ObjectiveTo study the mechanism of Huanglian Jiedutang （HLJDT） in treating mice with atherosclerosis （AS） by improving ferroptosis. MethodsA total of 10 SPF C57BL/6J mice were selected as a normal group， and 50 ApoE^-/- mice were randomly divided into five groups： model group， low-dose group of HLJDT， medium-dose group of HLJDT， high-dose group of HLJDT， and atorvastatin （ATV） group. ApoE^-/- mice were fed a high-fat diet for eight weeks to establish the AS model， and at the 9th week， they were given normal saline， low， medium， and high doses of HLJDT （3.9， 7.8， 15.6 g·kg^-1·d^-1）， and atorvastatin calcium tablets （0.01 g·kg^-1·d^-1）， respectively， for a total of eight weeks. The formation of aortic plaque in mice was observed by gross oil red O staining and Masson staining. The levels of total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， triglyceride （TG）， and high-density lipoprotein cholesterol （HDL-C） in blood fat were measured by the automatic biochemical analyzer， and the mitochondrial structure of the aorta was observed by transmission electron microscopy. The content of serum superoxide dismutase （SOD） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. The content of reduced glutathione （GSH） in serum was detected by the microplate method， and that of malondialdehyde （MDA） in serum was detected by the TBA method. The protein expression of nuclear factor E₂-associated factor 2 （Nrf2）/glutathione peroxidase 4 （GPX4） signaling pathway was detected by Western blot. ResultsCompared with those of the normal group， the contents of TC， LDL-C， TG， HDL-C， and MDA in the serum and the aortic vascular plaque deposition of the model group were significantly increased （P<0.01）， while the expression levels of SOD and GSH in serum， as well as Nrf2， solute carrier family 7 member 11 （SLC7A11）， and GPX4 in aorta were significantly decreased （P<0.01）. Mice in the model group appeared mitochondrial fragmentation and vacuolation in the aorta， volume atrophy， mitochondrial crista reduction， or a loose and disorganized form. Compared with those in the model group， the aortic vascular plaque deposition was significantly decreased in the low-dose， medium-dose， and high-dose groups of HLJDT and ATV group， and the contents of serum TC， LDL-C， TG， and MDA in serum were significantly decreased （P<0.05， P<0.01）. The contents of serum SOD and GSH and the expression levels of Nrf2， SLC7A11， and GPX4 in the aorta were increased （P<0.05， P<0.01）， and the symptoms of aortic mitochondrial vacuolation were alleviated. The number of cristae was increased， and they were ordered neatly. ConclusionHLJDT can reduce aortic vascular plaque deposition， decrease blood lipid and MDA expression， increase SOD and GSH expression， and ameliorate the pathological changes of ferroptosis， the mechanism of which is related to the Nrf2/GPX4 signaling pathway.

Objective To compare the efficacy of endoscopic submucosal dissection(ESD)using the flexible auxiliary single-arm transluminal endoscopic robot(FASTER)with that of the traditional technique,and explore a safer and more efficient ESD operation method.Methods FASTER-assisted ESD and traditional ESD were used to operate in the isolated pig esophagus model.The differences of total procedure time,ESD time,the rate of direct-vision dissection,complete en bloc resection and complication rate between the two groups were compared and analyzed.Results The total procedure time[(19.2±2.9)and(28.9±8.2)min]and ESD time[(13.0±2.9)and(21.6±8.3)min]were significantly shorter in FASTER-assisted ESD group than those in traditional ESD group,the differences were statistically significant(P<0.01);The rate of direct-vision dissection was significantly higher than that of the traditional ESD(96.2%and 65.4%),the difference was statistically significant(P=0.014).Muscle layer injury rate was significantly lower than of the traditional group(19.2%and 69.2%),the difference was statistically significant(P<0.01).There was no significant difference in complete en bloc resection rate and perforation rate between the two groups(P>0.05).These advantages were more apparent in esophageal non-gravity lesions.Conclusion Esophageal ESD assisted by FASTER is safer and more efficient than traditional ESD.

Objective To study the effect of Qingke Pingchuan Granule on the clinical efficacy in patients with phlegm-heat obstructing lung syndrome(AECOPD).Methods A total of 80 patients with acute exacerbation of chronic obstructive pulmonary disease(syndrome of phlegm-heat stagnation in the lung)hospitalized in the respiratory department of our hospital were selected and divided into the conventional group and the combinational group,with 40 cases in each group.The CAT score,TCM syndrome score,serum IL-6,CRP,lung function FEV1%pred,and FEV1/FVC were retrospectively observed before treatment,at the end of the second week of treatment,and at the follow-up after 1 month of treatment in the two groups.Results The total effective rate was significantly better in the combinational group than that of the conventional group(92.5%vs.75.0%,P＜0.05).At the end of the second week of treatment,the CAT score,each single syndrome score,serum IL-6 and CRP levels were all improved than those before treatment in the two groups(P＜0.05),and the improvement degree was better in the combined group than that of the conventional group(P＜0.05).The severity of airflow limitation and respiratory failure were significantly improved compared with those before treatment in both groups.At the follow-up after 1 month of treatment,the recovery rate of scores of each single syndrome score and CAT score were significantly lower in the combined group than those in the routine group(P＜0.05).There were no significant differences in adverse drug reactions between the two groups(12.5%and 2.5%,P＞0.05).Conclusion Qingke Pingchuan Granule can effectively relieve the symptoms and improve lung function and the quality of life of AECOPD patients.

Retinopathy of prematurity(ROP), an abnormal vascular proliferative retinopathy of prematurity, is a serious condition that can lead to retinal detachment or blindness. With the development of neonatal medicine, the survival rate of low birth weight and low gestational age infants has been increasing, as well as the incidence of ROP. Therefore, studying ROP's pathogenesis and influencing factors is of great clinical importance. Numerous studies have been conducted on the risk factors for ROP, including gestational age, oxygen intake, mode of delivery, neonatal bronchopulmonary dysplasia, and the use of surfactants. At present, it is widely accepted both at home and abroad that preterm birth, low birth weight, and high oxygen concentration after birth are independent risk factors for ROP. In recent years, more and more scholars have found that abnormalities in blood indicators in preterm infants may be associated with the development of ROP. This article reviews the effects of platelets, haemoglobin, blood glucose, inflammatory cells, and lipids on ROP, providing a reference for identifying and preventing risk factors for ROP.

Meibomian gland dysfunction is a chronic and diffuse disease of the meibomian glands, characterized by obstruction and(or)abnormal secretion of the terminal ducts. Clinically, it can lead to tear film abnormalities and inflammation of the ocular surface, resulting in symptoms of ocular irritation and potential corneal damage that may impact visual function. Meibomian gland dysfunction can be classified into two types based on meibomian gland secretion: low secretion type and high secretion type. The low secretion type further includes acinar atrophy type and obstruction type. In recent years, research has revealed that patients with diabetes experience chronic damage to their meibomian gland tissue in the early stages of the disease, leading to structural and functional changes. The incidence and severity of meibomian gland dysfunction are higher in diabetic patients. However, there are numerous complex factors contributing to this condition in diabetes patients, and mechanisms remain unclear at present. This article reviews both domestic and international research progress on the pathological mechanism underlying meibomian gland dysfunction in diabetes.

Objective To construct a relationship model of emotional intelligence,psychological capital and professional identity by using structural equation model in probationer nursing students,explore the mechanism of interaction among them,and investigate the corresponding intervention measures in combination with the present situation of their emotional intelligence and psychological capital in order to improve their professional identity.Methods An anonymous survey was conducted on 308 probationer nursing students,with questionnaires including General Information Questionnaire,Wong and Law Emotional Intelligence Scale (WLEIS),and Psychological Capital Questionnaire (PCQ)and Professional Identity Questionnaire for Nurse Students (PIQNS).AMOS25.0 software was used to establish a structural equation model fitting the relationship of emotional intelligence,psychological capital and professional identity.Results There were positive correlations between each other among emotional intelligence,psychological capital and professional identity in the students (r=0.681～0.755,P<0.01).The structural equation model showed that the total effect of emotional intelligence on professional identity was 0.633,of which the direct effect was 0.380,the mediating effect was 0.253.Significant mediating effect was observed in emotional intelligence on professional identity,with the direct effect accounting for 60.03％ and the mediating effect for 39.97％,indicating a mediating role of psychological capital.Conclusion For probationer nursing students,their psychological capital and emotional intelligence have a positive predictive effect on professional identity,and psychological capital is the intermediary variable in the relationship between the emotional intelligence and professional identity.It suggested that nursing educators and hospital administrators should pay full attention to psychological state of nursing students during practice,and at the same time,should also attach importance to the positive incentive effect of psychological capital and take corresponding intervention measures,and actively guide psychological adjustment in order to improve their professional identity and stabilize nursing team.

Objective:To observe the influence of shared medical appointments on health-related quality of life and quality of sleep in patients after liver transplantation.Methods:By randomized controlled study, a total of 124 patients after liver transplantation were included from our hospital from January 2018 to January 2019, and according to the lottery method, all subjects were divided into the routine management group ( n=64) who received routine outpatient intervention and the shared medical management group ( n=60) who received shared medical appointments management. The health-related quality of life and quality of sleep were investigated and compared by post-liver transplant quality of life questionnaire (pLTQ) and Pittsburgh sleep quality index (PSQI) before intervention (the day of discharge) and after intervention (the end of the last shared outpatient service). Results:After intervention, the dimension scores of worry, economics, body function, emotional function, health service, complication and total score of pLTQ were improved in tow groups than before intervention [the routine management group: (41.90±7.61), (18.13±4.22), (22.22±5.10), (14.92±3.28), (20.39±4.87), (14.63±3.99), and (132.19±37.09) vs (32.25±5.55), (12.77±3.47), (17.58±4.72), (9.23±1.38), (15.17±4.81), (10.89±1.51) and (98.00±29.03) score, t=8.20, 7.85, 3.58, 12.79, 6.10, 7.01, 5.81, all P<0.001; shared medical management group: (46.12±7.92), (24.16±5.34), (25.55±5.42), (17.90±3.60), (24.81±5.12), (17.93±3.60) and (155.47±41.00) vs (32.57±5.69), (12.81±3.82), (17.00±4.70), (9.60±1.39), (15.39±4.84), (11.00±3.52) and (98.37±28.96) score, t=10.76, 13.39, 9.23, 16.66, 10.36, 10.66, 8.81, all P<0.001], and those in the shared medical management group were higher than those in routine management group ( t=3.03, 6.95, 3.53, 4.82, 4.93, 4.83, 3.32, all P<0.05). After intervention, the total score of PSQI scale were lower than before intervention in the routine management group [(10.48±2.14) vs (11.89±2.45) score, t=3.47, P=0.001], and the dimensions score of sleep quality, full-sleep time, sleep time, sleep efficiency, sleep disorders, daytime function, hypnotic and total score of PSQI were lower than before intervention in the shared medical management group [(1.41±0.32), (0.54±0.13), (1.17±0.26), (1.11±0.35), (1.21±0.27), (1.30±0.33), (1.08±0.21) and (8.05±1.75) vs (1.88±0.53), (0.86±0.37), (1.84±0.41), (2.05±0.56), (1.39±0.33), (1.47±0.43), (1.22±0.32) and (11.71±2.43) score, t=-5.88, -6.32, -10.69, -11.03, -3.27, -2.43, -3.65, -9.47, all P<0.05], and those in the shared medical management group were lower than those in routine management group ( t=-6.68, -6.39, -10.43, -10.97, -2.62, -2.12, -3.54, -6.90, all P<0.05). Conclusion:Shared medical appointments model can improve the health-related quality of life and quality of sleep in patients after liver transplantation, and improve the effectiveness of outpatient intervention.

Objective:To evaluate the efficacy and safety of sodium hyaluronate gel in preventing adhesion after prophylactic enterostomy.Methods:One hundred and twenty four patients from 6 hospitals were enrolled in this prospective multi-center randomized controlled trial. Patients were randomized into the study group ( n=59) or the control group ( n=65).All patients underwent prophylactic enterostomy. Patients of study group received odium hyaluronate gel for adhesion-prevention,while those in control group did not receive any adhesion-prevention treatment. The incidence of moderate to severe adhesion around the incision in the stoma area were evalutated during stoma reduction surgery. Results:The incidence of moderate to severe adhesion around the incision in the stoma area was 6.3% in the study group, the difference was statistically significant ( P<0.05) compared to that of the control group (32.6%). Conclusion:Sodium hyaluronate gel can safely and effectively reduce the incidence of moderate and severe adhesions after abdominal surgery.

Objective:To investigate the efficacy of different doses of vitamin C (VC) in prevention and treatment of non-alcoholic fatty liver disease (NAFLD) in mice.Methods:C57BL/6 mice were fed with high-fat diet to establish NAFLD models. The experimental animals were divided into early prevention and later treatment groups. Both of these two experimental processes had five subgroups, including control, high-fat diet (HFD), low-dose vitamin C (LD-VC, 15 mg/kg per day), medium-dose vitamin C (MD-VC, 30 mg/kg per day) and high-dose vitamin C (HD-VC, 90 mg/kg per day) subgroup, with six mice in each subgroup. In the early prevention group, the mice were prophylactically received VC for 12 weeks. In the later treatment group, the mice were treated with different dose of VC for 12 weeks after fed with HFD for six weeks and confirmed NAFLD by liver pathology. The differences in body weight, perirenal adipose tissue mass and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), and triacylglycerol (TG) were observed among different groups. The scores of hepatocyte steatosis, lobular inflammation and ballooning in liver histopathology of mice in each group were evaluated by non-alcoholic fatty liver disease activity score (NAS) scoring system. Tukey′s multiple comparison test and Kruskal-Wallis H test were performed for statistical analysis. Results:In the early prevention group, the body weight, perirenal adipose tissue mass, TG level and the score of liver steatosis of LD-VC subgroup were all lower than those of HFD subgroup ((30.27±0.94) g vs. (32.18±1.35) g, (0.25±0.05) g vs. (0.32±0.02) g, (0.25±0.02) mmol/L vs. (0.30±0.03) mmol/L, 0 vs. 1.0(1.0)). The body weight, perirenal adipose tissue mass, blood glucose level, TG level and score of liver steatosis of MD-VC subgroup were all lower than those of HFD subgroup ( (29.72±0.58) g vs. (32.18±1.35) g, (0.24±0.05) g vs. (0.32±0.02) g, (6.93±0.59) mmol/L vs. (8.33±1.02) mmol/L, (0.24±0.04) mmol/L vs. (0.30±0.03) mmol/L, 0 vs. 1.0(1.0)); meanwhile, the blood glucose level and TG level of HD-VC subgroup were both lower than those of HFD subgroup ((6.72±0.59) mmol/L vs. (8.33±1.02) mmol/L, (0.23±0.04) mmol/L vs. (0.30±0.03) mmol/L), and the differences were statistically significant (all P<0.05). In the later treatment group, TG level of LD-VC subgroup was lower than that of HFD subgroup ((0.25±0.07) mmol/L vs. (0.37±0.06) mmol/L); the body weight, perirenal adipose tissue mass, blood glucose level, TG level and liver steatosis score of MD-VC subgroup were lower than those of HFD subgroup ((29.93±1.28) g vs. (33.24±2.45) g, (0.29±0.08) g vs. (0.53±0.14) g, (7.63±0.57) mmol/L vs. (9.13±1.52) mmol/L, (0.23±0.03) mmol/L vs. (0.37±0.06) mmol/L, 0.5(1.0) vs. 2.0(1.0)); the blood glucose level and TG level of HD-VC subgroup were both lower than those of HFD subgroup ((7.20±0.72) mmol/L vs. (9.13±1.52) mmol/L, (0.19±0.03) mmol/L vs. (0.37±0.06) mmol/L); however the body weight, liver weight, perirenal adipose tissue mass and lobular inflammation score of HD-VC subgroup were all high than those of HFD subgroup( (36.34±2.44) g vs. (33.24±2.45) g, (1.18±0.07) g vs. (1.06±0.09) g, (0.78±0.17) g vs. (0.53±0.14) g, 1.0(1.0) vs.0(1.0)), and the differences were statistically significant (all P<0.05). The body weight, perirenal adipose tissue mass and the score of liver steatosis, lobular inflammation and ballooning of LD-VC subgroup of the early prevention group were all lower than those of LD-VC subgroup of the later treatment group ((30.27±0.94) g vs. (34.75±1.64) g, (0.25±0.05) g vs. (0.61±0.14) g, 0 vs.1.5(1.0), 0 vs. 0.5(1.0), 0 vs. 1.0(0)); and the body weight, liver weight, perirenal adipose tissue mass, ALT level, AST level and scores of liver steatosis and lobulor inflammation of HD-VC subgroup of the early prevention group were all lower than those of HD-VC subgroup of the late treatment group ((31.78±0.71) g vs. (36.34±2.44) g, (1.01±0.02) g vs. (1.18±0.07) g, (0.30±0.05) g vs. (0.78±0.17) g, (8.83±0.98) U/L vs. (12.75±2.05) U/L, (29.00±4.19) U/L vs. (41.88±14.36) U/L, 1.0(0) vs. 2.5(1.0), 0 vs. 1.0(1.0)), and the differences were statistically significant (all P<0.05). Conclusions:MD-VC can prevent the occurrence of NAFLD in mice at an early stage, and it is also benefit to the later treatment of NAFLD in mice. However, HD-VC has potential risks in early prevention and later treatment of NAFLD in mice.

Objective: To investigate the diagnostic value of endoscopic ultrasonography (EUS), Fibroscan, acoustic radiation force impulse (ARFI), and aspartate aminotransferase-to-platelet ratio (APRI) and their combination for early stage liver cirrhosis. Methods: Three hundred and twenty-two hospitalized patients who had been diagnosed with chronic viral liver disease from March 2016 to April 2018 were included. According to the clinical diagnosis, patients were divided into chronic hepatitis and the early stage liver cirrhosis group (Child-Pugh A grade). All patients were examined by Fibroscan to detect liver stiffness measurement (LSM), ARFI to detect liver virtual touch tissue quantification (VTQ) value, esophagogastroduodenoscopy and EUS to detect esophagogastric varices, laboratory and imaging examination. The index of EUS, Fibroscan, ARFI, and APRI was analyzed and the regression model was established by binary logistic regression, and the diagnostic efficacy of the above index and regression model for early stage of cirrhosis was evaluated by the area under a receiver operating characteristic curve (AUROCs). Results: An early stage cirrhosis group had significantly higher detection rate with EUS (esophagogastric varices), Fibroscan (LSM), ARFI (VTQ) and APRI than chronic hepatitis group [76.7% vs. 10.7%, 10.4 (7.8, 17.3) vs. 6.1 (5.2, 8.4) kPa, 1.71(1.48, 2.07) m/s vs. 1.25(1.14, 1.43) m/s and 0.65 (0.38, 1.15) vs. 0.38(0.26, 0.62), respectively]. The corresponding chi-square test were 140.86, Z = -9.069, Z = -9.948 and Z = -5.764, respectively and the differences were statistically significant (P < 0.01). The areas under the receiver operating characteristic curve and regression model were 0.830 (0.783 ~ 0.877), 0.793 (0.744 ~ 0.841), 0.821 (0.775 ~ 0.868), 0.686 (0.628 ~ 0.744) and 0.947 (0.925 ~ 0.969) for the diagnosis of early stage cirrhosis, respectively. Among them, the regression model of three indices (EUS, LSM and VTQ) had the largest AUROCs (0.947) and the corresponding sensitivity and specificity were 0.878 and 0.867, respectively. Conclusion The combination of EUS, LSM and ARFI had a superior diagnostic value for early stage liver cirrhosis, and may improve the diagnosis rate and reduce the misdiagnosis rate.