant ( P>0.05). In the cell Transwell assay, after 24 hours of culture, there was no statistically significant difference in the number of migrated cells between patients in weight loss group and volunteers in healthy group ( P>0.05). After 18 days of adipogenic induction, the cell adipogenic differentiation level of patients in weight loss group was significantly lower than that of volunteers in healthy group ( t=27.81, P<0.05). After 21 days of osteogenic induction, the cell osteogenic differentiation level of patients in weight loss group was significantly lower than that of volunteers in healthy group ( t=14.85, P<0.05). Compared with those of volunteers in healthy group, the mRNA expressions of LPL, PPARγ, TGF-β, and Runx2 of patients in weight loss group were significantly reduced (with t values of 59.48, 146.10, 46.10, and 3.13, respectively, P<0.05), while there were no statistically significant changes in the mRNA expressions of osteopontin, ALP, or MMP-9 ( P>0.05). Conclusions:Compared with healthy volunteers, the proliferative capacity of ASCs in obese patients after successful weight loss is significantly diminished, the differentiation potential is relatively weak, and the expression levels of some genes corresponding to adipogenic and osteogenic differentiation are decreased, which may affect the therapeutic efficacy of these ASCs in treating refractory wounds caused by burns, diabetes, or radiation injuries. Therefore, the donor differences of ASCs need to be considered in clinical application.

Objective:To retrieve the evidence on rehabilitation functional exercise for total knee arthroplasty (TKA) patients both domestically and internationally, and summarize the best evidence to provide a basis for constructing a management plan of rehabilitation functional exercise for TKA patients.Methods:Using population, intervention, professional, outcome, setting and type of evidence (PIPOST) to construct evidence-based nursing issues, all evidence on rehabilitation functional exercise for TKA patients was searched through computers in the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia, British Medical Journal (BMJ) Best Practice, Embase, UpToDate, Web of Science, Cochrane Library, PubMed, American College of Sports Medicine, National Institute for Health and Clinical Excellence, China National Knowledge Infrastructure, WanFang Data and China Biomedical Literature Database. The Chinese and English search terms were "knee replacement/knee arthroplasty" and "functional training/exercise/strength training/early mobilization/recovery/ rehabilitation". The types of literature included guidelines, systematic reviews, summary of evidence, expert consensus, clinical decision-making, and randomized controlled trials (RCTs) . The search period was from the establishment of the database to January 10, 2023. Two researchers trained in evidence-based nursing independently completed the literature quality evaluation, and combined with professional judgment, extracted and summarized evidence for literature that met quality standards.Results:A total of 11 articles were included, including 4 guidelines, 4 systematic reviews, 2 RCTs, and 1 clinical decision-making. A total of 26 best evidence pieces were summarized from 5 aspects, namely multidisciplinary organizational management, pre-rehabilitation exercise, rehabilitation functional exercise plan, continuous function exercise, and exercise compliance.Conclusions:The best evidence summarized regarding rehabilitation functional exercise for TKA patients can provide a basis for medical and nursing staff to develop management plans. Medical and nursing staff need to consider clinical practice, patient's own condition, and willingness when applying evidence, and develop targeted rehabilitation functional exercise plans.

Objective:To explore the effect of family function combined with positive suggestion on self-assessment and quality of life of patients with ischemic stroke.Methods:Totally 120 patients with ischemic stroke admitted to hospital from May 2018 to May 2019 were selected by experimental research method, and they were divided into control group and observation group according to the random alphabet, with 60 cases in each, the control group was given positive suggestion, while the observation group was given family function combined positive suggestion, the Activities of Daily Life (ADL), General Self-Efficacy Scale (GSES), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), the MOS item short form Health Survey (SF-36) were compared before and after nursing and nursing satisfaction.Results:Before nursing, the ADL scores of the observation group and the control group were (34.61±4.36), (35.58±4.82) points, GSES scores were (17.94±2.48), (17.38±2.62) points, SAS scores were (61.82±6.57), (61.37±6.64) points, SDS scores were (63.71±6.65), (63.28±6.94) points respectively, and there was no significant difference between the two groups ( P> 0.05); after nursing, the ADL score of the observation group was (69.85±7.84) points, higher than (58.39±6.72) points of the control group, the GSES score was (24.25±2.69) points, higher than (20.48±2.31) points of the control group, the SAS score was (47.64±4.91) points, lower than (54.52±5.83) points of the control group, and the SDS score was (50.29±5.26) points,lower than (54.15±5.91) points of the control group ( t values were from 3.779 to 8.597, P< 0.05). There was no significant difference in SF-36 score between the two groups before nursing ( P> 0.05), and the improvement of the observation group was significantly better than that of the control group after nursing ( t values were 2.037-3.656, P< 0.05). The nursing satisfaction of the observation group was 90.00% (54/60), higher than 75.00% (45/60) of the control group ( χ2 value was 4.675, P< 0.05). Conclusion:Family function combined with positive suggestion can significantly improve the life ability and self-efficacy of patients with ischemic stroke, relieve anxiety and depression, significantly improve the quality of life, and obtain satisfactory nursing effect.

Objective: To investigate the expectations and perceptions of nurses and patients in the intensive care unit (ICU) on the quality of nursing services, and to compare and analyze the differences and similarities between the two groups. Methods: 97 nurses and 184 patients from three ICU of three hospitals in our city were selected by convenient sampling, and their nursing service quality expectation and perception questionnaire were used to investigate. Results: The expectation scores of ICU nurses and patients on the quality of nursing service were (4.31 ± 0.63) and (4.22 ± 0.62) respectively. The scores of perception were (4.05 ± 0.58) and (3.96 ± 0.70) respectively. The difference of perception expectation score between nurses and patients is negative. The score difference between nurses in Item 3, 9~12 and responsiveness was significantly higher than that of the patients. The score difference between the entry 4~7 and the reliability dimension was significantly lower than that of the patients, and the difference was statistically significant (P<0.05). Conclusions The quality of nursing service perceived by ICU patients and nurses is relatively poor, and there are differences in reliability and responsiveness between the two patients.

This study was aimed to explore the clinical mechanism of combined acupuncture and traditional Chinese medicine (TCM) in the treatment of polycystic ovarian syndrome (PCOS) and to evaluate its clinical curative effect.A total of 100 PCOS patients were randomly divided into three groups,which were group A,B and C,with 50 cases in each group.Group A was treated with ethinyl estradiol and clomiphene.Group B was treated with TCM.Group C was treated with acupuncture combined with TCM.One menstrual cycle was counted as one treatment course.There were a total of 6 treatment courses.Observation was given on menstrual condition of the patient,basal body temperature (BBT),level of sex hormones,ovulation and follicular before and after treatment.The results showed that the total effective rate of group C was 82％,which was significantly higher than that of the control group (P ＜ 0.05).The normal rate of menstruation recovery of group C was 100％,which was significantly higher than those of group A and B (P ＜ 0.05).After treatment,the biphasic rate of BBT in group C was 70％,which was significantly higher than that of the control group (P ＜ 0.05).The basal FSH (14.6±2.9) IU/L and basal E2 (53.2± 12.4) pg/ml of group C were significantly higher than those of group A and B.The basal LH (25.4±5.8) IU/L,T (1.0±0.2) μg/L of group C were significantly lower than those of group A and B (P ＜ 0.05),with statistical significance.It was concluded that acupuncture combined with TCM can be used in the treatment of PCOS by regulating menstruation,adjusting BBT,the level of sex hormone,and promoting ovulation.

This study was aimed to investigate the effect of acupuncture combined with traditional Chinese medicine (TCM) on the incidence of lipid metabolism and the incidence of hyperandrogenism in patients with polycystic ovary syndrome (PCOS).The clinical data of 85 PCOS cases in our hospital from March 2015 to August 2016 were retrospectively analyzed.There were TCM treatment group and acupuncture combined with TCM group according to the treatment method.The difference of blood lipid level,hormone level,incidence rate of hyperandrogenism and clinical symptom score before and after treatment in both groups were observed.The results showed that the incidence rate of hyperandrogenism was 2.22％ in the acupuncture combined with TCM group,which was significantly lower than TCM group (x2=7.070,P =0.008).There was no difference on blood lipid level before treatment in both groups.After treatment,levels of TC,LDL-C and TG of the acupuncture combined with TCM group were significantly lower than those of the TCM group;however,level of HDL-C was higher than that of the TCM group (t =1.817,-3.627,2.554,2.226,P ＜0.05).There was no difference on hormone levels before treatment.After treatment,hormone levels of the acupuncture combined with TCM group were significantly lower than the TCM group.Before treatment,there was no difference on TCM symptom score between both groups.After treatment,the TCM symptom score of the acupuncture combined with TCM group was significantly lower than that of the TCM group.It was concluded that acupuncture combined with TCM had a better therapeutic effect on PCOS.It can improve the blood lipid level of patients and reduce the incidence of hyperandrogenism.It had good clinical value.

Objective: To investigate the possibility of heart rate as an optimum index for evaluating physical labor intensity. Methods: From September to October, 2015, a total of 111 male young adults were selected as study subjects. A cycle ergometer was used for exercise at different intensities (20, 40, 60, 80, 100, 120, 140, 160, and 180 W) , and the exercise at each intensity lasted for 6 minutes. The subjects wore the K4b2 portable cardiopulmonary function testing instrument for the real-time monitoring of heart rate (HR) , pulmonary ventilation volume (Ve) , oxygen consumption (VO₂) , and energy metabolic rate (E) . The origin software was used for correlation and regression analyses of HR, Ve, VO₂, and E collected at different intensities to establish Ve-HR, VO₂-HR, and E-HR regression equations. Results: At different intensities, HR was positively correlated with Ve, VO₂, and E (r=0.8985, 0.8733, and 0.8973, all P<0.01) . There was a significant difference in the R² value of Ve-HR, VO₂-HR, and E-HR regression equations (R²=0.8070, 0.7625, and 0.8049, all P <0.01) . The validation results showed that there was no significant difference between the calculated values and the measured ones (P>0.05) . Conclusion HR can replace Ve, VO₂, and E and be used as an optimum index for evaluating physical labor intensity.

Objective To understand the correlation between RT-CGM at different time-window and portable blood glucose meter in the blood sugar value .Methods We observed the diabetes patients′the portable blood glucose meter:before and after meals and bedtime , as well as RT-CGM display value in different time-window:at the same time as meter blood glucose (0 minute), 10 minutes after, 20 minutes after, 30 minutes after, and analyzed the correlation of them .Results The portable blood glucose meter with RT-CGM display value at different time-window had no statistical difference , and all had high correlation .The portable blood glucose meter showed the highest correlation with RT-CGM value after 20 minutes.Conclusions RT-CGM as a reliable tool for clinical blood sugar management , is an effective way for clinical medical staff to know the trends of blood sugar , which should be fully applied its warning function , weaken its observing the performance of the immediate blood sugar levels .