1.Key Genes in Phenylpropanoid Biosynthesis Pathway of Lonicera macranthoides Based on Transcriptome and Metabolome Conjoint Analysis
Jiawei HE ; Jingyu ZHANG ; Juan ZENG ; Jiayuan ZHU ; Simin ZHOU ; Meiling QU ; Ribao ZHOU ; Xiangdan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):167-175
ObjectiveBased on the conjoint analysis of transcriptome and metabolome, the key genes in the phenylpropanoid biosynthesis pathway of Lonicera macranthoides were explored, which provided a basis for further exploring the synthesis and regulation mechanism of phenylpropanoid compounds in "Xianglei" L. macranthoides. MethodsThe stem, leaves, and three flowering flowers of "Xianglei" L. macranthoides were selected as experimental materials to construct transcriptome and metabolome. The transcriptome and metabolomics were conjointly analyzed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) database and weighted correlation network analysis (WGCNA), and the key genes in the phenylpropanoid biosynthesis pathway of L. macranthoides were explored. ResultsIn this study, 77 differential phenylpropanoids and 315 differential genes were found. Through the joint analysis of transcription and metabolism, nine key differential metabolites and four key genes related to them were finally discovered. Among them, cinnamic acid, 5-O-caffeoylshikimic acid,sinapyl alcohol, and chlorogenic acid were higher in flowers, and the content of the iconic effective component, namely chlorogenic acid,decreased sharply during the withering period. Caffeic acid,ferulic acid, 5-hydroxyconiferaldehyde,p-coumaryl alcohol, and syringin were higher in leaves. These four key genes belong to the cinnamic alcohol dehydrogenase (CAD) family, 4-coumaric acid: Coenzyme A (4CL) family, hydroxycinnamyl transferase (HCT) family, and L-phenylalanine ammonlyase (PAL) family genes. ConclusionAmong the four key genes excavated from L. macranthoides, TRINITY_DN42767_c0_g6 is related to the synthesis of p-coumaryl alcohol and sinapyl alcohol. TRINITY_DN43525_c4_g1 uses caffeic acid,ferulic acid,and cinnamic acid as substrates to catalyze the next reaction. TRINITY_DN47958_c3_g4 correlates with the synthesis of 3-p-coumaroyl quinic acid and caffeoyl-CoA, and TRINITY_DN52595_c1_g2 correlates with cinnamic acid synthesis. These findings provide a basis for further exploring the synthesis and regulation mechanism of phenylpropanoids in "Xianglei" L. macranthoides.
2.Mechanism of electroacupuncture-induced macrophage polarization in promoting acute skeletal muscle injury repair in rats.
Yuting HUANG ; Yuye LIN ; Guojun ZHANG ; Chufan ZENG ; Xia ZHANG ; Jingyu ZHANG ; Yu KAN ; Yanping FANG ; Xianghong JING ; Jun LIAO
Chinese Acupuncture & Moxibustion 2025;45(6):791-800
OBJECTIVE:
To investigate the potential mechanism by which electroacupuncture (EA) induces macrophage polarization to promote muscle satellite cell proliferation and differentiation, accelerating the repair of acute skeletal muscle injury.
METHODS:
Forty-two SPF-grade SD rats were randomly divided into three groups: a blank group (n=6), a model group (n=18), and an EA group (n=18). The model and EA groups established acute blunt contusion model of the right gastrocnemius muscle using a self-made striking device. From day 1 after modeling, rats in the EA group received EA at "Chengshan" (BL57) and "Yanglingquan" (GB34) on the right side, using disperse-dense wave with a frequency of 2 Hz/100 Hz and a current of approximately 2 mA. The EA treatment was administered once daily for 30 minutes for 3, 7, or 14 days based on the designated sampling time points. Gait analysis was performed using the Cat Walk XTTM system. Hematoxylin-eosin (HE) staining was used to observe the morphological changes in the gastrocnemius muscle. Masson staining was applied to evaluate collagen fiber content. Immunofluorescence was used to detect the expression of proliferating cell nuclear antigen (PCNA) in muscle satellite cells. Immunohistochemistry was used to assess the expression levels of CD68 and CD206, markers of macrophages. Serum levels of pro-inflammatory cytokines (TNF-α, IL-1β) and anti-inflammatory cytokines (IL-10, IL-13) were detected using ELISA.
RESULTS:
Compared with the blank group, the model group showed a significant reduction in average movement speed on days 3 and 7 after modeling (P<0.05), and a decrease in the right hind limb stride length on day 3 (P<0.05). Compared with the model group, the EA group showed increased average movement speed and right hind limb stride length on day 7 (P<0.05). In the blank group, the gastrocnemius muscle on the right side showed uniform and consistent inter-fiber spacing, with neatly and regularly arranged muscle cells. In contrast, the model group exhibited enlarged inter-fiber spacing, edema, and significant infiltration of red blood cells and inflammatory cells, with progressively increasing fibrosis over time. By day 14 after modeling, the EA group showed a return to baseline levels of inflammatory cell infiltration, and the degree of fibrosis was significantly lower than that observed in the model group. Compared with the blank group, the ratio of collagen fibers in the gastrocnemius muscle of the model group increased significantly on days 3, 7, and 14 after modeling (P<0.05). Compared with the model group, the EA group exhibited a lower collagen fiber ratio on days 3, 7, and 14 (P<0.05). Compared with the blank group, PCNA positive expression in the gastrocnemius muscle of the model group was significantly increased on days 3, 7, and 14 after modeling (P<0.05). Compared with the model group, the EA group exhibited significantly higher PCNA positive expression on days 3 and 7 (P<0.05). Compared with the blank group, the model group showed a significant increase in CD68-positive macrophage expression in the gastrocnemius muscle on day 3 after modeling (P<0.05), while CD206-positive macrophage expression increased on days 3, 7, and 14 (P<0.05). Compared with the model group, CD68 expression was significantly lower in the EA group on day 3 (P<0.05), whereas CD206 expression was significantly higher on days 3 and 7 (P<0.05), peaking on day 7 with CD206 expression. Compared with the blank group, serum TNF-α levels were significantly elevated in the model group on days 3 and 7 after modeling (P<0.05), while serum IL-1β levels were increased on days 3, 7, and 14 (P<0.05). Serum IL-10 and IL-13 levels were significantly higher on day 7 after modeling (P<0.05). Compared with the model group, the EA group exhibited lower serum TNF-α level on day 3 (P<0.05) and reduced serum IL-1β levels on days 3 and 7 (P<0.05), while serum IL-10 and IL-13 levels were significantly increased on day 7 (P<0.05).
CONCLUSION
EA could promote the repair of acute blunt contusion-induced gastrocnemius muscle injury by regulating the proliferation and differentiation of muscle satellite cells. This process is closely related to macrophage polarization.
Animals
;
Electroacupuncture
;
Rats, Sprague-Dawley
;
Rats
;
Macrophages/immunology*
;
Muscle, Skeletal/immunology*
;
Male
;
Humans
;
Female
;
Tumor Necrosis Factor-alpha/immunology*
;
Cell Proliferation
3.Compound Centella asiatica formula alleviates Schistosoma japonicum-induced liver fibrosis in mice by inhibiting the inflammation-fibrosis cascade via regulating the TLR4/MyD88 pathway.
Liping GUAN ; Yan YAN ; Xinyi LU ; Zhifeng LI ; Hui GAO ; Dong CAO ; Chenxi HOU ; Jingyu ZENG ; Xinyi LI ; Yang ZHAO ; Junjie WANG ; Huilong FANG
Journal of Southern Medical University 2025;45(6):1307-1316
OBJECTIVES:
To explore the therapeutic mechanism of compound Centella asiatica formula (CCA) for alleviating Schistosoma japonicum (Sj)-induced liver fibrosis in mice.
METHODS:
The active components and targets of CCA were identified using the TCMSP database with cross-analysis of Sj-related liver fibrosis targets. A "drug-component-target-pathway-disease" network was constructed using Cytoscape 3.9.1. Functional enrichment analysis (GO/KEGG) was performed using DAVID. Molecular docking study was carried out to validate interactions between the core targets and the key compounds. For experimental validation of the results, 36 mice were divided into control group, Sj-infected model group, and CCA-treated groups. In the latter two groups, liver fibrosis was induced via abdominal infection with Sj cercariae for 8 weeks, followed by 8 weeks of daily treatment with CCA decoction or saline. Hepatic pathology of the mice was assessedwith HE and Masson staining, and hepatic expressions of collagen-I and collagen-III were detected using immunohistochemistry; serum IL-6 and TNF-α levels were determined with ELISA. Hepatic expressions of TLR4 and MyD88 proteins were analyzed with Western blotting.
RESULTS:
We identified a total of 107 bioactive CCA components and 791 targets, including 37 intersection targets linked to Sj-induced fibrosis. The core targets included TNF, TP53, JUN, MMP9, and CXCL8, involving the IL-17 signaling, lipid metabolism, TLR4/MyD88 axis, and cancer pathways. Molecular docking study confirmed strong binding affinity between quercetin (a primary CCA component) and TNF/TP53/JUN/MMP9. In Sj-infected mouse models, CCA treatment significantly attenuated hepatic inflammatory cell infiltration, reduced collagen-I and collagen-III deposition, improved tissue architecture, reduced serum IL-6 and TNF-α levels, and downregulated TLR4 and MyD88 expressions in the liver.
CONCLUSIONS
CCA mitigates Sj-induced liver fibrosis by targeting TNF, TP53, JUN, and MMP9 to modulate the TLR4/MyD88 pathway, thereby suppressing pro-inflammatory cytokine release, inhibiting hepatic stellate cell activation, reducing collagen deposition, and preventing granuloma formation in the liver.
Animals
;
Toll-Like Receptor 4/metabolism*
;
Mice
;
Myeloid Differentiation Factor 88/metabolism*
;
Schistosoma japonicum
;
Liver Cirrhosis/parasitology*
;
Schistosomiasis japonica
;
Signal Transduction
;
Molecular Docking Simulation
;
Inflammation
;
Centella/chemistry*
;
Drugs, Chinese Herbal/pharmacology*
;
Tumor Necrosis Factor-alpha/metabolism*
4.Study on the mechanism of electroacupuncture stimulation to activate the acupoint effect and promote skeletal muscle repair
Yuting HUANG ; Jun LIAO ; Tianyu RAO ; Kezhi LIU ; Jia LIN ; Yuye LIN ; Chufan ZENG ; Guojun ZHANG ; Xia ZHANG ; Xiubing TONG ; Jingyu ZHANG ; Yu KAN ; Yanping FANG ; Xianghong JING ; Xuan WANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(8):1160-1170
Objective To investigate the mechanism of inducing macrophage polarization induced by acupoint effect of electroacupuncture to promote the repair of acute skeletal muscle injury.Methods 45 SD rats were randomly divided into blank group,model group,electroacupuncture group(EA group),sodium chrominate group (DSCG group) and electroacupuncture+sodium chrominate group (hereinafter referred to as EA+DSCG group),with 9 rats in each group. The rats in the EA group and the EA+DSCG group were subjected to EA intervention at the right "Chengshan" (BL57) and "Yanglingquan"(GB34),with a frequency of 2 Hz/100 Hz. The gait changes of rats were recorded by animal gait analyzer. The morphological changes of the right gastrocnemius were observed by HE staining. The changes of mast cell aggregation and degranulation in local skin muscles of "chengshan" point were observed by toluidine blue staining. The expressions of Pax7,MyoD and skin mast cells and 5-HT in the right gastrocnemius were detected by immunofluorescence method. The positive expressions of CD68 and CD206 in right gastrocnemius macrophage was observed by immunohistochemical staining.Results Compared with blank group,the wiggle time of the right hind leg in model group and DSCG group increased,stride length decreased,HE staining showed inflammatory cell infiltration,myocyte enlargement,degeneration and necrosis. The degranulation rate of local skin mast cells in "Chengshan" (BL57) area increased,and the expressions of mast cell tryptase,5-HT,Pax7,MyoD,CD68 and CD206 increased (P<0.05). Compared with model group,the wiggle time of the right hind leg in EA group and EA+DSCG group decreased,stride length increased,HE staining showed that inflammatory cell infiltration was reduced,muscle cells were uniform in size and arranged neatly. Mast cell degranulation rate increased significantly in EA group,and the expressions of mast cell tryptase,5-HT,Pax7,MyoD and CD206 increased (P<0.05),while CD68 expression decreased (P<0.05). Compared with EA+DSCG group,the degranulation rate of mast cells and the expressions of mast cell tryptase,5-HT,Pax7,MyoD and CD206 increased (P<0.05),while CD68 expression decreased in EA group (P<0.05). Conclusion EA "Chengshan" (BL57) and "Yanglingquan" (GB34) can stimulate acupuncture points to locally induce mast cell degranulation,promote the polarization of macrophages,and then activate muscle satellite cells to play the regulatory process of repairing skeletal muscle injury.
5.Analysis of factors influencing premature birth in cases with placenta previa complicated by placenta ac-creta spectrum disorders
Jingyu WANG ; Yi HE ; Cuifang FAN ; Guoping XIONG ; Guoqiang SUN ; Shaoshuai WANG ; Suhua CHEN ; Jianli WU ; Dongrui DENG ; Ling FENG ; Haiyi LIU ; Xiaohe DANG ; Wanjiang ZENG
The Journal of Practical Medicine 2024;40(21):2982-2988
Objective To retrospectively analyze of factors influencing early preterm birth(EPB)and late preterm birth(LPB)in pregnancy women with placenta previa complicated by placenta accreta spectrum disorders(PAS),and assess maternal and infant outcomes.Methods We included 590 cases of pregnancy women with placenta previa complicated by PAS who underwent cesarean sections at five hospitals in Wuhan and Xianning cities between January 2018 and June 2021.These patients were divided into three groups based on delivery gesta-tional age:EPB,LPB,and term birth(TB).A multiple logistic regression model was employed to analyze the risk factors associated with EPB and LPB.Additionally,differences in early maternal and infant outcomes among these groups were examined.Results Among 590 pregnancy women with placenta previa complicated by PAS,the proportions of EPB and LPB were 9.7%and 54.4%.The use of uterine contraction inhibitors prior to cesarean section,vaginal bleeding,and previous cesarean sections history were identified as risk factors for both EPB and LPB.The proportion of severe postpartum hemorrhage was comparable between the EPB group and the LPB group;however,the incidence of neonatal asphyxia,low birth weight infants,and the rate of newborns transferred to the Neonatal Intensive Care Unit(NICU)within 24 hours after cesarean delivery were significantly higher in the EPB group compared to the LPB group.Conclusions Placenta previa complicated by PAS predominantly leads to LPB.The history of prior cesarean sections,uterine contractions,and vaginal bleeding prior to cesarean section,are sig-nificantly associated with both EPB and LPB.During the perinatal period,efforts should be made to extend gesta-tional weeks under close monitoring to minimize the incidence of premature births and thereby improve early mater-nal and infant outcomes.
6.Study on the Intervention of Gandouling Tablets in Wilson Disease Based on Autophagy
Jianhua QIAN ; Guocun XU ; Jingyu ZENG
Journal of Medical Research 2024;53(7):57-61
Objective To investigate the clinical efficacy of gandouling tablets in patients with Wilson disease(WD)and the role of autophagy in it.Methods A total of 77WD patients admitted to the Department of Neurology of the First Affiliated Hospital of Anhui U-niversity of Chinese Medicine from February 2021 to October 2022 were retrospectively collected,and divided into treatment group(n=42)and control group(n=35).The treatment group was treated with gandouling tablets(GDLT)combined with western medicine,the control group was treated with western medicine.A total of 40healthy siblings of the patients were selected as the healthy group.The ser-um Beclin-1,p62 and LC3-Ⅱ levels of all subjects were detected by enzyme-linked immunosorbent assay(ELISA),and gene ex-pression levels were detected by extracting peripheral blood single nucleated cells and real-time quantitative polymerase chain reaction(RT-qPCR).All WD patients were scored on the unified Wilson disease rating scale(UWDRS).The correlation between the changes of UWDRS score and the levels of Beclin1,LC3-Ⅱ and p62 in WD patients was also analyzed.The effects of GDLT treatment on UW-DRS score and autophagy proteins Beclin-1,p62 and LC3-Ⅱ in WD patients were analyzed.Results The expression levels of Beclin-1,LC3-Ⅱ protein and mRNA were increased and p62 was significantly decreased in WD patients.UWDRS scores were posi-tively correlated with Beclin-1 and LC3-Ⅱ,and negatively correlated with p62.After GDLT intervention,UWDRS score improved sig-nificantly,Beclin-1 and LC3-Ⅱ levels decreased significantly,and p62 increased significantly(P<0.05).Conclusion Beclin-1,p62,LC3-Ⅱ are closely related to the development of WD,which is of great significance for the evaluation and prognosis of WD.GDLT intervention can inhabit the overactivation of WD autophagy and reverse the progression of WD.
7.Differentiation of cystic biliary atresia and choledochal cysts using prenatal ultrasonography
Lizhu CHEN ; Fujiao HE ; Kaihui ZENG ; Bing WANG ; Jingyu LI ; Dan ZHAO ; Zeyu YANG ; Weidong REN
Ultrasonography 2022;41(1):140-149
Purpose:
This study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC).
Methods:
Fetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth.
Results:
Between January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971.
Conclusion
The GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC.
8.Ultrasound evaluation of acute compartment syndrome: Based on healthy volunteers
Shaoyun LIU ; Jingyu YOU ; Yingnan ZENG ; Mao ZHANG
Chinese Journal of Emergency Medicine 2021;30(12):1476-1483
Objective:To explore the application value of ultrasound in the early noninvasive monitoring of acute compartment syndrome model, and to provide reference for further clinical applications.Methods:This was a prospective self-controlled study. A model of healthy volunteers with acute compartment syndrome was established by cuff compression. The random method was used to determine the experimental side and the control side. The experimental side cuff was given 0, 20, 30, 40, 50, 60, 70, and 80 mmHg pressure in sequence, while the control side cuff was kept uncompressed at all times. Each pressure on the experimental side lasted for 5 min, during which the ultrasound was used to measure the blood flow waveform and vascular structure of the bilateral popliteal artery, popliteal vein and dorsal plantar artery. Statistical analysis was performed using repeated measures analysis of variance and multivariate analysis of variance.Results:The study included 25 healthy volunteers. There was no statistically significant difference in calf circumference and anterior tibial compartment thickness ( P = 0.314 and 0.678). During compression, the volunteers' heart rate and blood pressure were stable ( P = 0.235 and 0.358). On the experimental side, the maximum blood flow velocity of the popliteal artery during systole increased with the increase of pressure ( P<0.001), and the minimum blood flow velocity of the popliteal artery increased with the increase of pressure ( P<0.001). When pressurized by 30 mmHg, the maximum blood flow velocity of the popliteal artery on the experimental side was significantly higher than that on the control side [(73 ± 19) cm/s vs (59 ± 14) cm/s, P=0.023)]. When pressurized by 20 mmHg, the minimum blood flow velocity of the popliteal artery on the experimental side was significantly higher than that on the control side [(-28 ± 8) cm/s vs (-22 ± 6) cm/s, P=0.012)]. With the increase of pressure, the diastolic retrograde arterial flow ratio of the experimental side gradually increased ( P <0.001), and when the pressure was increased by 20 mmHg, the diastolic retrograde arterial flow ratio of the experimental side of the popliteal artery increased significantly [(0.42 ± 0.14) cm/s vs (0.30 ± 0.12) cm/s, P=0.009)]. The systolic prograde arterial flow ratio of the dorsal artery in the experimental side decreased with the increase of pressure ( P = 0.024). Conclusions:Increased limb compartment pressure can significantly change the arterial flow waveform of the proximal and distal arteries, and ultrasound can be used as an early monitoring tool for acute compartment syndrome.
9.Analysis of the factors of brucellosis infection in professional population in Jingyuan County, Gansu Province
Wu LIU ; Tongxia ZENG ; Xiaobin HU ; Jiusheng WEI ; Jingyu LI ; Liguo YANG ; Hongrui LIU ; Huijuan KONG
Chinese Journal of Endemiology 2017;36(10):724-730
Objective To investigate influencing factors of brucellosis infection in occupational population in Gansu Province.Methods In Jingyuan County of Gansu Province,using the case-control method,the cases were collected through "National Disease Surveillance Information Reporting Management System",the case group was confirmed as brucellosis professionals after laboratory tests were positive in 2013-2015 (203 cases),and the control group was confmmed as occupations without brucellosis (809 cases) in the same periods.Information on general sociological characteristics and occupational exposure characteristic was collected,non-conditional Logistic regression analysis was used for analyzing influence factors of brucellosis.Results A total of 1 012 questionnaires were collected,among them,203 were case group and 809 were control group.Logistic regression analysis showed that,captive (OR =1.971,95%CI:1.193-3.256),type of water source (lage,OR =1.610,95%CI:1.392-1.950),often stripping the dead lamb (OR =2.027,95 % CI:1.272-3.231),processing abortion material (throwing away,feeding the dog,stripping;OR =2.120,1.176,2.160;95%CI:1.274-3.731,1.148-2.134,1.548-4.671),often eating dead meat (OR =2.497,95%CI:1.438-4.339),Hui nationality (OR =1.202,95%CI:1.061-1.995),household income less than 10 000 yuan (OR =3.857,95%CI:1.593-9.336),work experience 1-4 years (OR =2.892,95%CI:1.838-4.552) were major risk factors for occupational persons suffering from brucellosis.Livestock was sheep or sheep and goats (OR =0.412,0.277,95%CI:0.217-0.782,0.107-0.720),married(OR =0.124,95%CI:0.016-0.979),wearing gloves and mask when exposed to livestock or livestock lambing (OR =0.455,95%CI:0.230-0.899),and livestock vaccination (OR =0.283,95%CI:0.107-0.747) were protective factors for occupational infection of brucellosis.Conclusions The poor living habits and behaviors of professional people in Jingyuan County of Gansu Province are the main causes of the disease.Among them,captive,often stripping the dead lamb,processing abortion material,eating dead meat are the risk factors for brucella infection.Wearing masks and gloves when livestock lambing,and livestock vaccination are important means in avoiding brucellosis infection.
10.On the optimal management of the closed-loop management in safe practice of nursing teaching in private hospitals
Xiaohua ZENG ; Baohua XU ; Jingyu YE ; Yiwen JIANG ; Liping ZENG ; Danju LI
Chinese Journal of Medical Education Research 2015;14(6):630-635
Objective To study the optimal management of the closed-loop management in safe practice of nursing teaching in private hospitals.Method Through analyzing the causes and problems during the teaching of nursing adverse events,the closed-loop management in safe practice of nursing teaching was investigated,including the closed-loop management team,implementation cycle and range,etc.Totally 100 teachers and 220 students were chosen in 27 clinical teaching departments of our hospital during January 2013 and March 2014.The teachers were divided into experimental group (n=50) and the control group (n=50).The closed-loop management model was applied in experimental group while routing management was applied in control group.At the same time,220 students' behavior in experimental group was compared before and after the closed-loop management.Through the evaluation of nursing teaching' safe hidden trouble and questionnaire survey,the nursing teaching of both groups were safe.SAS 9.2 was applied to do statistical analysis and non-parametric Wilcoxon Fisher exact test and x2 test were used.Results The number of teachers' operating key points in experimental group was significantly higher than the control group,with statistically significant differences (46 vs.15) (P=0.000).The safety hazard times of nursing teaching were 38 and 8 respectively before and after the closed loop management,and the difference was statistically significant (P=0.000).In addition,the comparison before the students' implementing the check system,hospital safety index patients and regulation for technical operations and hospital infection was significant after the closedloop management (P<0.01 for all).Conclusion The full implementation of the closed-loop management,effective tracking and prevention in place,can optimize the safety management of nursing teaching.

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