Objective To investigate the effect of Yiqi Jiedu Recipe(YQ)on the proliferation,migration,and invasion of nasopharyngeal carcinoma cells,and to explore its mechanisms of action on proliferation,migration,and invasion through the TGF-β1/SMAD3 signaling pathway.Methods(1)The 5-8F cells were divided into four groups:solvent control group,YQ 0.5 mg·mL-1 group,YQ 1.0 mg·mL-1 group,and 5-fluorouracil 2 μg·mL-1 group.Cell proliferation was monitored using real-time cell analysis(RTCA).Wound healing experiment was conducted to assess cell migration.After 24 hours of drug intervention,transwell assay was employed to measure cell invasion.The protein expression levels of β-catenin,E-cadherin,N-cadherin,TGF-β1,and SMAD3 in the cells were evaluated using the Western Blot method.(2)The 5-8F cells were divided into five groups:solvent control group,TGF-β1 10 ng·mL-1 group,TGF-β1 10 ng·mL-1+YQ 1.0 mg·mL-1 group,YQ 1.0 mg·mL-1 group,and LY3200882 10 μmol·L-1 group.Cell proliferation was monitored using RTCA.Wound healing experiment was conducted to assess cell migration.After 24 hours of drug intervention,transwell assay was employed to measure cell invasion.The protein expression levels of β-catenin,E-cadherin,N-cadherin,TGF-β1,and SMAD3 in the cells were evaluated using Western Blot.(3)The nude mice were randomly assigned into the model group,YQ group,and 5-fluorouracil group.Subcutaneous injection of 5-8F cell suspension was performed to establish the xenograft nude mouse model of nasopharyngeal carcinoma.After the tumors reached a certain size,the 5-fluorouracil group received intraperitoneal injection of 5-Fu once every 2 days,while the other groups were orally administered corresponding drugs once a day for three consecutive weeks.Tumor volume was measured every 3 days.Western Blot was conducted to assess the protein expression levels of β-catenin,E-cadherin,and N-cadherin in the tissues of each group.Results Compared with the solvent control group,the proliferation curves of 5-8F cells in the YQ(0.5 mg·mL-1,1.0 mg·mL-1)groups showed a decrease.The migration and invasion abilities of the cells were both reduced(P＜0.05,P＜0.01).Additionally,the expression of E-cadherin protein significantly increased(P＜0.01),while the protein expression of β-catenin,N-cadherin,TGF-β1,and SMAD3 all decreased(P＜0.05,P＜0.01).Compared with the model group,the transplanted tumor volume of nasopharyngeal carcinoma in the YQ group significantly decreased(P＜0.05).Furthermore,the protein expression of β-catenin and N-cadherin in the transplanted tissues of the YQ group was significantly downregulated(P＜0.05,P＜0.01),while the expression of E-cadherin protein was significantly upregulated(P＜0.01).After the addition of the activator and inhibitor of TGF-β1 signaling pathway,compared with the YQ 1.0 mg·mL-1 group,the TGF-β1 10 ng·mL-1+YQ 1.0 mg·mL-1 group showed a significant increase in the expression of TGF-β1,SMAD3,β-catenin,and N-cadherin proteins(P＜0.05,P＜0.01)and obvious enhancement of the abilities of cell proliferation,migration,and invasion(P＜0.01).Conclusion Yiqi Jiedu Recipe can inhibit the proliferation,migration,and invasion by regulating the TGF-β1/SMAD3 signaling pathway.

The implementation of the "three-child" policy has increased the workload of obstetric nursing and the proportion of elderly pregnancies. Therefore, it is worth exploring how to improve the core competencies, professional skills and service quality of obstetric nurses. This article reviews the content, characteristics and application status of the core competency assessment tool for obstetric nurses, in order to provide a basis for constructing a core competency assessment tool for obstetric specialist nurses.

Objective To investigate the role of bone marrow mesenchymal stem cells (BMSCs) pretreated with erythropoietin (EPO) in the prevention of acute rejection after renal transplantation in rats. Methods BMSCs were divided into five groups: control group (without EPO), group A (pretreated with EPO at a final concentration of 10 IU/mL), group B (pretreated with EPO at a final concentration of 100 IU/mL), group C (pretreated with EPO at a final concentration of 500 IU/mL) and group D (pretreated with EPO at a final concentration of 1 000 IU/mL). In each group, the BMSCs were cultured for 24 h and 48 h. The proliferation rate of the BMSCs was determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. The BMSCs were divided into two groups: BMSC group (without EPO) and EPO-BMSC group (pretreated with EPO at a final concentration of 500 IU/mL). After 48 h culture, Western blot was adopted to measure the expression level of CXC chemokine receptor (CXCR) 4 protein in BMSCs. Wistar rats were used as the donors, and SD rats were utilized as the recipients to establish the rat models with acute rejection after renal transplantation. The recipient rats were randomly divided into four groups (n=6 in each group) including the control group (without any intervention), EPO group (injection of 1 mL of solution containing 500 IU EPO via tail vein immediately after surgery), BMSC group (injection of 1 mL of solution containing 1×106/mL BMSCs via tail vein immediately after surgery) and EPO-BMSC group (injection of 1 mL of solution containing 1×106/mL BMSCs cultured in vitro with 500 IU/mL EPO via tail vein). The level of serum creatinine (Scr) level was determined by Scr detection kit. Western blot was used to detect the expression levels of interferon (IFN)-γ and interleukin (IL)-4 proteins. Results After 24 h culture, the proliferation rate of BMSCs did not significantly differ among all groups (all P>0.05). After 48 h culture, the proliferation rate of BMSCs in group C (pretreated with EPO at a final concentration of 500 IU/mL) was significantly higher than that in the control group (P<0.05). Compared with the BMSC group, the expression level of CXCR4 protein on the surface of BMSCs was higher in the EPO-BMSC group (P<0.05). At 1 d after renal transplantation, the levels of Scr did not significantly differ among all groups (all P>0.05). At 5 d after operation, the levels of Scr in the EPO, BMSC and EPO-BMSC groups were significantly lower than that in the control group (all P<0.05). The level of Scr in the EPO-BMSC group was markedly lower than those in the EPO and BMSC groups (both P<0.05). At postoperative 1 d and 5 d, the expression levels of IL-4 protein in the kidney tissues did not significantly differ among all groups (all P>0.05). At 1 d after surgery, compared with control group, the expression levels of IFN-γ protein and IFN-γ/IL-4 ratio in the renal tissues in the EPO, BMSC and EPO-BMSC groups were significantly decreased to varying extents (all P<0.05), and similar results were obtained at 5 d after surgery (all P<0.05). The expression levels of IFN-γ protein and IFN-γ/IL-4 ratio in the EPO-BMSC group were significantly lower than those in the EPO group and BMSC group (both P<0.05). Conclusions BMSCs pretreated with EPO can prevent the incidence of acute rejection after renal transplantation and protect the renal graft function.

Objective To observe the anesthesia effect of propofol combined with small dose of sufentanyl in the painless gastroscopy.Methods From January 2017 to June 2017,68 patients with painless gastroscopy in Lishui Central Hospital were selected in the research.According to the digital table,the patients were randomly divided into observation group (propofol and sufentanil ) and control group (propofol plus fentanyl ),with 34 cases in each group. The anesthesia effect , the intraoperative vital signs , directional recovery and consciousness recovery time were compared between the two groups.The adverse reactions were recorded.Results The effective rate of anesthesia in the observation group was 100.00%,which was significantly higher than 82.35%in the control group (χ2＝8.856, P＜0.05).After medication, the MAP, HR, RR, SpO2in the observation group were ( 73.15 ±6.15 ) mmHg, (67.52 ±9.15)times/min,(11.02 ±2.54)times/min,(91.54 ±1.02)%,respectively,compared with those before medication [(87.51 ±8.16)mmHg,(81.02 ±10.24)times/min,(18.24 ±1.52)times/min,(98.45 ±1.52)%], the differences were statistically significant (t＝8.194,5.732,14.305,5.732,all P＜0.05).After medication,the MAP,HR,RR,SpO2in the control group were (73.20 ±6.16) mmHg, (67.62 ±9.14) times/min, (11.03 ± 2.58)times/min,(91.58 ±1.05)%,respectively,compared with those before medication [(87.59 ±8.14)mmHg, (81.05 ±10.28) times/min,(18.25 ±1.56) times/min,(98.46 ±1.58)%],the differences were statistically significant (t＝8.219,5.692,13.963,21.146,all P＜0.05).The differences of MAP,HR,RR and SpO2between the two groups after medication were not statistically significant (t ＝0.033,0.045,0.019,0.159,all P＞0.05).The orientation force recovery time and consciousness recovery time in the observation group were (3.01 ±0.75) min, (2.02 ±1.05)min,respectively,which were shorter than those in the control group [(4.67 ±1.20)min,(3.71 ± 1.18)min],the differences were statistically significant (t＝6.840,6.238,all P＜0.05).The dosage of propofol of the observation group was (1.03 ±0.19)mg/kg,which was less than (1.77 ±1.58)mg/kg of the control group,the difference was statistically significant (t＝2.711,P＜0.05).The incidence rate of adverse reaction in the observation group (0.00%) was lower than that in the control group (20.59%) (χ2＝7.803,P ＜0.05).Conclusion Application of propofol combined with small dose of sufentanil in painless gastroscopy has satisfactory anesthetic effect,and with stable vital signs,redirected restore and consciousness recovery time ,small adverse reactions,drug safety,it is worthy of clinical promotion.

Juvenile myoclonic epilepsy (JME) diagnosed with seizure history,semiology and electroencephalography is a syndrome of idiopathic generalized epilepsy.MRS can quantitatively detect the concentration of neurometabolites noninvasively,and assess the metabolic changes in brain.Currently,studies of pathogenesis of JME are focused on the dysfunction of thalamo-cortical network and the neurometabolites and imbalance of Glutamate and γ-aminobutyric acid in the network are alterted.Epilepsy is associated with the imbalance of the ratio of excitatory and inhibitory amino acid,and seizures lead to neuronal lesions which result in altered concentration of neuron related metabolites.This article reviewed MRS studies of JME by combining material metabolism,neural structure and function.

Aim To explore the protective roles of lic-ochalcone A ( LA) on mice with cigarette smoke-medi-ated acute lung injury and the related mechanisms. Methods In vivo: Mice were exposed to cigarette smoke ( CS) to establish acute lung injury model. The bronchoalveolar lavage fluid ( BALF ) was conducted for cell counting. The mRNA and protein expression of keratinocyte-derived chemokine ( KC ) , tumor necrosis factor alpha ( TNF-α) , interleukin 1β ( IL-1β) and matrix metalloproteinases ( MMP)-9 in lungs were de-termined. The myeloperoxidase ( MPO ) , superoxide dismutase ( SOD ) activities and glutathione ( GSH ) levels in lungs were quantified. The paraffin sections of lungs were prepared and stained with HE. In vitro:Human lung epithelial cells (BEAS-2B) were exposed to cigarette smoke extract ( CSE ) , which induced cell injury. The releases of interleukin 8 (IL-8) and MMP-9 were assessed. The phosphorylation of mitogen-acti-vated protein kinases ( MAPKs, including ERK1/2, p38 and JNK ) and nuclear factor-κB ( NF-κB ) p65 protein were analyzed by Western blot. Results In vi-vo: The accumulation of inflammatory cells was lower in LA groups than that in model group. In comparison with normal control group, the mRNA and protein lev-els of KC, TNF-α, IL-1βand MMP-9 were significant-ly increased in model group. Following treatment with LA, the above indicators were significantly decreased as compared to model group. In the CS-exposed mice, the MPO activity in lungs was significantly increased, meanwhile the SOD activity and GSH level were signif-icantly decreased compared with the air-exposed ani-mals. CS-induced activity of MPO was significantly in-hibited, which were accompanied by increases in SOD and GSH levels by LA. In vitro: CSE-induced mRNA levels of IL-8 and MMP-9 were significantly inhibited by LA at 2 . 5 and 5 μmol · L-1 . The CSE-induced phosphorylation of ERK1/2 and nucleus NF-κB p65 protein expression were prevented by pretreatment with LA. Conclusions LA has protective effects on CS-ex-posed acute lung injury in mice by preventing CS-in-duced pulmonary inflammation, oxidative stress and protease rise. The exploration of the mechanisms sug-gests that LA exerts protective effects via suppressing ERK1/2/NF-κB pathways.

Objective To explore the significance of shock index in the early assessment of patients with severe sepsis and septic shock.Methods A retrospective study of 100 patients with severe sepsis and septic shock admitted in the Emergency Department of the Beijing Friendship Hospital from September 2011 to August 2013 was carried out.According to the 28-day outcome,all patients were divided into survival group (n =48) and death group (n =52).Shock index of patients was calculated at admission (SI1) and 2 hours after resuscitation (SI 2).Results (1) The SI1 and SI2 (1.5 ± 0.05),(1.2 ± 0.04) in the death group were significantly higher than those (1.3 ± 0.08),(0.9 ± 0.05),in the survival group (P ＜ 0.01) ; (2) AUC of SI1 and SI2 of death group were 0.7075 and 0.8894,respectively.The SI2 showed higher sensitivity (80.3％) and specificity (78.4％) compared to SI1.The optimal cut-off point for SI2 was ≥ 1.Conclusions SI2 may potentially be utilized as a reliable predictor for death in patients with septic shock and severe sepsis in an emergency department.

Objective To explore the clinical features and feasibility of renal transplantation for end-stage renal disease (ESRD) following hematopoietic stem cell transplantation (HSCT).Method A retrospective study was done in one case of renal transplantation for ERSD following HSCT.Clinical manifestations were summarized and prognosis was described.The 22-year-old male recipient had received HLA allele matched related bone marrow transplantation from his sister in 2001 and accepted renal transplantation 14 years after HSCT because of delayed renal dysfunction.Donor was a cardiac death patient,the preoperative Panel Reactive Antibody Testing was negative and there were 1.5 HLA antigen mismatches of 6 HLA-A,B,DR antigens of donor and recipient.The recipient received immunosuppressive therapy of tacrolimus + mycophenolate mofetil + steroid after renal transplantation.Result The patient's renal function remained stable and serum creatinine level was 65 μmol/L.The outcome of the patient was fairly good during the follow-up period of short-term.Conclusion Renal transplant is a feasible alternative for patients with ESRD following HSCT.If the transplanted kidney and abbr.hematopoietic stem cells are from different donors,irnmunosuppressive treatment is essential after renal transplantation.Long-term follow-up and adjustment of immunosuppression treatment are needed to prevent and treat postoperative complications.

Objective To investigate the interventional treatment timing of patients with non-ST segment elevation myocar-dial infarction with ST segment elevation in lead aVR.Methods Totally 57 cases with non-ST segment elevation myocardial infarc-tion with ST segment elevation in lead aVR in our hospital from July 2010 to July 2013 were selected.They were divided into two groups,30 cases in group A and they were given emergency PCI treatment with in 12 hours of onset,27 cases in group B and they were given emergency PCI treatment within 12-24 hours of onset.Compare the therapeutic efficacy and adverse cardiovascular e-vents after discharge.Results Therapeutic efficacy of group A was better than group B after 1,6,12 month follow up and rate of adverse cardiovascular events of group A was shorter than group B.Conclusion Emergency PCI treatment within 12 hours can im-prove the prognosis of patients with non-ST segment elevation myocardial infarction with ST segment elevation in lead aVR.

Objective:To investigate the clinical efficacy of gabapentin capsules( GBP)combined with amitriptyline and tramadol in the treatment of patients with postherpetic neuralgia( PHü)and anxiety. Methods:Totally 106 PHü patients with anxiety symptoms at different degree were selected and divided into group A(n=53)and group B(n=53). Group A was given GBP,amitriptyline and tramadol,while group was given GBP only. The anxiety,depression,quality of life and pain-relieving intensity( by VAS)of the pa-tients were determined before the medication( T1 )and in the first week( T2 )and the fourth week( T3 )after the medication. Follow-up was carried out regularly according to the requirements to evaluate the clinical efficacy. Results:The anxiety,depression and VAS scores in the two groups on T2 were statistically significant lower than the corresponding results on T1(P<0.05). On T3,however, there were statistically significant differences between the two groups(P<0. 05). The total adverse reaction rate of group A was signif-icantly lower than that of group B(P<0. 05). The total effective rate of group A was significantly higher than that of group B(P<0. 05). Conclusion:GBP combined with tramadol and amitriptyline in the treatment of PHü patients with anxiety can effectively con-trol the pain of the patients,significantly reduce the scores of VAS and improve the quality of life of the patients.