Objective To retrieve,evaluate and summarize the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis and to provide references for clinical practice.Methods We systematically searched computer decision support systems,guideline websites,association official websites and databases for evidence on prevention and nursing care of pregnancy-induced diastasis recti abdominis,including guidelines,expert consensuses,clinical decision-making,systematic reviews and randomized controlled trials.The retrieval period was from the inception of databases to January 2024.There were 4 researchers who evaluated the quality of the included literature independently,extracted and summarized the evidence according to the subject.Results A total of 18 articles were included,including 2 clinical decisions,4 guidelines,5 expert consensuses,3 systematic reviews,and 4 randomized controlled trials.24 pieces of best evidence were summarized from 5 aspects,including the antenatal prevention,team building,nursing assessment,intervention strategies,and effecti-veness evaluation.Conclusion This study summarizes the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis,which can provide a reference basis for nurses to manage diastasis recti abdominis and improve the life quality of maternal woman.

[Objective]To summarize the clinical experience of Professor YAN Jun in treating idiopathic pulmonary fibrosis(IPF)with the principle of"moistening with pungent herbs".[Methods]Through attending the outpatient work and collating the relevant medical records,Professor YAN's understanding of the etiology and pathogenesis of IPF was analyzed,and the theoretical basis,the clinical medication experience of Professor YAN in treating IPF by using Bushen Yifei Xiaozheng Formula were explained and verified with one clinical case.[Results]According to Professor YAN,the pathogenesis of IPF is deficiency of lung and kidney,deficiency of Yin and fluids,loss of nourishment of the lung lobes,resulting in lung impotence;the lung lobes are weak,dysfunctional in declaring and descending,leading to stagnation of Qi movement,inable to move water,phlegm and drink stopping,Qi stagnation and blood stasis,internal accumulation of phlegm and blood stasis,resulting in paralytic obstruction of the lung channels and the occurrence of lung paralysis,and the lung paralysis for a long period of time results in lung dysfunction and the aggravation of impotence.Pungent medicine can disperse and move,enter the lung,promote through the Xuanfu,regulate Qi,disperse blood stasis,expel phlegm and accumulated nodules,and is consistent with the treatment rule of IPF.Based on the principle of"moistening with pungent herbs",Professor YAN creates Bushen Yifei Xiaozheng Formula.The cited IPF patient was deficiency of the lungs and kidneys,phlegm and blood stasis syndrome,the rule of tonifying the lungs and benefiting the kidneys,eliminating phlegm and removing blood stasis was applied,using Bushen Yifei Xiaozheng Formula,which had a good therapeutic effect in clinic.[Conclusion]The efficacy of using"moistening with pungent herbs"in the treatment of IPF is remarkable,and it has a good significance for clinical guidance,which is worth studying and passing on.

BACKGROUND:Osteonecrosis due to drugs is a serious adverse reaction occurring after the application of such drugs.Increasing evidence suggests that the gut microbiota composition is associated with osteonecrosis due to drugs.However,the causal relationship of the gut microbiota to osteonecrosis due to drugs is still unclear. OBJECTIVE:To evaluate the potential causal relationship between the gut microbiota and the risk of osteonecrosis due to drugs using the Mendelian randomization method. METHODS:A two-sample Mendelian randomization study was performed using the summary statistics of gut microbiota from the largest available genome-wide association study meta-analysis(n=13 266)conducted by the MiBioGen consortium as well as the summary statistics of osteonecrosis due to drugs obtained from the FinnGen consortium R9 release data(264 cases and 377 013 controls).Inverse variance weighted,MR-Egger,weighted median,weighted model and simple model were used to examine the causal association between gut microbiota and osteonecrosis due to drugs.Sensitivity analysis was used to test whether the results of the Mendelian randomization analysis were reliable.Reverse Mendelian randomization analysis was performed on all the bacteria as an outcome for effect analysis and sensitivity analysis. RESULTS AND CONCLUSION:Inverse variance weighted estimates suggested that Lentisphaerae(phylum),Lentisphaeria(class),Melainabacteria(class),Gastranaerophilales(order),Rhodospirillales(order),Victivallales(order)and Bifidobacterium(genus)had protective causal effects on osteonecrosis due to drugs.Methanobacteria(class),Bacillales(order),Methanobacteriaceae(family),Lachnospiraceae(family),Methanobacteriales(order),Holdemania(genus),Holdemania(UCG010 group)(genus),Odoribacter(genus)and Tyzzerella3(genus)had negative causal effects on osteonecrosis due to drugs.According to the results of reverse Mendelian randomization analysis,Clostridiaceae1(family),Peptostreptococcaceae(family),Streptococcaceae(family),Clostridiumsensustricto1(genus)and Streptococcus(genus)showed negative causal effects on osteonecrosis due to drugs.However,Eisenbergiella(genus)showed protective causal effects on osteonecrosis due to drugs.None of the bidirectional sensitivity analysis revealed heterogeneity or horizontal pleiotropy.When gut microbiota were used as exposure and osteonecrosis due to drugs as the outcome,Mendelian randomization analysis found that seven bacterial traits were positively correlated to osteonecrosis due to drugs,nine bacterial traits were negatively related to osteonecrosis due to drugs.When osteonecrosis due to drugs were used as exposure and gut microbiota as the outcome,reverse Mendelian randomization analysis found a negative correlated relationship with five bacterial traits and a positive causal relationship with one bacterial trait.By changing the diversity and composition of gut microbiota,it is expected to improve the incidence and prognosis of osteonecrosis due to drugs,providing new ideas for the study of orthopedic diseases.

The pathogenesis of aplastic anemia(AA)is complex and associated with hematopoietic stem cell defect,abnormal bone marrow microenvironment,immune dysfunction,and somatic mutation,in which the immune mechanism plays an important role.This article reviews the pathogenesis of AA from the following aspects:regulatory T cell reduction,hematopoietic stem cell reduction caused by factor-related apoptosis/factor-related apoptosis ligand signaling pathway,aberrant target gene expression induced by inflammatory factor-stimulated microRNAs,and regulatory T cell dysfunction,so as to provide ideas and methods for clinical practice.

Objective To investigate the effect of Fuzheng Touxie Jiedu Decoction on lung injury in Pseudomonas aeruginosa pneumonia(PAP)rats and explore its possible mechanism.Methods The suspension of Pseudomonas aeruginosa(3×109 CFU/mL)0.1 mL was injected by orotracheal cannula to replicate the PAP rat model.A total of 36 SD rats were divided into the normal group,the model group,the Fuzheng Touxie Jiedu Decoction low-(3.18 g/kg),medium-(6.36 g/kg),high-(12.72 g/kg)dose groups and the piperacillin group(0.27g/kg)according to random number table method,with six rats in each group.Rats in each drug administration group received the corresponding drugs,while rats in the normal and model groups received an equal volume of distilled water by gavage once a day for seven consecutive days.Nucleic acid values of Pseudomonas aeruginosa were detected in the lung tissues of rats in each group by real-time fluorescence PCR.Hematoxylin-eosin staining was used to observe pathological morphological changes in lung tissues in rats in each group.Flow cytometry assay was used to detect the differentiation of T helper 17(Th17)cells and regulatory T(Treg)cells in the peripheral blood of rats in each group.Serum tumor necrosis factor-α(TNF-α),transforming growth factor-β(TGF-β),interleukin-6(IL-6),interleukin-10(IL-10),and interleukin-17(IL-17)levels were detected in rats of each group with an enzyme-linked immunosorbent assay.The mRNA level of retinoid-related orphan receptor γt(RORγt),forkhead box protein 3(FoxP3),and related inflammatory factors were detected by real-time fluorescence PCR.The protein expressions of RORγt,FoxP3,and related inflammatory factors were detected by Western blotting.Results The positive detection of Pseudomonas aeruginosa in the serum of model rats and the obvious inflammatory lesions observed in the pathological tissue sections indicated successful modeling.A large number of inflammatory cell infiltration,structural damage and epithelial cell shedding were observed in the lung issue of the model group rats.Compared to the normal group,the proportion of Th17 in CD4 T+cells of peripheral blood of rats in the model group increased,the proportion of Treg decreased and the ratio of Th17/Treg increased(P<0.01).The contents of TNF-α,TGF-β,IL-6,and IL-17 in serum were increased,while IL-10 was decreased(P<0.01).The mRNA expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 increased,while the mRNA expression levels of FoxP3 and IL-10 decreased in the model group(P<0.01).The protein expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 were increased,while those of FoxP3 and IL-10 were decreased(P<0.05,P<0.01).Compared to the model group,damage to lung structure,epithelial exfoliation condition,and inflammatory cell infiltration improved in the Fuzheng Touxie Jiedu Decoction low-,medium-,and high-dose groups and the piperacillin group.The proportion of Th17 decreased,the proportion of Treg increased,and the ratio of Th17/Treg decreased(P<0.05,P<0.01)in the Fuzheng Touxie Jiedu Decoction medium-and high-dose groups and the piperacillin group.Serum levels of TNF-α,TGF-β,IL-6,and IL-17 decreased,while anti-inflammatory factor(IL-10)levels increased in rats in all drug-administered groups(P<0.05,P<0.01).The mRNA expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 were decreased,the mRNA expression levels of FoxP3 and IL-10 were increased in the Fuzheng Touxie Jiedu Decoction medium-,high-dose groups and the piperacillin group(P<0.05,P<0.01).The protein expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 were decreased,the protein expression levels of FoxP3 and IL-10 were increased in the Fuzheng Touxie Jiedu Decoction medium-,high-dose groups and the piperacillin groups(P<0.01).Conclusion Fuzheng Touxie Jiedu Decoction showed a remarkable capability to alleviate lung inflammatory injury in PAP rat models,reduce the levels of proinflammatory factors,and enhance anti-inflammatory factors.Therapeutic efficacy is believed to operate through regulation of Th17/Treg immune balance.

Objective:To explore the effects of the toolkit program for managing symptom clusters of adverse reactions to chemotherapy for ovarian cancer based on the comprehensive symptom management model on the symptom status, self-care ability and quality of life of ovarian cancer patients, and to provide guidance for clinical guidance on symptom management of adverse reactions to chemotherapy for ovarian cancer patients.Methods:A non-simultaneous before-and-after control was used to facilitate the selection of 45 ovarian cancer chemotherapy patients from the Department of Gynecology, Fenyang Hospital, Shanxi Province, from August 2022 to January 2023 as the control group, and 45 ovarian cancer chemotherapy patients from February to July 2023 as the experimeatal group. Routine care was used in the control group, and the experimental group used the Symptom Cluster Management Toolkit program based on the control group. Before intervention and after the end of the first, second, and third chemotherapy cycles, two groups of patients were evaluated using the Functional Assessment of Cancer Therapy-Generic scale and Exercise of Self-Care Agency Scale; after the end of the first, second, and third chemotherapy cycles, Adverse Reaction Events Evaluation Criteria 5.0 was used to evaluate the two groups. The symptom status, self-care ability, and quality of life between two groups of patients were compared.Results:Finally 43 cases in control group and 41 cases in experimental group were included, age of control group was (59.37 ± 8.61) years old and experimental group was (57.10 ± 9.97) years old. After intervention, at the end of the first, second, and third chemotherapy cycles were assessed for side effects, respectively: the nausea rating of the experimental group were 1 (1, 2), 1(1, 2), 2(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); the vomiting rating of the experimental group were 1 (1, 2), 1(1, 2), 1(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); peripheral sensory nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 2), and the control group were 1 (1, 1), 1(1, 2), 2(1, 2); peripheral motor nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group had a 1 (1, 1), 1(1, 2), 2(1, 2); the cognitive impairment rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group were 1 (1, 1), 1(1, 2), 1(1, 2). All the differences were all statistically significant (Wald χ2 were from 4.41 to 6.54, all P<0.05); the control group′s self-care competence scores at the end of the first, second, and third cycles of chemotherapy for patients with ovarian cancer were (106.30 ± 13.03), (109.53 ± 13.85) and (111.95 ± 13.49) points, and (113.68 ± 11.33), (118.95 ± 11.39) and (123.66 ± 11.67) points in the experimental group, and the level of self-care ability of the experimental group was higher than that of the control group when comparing the two groups ( F = 8.61, P<0.05); and the level of quality of life at the end of the first, second, three chemotherapy cycles were (65.35 ± 7.58), (68.58 ± 7.61) and (70.95 ± 7.56) points in the control group, and (70.51 ± 5.89), (74.10 ± 5.70) and (77.00 ± 5.55) points in the experimental group, and the level of quality of life in the experimental group was higher than that of the control group in the comparison between groups ( F = 10.16, P<0.05). Conclusions:The application of the toolkit intervention program for the management of symptom clusters of adverse reactions to chemotherapy in patients with ovarian cancer can reduce the symptom load of patients, improve self-care ability, and improve the quality of life.

Objective To investigate the effect of Fuzheng Touxie Jiedu Decoction on lung injury in Pseudomonas aeruginosa pneumonia(PAP)rats and explore its possible mechanism.Methods The suspension of Pseudomonas aeruginosa(3×109 CFU/mL)0.1 mL was injected by orotracheal cannula to replicate the PAP rat model.A total of 36 SD rats were divided into the normal group,the model group,the Fuzheng Touxie Jiedu Decoction low-(3.18 g/kg),medium-(6.36 g/kg),high-(12.72 g/kg)dose groups and the piperacillin group(0.27g/kg)according to random number table method,with six rats in each group.Rats in each drug administration group received the corresponding drugs,while rats in the normal and model groups received an equal volume of distilled water by gavage once a day for seven consecutive days.Nucleic acid values of Pseudomonas aeruginosa were detected in the lung tissues of rats in each group by real-time fluorescence PCR.Hematoxylin-eosin staining was used to observe pathological morphological changes in lung tissues in rats in each group.Flow cytometry assay was used to detect the differentiation of T helper 17(Th17)cells and regulatory T(Treg)cells in the peripheral blood of rats in each group.Serum tumor necrosis factor-α(TNF-α),transforming growth factor-β(TGF-β),interleukin-6(IL-6),interleukin-10(IL-10),and interleukin-17(IL-17)levels were detected in rats of each group with an enzyme-linked immunosorbent assay.The mRNA level of retinoid-related orphan receptor γt(RORγt),forkhead box protein 3(FoxP3),and related inflammatory factors were detected by real-time fluorescence PCR.The protein expressions of RORγt,FoxP3,and related inflammatory factors were detected by Western blotting.Results The positive detection of Pseudomonas aeruginosa in the serum of model rats and the obvious inflammatory lesions observed in the pathological tissue sections indicated successful modeling.A large number of inflammatory cell infiltration,structural damage and epithelial cell shedding were observed in the lung issue of the model group rats.Compared to the normal group,the proportion of Th17 in CD4 T+cells of peripheral blood of rats in the model group increased,the proportion of Treg decreased and the ratio of Th17/Treg increased(P<0.01).The contents of TNF-α,TGF-β,IL-6,and IL-17 in serum were increased,while IL-10 was decreased(P<0.01).The mRNA expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 increased,while the mRNA expression levels of FoxP3 and IL-10 decreased in the model group(P<0.01).The protein expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 were increased,while those of FoxP3 and IL-10 were decreased(P<0.05,P<0.01).Compared to the model group,damage to lung structure,epithelial exfoliation condition,and inflammatory cell infiltration improved in the Fuzheng Touxie Jiedu Decoction low-,medium-,and high-dose groups and the piperacillin group.The proportion of Th17 decreased,the proportion of Treg increased,and the ratio of Th17/Treg decreased(P<0.05,P<0.01)in the Fuzheng Touxie Jiedu Decoction medium-and high-dose groups and the piperacillin group.Serum levels of TNF-α,TGF-β,IL-6,and IL-17 decreased,while anti-inflammatory factor(IL-10)levels increased in rats in all drug-administered groups(P<0.05,P<0.01).The mRNA expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 were decreased,the mRNA expression levels of FoxP3 and IL-10 were increased in the Fuzheng Touxie Jiedu Decoction medium-,high-dose groups and the piperacillin group(P<0.05,P<0.01).The protein expression levels of RORγt,TNF-α,TGF-β,IL-6,and IL-17 were decreased,the protein expression levels of FoxP3 and IL-10 were increased in the Fuzheng Touxie Jiedu Decoction medium-,high-dose groups and the piperacillin groups(P<0.01).Conclusion Fuzheng Touxie Jiedu Decoction showed a remarkable capability to alleviate lung inflammatory injury in PAP rat models,reduce the levels of proinflammatory factors,and enhance anti-inflammatory factors.Therapeutic efficacy is believed to operate through regulation of Th17/Treg immune balance.

Objective:To explore the effects of the toolkit program for managing symptom clusters of adverse reactions to chemotherapy for ovarian cancer based on the comprehensive symptom management model on the symptom status, self-care ability and quality of life of ovarian cancer patients, and to provide guidance for clinical guidance on symptom management of adverse reactions to chemotherapy for ovarian cancer patients.Methods:A non-simultaneous before-and-after control was used to facilitate the selection of 45 ovarian cancer chemotherapy patients from the Department of Gynecology, Fenyang Hospital, Shanxi Province, from August 2022 to January 2023 as the control group, and 45 ovarian cancer chemotherapy patients from February to July 2023 as the experimeatal group. Routine care was used in the control group, and the experimental group used the Symptom Cluster Management Toolkit program based on the control group. Before intervention and after the end of the first, second, and third chemotherapy cycles, two groups of patients were evaluated using the Functional Assessment of Cancer Therapy-Generic scale and Exercise of Self-Care Agency Scale; after the end of the first, second, and third chemotherapy cycles, Adverse Reaction Events Evaluation Criteria 5.0 was used to evaluate the two groups. The symptom status, self-care ability, and quality of life between two groups of patients were compared.Results:Finally 43 cases in control group and 41 cases in experimental group were included, age of control group was (59.37 ± 8.61) years old and experimental group was (57.10 ± 9.97) years old. After intervention, at the end of the first, second, and third chemotherapy cycles were assessed for side effects, respectively: the nausea rating of the experimental group were 1 (1, 2), 1(1, 2), 2(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); the vomiting rating of the experimental group were 1 (1, 2), 1(1, 2), 1(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); peripheral sensory nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 2), and the control group were 1 (1, 1), 1(1, 2), 2(1, 2); peripheral motor nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group had a 1 (1, 1), 1(1, 2), 2(1, 2); the cognitive impairment rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group were 1 (1, 1), 1(1, 2), 1(1, 2). All the differences were all statistically significant (Wald χ2 were from 4.41 to 6.54, all P<0.05); the control group′s self-care competence scores at the end of the first, second, and third cycles of chemotherapy for patients with ovarian cancer were (106.30 ± 13.03), (109.53 ± 13.85) and (111.95 ± 13.49) points, and (113.68 ± 11.33), (118.95 ± 11.39) and (123.66 ± 11.67) points in the experimental group, and the level of self-care ability of the experimental group was higher than that of the control group when comparing the two groups ( F = 8.61, P<0.05); and the level of quality of life at the end of the first, second, three chemotherapy cycles were (65.35 ± 7.58), (68.58 ± 7.61) and (70.95 ± 7.56) points in the control group, and (70.51 ± 5.89), (74.10 ± 5.70) and (77.00 ± 5.55) points in the experimental group, and the level of quality of life in the experimental group was higher than that of the control group in the comparison between groups ( F = 10.16, P<0.05). Conclusions:The application of the toolkit intervention program for the management of symptom clusters of adverse reactions to chemotherapy in patients with ovarian cancer can reduce the symptom load of patients, improve self-care ability, and improve the quality of life.

Objective To observe the effects of Fuzheng Huayu Capsule on the expressions of the main roles, Rock1 and Rock2, in RhoA/Rock signal transduction pathway in rats with myocardial infarction (MI);To explore the possible mechanism of Fuzheng Huayu Capsule to improve ventricular remodeling in myocardial fibrosis. Methods The MI model was induced by ligation of the left coronary artery. Rats with MI were randomly divided into the model group, Fuzheng Huayu group and Fasudil hydrochloride group. A sham-operation group threading without ligation was setting as a control group, with eight rats in each group. The rats were treated with corresponding medicine for 4 weeks from the second day after modeling. The expression of Rock1, Rock2 and its mRNA were detected by immunohistochemical and real-time PCR method. Results The protein expression of Rock1 and Rock2 in model group were significantly higher than those in the sham-operation group (P<0.05). The protein expression of Rock1 and Rock2 in the Fuzheng Huayu group and Fasudil hydrochloride group were lower than those in the model group. The mRNA expression of Rock2 was significantly higher in the model group than that in the sham-operation group (P<0.05). The mRNA expression of Rock1 in the Fasudil hydrochloride group was lower than that in the model group (P<0.05). The mRNA expression of Rock2 in the Fuzheng Huayu group and Fasudil hydrochloride group was lower than that in the model group (P<0.05). Conclusion Fuzheng Huayu Capsule can decrease the expression of Rock1, Rock2 and Rock2 in the marginal zone of myocardial infarction in rats with MI. The anti ventricular remodeling mechanism of Fuzheng Huayu Capsule maybe related with this.

A 66-year-old woman received Zhibituo 0. 35 g thrice daily by mouth for hypirlipidemia. Four days after the drug administration,the patient developed ache and weakness of deltoid;25 days later, the patient developed generalized aching pain,weakness,and hard to walk up and down stairs;on 4 weeks of the drug treatment,laboratory testing showed the following values:creatine kinase( CK)>6 400 U/L, creatine kinase isoenzyme(CK-MB)of 150. 7 U/L,lactic acid dehydrogenase(LDH)611 U/L,alanine aminotransferase(ALT)52 U/L,aspartate aminotransferase(AST)121 U/L,blood urea nitrogen 10. 1 mmol/L,and creatinine 106 μmol/L. Rhabdomyolysis was diagnosed. The patient received cyclosporine for aplastic anemia for a long time. It was considered that the interaction between Zhibituo and cyclosporin induced the rhabdomyolysis. Zhibituo was stopped and fluid replacement,diuretic,and liver-protective drugs were given. Five days later,the symptoms of generalized aching pain and weakness relieved obviously and CK level decreased to 1 170 U/L. Ten days later,the symptoms of generalized aching pain and weakness disappeared completely and the levels of CK,CK-MB,LDH,ALT,and AST were 59 U/L,6. 3 U/L,173 U/L,17 U/L,and 16 U/L,respectively.