This study was performed to investigate the inhibitory effects of Xuebijing injection(XBJ)on lipopolysaccharide(LPS)-induced inflammatory signals on EA.hy926 vascular endothelial cells and the underlying mechanism,and to provide a theoretical basis for the treatment of sepsis with XBJ.WST-1 assay was used to detect the effects of XBJ on the cell viability;Western blot analysis was performed to detect the protein expression levels of IκBα,p-p65,p-ERK,p-JNK,p-p38,p-AMAD17 in cell lysates and the content of sTLR4 fragment in the concentrated culture supernatants.ADAM17 sheddase activity in cells was detected by using a commercial available kit.Data showed that all of the TLR4-mediated inflammatory signals were significantly inhibited by the treatment of XBJ(P＜0.01).ADAM17 phosphorylation and shedding activity were induced by XBJ treatment,simultaneously the sTLR4 contents in the culture media were increased.XBJ-induced shedding of TLR4 was suppressed by the preteatment of 10 μmol/L TAPI-1(an ADAM17 inhibitor).Taken together,XBJ can induce the shedding of TLR4 from cell membrane by up-regulating ADAM17 shedding activity,thereby inhibiting the activation of TLR4-mediated intracellular inflammatory signals in EA.hy926 cells.

Objective:To evaluate the role of autophagy in hydrogen-rich solution-induced reduction of remifentanil-induced hyperalgesia in rats.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, aged 2-3 months, weighing 240-260 g, were divided into 4 groups ( n=8 each) by a random number table method: incisional pain group (group I), remifentanil+ incisional pain group (group RI), hydrogen-rich solution+ remifentanil+ incisional pain group (group HRI), and hydrogen-rich solution + autophagy inhibitor+ remifentanil+ incisional pain group (MHRI group). The tail vein was catheterized, the equal volume of normal saline was intravenously infused for 60 min while the incisional pain model was developed in group I, and remifentanil was intravenously infused at a rate of 1 μg·kg -1·min -1 for 60 min while the incisional pain model was developed in RI, HRI and MHRI groups, hydrogen-rich solution 10 ml/kg was intraperitoneally injected at 10 min before preparing the model in group HRI, and 3-MA 15 mg/kg was intraperitoneally injected at 1 h before preparing the model in MHRI group, and the other treatments were similar to those previously described in group HRI. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were determined at 24 h before and 2, 6, 24 and 48 h after the end of infusion. The rats were sacrificed under anesthesia after the behavioral testing, and the lumbar enlargement segment of the spinal cord was removed for determination of the expression of microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 by Western blot. Results:Compared with the baseline at T 0, the MWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with group I, the MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 II and Beclin-1 was up-regulated, and the expression of P62 was down-regulated in group RI and group HRI ( P<0.05). Compared with group RI, the MWT was significantly increased and TWL was prolonged at T 1-4 in group HRI and group MHRI, the expression of LC3 II and Beclin-1 was significantly up-regulated, and the expression of P62 was down-regulated in group HRI, and the expression of LC3 II and Beclin-1 was significantly down-regulated, and the expression of P62 was up-regulated in group MHRI ( P<0.05). Compared with group HRI, the MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 II and Beclin-1 was down-regulated, and the expression of P62 was up-regulated in group MHRI ( P<0.05). Conclusions:The mechanism by which hydrogen-rich solution alleviates hyperalgesia may be related to enhancing the level of autophagy in the spinal cord of rats with incisional pain induced by remifentanil.

Several mitochondrial dysfunctions in obesity and diabetes include impaired mitochondrial membrane potential, excessive mitochondrial reactive oxygen species generation, reduced mitochondrial DNA, increased mitochondrial Ca2+ flux, and mitochondrial dynamics disorders. Mitophagy, specialized autophagy, is responsible for clearing dysfunctional mitochondria in physiological and pathological conditions. As a paradox, inhibition and activation of mitophagy have been observed in obesity and diabetes-related heart disorders, with both exerting bidirectional effects. Suppressed mitophagy is beneficial to mitochondrial homeostasis, also known as benign mitophagy. On the contrary, in most cases, excessive mitophagy is harmful to dysfunctional mitochondria elimination and thus is defined as detrimental mitophagy. In obesity and diabetes, two classical pathways appear to regulate mitophagy, including PTEN-induced putative kinase 1 (PINK1)/Parkin-dependent mitophagy and receptors/adapters-dependent mitophagy. After the pharmacologic interventions of mitophagy, mitochondrial morphology and function have been restored, and cell viability has been further improved. Herein, we summarize the mitochondrial dysfunction and mitophagy alterations in obesity and diabetes, as well as the underlying upstream mechanisms, in order to provide novel therapeutic strategies for the obesity and diabetes-related heart disorders.

Objective:To explore the teaching effect and novel ideas of online teaching applied in skill operation course.Methods:One hundred and fifty-one students studying in Sichuan University taking the First Aid in the Life: Basic Knowledge and Skills as an elective course in the autumn semester of 2019 and spring semester of 2020 were included as the research subjects in this study. Among them, 77 students in the spring semester of 2020 were selected as the experimental group and 74 students in the autumn semester of 2019 were selected as the control group. The students in the experimental group studied the first aid course by online platform, and the others in the control group studied through traditional teaching mode. The teaching effect of the two groups was compared and the teaching satisfaction of the two groups weas analyzed. SPSS 23.0 was used for Chi-square test and t-test. Results:There was no significant difference between the control group and the experimental group in the assessment scores of cardiopulmonary resuscitation, hemostatic bandaging, and fracture fixation [(8.65±0.81 vs 8.69±0.90, P=0.750); (8.10±0.50 vs 8.12±0.61, P=0.880); (8.21±0.89 vs 8.16±0.78, P=0.710)]. Among the students participating in the questionnaire survey in the experimental group, 59 (95.16%) students thought that this course was helpful in dealing with first aid in daily life, and 38 (61.29%) students did not want to change the traditional teaching method to online teaching. Conclusion:The application of online teaching in first-aid skill operation course is feasible and can achieve the similar teaching effect, which provides a novel idea for exploring the online teaching of first aid skills.

Objective:To develop the supportive care information platform based on full cycle needs of patients and explore the application effect of platform in hemiplegia patients with ischemic stroke.Methods:Based on the supportive care scheme for patients with ischemic stroke in the previous study of the research group, combined with literature review and expert group discussion, the supportive care information platform version 1.0 was developed. After 5 patients with ischemic stroke hemiplegia tried for 3 weeks, it was optimized and upgraded to version 2.0 according to the use experience. From June to December 2020, 64 patients with acute ischemic stroke hemiplegia in the Department of Neurology of the First Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Soochow University hospital were randomly divided into intervention group and control group, 32 cases in each group. Barthel Index and balance ability were compared between the two groups. The control group received supportive care plan, and the intervention group received supportive care information platform.Results:After the intervention, the scores of Barthel index in the intervention group were 85 (75,90), 95 (95,100) at 1 and 3 months of illness, which were significantly higher than 65 (55,75), 75 (70,85) in the control group ( P<0.05). After intervention, the scores of balance ability in intervention group were 37 (28,43), 48 (45,51) at 1 and 3 months after illness, which were significantly higher than 28 (16,36), 31(20,37) in control group ( P<0.05). After the intervention, the scores of stroke related knowledge in the intervention group one day before discharge, one month after illness and three months after illness were 14.97 ± 2.98, 19.00 ± 2.14, 22.81 ± 1.60, which were significantly higher than those in the control group (8.69 ± 1.64), (8.88 ± 1.52), (9.09 ± 1.61) ( t values were 109.37-1 169.84, P<0.05). Conclusions:The application of supportive care information platform can provide targeted nrusing measures for patients at different stages of disease development. The platform has good feasibility, and can significantly improve patients′ Barthel index, balance ability and stroke related knowledge, which shows that the platform has good feasihility and clinical application value.

Objective:To evaluate the relationship between autophagy and oxidative stress during remifentanil-induced hyperalgesia in the rats with incisional pain.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, weighing 230-250 g, aged 2-3 months, were divided into 4 groups ( n=8 each) using a random number table method: incisional pain group (I group), remifentanil + incisional pain group (RI group), autophagy inhibitor 3-methyladenine + remifentanil + incisional pain group (MRI group) and autophagy agonist rapamycin group + remifentanil + incisional pain group (RRI group). The model of incision pain was developed and the equal volume of normal saline was intravenously infused simultaneously for 60 min.In RI, MRI and RRI groups, the model of incision pain was developed and remifentanil 1 μg·kg -1·min -1 was simultaneously infused for 60 min.In MRI group, 3-methyladenine 15 mg/kg was intraperitoneally injected at 12 h before developing the model, and rapamycin 10 mg/kg was intraperitoneally injected at 12 h before developing the model in RRI group.Thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 24 h before infusion of remifentanil or normal saline (T 0) and at 2, 6, 24 and 48 h after the end of infusion (T 1-4). The rats were sacrificed after the end of behavioral testing, and the lumbar enlargement segments of the spinal cord were harvested for determination of the expression of autophagy microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 (by Western blot), activity of superoxide dismutase (SOD) (by xanthine oxidase method) and content of malondialdehyde (MDA) (by thiobarbital method). Results:Compared with the baseline at T 0, PWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with I group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was decreased, and MDA content was increased in RI group ( P<0.05). Compared with RI group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was down-regulated, the expression of P62 was up-regulated, SOD activity was decreased, and MDA content was increased in MRI group ( P<0.05), and MWT was significantly increased and TWL was prolonged at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was increased, and MDA content was decreased in RRI group ( P<0.05). Conclusions:Autophagy is involved in the process of remifentanil-induced incisional hyperalgesia through regulating the level of oxidative stress in rats.

The development of internet technology provides a new method for management of workplace violence (WPV) in hospitals. This paper reviews the specific application of information technology in hospital workplace violence in the "Internet +" era from three aspects of pre-warning, in-process response and post control and analyzes the shortcomings of application of Internet technology in workplace violence in hospitals, in order to provide reference for further effective prevention of workplace violence in hospitals.

Objective:To explore supportive care needs of patients with stable stroke in the acute phase and provide guidance for effective supportive care through mixed-methods.Methods:A mixed-method study with convergent parallel design was used. A convenient sampling method was used to select neurological inpatients for questionnaire survey. At the same time, a purposive sampling was used to conduct semi-structured interviews with 15 stroke patients.Results:A total of 176 valid questionnaires were collected, and the average score of supportive care needs were 2.17±0.37, The top 3 were disease-related information needs (2.75 ± 0.40), daily life care needs (2.28 ± 0.51), and social support needs (2.26 ± 0.28). Knowing the causes of stroke ranked first in each entry. The theme of qualitative interviews included: assisting daily activities, management of impaired functions, early functional rehabilitation, disease-related knowledge, psychosocial support, and discharge guidance.Conclusions:Stroke patients have rich and high-level supportive care needs, and provide corresponding information needs based on patient needs. Implement early secondary prevention guidance to prevent stroke recurrence; cooperate with multidisciplinary teams to provide early rehabilitation, reduce functional impairment; timely identify negative emotions of patients, and jointly provide family with patients psychological support. Implement a case management model to promote full-course care for stroke patients.

Objective:To investigate whether autophagy in the inflammatory environment of thrombotic antiphospholipid syndrome (APS) drives polymorphonuclear neutrophils (PMNs) to release neutrophil extracellular traps (NETs) and whether IFN-λ1(IL-29) has a function of inhibiting NETs-related thrombin production.Methods:PMNs isolated from peripheral blood of healthy volunteers were in vitro stimulated by serum samples of patients with active APS. IL-29 and 3-methyladenine (3-MA) were used to regulate NETs release and autophagy. NETs expression was evaluated by immunofluorescence technique (IFT) and flow cytometry (FCM). Autophagy-related proteins were detected by Western blot. The levels of thrombin-antithrombin (TAT) complexes were determined by enzyme-linked immunosorbent assay (ELISA). Results:The percentages of NETs released from PMNs of healthy volunteers after stimulation with serum samples of APS patients were (22.8±3.1)% according to IFT and (10.1±2.7)% according to FCM and used as control group. IL-29 and 3-MA inhibited the release of NETs from PMNs stimulated by serum samples of APS patients and the percentages of NETs were (5.3±2.2)% and (4.9±2.4)% detected by IFT, and (2.1±1.3)% and (2.7±1.4)% by FCM, respectively. There were significant differences with the control group ( q=9.89, 10.67, 11.74, 9.61, all P<0.01). IL-29 inhibited the expression of LC3B, but promoted the expression of p62 on PMNs of healthy volunteers after stimulating with serum samples of APS patients, and the differences with the group without IL-29 pretreatment were statistically significant [LC3B/GAPDH: (0.28±0.03)% vs (0.77±0.06)%, q=8.65; p62/GAPDH: (0.63±0.05)% vs (0.33±0.03)%, q=4.78; both P<0.01]. IL-29 and 3-MA reduced the levels of NETs-related TAT complexes from (7.6±0.6) ng/ml to (3.1±0.5) ng/ml and (4.7±0.4) ng/ml, respectively ( q=6.34 and 5.15, both P<0.01). Conclusions:Autophagy was involved in the formation of NETs and subsequent coagulation cascade activation in PMNs of healthy subjects after stimulation with serum samples of APS patients with thrombosis. IL-29 suppressed the production of NETs and NETs-associated thrombin by inhibiting autophagy.

Objective:To understand the cognition of experiencers and witnesses on workplace violence (WPV) in nurses and to analyze the differences among them so as to provide a theoretical basis for formulating intervention.Methods:From February to May 2018, totals of 26 nurses, experiencers and witnesses of WPV, at a hospital in Suzhou were selected as subjects by purposive sampling to carry out semi-structured interview with the method of descriptive qualitative study. Content analysis was used to the data.Results:Under different perspectives, the differences of nurses' cognition on WPV included three aspects involving subject responsibility attribution, pre-recognition in advance and organizational support of WPV. Experiencers thought that patients had great responsibilities on violence, WPV was difficult to identify, lack of organizational support. Witnesses showed that nurses and patients matched each other in responsibilities, WPV could be identified in advance, the ways of organizational support needed diversification.Conclusions:Under different perspectives, there are differences in nurses' cognition on WPV. Hospital managers should strengthen the building of security, and improve nurses' violence identification and coping capacity to reduce the incidence of hospital violent incidents.