OBJECTIVE: This study investigates the efficacy and mechanisms of Qingjie Fuzheng Granules (QFG) in inhibiting colitis-associated colorectal cancer (CAC) development via RNA sequencing (RNA-seq) and 16S ribosomal RNA (rRNA) correlation analysis. METHODS: CAC was induced in BALB/c mice using azoxymethane (AOM) and dextran sulfate sodium (DSS), and QFG was administered orally to the treatment group. The effects of QFG on CAC were evaluated using disease index, histology, and serum T-cell ratios. RNA-seq and 16S rRNA analysis assessed the transcriptome and microbiome change. Key pharmacodynamic pathways were identified by integrating these data and confirmed via Western blotting and immunofluorescence. The link between microbiota and CAC-related markers was explored using linear discriminant analysis effect size and Spearman correlation analysis. RESULTS: Long-term treatment with QFG prevented AOM/DSS-induced CAC formation, reduced levels of interleukin (IL)-1β, tumor necrosis factor-alpha (TNF-α), IL-6, and interferon γ (IFN-γ), and increased CD3⁺ and CD4⁺/CD8⁺ T cells ratio, without causing hepatic or renal toxicity. A 16S rRNA analysis revealed that QFG rebalanced the Firmicutes/Bacteroidetes ratio and mitigated AOM/DSS-induced microbiota disturbances. Transcriptomics and Western blotting analysis identified the nucleotide-binding oligomerization domain-containing protein 2 (NOD2)/nuclear factor kappa-B (NF-κB) pathway as key for QFG's treatment against CAC. Furthermore, QFG decreased the abundance of Bacilli, Bacillales, Staphylococcaceae, Staphylococcus, Lactobacillales, Aerococcus, Alloprevotella, and Akkermansia, while increasing Clostridiales, Lachnospiraceae, Lachnospiraceae_NK4A136_group, Ruminococcaceae, and Muribaculaceae, which were highly correlated with CAC-related markers or NOD2/NF-κB pathway. CONCLUSION By mapping the relationships between CAC, immune responses, microbiota, and key pathways, this study clarifies the mechanism of QFG in inhibiting CAC, highlighting its potential for clinical use as preventive therapy.

【Objective】 To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of skin injury around enterostomy. 【Methods】 The treatment process by PRP of 2 patients with skin injury around enterostomy was analyzed, and the PRP for each patient was tested with platelet count, bacteria and 5 growth factors. The clinical efficacy of enteral nutrition support therapy combined with allogeneic PRP was explored through analyzing treatment key points and literature review. 【Results】 After cleaning the skin around enterostomy, the patients were treated with PRP once daily for 5 days, adjusted to once every other day, and cure was achieved at 15 and 18 days, respectively. 【Conclusion】 Allogeneic PRP is a safe and effective treatment to promote skin injury around enterostomy regeneration in a short time, which can provide a new perspective for clinical.

Objective To analyze the application dose of ciprofol combined with fentanyl in patients undergoing gastroscopy.Method 99 gastroscopy patients from June 2021 to June 2023 were selected as the study objects,and divided into three groups with 33 cases each by random number table method.Group A was given 0.3 mg/kg ciprofol+1.5 μg/kg fentanyl anesthesia,group B was given 0.4 mg/kg ciprofol+1.5 μg/kg fentanyl anesthesia,group C was given 0.5 mg/kg ciprofol+1.5 μg/kg fentanyl anesthesia.Anesthesia,examination,electroencephalogram bispectral index(BIS),mean arterial pressure(MAP),heart rate(HR)and adverse reaction were compared among all groups.Results The success rate of the first anesthesia in Group A was lower than that in Group B and Group C,the gastroscopy examination time was longer than that in Group B and Group C,and the awakening time and hospital leave time were shorter than those in Group B and Group C,the awakening time and hospitalization time of Group B were shorter than those of Group C,the BIS of Group A at time points T2 to T5 was higher than that of Group B and Group C,the MAP and HR levels at time points T2 to T5 in Group A were lower than those in Group B and Group C,the incidence of body movement and coughing in Group A was higher than that in Group B and Group C,the incidence of hypotension and nausea and vomiting in Group C was higher than that in Group A and Group B,and the differences were statistically significant(P<0.05).One patient in Group A and one patient in Group C stopped gastroscopy due to hypoxemia,Group B did not experience hypoxemia,and the difference was not statistically significant(P>0.05).There were 4 cases in Group A,6 cases in Group B and 10 cases in Group C who received intervention with vasoactive drugs due to hypotension,and the difference was statistically significant(P<0.05).Conclusion Patients undergoing gastroscopy which should use 0.4 mg/kg ciprofol+1.5 μg/kg fentanyl anesthesia can achieve better anesthesia effect,shorten examination time and hospitalization time,stabilize vital signs,and reduce adverse reaction incidence rate.

Osteoarthritis (OA) is a type of highly prevalent heterogeneous degenerative disease that leads to joint pain, deformity, the destruction of articular cartilage, and eventual disability. The current treatment strategies for OA often suffer from systemic side effects, poor anti-inflammatory efficacy, and persistent pain. To address these issues, we develop light-inducible nanomedicine that enables the co-delivery of anti-inflammatory drug (diacerein, DIA) and small interfering RNA (siRNA) targeting nerve growth factor (NGF) for pain relief to enhance the therapeutic efficacy of OA. The nanomedicine is based on poly(β-amino-ester)-coated gold nanocages (AuNCs), which is further incorporated with the phase-change material (lauric acid/stearic acid, LA/SA). Following intra-articular (IA) injection in vivo, the nanomedicine displays high degree of drug accumulation and retention in the joint lesion of OA mouse models. The photothermal effect, induced by AuNCs, not only promotes DIA and siRNA release, but also upregulates the expression of heat shock protein 70 (HSP-70) to resist the apoptosis of chondrocytes in the inflammatory condition. The internalization of both DIA and siRNA results in strong anti-inflammatory and pain-relieving effects, which greatly contribute to the joint repair of OA mice. This study offers a promising combination strategy for OA treatment.

Objective To investigate the effect of ultrasound-guided transverse abdominal plane block(TAPB)on pain inhibition and stress response in patients undergoing laparoscopic sleeve gastrectomy(LSG).Methods 98 cases of laparoscopic sleeve Gastrectomy patients admitted from March 2021 to October 2022 were selected as the research object,and they were randomly divided into control group(49 cases)and observation group(49 cases)by double blind method.The control group received general anesthesia,and the observation group received TAPB+general anesthesia.The postoperative pain,analgesic dosage,stress level,hemodynamics and adverse reactions of the two groups were compared.Results The dosage of sufentanil and propofol in the observation group,as well as the effective press frequency of the intravenous analgesia pump 48 hours after surgery[(232.38±29.62)μg,(328.40± 40.68)mg and(5.60±1.25)],were lower than those in the control group[(294.07±35.88)μg,(402.25±46.74)mg and(9.75±2.40)](P＜0.05).The visual analogue scale(VAS)scores for each time period of the observation group were(2.43±0.49),(2.29±0.46),(2.85±0.49),(2.41± 0.39),(2.12±0.41)and(1.82±0.32),respectivly.While,the control group were(2.95±0.46),(3.22±0.51),(3.92±0.47),(3.13±0.65),(2.83±0.57)and(2.05±0.53),respectivly.The difference between the two groups was statistically significant(P＜0.05).At the time of tracheal intubation(T2),at the end of operation(T3),and at the time of leaving the anesthesia recovery room(T4),the fluctuation range of mean arterial pressure[86.00(79.00,94.00)mmHg,87.00(80.00,90.00)mmHg and 89.00(84.00,95.00)mmHg vs 82.00(75.00,90.00)mmHg,85.00(77.00,93.00)mmHg and 87.00(80.00,97.00)mmHg],heart rate[78.00(67.00,83.00)times/min,80.00(74.00,86.00)times/min and 81.00(76.00,90.00)times/min vs 78.00(67.00,83.00)times/min,80.00(74.00,86.00)times/min and 81.00(76.00,90.00)times/min]and blood oxygen saturation[97.38(97.00,97.75)％,98.69(98.30,99.05)％and 99.16(98.80,99.35)％vs 96.54(96.15,96.80)％,98.02(97.65,98.45)％and 98.73(98.43,99.15)％]in the observation group was significantly smaller than that of the control group(P＜0.05).In the observation group,cortisol levels were(192.47 ±40.25)ng/ml,(151.34±39.62)ng/ml and(118.69±30.57)ng/ml at 6 hours,24 hours and 48 hours,respectively,while in the control group were(206.24±45.34)ng/ml,(178.24±37.58)ng/ml and(143.63±32.34)ng/ml,respectively;C-reactive protein(CRP)in the observation group were(25.24±6.29)mg/L,(20.93±5.83)mg/L and(13.61±4.29)mg/L,respectively,while in the control group were(28.13±6.92)mg/L,(23.25±5.21)mg/L and(16.38±4.35)mg/L,respectively;interleukin-6(IL-6)in the observation group were(44.87±7.95)pg/L,(38.34±6.13)pg/L and(34.27±5.32)pg/L,respectively,while in the control group were(56.43±7.23)pg/L、(42.24±6.58)pg/L、(37.66±6.03)pg/L,respectively.The difference between the two groups was statistically significant(P＜0.05).The total incidence of adverse reactions of the observation group(4.08％)was lower in than that of the control group(20.41％)(P＜0.05).Conclusion Ultrasound-guided TAPB for LSG patients has a good effect on postoperative pain suppression,can reduce the stress response of the body after surgery,and is safe.

Objective:To explore the influences of abdominal pressure monitoring in different positions on patients with abdominal hypertension.Methods:From January to June 2019, convenience sampling was used to select 100 critical ill patients with abdominal hypertension who were admitted to the Intensive Care Unit of General Surgery of the General Hospital of Eastern Theater Command as the research object. The abdominal pressure was monitored by indirectly measuring the bladder pressure. We measured the abdominal pressure when patients were in stable condition and in 30° lying position, 45° lying position as well as the supine position respectively, recorded the single measurement data of the patient's abdominal pressure in different positions, and performed another position measurement rest for 15 minutes after changing the position.Results:The abdominal pressures measured in 100 critical ill patients with abdominal hypertension in the supine position, 30° lying position and 45° lying position were (19.18±3.95) , (23.40±3.87) and (28.17±3.60) mmHg (1 mmHg=0.133kPa) respectively, and the difference was statistically significant ( P<0.01) . The abdominal pressure monitored in the supine position was lower than those in the 30° lying position and 45° lying position, the difference was statistically significant (supine position vs. 30° lying position, P<0.01; supine position vs. 45° lying position, P<0.01) . The abdominal pressure monitored in the 30 ° lying position and 45 ° lying position was higher than that in the supine position by one to two levels. With the increase of the bed head elevation angle, the abdominal pressure value is getting higher and higher, regardless of the level of abdominal pressure in critical ill patients with abdominal hypertension. Conclusions:The abdominal pressure monitoring in actual positions can reflect the true situation of the patient well, and can provide a relatively true and reliable monitoring data for clinical nursing decision-making.

Objective: To explore the association between the exposure to major air pollutants in pre-pregnancy and early pregnancy (peri-conceptional period) and gestational diabetes mellitus (GDM). Methods: From March 2015 to April 2018, 4 817 pregnancies were recruited at three prenatal check-ups hospital in Hefei (Hefei First People′s Hospital, Hefei. Maternal and Child Care Hospital and the First Affiliated Hospital of Anhui Medical University), China. Questionnaire was used to collect the demographic data, the health status and lifestyle of pregnant women. GDM was diagnosed according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 Edition). Logistic regression was used to investigate the association of exposure to major air pollutants (PM_2.5, PM₁₀, SO₂, CO and NO₂) during different periods of pre-pregnancy (12 weeks before pregnancy) and first trimester (12 weeks after last menstruation) and duration of exposure to high levels of pollutants with GDM. Results: The mean±SD of the age of subjects was (29.14±4.19) years old and the prevalence of GDM was 21.4% (n=1 030). The results of multivariate logistic regression analysis showed that after adjusting for confounding factors, the risk of GDM increased gradually with the prolonged exposure time of high-concentration pollutants compared with pregnant women who were not exposed to high pollution during the pre-pregnancy (χ²=61.28, P_trend<0.001) with the OR (95%CI) values for exposure time of 1, 2, and 3 months about 1.42 (1.10-1.84), 1.73 (1.29-2.33), and 2.51 (1.75-3.59), respectively. In the pre-pregnancy period, in every 10 μg/m³ increase of PM_2.5 and PM₁₀, the OR (95%CI) values of GDM were 1.14 (1.08-1.20) and 1.13 (1.08-1.19), respectively; for each increase of 1 μg/m³ and 0.10 mg/m³ of SO₂ and CO, the OR (95% CI) values of GDM were 1.03 (1.01-1.05) and 1.07 (1.01-1.13), respectively. For every 1 μg/m³ increase in the average concentration of SO₂ in the first trimester, the OR (95%CI) value of GDM was 1.02 (1.01-1.05). Conclusion PM_2.5, PM₁₀, SO₂ and CO exposure during the pre-pregnancy and SO₂ exposure in first trimester were positively correlated with the risk of GDM.

To explore the association between the exposure to major air pollutants in pre?pregnancy and early pregnancy (peri?conceptional period) and gestational diabetes mellitus (GDM). Methods From March 2015 to April 2018, 4 817 pregnancies were recruited at three prenatal check?ups hospital in Hefei (Hefei First People′s Hospital, Hefei. Maternal and Child Care Hospital and the First Affiliated Hospital of Anhui Medical University), China. Questionnaire was used to collect the demographic data, the health status and lifestyle of pregnant women. GDM was diagnosed according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 Edition). Logistic regression was used to investigate the association of exposure to major air pollutants (PM2.5, PM10, SO2, CO and NO2) during different periods of pre?pregnancy (12 weeks before pregnancy) and first trimester (12 weeks after last menstruation) and duration of exposure to high levels of pollutants with GDM. Results The mean±SD of the age of subjects was (29.14±4.19) years old and the prevalence of GDM was 21.4% (n=1 030). The results of multivariate logistic regression analysis showed that after adjusting for confounding factors, the risk of GDM increased gradually with the prolonged exposure time of high?concentration pollutants compared with pregnant women who were not exposed to high pollution during the pre?pregnancy (χ2=61.28, Ptrend<0.001) with the OR (95% CI ) values for exposure time of 1, 2, and 3 months about 1.42 (1.10-1.84), 1.73 (1.29-2.33), and 2.51 (1.75-3.59), respectively. In the pre?pregnancy period, in every 10 μg/m3 increase of PM2.5 and PM10, the OR (95%CI) values of GDM were 1.14 (1.08-1.20) and 1.13 (1.08-1.19), respectively;for each increase of 1 μg/m3 and 0.10 mg/m3 of SO2 and CO, the OR (95% CI) values of GDM were 1.03 (1.01-1.05) and 1.07 (1.01-1.13), respectively. For every 1 μg/m3 increase in the average concentration of SO2 in the first trimester, the OR (95%CI) value of GDM was 1.02 (1.01-1.05). Conclusion PM2.5, PM10, SO2 and CO exposure during the pre?pregnancy and SO2 exposure in first trimester were positively correlated with the risk of GDM.

Objective? To summarize the key content of nursing of stepped drainage new model for severe acute pancreatitis (SAP) patients with necrosis and infection. Methods? From January 2014 to December 2016, we selected 417 SAP patients with infected pancreatic necrosis (IPN) in General Surgery Intensive Care Unit at Nanjing General Hospital, People's Liberation Army. The "four-step" stepped drainage model was adopted during treatment including four stages, percutaneous catheter drainage, continuous negative pressure irrigation drainage, endoscopic drainage and laparotomy necrotic tissue debridement drainage. All stages of nursing had something in common and different emphasis points. Nursing care paid attention to strengthening the nursing for abdominal puncture catheter, abdominal double pipe, endoscopic operation cooperation and postoperative nursing of laparotomy. Results? Among 417 SAP patients with IPN, a total of 413 patients were with percutaneous catheter drainage and single patient was with one to seven drainage tubes, a total of 2 252 tubes; 315 patients were with abdominal double pipe irrigation drainage and single patient was with two to seven double pipes, a total of 1 386 double pipes; 186 patients were with endoscopic drainage and single patient was with two to five times of endoscopic necrotic tissue debridement, a total of 725 times; 91 patients were with laparotomy and single patient was with laparotomy one to three times. During nursing care, totals of 13 percutaneous drainage catheters and abdominal double pipes slipped off; 109 cases of poor drainage happened to double pipe drainage with 56 cases of obstructed drainage;there were 30 cases of folding, 7 cases of hemorrhage and 16 cases of shifting. Those problems were all found and handled timely with no consequence caused by poor drainage and improper nursing care. Conclusions? Among SAP patients with IPN, keys to guarantee high quality of nursing included mastering nursing emphasis of all stages, taking targeted nursing, keeping abdominal puncture catheter unobstructed, abdominal double pipes effectively sucking, cooperating on endoscopic necrotic tissue debridement and strengthening postoperative monitoring and wound management.

To explore the association between the exposure to major air pollutants in pre?pregnancy and early pregnancy (peri?conceptional period) and gestational diabetes mellitus (GDM). Methods From March 2015 to April 2018, 4 817 pregnancies were recruited at three prenatal check?ups hospital in Hefei (Hefei First People′s Hospital, Hefei. Maternal and Child Care Hospital and the First Affiliated Hospital of Anhui Medical University), China. Questionnaire was used to collect the demographic data, the health status and lifestyle of pregnant women. GDM was diagnosed according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 Edition). Logistic regression was used to investigate the association of exposure to major air pollutants (PM2.5, PM10, SO2, CO and NO2) during different periods of pre?pregnancy (12 weeks before pregnancy) and first trimester (12 weeks after last menstruation) and duration of exposure to high levels of pollutants with GDM. Results The mean±SD of the age of subjects was (29.14±4.19) years old and the prevalence of GDM was 21.4% (n=1 030). The results of multivariate logistic regression analysis showed that after adjusting for confounding factors, the risk of GDM increased gradually with the prolonged exposure time of high?concentration pollutants compared with pregnant women who were not exposed to high pollution during the pre?pregnancy (χ2=61.28, Ptrend<0.001) with the OR (95% CI ) values for exposure time of 1, 2, and 3 months about 1.42 (1.10-1.84), 1.73 (1.29-2.33), and 2.51 (1.75-3.59), respectively. In the pre?pregnancy period, in every 10 μg/m3 increase of PM2.5 and PM10, the OR (95%CI) values of GDM were 1.14 (1.08-1.20) and 1.13 (1.08-1.19), respectively;for each increase of 1 μg/m3 and 0.10 mg/m3 of SO2 and CO, the OR (95% CI) values of GDM were 1.03 (1.01-1.05) and 1.07 (1.01-1.13), respectively. For every 1 μg/m3 increase in the average concentration of SO2 in the first trimester, the OR (95%CI) value of GDM was 1.02 (1.01-1.05). Conclusion PM2.5, PM10, SO2 and CO exposure during the pre?pregnancy and SO2 exposure in first trimester were positively correlated with the risk of GDM.