OBJECTIVE To predict and validate the mechanisms of Chaiqi yigan granules （CQYG） improving hepatocellular carcinoma （HCC）. METHODS The signaling pathways of CQYG intervention in HCC were predicted using network pharmacology. A mice model of transplanted hepatocellular carcinoma was established by injecting H22 hepatoma cells into the axilla. Successfully modeled mice were randomly divided into model group （normal saline）， sorafenib group （positive control， 50 mg/kg）， and CQYG low-， medium- and high-dose groups （24.83， 49.66， 99.32 g/kg）， with 10 mice in each group. Mice in each group were administered the corresponding drug solution or normal saline intragastrically， once a day， for 14 consecutive days. After last administration， pathological morphological changes in the tumor tissues of mice were observed in each group. Immunohistochemical staining was performed to detect the expression of the nuclear proliferation antigen Ki-67 in tumor tissues of mice. Western blot assay was used to measure the expression of proteins related to epithelial-mesenchymal transition （EMT） [N-cadherin， E-cadherin， Vimentin， matrix metalloproteinase 7 （MMP7）] and the mitogen-activated protein kinase （MAPK） signaling pathway [p38 MAPK， phosphorylated p38 MAPK， c-Jun N-terminal kinase （JNK）， phosphorylated JNK， extracellular regulated protein kinase 1/2 （ERK1/2）， phosphorylated ERK1/2] in tumor tissue of mice. RESULTS Network pharmacology analysis revealed that metabolic pathways， pathways in cancer， and the MAPK signaling pathway were key signaling pathways through which CQYG exert their anti-hepatocellular carcinoma effects. In animal experiments， the tumor tissues of mice in the model group exhibited dense tumor cells and vigorous growth. Compared with model group， CQYG high-dose group showed a decreased density of tumor cells in the tumor tissues of mice. Moreover， the expression levels of Ki-67， N-cadherin， MMP7 and Vimentin proteins， along with the phosphorylation levels of ERK1/2 and JNK proteins， were all significantly reduced （ P ＜0.05）. The expression level of E-cadherin protein was significantly increased （ P ＜0.05）， the phosphorylation level of p38 MAPK protein was increased， the difference was not statistically significant （ P ＞0.05）. CONCLUSIONS CQYG can inhibit EMT by regulating the MAPK signaling pathway， thereby suppressing tumor cell invasion and metastasis and ultimately exerting a therapeutic effect in improving HCC.

Objective:To observe any effect of low-frequency whole body resonant stimulation on the ba-lance and walking ability of hemiplegic stroke survivors.Methods:Sixty-six stroke survivors with hemiplegia were randomly divided into a low-frequency resonance training group, a high-frequency vibration training group and a control group, each of 22. All received routine exercise training at individualized intensities. All three groups underwent five 1-minute cycles of 7Hz, 15Hz or 1Hz stimulation twice a day, five days a week for eight weeks. Before and after the intervention, balance and walking ability were evaluated using the Berg Balance Scale, the timed up and go test and a 10m walking test. Step length, step frequency and step speed were also measured.Results:There were no significant differences among the three groups before the training. Afterward, significant improvement was observed in all of the groups in terms of all of the measurements. The average results of the low-frequency resonance training group were at that point significantly better than the other two groups′ averages, while the high-frequency vibration training group′s results were superior to those of the control group.Conclusion:Resonance training at 7Hz is the most effective in improving the balance and walking ability of stroke survivors with hemiplegia.

Objective To explore the effect of Naikan cognitive-music reminiscence therapy on coping style in female patients with chronic schizophrenia.Methods In May, 2020, 72 female patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into control group (n = 48) and music group (n = 24) after trait matching. Both groups accepted routine medicine, while the control group accepted Naikan cognitive therapy, and the music group accepted Naikan cognitive therapy combined music reminiscence, for twelve weeks. They were blind assessed with Simplified Coping Style Questionnaire, Self-rating Depression Scale and Self-rating Anxiety Scale before and after intervention.Results There were five cases in the control group removed for erroneous response. The main effects of group were not significant for all the assessments (F < 0.567, P > 0.05). The main effect of time was significant for negative coping style score (F = 6.968, P = 0.01), and the interaction effects were significant for positive coping style score and Self-rating Depression Scale score (F > 4.227, P < 0.05).Conclusion Combining with music reminiscence, Naikan cognitive therapy may be advantageous for the coping style of female patients with chronic schizophrenia.

Objective:To evaluate the role of adenosine monophosphate-dependent protein kinase/p38 mitogen-activated protein kinase/nuclear factor E2-associated factor 2 (AMPK/p38 MAPK/Nrf2) pathway in myocardial ischemia-reperfusion (I/R) injury in diabetic rats.Methods:Clean-grade healthy Sprague-Dawley male rats, aged 2-3 months, weighing 220-280 g, were fed with a high fat diet, and 1% streptozotocin 50 mg/kg was intraperitoneally injected for 4 consecutive days to develop the model of diabetes mellitus.Thirty diabetic rats were divided into 3 groups ( n=10 each) using the random number table method: sham operation group (sham group), myocardial I/R group (I/R group), and AMPK inhibitor compound C+ myocardial I/R group (C+ I/R group). The model of myocardial I/R injury was developed by ligation of the left anterior descending coronary artery for 30 min followed by 120 min reperfusion.Compound C 0.5 mg/kg was injected via the caudal vein at 30 min before ischemia in C+ I/R group, while the equal volume of normal saline was given instead in Sham group and I/R group.At 120 min of reperfusion, the percentage of myocardial infarct size was calculated, the serum concentrations of creatine kinase isoenzymes (CK-MB) and lactic dehydrogenase (LDH) were determined by enzyme-linked immunosorbent assay, the levels of glutathione (GSH), superoxide dismutase (SOD) and reactive oxygen species (ROS) in myocardial tissues were measured by enzyme-linked immunosorbent assay, and the expression of AMPK, phosphorylated AMPK (p-AMPK), phosphorylated p38 MAPK (p-p38 MAPK), Nrf2 and heme oxygenase-1 (HO-1) in myocardium was determined by Western blot. Results:Compared with Sham group, the percentage of myocardial infarct size and serum CK-MB and LDH levels were significantly increased, the levels of GSH and SOD in myocardial tissues were decreased, ROS level was increased, and the expression of AMPK, p-AMPK, p-p38 MAPK, Nrf2 and HO-1 was up-regulated in I/R group ( P<0.05). Compared with I/R group, the percentage of myocardial infarct size and serum CK-MB and LDH levels were significantly increased, the levels of GSH and SOD in myocardial tissues were decreased, ROS level was increased, and the expression of AMPK, Nrf2 and HO-1 was down-regulated in C+ I/R group ( P<0.05). Conclusions:AMPK/p38 MAPK/Nrf2 signaling pathway is involved in the mechanism of endogenous antioxidant stress during myocardial I/R in diabetic rats.

Objective:To explore the current situation of nursing service perception in parents of children during the perioperative period, and to analyze the impact of nursing service perception on the coping style of children's parents.Methods:From October to December 2019, a total of 500 parents of children who underwent surgery in three ClassⅢgeneral hospitals in Henan Province were conveniently selected as the research subject. The survey was conducted with the General Information Questionnaire, Nursing Service Servqual Scale, Coping Health Inventory for Parents (CHIP) . Pearson correlation analysis and hierarchical regression analysis were used to explore the impact of nursing service perception of children's parents on their coping styles. A total of 500 questionnaires were distributed, and 476 valid questionnaires were returned with the effective response rate of 95.2%.Results:Among 476 parents of children during the perioperative period, total scores of nursing service perception and coping style were (3.99±0.56) and (92.25±9.3) respectively. The result of Pearson correlation analysis showed that the total score of nursing service perception of parents of children during perioperative period was positively correlated with the total score of coping style ( r=0.271, P<0.05) . The results of univariate analysis showed that the scores of parents' coping styles of children during perioperative period were statistically significant in terms of whether they were the only child, educational level of parents, family residence, and monthly family income ( P<0.05) . Hierarchical regression analysis showed that after controlling general data, assurance and empathy in the Nursing Service Servqual Scale were the main factors affecting the coping style of parents of children during perioperative period with a statistical difference ( P<0.05) . Conclusions:Nursing service perceptions of parents of children during perioperative period affect their coping styles. Clinical nursing staff should take targeted measures to improve the quality of nursing service, and increase the perception of the nursing service quality by parents of children, so as to help parents of children deal with the disease in an active way.

Objective:To study the correlation between OPRM1 A118G gene polymorphism (rs1799971) and the dosage of opioid analgesics in patients after lumbar decompression.Methods:From July 2017 to September 2018, 147 patients undergoing selective posterior lumbar decompression under general anesthesia in the People's Hospital of Xinjiang Uygur Autonomous Region were treated with sufentanil intravenous controlled analgesia(PCIA). The gene polymorphism was detected by PCR.The VAS, Ramasy sedation score, total dosage of sufentanil and adverse reactions of sufentanil in 48 h after operation were observed.Results:The genotype frequencies of AA, GA and GG were 30.6%, 55.5% and 13.9%, respectively, the difference was statistically significant(χ 2=6.324, P=0.423), and G and A allele frequencies were 41.7%, 58.3%, respectively, the difference was statistically significant(χ 2=5.559, P=0.184). There were no statistically significant differences in SpO 2, Ramasay sedation score and VAS score among the groups after operation(all P>0.05). The total dosage of sufentanil in OPRM1 mutant GG[(151.0±23.4)μg] and GA[(132.0±19.1)μg] was higher than that in AA[(123.0±16.2)μg] within 48 h of PCIA, the differences were statistically significant( t=5.206, 2.817, all P<0.05). Conclusion:The OPRM1 A118G gene polymorphism(rs1799971) is correlated with the dosage of opioid analgesics after lumbar decompression.

OBJECTIVE： To establish QAMS method for content determination of paeoniflorin， rutin， oroxin B， baicalin and cinnamates in Yanyan tablets. METHODS： HPLC method was adopted. The determination was performed on Hypersil GOLD-C18 column （250 mm×4.6 mm，5 μm） with mobile phase consisted of methanol-0.35％ phosphoric acid solution （gradient elution） at flow rate of 1 mL/min. The detection wavelengths were set at 280 nm （rutin， oroxin B， baicalin， cinnamates） and 230 nm （paeoniflorin）. The column temperature was 30 ℃， and sample size was 10 μL. Using paeoniflorin as internal reference， relative correction factors （RCF） of rutin， oroxin B， baicalin and cinnamates were established. Effects of different chromatogram system， chromatogram column， mobile phase proportion， flow rate and column temperature on relative correction factors were investigated； the chromatographic peaks of the components were located according to the relative retention time. The content of paeoniflorin as internal reference was determined by external standard method， and the other four components were determined by QAMS， and then compared with the results of external standard method. RESULTS： The separation degree of each component to be measured was greater than 1.5. The linear range was 3.97-119.22 μg/mL for paeoniflorin，1.96-58.68 μg/mL for rutin，2.39-71.64 μg/mL for oroxin B， 1.92-57.51 μg/mL for baicalin， 0.54-16.24 μg/mL for cinnamates（r≥0.999 7）， respectively. RSDs of precision， reproducibility and stability tests were all lower than 2％. Average recoveries were 97.20％-98.07％（RSD＜3％，n＝6）. RCFs of rutin， oroxin B， baicalin and cinnamates were 0.554 6，1.815 6，2.489 3 and 5.423 2， using paeoniflorin as internal reference. RSDs of RCF and relative retention time were all lower than 5％ under different chromatogram conditions. Absolut relative error of four components （except for internal reference） in 10 batches of Yanyan tablets sampled by QAMS and external standard method were all less than 1％. The results of the two methods were identical. CONCLUSIONS： The established method is accurate， rapid， efficient and inexpensive， and it can be used for simultaneous determination of 5 indicator components in Yanyan tablet.

Objective To analyze the bone metabolism in hospitalized patients with Graves disease and the changes after 131I therapy.Methods The differences of bone metabolism were analyzed between 315 patients with Graves disease and 300 normal controls in a case-control study.The changes in bone turnover markers and BMD levels before and one year after 131I therapy were observed in 60 patients.Results Compared to normal control,bone turnover markers were markly higher and BMD levels were lower in patients with Graves disease.The level of thyroid hormones were positively related to bone turnover markers,while negatively related to total hip BMD (Z-score).But there was no linear relationship with lumbarand femoral neck BMD (Z-score).After one year of 131I therapy,bone turnover markers were markly lower than that before treatment,while BMD levels were partly higher than that before treatment.Conclusions In Graves disease patients,bone turnover markers were generally increased,while BMD levels decreased compared with normal people.After 131I therapy,along with the improvement of thyrotoxicosis,the high bone turnover rate can be suppressed,and BMD can partly recover.

Mastering peripheral nerve block technique is a basic requirement for residents stan-dardization training. Ultrasound-guided nerve block has broken through the limitation of traditional blind operation, promoted the quality and safety of anesthesia, and improved the quality of the peripheral nerve block teaching. However, the safety of ultrasound-guided nerve block technique must be based on the speci-fication training. In the teaching experience, we have used theoretical study, simulation training and clinical practice to explore a new method for upgrading the quality of resident doctor training.