Objective To design and produce a bleeding alert bandage and investigate its effectiveness in patients undergoing hemodialysis.Methods The bleeding alert bandage consists of elastic bandage,monitoring element and monitoring box.A convenience sampling method was used to select patients who received regular hemodialysis treatment in the blood purification center of a tertiary A comprehensive hospital in Anhui Province from January 2021 to June 2021.These patients were randomly assigned into an experimental group and a control group,with 40 cases in each group.Patients in the control group were inspected every 30 min by traditional method.Patients in the experimental group were monitored in real-time with a bleeding alert bandage in addition to the 30 min rounds.The detection rate,incidence,and volume of bleeding at the puncture site were compared in 2 groups of patients.Results The incidence of bleeding from the puncture sites was 17.00％in the experimental group and 25.25％in the control group,with statistical significance(x2=8.170,P=0.004).The incidence of bleeding for severe bleeding from puncture sites was 1.50％in the experimental group and 11.50％in the control group,with statistical significance(x2=32.910,P＜0.001).The bleeding detection rate from puncture sites was 94.12％in the experimental group and 89.11％in the control group,with no statistical difference(x2=1.261,P=0.262).The detection rate for moderate bleeding from puncture sites was 100％in the experimental group and 85.37％in the control group,with statistical significance(x2=6.170,P=0.013).Additionally,the bleeding volume from the puncture site was 1.29(0.88,1.74)g in the experimental group and 2.77(1.60,4.77)g in the control group,with statistical significance(Z=-5.825,P＜0.001).The moderate bleeding volume from the puncture site was 1.49(1.27,1.81)g in the experimental group and 1.92(1.52,2.44)g in the control group,with statistical significance(Z=-2.835,P=0.005).Conclusion The bleeding alert bandage is effective in real-time monitoring and alerting of bleeding at the puncture sites during hemodialysis,which can help reduce the incidence of blood seepage,improve the detection rate of blood seepage,reduce the amount of bleeding and improve the safety of dialysis treatment.

Objective To design and produce a bleeding alert bandage and investigate its effectiveness in patients undergoing hemodialysis.Methods The bleeding alert bandage consists of elastic bandage,monitoring element and monitoring box.A convenience sampling method was used to select patients who received regular hemodialysis treatment in the blood purification center of a tertiary A comprehensive hospital in Anhui Province from January 2021 to June 2021.These patients were randomly assigned into an experimental group and a control group,with 40 cases in each group.Patients in the control group were inspected every 30 min by traditional method.Patients in the experimental group were monitored in real-time with a bleeding alert bandage in addition to the 30 min rounds.The detection rate,incidence,and volume of bleeding at the puncture site were compared in 2 groups of patients.Results The incidence of bleeding from the puncture sites was 17.00％in the experimental group and 25.25％in the control group,with statistical significance(x2=8.170,P=0.004).The incidence of bleeding for severe bleeding from puncture sites was 1.50％in the experimental group and 11.50％in the control group,with statistical significance(x2=32.910,P＜0.001).The bleeding detection rate from puncture sites was 94.12％in the experimental group and 89.11％in the control group,with no statistical difference(x2=1.261,P=0.262).The detection rate for moderate bleeding from puncture sites was 100％in the experimental group and 85.37％in the control group,with statistical significance(x2=6.170,P=0.013).Additionally,the bleeding volume from the puncture site was 1.29(0.88,1.74)g in the experimental group and 2.77(1.60,4.77)g in the control group,with statistical significance(Z=-5.825,P＜0.001).The moderate bleeding volume from the puncture site was 1.49(1.27,1.81)g in the experimental group and 1.92(1.52,2.44)g in the control group,with statistical significance(Z=-2.835,P=0.005).Conclusion The bleeding alert bandage is effective in real-time monitoring and alerting of bleeding at the puncture sites during hemodialysis,which can help reduce the incidence of blood seepage,improve the detection rate of blood seepage,reduce the amount of bleeding and improve the safety of dialysis treatment.

Objective To analyze the hepatitis B virus infection with extreme reduction of cholinesterase(CHE)not caused by liver synthesis dysfunction,and to explore its clinical significance.Methods The clinical data of 2 rare cases hospitalized in the 3rd people's hospital of Kunming in July 2021 and February 2022,including liver function,coagulation function,hepatitis B markers,hepatitis B virus volume,and whole exon sequencing,were collected and analyzed,and literature was reviewed.Results CHE was extremely reduced in 2 patients with HBV infection,liver synthesis function was good,and whole exon sequencing showed the presence of butyrylcholinesterase(BCHE)gene mutation.Conclusion The extremely low CHE in this case is not due to liver function disorder.Exon sequencing detected mutations in the BCHE gene in two patients.Screening for BCHE mutations may be necessary in patients with extremely low cholinesterase levels not due to liver dysfunction.

【Objective】 To conduct a retrospective analysis of HIV Ag-Ab detection by ELISA in our blood center, so as to provide reference for continuous improvement. 【Methods】 The reactive rate of HIV by each reagent, reactive rate of both reagents, re-test rate, concordance rate of initial-repeat test, and reagent utilization rate were counted, and the external quality assessment results were analyzed by PT score and z-ratio. 【Results】 The total reactive rate of HIV was 0.15%. The reactive rate by both reagents was 0.02%. The re-test rates, reactive rates, concordance rates and reagent utilization rates of the two reagents were 0.09% vs 0.08%, 0.07% vs 0.06%, 75.86% vs 78.21%, and 114.54% vs 113.92%, respectively. PT score was 100%, and z-ratio of 7 negative samples and 1 positive sample was less than 2, and of 2 positive samples was more than 3. 【Conclusion】 The laboratory quality monitoring indicators and external quality assessment can effectively monitor the operation of blood testing laboratory.

Objective To study the expression of miRNA-219 and γCaMK Ⅱ mRNA in the peripheral blood of the first-episode major depressive disorder (MDD) patients,and explore the relationship between these molecular level and MDD symptom.Methods Fourty-one first-episode major depressive disorder patients diagnosed with DSM-5 criteria and 31 heahy volunteers were included.The blood was collected in the fasting state and the expression levels of miRNA-219 and γCaMK Ⅱ mRNA was detected.The patients' severity of symptoms was assessed with HAMD17.Real-time PCR was used to detect the levels of miRNA-219 and γCaMK Ⅱ mRNA in peripheral blood leukocytes.The correlation between miRNA-219,γCaMK Ⅱ mRNA and HAMD17 was analyzed.Results The miRNA-219 levels of MDD group was significantly lower than that of control group (0.91 ±0.21 vs.1.80±0.24,t=2.753,P=0.0075) in peripheral blood,and the γCaMK Ⅱ mRNA levels of MDD group was significantly higher than that of control group (5.55±0.57 vs.2.16±0.20,t=4.970,P＜0.01).There was the positive correlation between γCaMK Ⅱ mRNA levels and the HAMD17 score of MDD (r=0.460,P=0.0025).Conclusion The levels of miRNA-219 in peripheral blood of MDD patients decreased,and the levels of γCaMK Ⅱ mRNA increased,suggesting that miRNA-219 and γCaMK Ⅱ may be related to the pathogenesis of depression.

Objective To study the expression of miRNA-219 and γCaMK Ⅱ mRNA in the peripheral blood of the first-episode major depressive disorder (MDD) patients,and explore the relationship between these molecular level and MDD symptom.Methods Fourty-one first-episode major depressive disorder patients diagnosed with DSM-5 criteria and 31 heahy volunteers were included.The blood was collected in the fasting state and the expression levels of miRNA-219 and γCaMK Ⅱ mRNA was detected.The patients' severity of symptoms was assessed with HAMD17.Real-time PCR was used to detect the levels of miRNA-219 and γCaMK Ⅱ mRNA in peripheral blood leukocytes.The correlation between miRNA-219,γCaMK Ⅱ mRNA and HAMD17 was analyzed.Results The miRNA-219 levels of MDD group was significantly lower than that of control group (0.91 ±0.21 vs.1.80±0.24,t=2.753,P=0.0075) in peripheral blood,and the γCaMK Ⅱ mRNA levels of MDD group was significantly higher than that of control group (5.55±0.57 vs.2.16±0.20,t=4.970,P＜0.01).There was the positive correlation between γCaMK Ⅱ mRNA levels and the HAMD17 score of MDD (r=0.460,P=0.0025).Conclusion The levels of miRNA-219 in peripheral blood of MDD patients decreased,and the levels of γCaMK Ⅱ mRNA increased,suggesting that miRNA-219 and γCaMK Ⅱ may be related to the pathogenesis of depression.

Objective To investigate the effect and mechanism of liver X receptor ( LXR ) agonist on expression of fatty acid synthase( FAS) in diabetic kidney. Methods In the part of in vivo study, immunostaining was used to detect the FAS protein expression in kidney. 16-week-old male db/db mice on C57BL/6 background were administered via gavage a LXR synthetic agonist, TO901317, at a dose of 3 mg · kg-1 · d-1 or vehicle ( 0. 5%Carboxymethyl Cellulose Sodium, CMC-Na) alone for 7 d;Quantitative RT-PCR and Western blot were used to detect mRNA and protein levels of FAS and SREBP-1. In the part of in vitro study, MCT cell(a mouse murine proximal tubule cell line)was treated with 10μmol/L TO901317 for 24 h or transfected with active SREBP-1c expression vector (SREBP-1cN). HEK293 cells(a human renal tubule cell line)were transfected with mFAS-(1. 7 kb)-luc, LXR expression vector or SREBP-1cN for 12 h. Quantitative RT-PCR and luciferase reproter assay were utilized to examine FAS mRNA level and FAS promoter activity. Results FAS was abundantly expressed in renal cortex, with low expresson in renal glomeruli. The mRNA and protein expressious of FAS in kidney of db/db mice were lowered compared with db/m mice. TO90137 treatment increased FAS mRNA expression by 1. 3-fold. TO901317 increased expression of SREBP-1 in kidneys of db/m and db/db mice by 5. 1-fold and 17-fold, respectively. TO901317 and overexpression of SREBP-1c increased expression of FAS in MCT cells by 1. 5-fold and 1. 8-fold. Transcription activity of FAS were induced by TO901317, LXR, and SREBP-1cN overexpressions in HEK293 cells. Conclusions Both direct(LXRE)and indirect(SREBP-1c)mechanisms may contribute to the up-regulation of FAS expression by LXR in renal proximal tubule cells.

Objective To investigate the correlation between the level change of serum homocysteine (HCY) and vascular endothelial growth factor (VEGF) with the degree of the coronary artery stenosis in the patients with acute coronary syndrome (ACS) .Methods A total of 157 ACS patients were divided into the ST‐elevation myocardial infarction (STEMI) group ,non‐ST el‐evation myocardial infarction (NSTEMI) group and unstable angina pectoris(UA) group based on the symptoms ,cardiac enzymes level and electrocardiogram changes .The cases were induded into the mild ,moderate and severe stenosis lesion groups according to the coronary arteriography examination;meanwhile the enzyme‐linked immunosorbent assay (ELISA) was used to detect the change of the serum VEGF concentration .The HCY level was determined by enzymatic cycling methods with the biochemical analyzer (BXC800 ,Beckman ,USA) .The differences in the concentrations of VEGF and HCY compared among different groups .Results The VEGF level had statistical differences among the mild ,moderate and sever stenosis groups(F=39 .9 ,P=0 .00) ,and between the UA group with the NSTEMI group and STEMI group(F=123 .3 ,P=0 .00) .The HCY level had statistically significant differ‐ence between the severe stenosis group with the mild and moderate stenosis groups (F=39 .7 ,P=0 .00);the HCY level had statis‐tically significant difference among the UA group ,NSTEMI group and STEMI group(F=102 .65 ,P=0 .00) .The VEGF and HCY levels in the mild stenosis group ,different degrees of coronary stenosis groups and different clinical diagnosis groups were positively correlated with the Gensini scores(r=0 .723 ,0 .716) .Conclusion The serum VEGF and HCY levels are correlated with the degree of the coronary artery lesion and myocardial necrosis in ACS patients ,furthermore are related with the Gensini scores .

OBJECTIVETo compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and 5-HT (5-hydroxytryptamine) selective serotonini reuptake inhibitors (SSRIs) and the single application of SSRIs and explore the impact on the imbalance of 5-HT and TH1/TH2.

METHODSNinety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group, 45 cases in each one. In the medication group, SSRIs were prescribed forl oral administration, once or twice a day, continuously for 4 weeks. In the combined therapy group, on the basis of treatment as the medication group, acupuncture was combined. The main acupoints were Baihui (GV 20), Yintang (GV 29), Shenting (GV 24), Fengchi (GB 20), Dazhui (GV 14) and Sishencong (EX-HN 1), once every two. days, continuously for 4 weeks. Before treatment, and after the 1st, 2nd and 4th weeks of treatment, the Hamilton depression scale (HAMD) was used to evaluate the depression severity. Separately, before and after the 4 weeks of treatment, the levels of serum 5-HT, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-4 (IL-4) and interleukin-10 (IL-10) were determined and compared with those in 45 cases of the healthy group.

RESULTSHAMD score was reduced in the 1st, 2nd and 4th weeks of treatment as compared with that before treatment in the combined therapy group (all P<0 01). HAMD score was reduced in the 2nd and 4th weeks of treatment as compared with that before treatment in the medication group (all P<0. 01). HAMD scores in the combined therapy group were lower than those in the medication group in the 1st, 2nd and 4th weeks of treatment (all P< 0. 01). Before treatment, in the combined therapy group and the medication group, the levels of serum 5-HT, IL-4 and IL-10 were all lower than those in the healthy group (all P<0. 01); the levels of IL-1β and IL-6 were higher than those in the healthy group (all P<0. 01). In the combined therapy group and the medication group, the levels of 5-HT, IL-4 and IL-10 in 4 weeks of treatment were all increased as compared with those before treatment (all P<0. 01), and the levels of IL-1β and IL-6 were lower than those before treatment (all P<0. 01). In the combined therapy group, the levels of IL-1β and IL-6 in 4 weeks of treatment were lower than those in the medication group, and the levels of 5-HT, IL-4 and IL-10 were higher than those in the medication group (P<0. 01, P< 0. 05).

CONCLUSIONThe combined therapy of acupuncture and SSRIs achieves much quicker and more effective re-' sult for relieving depression in the patients of depressive disorder as compared with simple oral administration of' SSRIs, and much more contributes to adjust the imbalance of serum 5-HT and TH1/TH2.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Antidepressive Agents ; administration & dosage ; Combined Modality Therapy ; Depressive Disorder ; blood ; drug therapy ; therapy ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-1beta ; blood ; Interleukin-4 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Serotonin ; blood ; Th1 Cells ; metabolism ; Th2 Cells ; metabolism ; Young Adult

Objective To explore hemopurification clinical nurse specialist's effects and barriers,in order to provide evidences to define their value,to remove their barriers,to promote their effects.Methods A qualitative study was adopted in this study.In-depth interviews were conducted on 3 charge nurses in hemopurification and 10 hemopurification clinical nurse specialists.Results The effects of hemopurification clinical nurse specialist can be concluded as effects to patients,to nursing,to medical systems and to hemopurification clinical nurse specialist themselves.Barriers of hemopurification clinical nurse specialist can be concluded as medical environments,the process of nursing developing,ambiguous role of clinical nurse specialist.Conclusions The practice of hemopurification clinical nurse specialists have played various effects,but there were some barriers in their practice.The roles of clinical nurse specialist should be clarified,and guarantees in managements and regulations should be provided for their practice.