Objective To observe the application effect of the H2H model in rehabilitation nurs-ing for patients undergoing radical mastectomy.Methods A total of 294 patients who underwent rad-ical mastectomy were enrolled as study subjects and randomly divided into conventional group and H2H group using a simple randomization method(coin toss),with 147 patients in each group.The conventional group received routine nursing interventions,while the H2H group received nursing in-terventions based on the H2H model.At 1 week and 3 months post-intervention,shoulder joint func-tion[assessed using the Constant-Murley Shoulder Function Score(CMS)],nutritional indicators(serum albumin,hemoglobin)levels,self-management efficacy[assessed using the Self-care Self-ef-ficacy Scale(SUPPH)],and quality of life[assessed using the Functional Assessment of Cancer Therapy-Breast(FACT-B)]were observed and compared between the two groups.Results At 3 months post-intervention,the pain,daily living activities,range of motion,and muscle strength scores in the CMS were higher than those at 1 week post-intervention in both groups,with the H2H group showing higher scores than the conventional group,and the differences were statistically signifi-cant(P＜0.05).At 3 months post-intervention,the albumin and hemoglobin levels were lower than those at 1 week post-intervention in both groups,but the H2H group had higher levels than the con-ventional group,and the differences were statistically significant(P＜0.05).At 3 months post-inter-vention,the positive attitude,self-decision-making,and self-stress reduction scores in the SUPPH were higher than those at 1 week post-intervention in both groups,with the H2H group showing higher scores than the conventional group,and the differences were statistically significant(P＜0.05).At 3 months post-intervention,the scores for physical well-being,social/family well-being,emotional well-being,functional well-being,and the breast cancer-specific module in the FACT-B were higher than those at 1 week post-intervention in both groups,with the H2H group showing higher scores than the conventional group,and the differences were statistically significant(P＜0.05).Conclu-sion The application of the H2H model in rehabilitation nursing for patients after radical mastecto-my can promote the recovery of shoulder joint function,improve nutritional status,and enhance self-management efficacy and quality of life.

Objective To investigate the anticancer effect of tanshinone Ⅱ A(TⅡ A)on gastric cancer cells and its mechanism.Methods Gastric cancer cells AGS and BGC-823 were used in this study,the semi inhibi-tory concentration(IC50)of T Ⅱ A in gastric cancer cells AGS and BGC-823 were calculated based on MTT colorimetric assay.The appropriate concentration of T Ⅱ A was selected.The effects of T Ⅱ A on cell apoptosis and death were analyzed by flow cytometry.Gastric cancer cells AGS and BGC-823 were divided into control group,T Ⅱ A group and T Ⅱ A+ferroptosis inhibitor Fer-1 group(TⅡ A+Fer-1 group).The levels of gluta-thione(GSH),cysteine(Cys),reactive oxygen species(ROS)and lipid peroxidation in each group were detec-ted and compared.The potential targets of T Ⅱ A were screened and verified by traditional Chinese medicine system pharmacology and String database.The levels of glutamate/cystine transporter(xCT)in each group were detected by Western blot,and the mRNA levels of TP53,solute carrier 7 family 11 members(SLC7A11),and prostaglandin peroxide endosynthase 2(PTGS2)were detected by real-time fluorescence quantitative PCR.Results TⅡA had a good anticancer effect on gastric cancer cells AGS and BGC-823 with IC50 of 2.880 μg/mL and 2.350 μg/mL,respectively.TⅡA could inhibit the growth and promote apoptosis and death of gastric cancer cells AGS and BGC-823.TⅡA treatment reduced GSH and Cys levels(P＜0.05),increased ROS and lipid peroxidation levels(P＜0.05),and finally induced ferroptosis in AGS and BGC-823 cells.Database analysis showed that TP53 was an important target of T Ⅱ A.T Ⅱ A promoted the expression of TP53 and inhibited the expression of xCT.Fer-1 attenuated the effects of T Ⅱ A on the expression of TP53 and xCT.After adding TP53 inhibitor,the effects of T Ⅱ A on SLC7A11,PTGS2,and TP53 were weakened(P＜0.05).Conclusion TⅡA has a good anticancer effect on gastric cancer cells AGS and BGC-823,and it could promote ferroptosis of gastric cancer cells through TP53/xCT pathway.

Objective:To investigate the changes in total radioactivity in patient body with differentiated thyroid carcinoma (DTC) after 131I treatment and the factors influencing its metabolism. Methods:The clinical data from 218 patients after DTC treatment in the Department of Nuclear Medicine, the Second Affiliated Hospital of Air Force Medical University from September 2021 to April 2022 were retrospectively analyzed. Based on administrated 131I dose, 171 patients were divided into low-dose group (≤ 3.7 GBq) and 47 into high-dose group (>3.7 GBq) . A whole body dynamic radiation monitoring system was used to measure the in vivo residual activity of 131I 24, 48 and 72 h after 131I administration and to explore their influencing factors. Results:24, 48 and 72 h after adimination of 131I, the residual activity of 131I in the low-dose group patients was significantly lower than in the high-dose group patients ( t= -7.46, -3.31, -2.01, P<0.05) . The discharge compliance rate at 24 and 48 h in the low-dose group was significantly higher than that in the high-dose group (21.0% vs. 4.3%, 98.2% vs. 89.4%, χ2 = 7.23, 5.91, P<0.05) , and all patients could meet the discharge criteria at 72 h. Univariate analysis showed that the residual 131I activity at 24 and 48 h was dependent on age, body mass index (BMI) , basal metabolism rate (BMR) and thyroid stimulating hormone (TSH) . As have been shown by multiple linear regression analysis, in the low-dose group, the older age, the higher BMR and the higher TSH level at 24 h tended to the higher 131I residual activity in the body. At 48 h, the higher BMI and the higher TSH level lead to the higher 131I residual activity in patient body. Meanwhile, in the high-dose group, the higher age and BMR at 24 h, tended to the higher in vivo131I residual activity. The influencing factors were analyzed in terms that 131I residual activity reaching 400 MBq in patient body at 24 and 36 h. The result showed that at 24 h the lower TSH level leaded to the lower 131I residual activity in patient body. At 36 h, the younger age, the lower TSH level, and the smaller 131I treatment dose tended to the lower in vivo131I residual activity. Conclusions:Age, BMI, BMR and TSH levels are the influencing factors for the change in total activity in patient body after 131I treatment of DTC. Radiation dose assessment based on the above indicators can provide a reference for adjusting the length of hospitalization time.

Nature, a rich source of bioactive natural products, serves as a massive pool of drug candidates for the pharmaceutical industry. However, the supply of these structurally complex chemicals is costly as most of the natural products are scarce in nature, thus requiring de novo synthesis. The supply chain issue hinders the development of novel therapeutic agents from natural products. Microbial synthesis, based on the expression of biosynthetic genes in a suitable microbial host to produce certain chemicals, is a sustainable strategy to produce complex natural products. However, this strategy requires gaining insights into the biosynthesis of target molecules. Most natural products are biosynthetically unknown or not fully elucidated; thus, the sole application of microbial synthesis strategy to produce a given molecule is challenging. In this review, we highlight a strategy that combines microbial and chemical syntheses to tackle the supply chain issue in developing drugs from natural products. We believe this strategy can revive the drug development pipeline for natural products.
Biological Products/chemistry* ; Aminoglycosides

Objective To evaluate the efficiency and safety of genipin collagen crosslinking (G-CXL) on rabbit corneas in vivo.Methods Forty healthy New Zealand white rabbits were randomly divided into 0.20％ G-CXL,0.25％ G-CXL,standard UVA-CXL and normal control group.And the right eyes were treated in different grouping.No procedures were performed in the normal control group.The corneal curvature (Km) and central corneal thickness (CCT) of right eyes were evaluated before,7 days and 14 days after crosslinking treatment.Cornea strips were harvested from the right eyes and tensile strain measurements were performed 7 days and 14 days after crosslinking treatment.The structure of corneal stroma was observed under light microscope (LM) and transmission electron microscope (TEM).Results No statistically significant differences in Km were observed among different groups or different timepoints (Fgroup =0.301,P=0.825;Ftime =1.287,P=0.284).Significant difference in CCTs was noticed among different time pionts (Ftime =3.786,P =0.029).Compared with preoperative,the CCTs of all the groups were significantly increased 7 days after crosslinking (all at P＜0.05).No significant difference in CCT was found among the groups (Fgroup =0.557,P=0.646).Seven days after crosslinking treatment,the Young's modulus at 10％ strain was (1 1.96±5.74),(21.24±6.77),(18.76±3.34) and (11.56±4.37) MPa in 0.20％ G-CXL group,0.25％ G-CXL group,UVA-CXL group and normal control group,respectively;the stress at 10％ strain was (0.68 ±0.24),(1.20 ± 0.25),(1.0l ± 0.30) and (0.69 ± 0.26) MPa,respectively;the Young's modulus and stress in 0.25％ G-CXL group was significantly increased when compared with those in 0.20％ G-CXL and normal control group (both at P＜0.05).No significant difference in Young's modulus and stress was observed between 0.25％ G-CXL group and UVA-CXL group (all at P＞0.05).Forteen days after crosslinking treatment,Young's modulus at 10％strain was (16.65±3.19),(19.12±2.39),(22.83 ±4.38) and (12.70±2.72)MPa in 0.20％ G-CXL group,0.25％ G-CXL group,UVA-CXL group and normal control group,respectively;stress at 10％ strain was (0.83 ±0.12),(0.97±0.04),(1.23±0.30) and (0.65±0.20) MPa,respectively;the Young's modulus and stress in UVA-CXL group was significantly increased,when compared with 0.20％ G-CXL group and normal control group (all at P＜0.05).Statistical significance of stress was observed between 0.25％ G-CXL group and UVA-CXL group (P =0.046).There is no significant difference in Young's modulus between 0.25％ G-CXL and UVA-CXL group (P =0.090).LM showed the reduction of keratocytes existed in superficial stroma of 0.20％ and 0.25 ％ G-CXL groups,while the reduction of keratocyte was found in anterior and intermediate stroma of UVA-CXL group.In 0.20％ and 0.25％ G-CXL groups,the ultrastructure of keratocytes was normal except vacuole in some keratocytes.Keratocytes apoptosis was noticed in UVA-CXL group and keratocytes was normal in deep stroma under TEM.Conclusions 0.25％ has a similar biomechanics effect when compared to UVA-CXL.Moreover,histological observation proves a better safety of G-CXL in comparison of UVA-CXL.

Background Keratoconus is a chronic and progressive non-inflammatory ectatic disorder characterized by corneal thinning and irregular corneal topography,and its pathgenesis is a hot topic.A suitable animal model of keratoconus is still lacking,which limits the progress of relevant research.Corneal ectasia is a main anatomical basis of keratoconus,so we assume that keratoconus model could be constructed by simulating corneal ectasia.Objective This study was to investigate the influence of collagenase type Ⅱ on biomechanical responses detected by corneal visualization Scheimpflug technology (Corvis ST) and the feasibility of construction of rabbit model of corneal ectasia using coliagenase type Ⅱ.Methods This study protocol was approved by Ethic Committee of Peking University First Hospital and followed the Statement about experimental animal use and care from Association for Research in Vision and Ophthalmology (ARVO).Keratectasia models were established in 10 right eyes of 10 New Zealand white rabbits by soaking 8 mm-diameter central cornea using collagenase type Ⅱ solution prepared by PBS solution containing 15％ dextran (200 μl of 5 mg/ml) for 30 minutes after epithelial debridement,and only 200 μl PBS solution containing 15％ dextran was used in the same way in the left eyes as controls.The average corneal curvature (Km) and central corneal thickness (CCT) were measured with hand-held electronic corneal curvature meter and corneal ultra-sonic pachymetry respectively before modeling and 14 days after modeling.Corneal biomechanical parameters and intraocular pressure were measured in vivo by using Corvis ST at day 14 after modeling.The rabbits were sacrificed at day 14 after modeling,and corneal sections were prepared for hematoxylineosin staining and transmission electron microscopic examination.Results There were no significant differences in Km and C CT between model group and control group before modeling (Km:[48.28±2.29] D vs.[48.82± 1.63] D;CCT:[356.50± 19.13] μm vs.[356.20±21.66] μm;both at P＞0.05).The Km increased to (48.87±2.27) D and CCT decreased to (340.40±19.84)μm at day 14 after modeling,which were significantly different from (46.86±1.47) D and (367.80±23.38)μm (both at P＜0.01).The maximal deformation amplitude of model group and control group was (1.25±0.07) mm and (1.15 ±0.13) mm,respectively,showing a considerable difference between them (t=2.65,P＜0.05).No significant differences were found in applanation 1/2 time,applanation 1/2 length,applanation velocity,radius of curvature and peak distance between the two groups (all at P＞0.05).The morphology and ultrastructure examinations revealed that the arrangement of collagen fibers was loose and disorder and the interfiber space was enlarged in comparison with control group.Conclusions Collagenase type Ⅱ can lower corneal biomechanical properties.Soaking of cornea with collagenase type Ⅱ may be a potential way to establish a keratectasia animal model.

Objective To observe the application effect of nurses-dominated rehabilitation management mode in acute stroke patients.Methods A total of 86 patients with acute ischemic stroke (AIS) in the department of neurology were selected for the study and were randomly divided into observation group (n =43) and control group (n =43) according to the order of admission.All patients were given routine treatment and nursing,and the control group was given the routine rehabilitation training for self-choice after in a stable condition,and the observation group was followed by a multidisciplinary team consultation to carry out the early comprehensive rehabilitation training.The activities of daily living in the two groups,nerve function,nutrition risk condition were compared before intervention and at 14d after intervention,and the related complications within 1 month after intervention were analyzed between the two groups.Results At 7 d after intervention,the MBI score and nutritional adequacy rate of the observation group were significantly higher than intervention before and were significantly higher than that of the control group (P ＜ 0.05).The NIHSS score and nutritional risk rate of the observation group were significantly lower than intervention before and were significantly lower than that of the control group (P ＜ 0.05).At 14 d and 1 month after intervention,the MBI score and nutritional adequacy rate of the two groups were significantly higher than intervention before,and those in the observation group were significantly higher than that of the control group at the same time period (P ＜ 0.05).The NIHSS score and nutritional risk rate of the two groups were significantly lower than intervention before,and the observation group were lower than the control group at the same time period (P ＜0.05).The incidence rates of post-stroke depression,brain-induced spasm,swallowing dysfunction and shoulder-hand syndrome were significantly lower in the observation group than that in the control group within 1 month after intervention (P ＜ 0.05).Conclusion Nurses-dominated ASU rehabilitation management mode can effectively improve the rehabilitation effect of patients.

Objective To observe the application effect of nurses-dominated rehabilitation management mode in acute stroke patients.Methods A total of 86 patients with acute ischemic stroke (AIS) in the department of neurology were selected for the study and were randomly divided into observation group (n =43) and control group (n =43) according to the order of admission.All patients were given routine treatment and nursing,and the control group was given the routine rehabilitation training for self-choice after in a stable condition,and the observation group was followed by a multidisciplinary team consultation to carry out the early comprehensive rehabilitation training.The activities of daily living in the two groups,nerve function,nutrition risk condition were compared before intervention and at 14d after intervention,and the related complications within 1 month after intervention were analyzed between the two groups.Results At 7 d after intervention,the MBI score and nutritional adequacy rate of the observation group were significantly higher than intervention before and were significantly higher than that of the control group (P ＜ 0.05).The NIHSS score and nutritional risk rate of the observation group were significantly lower than intervention before and were significantly lower than that of the control group (P ＜ 0.05).At 14 d and 1 month after intervention,the MBI score and nutritional adequacy rate of the two groups were significantly higher than intervention before,and those in the observation group were significantly higher than that of the control group at the same time period (P ＜ 0.05).The NIHSS score and nutritional risk rate of the two groups were significantly lower than intervention before,and the observation group were lower than the control group at the same time period (P ＜0.05).The incidence rates of post-stroke depression,brain-induced spasm,swallowing dysfunction and shoulder-hand syndrome were significantly lower in the observation group than that in the control group within 1 month after intervention (P ＜ 0.05).Conclusion Nurses-dominated ASU rehabilitation management mode can effectively improve the rehabilitation effect of patients.

Objective To investigate the related factors that affect the valid period of sterile items. Methods Sterile items after well cleaning and disinfection were stored in the supply room with a standard storage conditions,as well as in different storage conditions such as neural therapy room,general surgery dressing room, outpatient and emergency injection room,clean operating room with 120 items respectively. Bacterial culture was performed regularly on the sterile items in different storage rooms.Results At 90 d after sterilization, 3 sterile items stored in the outpatient and emergency injection room with paper-plastic packaging had the bacterial growth. At 105 d after sterilization,2 samples in the general surgery dressing room with paper-plastic packaging were found to have the bacterial growth. At 150 d after sterilization,1 sample in the general surgery dressing room with non-woven packaging had the bacterial growth. Up to the end of the experiment,no bacterial growth was observed in the sterile items stored in disinfection supply center,neural therapy room and clean operating room. Conclusions The factors that affect the valid period of the sterilized items are related to the time. It is necessary to evaluate influencing factors of the valid period of sterile items from various perspectives. Specification,industry standards and provision should be executed to ensure the quality of the sterilized items and prevent nosocomial infection.

Objective To analyze the serum levels of medium-and long-chain free fatty acids (FFAs)in patients with hyperlipidemic non-alcoholic fatty liver disease (NAFLD) in order to shed some light on prevention and treatment of NAFLD.Methods The clinical data of 125 patients with high triglyceride (TG)levels who were treated in Hebei General Hospital from January 2011 to May 2011 were analyzed in this study.They were further divided into HF group (n =64) and H group (n =61) based on the presence of NAFLD or not.In addition,63 healthy individuals were recruited from the Central Hospital of Handan during the same period as the control group (N group).Serum medium-and long-chain FFAs were detected by gas chromatography.The body mass index (BMI),abdominal circumference,blood pressure,fasting blood glucose (FBG),and serum lipids including TG,total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),and low-density lipoprotein cholesterol (LDL-C) were measured.Results Compared with the N group,the H group had significantly higher BMI [(25.24 ± 1.41) kg/m2 vs.(24.32 ± 1.12) kg/m2,P =0.004],abdominal circumference [(84.72 ± 1.34) cm vs.(77.33 ±0.89) cm,P =0.010],and diastolic blood pressure [(77.35±1.21) mmHgvs.(75.21 ±1.61) mmHg,P=0.014]; also,the serum TG [(2.86±0.55) mmol/Lvs.(0.93±0.27) mmol/L,P=0.000] andTC levels [(4.56±0.66) mmol/Lvs.(4.36±0.47) mmol/L,P=0.000],serum myristic acid (C14∶0) [(0.49±0.04)％ vs.(0.36±0.01)％,P=0.011],palmitic acid (C16 ∶ 0) [(18.36 ± 0.47) ％ vs.(15.97 ± 0.30) ％,P =0.000],palmitoleic acid (C16∶ 1) [(1.00±0.12)％ vs.(0.58±0.02)％,P=0.001],and oleic acid (C18 ∶ 1) [(18.20±0.70) ％ vs.(12.23 ± 0.37) ％,P =0.000] all significantly increased,while stearic acid (C18 ∶ 0) [(7.52 ±0.22)％ vs.(8.15 ±0.28)％,P=0.012],eicosadienoic acid (C20 ∶ 2) [(0.61 ±0.07)％ vs.(1.03 ±0.17) ％,P =0.000],eicosatrienoic acid (C20 ∶ 3) [(1.77 ± 0.15) ％ vs.(2.49 ± 0.18) ％,P =0.002],and docosahexenoic acid (C22 ∶ 6) [(1.44 ± 0.08) ％ vs.(1.67 ± 0.09) ％,P =0.014] significantly decreased.Compared with the H group,the HF group had significantly higher weight [(85.76 ± 3.10) kg vs.(71.45 ±2.88) kg,P =0.003],abdominal circumference [(96.30 ±2.05) cm vs.(84.72 ± 1.34) cm,P=0.000],systolic blood pressure [(117.12 ±1.15) mmHg vs.(113.23 ±1.25) mmHg,P=0.009],and diastolic blood pressure [(79.54 ± 1.42) mmHg vs.(77.35 ± 1.21) mmHg,P =0.016],whereas the sreum FGB,TG,TC,HDL-C,and LDL-C showed no significant differentces; serum palmitic acid (C16 ∶ 0)[(19.54 ± 0.30) ％ vs.(18.36 ± 0.47) ％,P =0.000] also significantly increased.The serum level of eicosadienoic acid (C20 ∶ 2) in HF group was between that in N group and H group [(0.78 ± 0.09) ％ vs.(1.03 ±0.17)％,(0.78±0.09)％ vs.(0.61 ±0.07)％,both P=0.000].Conclusions The increased serum level of palmitic acid may be a risk factor for NAFLD.Reducing saturated fatty acids and increasing unsaturated acids in diets may be helpful for preventing NAFLD.