Objective To investigate the association of sleep disorders with the development and progression of nonalcoholic fatty liver disease(NAFLD).Methods A total of 1 868 participants from the health examination cohort and fatty liver cohort of Beijing Friendship Hospital from June 2022 to June 2023 were enrolled as subjects.Related data were collected from all subjects,including age,sex,education level,chronic medical history,and biochemical parameters,and all subjects completed Pittsburgh Sleep Quality Index(PSQI)scale independently.According to the diagnostic criteria,the subjects were divided into non-NAFLD group with 1 122 subjects and NAFLD group with 746 subjects,and according to the stage of progression,the patients in the NAFLD group were further divided into simple fatty liver group(SFL group with 624 subjects)and nonalcoholic steatohepatitis(NASH)group with 122 subjects.A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between three groups.The chi-square test was used for comparison of categorical data between the three groups.The binary Logistic regression analysis was used to investigate the association between sleep factors and NAFLD,and the multinomial Logistic regression analysis was used to investigate the association between sleep factors and the different stages of NAFLD;two multivariate models were constructed for adjustment of potential confounding factors,i.e.,an age-sex adjustment model and a multivariate adjustment model,and the multivariate adjustment model adjusted the factors of age,sex,education level,smoking,diabetes,hypertension,body mass index(BMI),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C).Results There were significant differences in age,sex,BMI,education level,smoking,diabetes,hypertension,alanine aminotransferase,TG,and HDL-C between the non-NAFLD,SFL,and NASH groups(all P<0.05).There were also significant differences between the three groups in the total score of PSQI scale and the proportion of subjects with a score of 0—3 points for the 7 sleep components(all P<0.05).The multivariate adjustment model showed no significant association between sleep disorders and SFL,while long sleep latency(odds ratio[OR]=4.04,95%confidence interval[CI]:2.33—7.03,P<0.001),short sleep duration(OR=3.53,95%CI:1.83—6.82,P<0.001),and severe sleep disorders(OR=2.96,95%CI:1.48—5.93,P=0.002)were closely associated with the risk of NASH.Conclusion Overall sleep condition and its components of sleep disorders are not significantly associated with the simple fatty liver;however,long sleep latency,short sleep duration,and severe sleep disorders can increase the risk of NASH,which should be taken seriously in clinical practice.

Objective:To investigate the effect and mechanism of human umbilical cord mesenchymal stem cells (hUCMSCs) transplantation on testicular function in aging mice with oxidative damage.Methods:Totally 18 SPF grade C57BL/C male mice aged 6-8 weeks were randomly divided into 3 groups using a complete randomization method. In control group, mice were injected with an equal amount of physiological saline; in model group, mice were subcutaneous injected D-galactose into the neck and back for 9 consecutive weeks, on the 4th weekend of modeling, the mice were injected with physiological saline via the tail vein; in hUCMSCs group: mice were subcutaneous injected D-galactose into the neck and back for 9 consecutive weeks, on the 4th weekend of modeling, the mice were injected with hUCMSCs via the tail vein of each mouse. After 9 weeks, body weight and testicular weight of the three groups mice were measured and testicular index was calculated. The contents of testosterone, malondialdehyde (MDA) and superoxide dismutase (SOD) in serum and testicular tissue were detected by enzyme-linked immunosorbent assay (ELISA) method. Visual observation of testicular appearance, the histopathological changes of testis were observed by hematoxylin-eosin (HE) staining, and the expression of NF-E2-related factor 2 (Nrf2) signal transduction-related genes and proteins were detected by RT-PCR and Western blotting, respectively.Results:Compared with control group [(0.81±0.13)%], the testicular index of mice in model group [(0.64±0.05)%, P=0.006] was decreased. In model group, the volume of testis was reduced, the integrity of spermatogenic tubules was damaged, spermatogenic cells and sperm were reduced, and the interstitium was sparse. In model group, serum testosterone [(4.10±0.67) μg/L] and SOD [(48.87±6.40) U/mg Prot] were decreased compared with control group [(5.71±0.81) μg/L, P=0.002; (78.53±9.70) U/mg Prot, P=0.001], MDA [(1.11±0.19) nmol/mg Prot] was increased compared with control group [(0.77±0.07) nmol/mg Prot, P=0.001], Keap1 mRNA and protein expression were increased ( P=0.006, P=0.043). The expression levels of Nrf2, SOD and NQO1 mRNA were significantly lower than those in control group ( P=0.002, P<0.001, P=0.001), and the expression levels of Nrf2 and HO-1 protein were significantly lower than those in control group ( P=0.011, P=0.021). Compared with the model group, the testicular index [(0.79±0.03)%, P=0.010] increased in hUCMSCs group, and the tissue structure of testis was clear and complete, spermatogenic cells at all levels of spermatogenic tubules, spermatogenic cells and stromal cells were abundant. Compared with the model group, the content of dihydrotestosterone [(5.24±0.21) μg/L, P=0.028] in serum and SOD [(79.47±14.32) U/mg Prot, P=0.001] in testicular tissue increased in hUCMSCs group, while the content of MDA [(0.77±0.08) nmol/mg Prot, P=0.001] decreased, Nrf2, SOD and NQO1 mRNA expression levels increased ( P=0.024, P=0.037, P=0.005), Keap1 mRNA expression decreased ( P=0.044), Nrf2 and HO-1 proteins expression increased ( P=0.009, P=0.012), while Keap1 protein expression decreased ( P=0.035). There were no statistically significant differences in testicular index, serum testosterone, SOD and MDA between hUCMSCs group and control group (all P>0.05). Conclusion:hUCMSCs significantly improve testicular structure and function damage caused by oxidative damage in aging mice, and the mechanism of action is related to upregulating Nrf2 signaling and downstream antioxidant activity SOD and HO-1 protein expression, reducing Keap1 mediated Nrf2 degradation.

Objective:To investigate the effect and mechanism of human umbilical cord mesenchymal stem cells (hUCMSCs) transplantation on testicular function in aging mice with oxidative damage.Methods:Totally 18 SPF grade C57BL/C male mice aged 6-8 weeks were randomly divided into 3 groups using a complete randomization method. In control group, mice were injected with an equal amount of physiological saline; in model group, mice were subcutaneous injected D-galactose into the neck and back for 9 consecutive weeks, on the 4th weekend of modeling, the mice were injected with physiological saline via the tail vein; in hUCMSCs group: mice were subcutaneous injected D-galactose into the neck and back for 9 consecutive weeks, on the 4th weekend of modeling, the mice were injected with hUCMSCs via the tail vein of each mouse. After 9 weeks, body weight and testicular weight of the three groups mice were measured and testicular index was calculated. The contents of testosterone, malondialdehyde (MDA) and superoxide dismutase (SOD) in serum and testicular tissue were detected by enzyme-linked immunosorbent assay (ELISA) method. Visual observation of testicular appearance, the histopathological changes of testis were observed by hematoxylin-eosin (HE) staining, and the expression of NF-E2-related factor 2 (Nrf2) signal transduction-related genes and proteins were detected by RT-PCR and Western blotting, respectively.Results:Compared with control group [(0.81±0.13)%], the testicular index of mice in model group [(0.64±0.05)%, P=0.006] was decreased. In model group, the volume of testis was reduced, the integrity of spermatogenic tubules was damaged, spermatogenic cells and sperm were reduced, and the interstitium was sparse. In model group, serum testosterone [(4.10±0.67) μg/L] and SOD [(48.87±6.40) U/mg Prot] were decreased compared with control group [(5.71±0.81) μg/L, P=0.002; (78.53±9.70) U/mg Prot, P=0.001], MDA [(1.11±0.19) nmol/mg Prot] was increased compared with control group [(0.77±0.07) nmol/mg Prot, P=0.001], Keap1 mRNA and protein expression were increased ( P=0.006, P=0.043). The expression levels of Nrf2, SOD and NQO1 mRNA were significantly lower than those in control group ( P=0.002, P<0.001, P=0.001), and the expression levels of Nrf2 and HO-1 protein were significantly lower than those in control group ( P=0.011, P=0.021). Compared with the model group, the testicular index [(0.79±0.03)%, P=0.010] increased in hUCMSCs group, and the tissue structure of testis was clear and complete, spermatogenic cells at all levels of spermatogenic tubules, spermatogenic cells and stromal cells were abundant. Compared with the model group, the content of dihydrotestosterone [(5.24±0.21) μg/L, P=0.028] in serum and SOD [(79.47±14.32) U/mg Prot, P=0.001] in testicular tissue increased in hUCMSCs group, while the content of MDA [(0.77±0.08) nmol/mg Prot, P=0.001] decreased, Nrf2, SOD and NQO1 mRNA expression levels increased ( P=0.024, P=0.037, P=0.005), Keap1 mRNA expression decreased ( P=0.044), Nrf2 and HO-1 proteins expression increased ( P=0.009, P=0.012), while Keap1 protein expression decreased ( P=0.035). There were no statistically significant differences in testicular index, serum testosterone, SOD and MDA between hUCMSCs group and control group (all P>0.05). Conclusion:hUCMSCs significantly improve testicular structure and function damage caused by oxidative damage in aging mice, and the mechanism of action is related to upregulating Nrf2 signaling and downstream antioxidant activity SOD and HO-1 protein expression, reducing Keap1 mediated Nrf2 degradation.

The diagnosis related groups( DRGs) method is applied in hospital management at both hospital and clinical department level. This technology enabled us to evaluate hospital medical services in general, objectively evaluate discipline development, and formulate individualized discipline guidelines, supporting scientific distribution of hospital resources. At the department level, the technology supported clinical departments in their discipline construction and quality management. The application of DRGs can improve fine management of hospitals.

Objective: To explore the effectiveness of Balint group on compassion fatigue among oncology nurses. Methods: From January to December 2016, 35 oncology nurses from one general hospital were enrolled. 18 cases were allocated in the observation group and 17 cases in the control group by computer randomization. Nurses in the observation group were received a total of 8 times Balint Group activities, with 2 times a month and 1.5 hours each time, which is aiming to discuss difficult cases encountered in the clinic to help nurses have a deeper experience and a better understanding of the emotions and behaviors, fantasies and needs between nurse-patient interaction. Nurses in the control group without intervention. All the Participants were requested to complete the survey of the Professional Quality of Life (ProQOL) , the Jefferson Scale of Empathy-Health Professionals (JSE-HP) , and the General Health Questionnaire (GHQ) at pre and post intervention. Results: Before intervention, two group of nurses in age, working years, marriage, and education were not statistically significant (P>0.05). There was no difference in the scores of empathy, compassion satisfaction, secondary traumatic stress, and General health (P>0.05). After intervention, the scores of JSE-HP and its three dimensions of perspective taking, emotional care, and trans-positional consideration in the observation group had significantly higher than the control group (P<0.05). The level of compassion satisfaction in the observation group was higher, and the general health status was lower (P<0.05). There was no statistically difference in the level of burnout and secondary traumatic stress between two groups (P>0.05) . Conclusion Balint group has a positive role in promoting nurses’empathetic skills, compassion satisfaction and mental health.

Objective To investigate the effect of informationalized monitoring processing system in prevention and control of pressure ulcer. Methods The informationalized monitoring processing system was constructed to collect information. The nursing department sent it to the ulcer treatment group and they worked together to treat and control the ulcers in patients in a dynamic and real-time way. The effect was compared before and after application. Results After use of the system, the pressure ulcers incidence in the hospital was significantly decreased as compared with pre-construct of the system. The reporting and improvement rates were significantly improved than those before(P<0.05). Conclusion The use of the informationalized monitoring processing system makes the reporting of pressure ulcers timely and accurate, helping control the occurrence and treatment of ulcers dynamically, so that the quality of pressure ulcer prevention and control is improved.

Objective To study the combination effects of telmisartan and pioglitazone on the expression of heparanases (HPA) and podocin in the kidney of diabetic nephropathy (DN) rats and its possible mechanism. Methods DN model rats were established by intraperitoneal injection with STZ for 12 weeks. All the DN rats were randomly divided into telmisartan group (T group), pioglitazone group (P group), combination of telmisartan and pioglitazone group (L group), and DN group (D group). Healthy rats were chosen as healthy control group(N group). After garage with drugs for 12 weeks, 24-h urinary protein and serum biochemical indicators were examined. RT-PCR and immunohistochemistry methods were applied to detect the mRNA and protein expression of HPA and podocin. Results Compared with T group and P group, 24-h urinary protein of L group was markedly decreased(P<0.05). Compared with the N group, the level of fasting blood glucose, relative renal weight, BUN and Scr in other 4 groups were markedly increased (P<0.05). Compared with T group and P group, the Scr level and the expression of HPA mRNA and protein in L group was markedly decreased (P<0.05), and the protein and mRNA expression of podoein in L group was markedly increased (P<0.05). Conclusion Combination of telmisartan and pioglitazone can down-regulate the mRNA and protein expression of HPA of glomerular basement membrane and up-regulate the protein expression of podocin of podocyte in DN rats, which may ameliorate the proteinuria.