Objective Two-sample Mendelian randomization(TSMR)was used to explore the causal relationship between inflammatory bowel disease(IBD)and gut microbiota(GM).Methods GM was taken as the exposure factor,and two subtypes of IBD,Crohn's disease(CD)and ulcerative colitis(UC),were selected as the outcome factors.The potential causal relationship between IBD and gut microbiota was screened by TSMR statistical method.Results The results of comprehensive multiple analysis showed that 15 kinds of intestinal microbiota might be related to IBD.Among them,the Gastroenterococcaceae,Eulogicum,Clostridium 1,Agnobacter,Ruminococcus 2 and Ruminococcaceae UCG009 may be potential protective factors for IBD(OR＜1,P＜0.05);The UCG-011 of the Alfalfa family,the UCG001 of the Clostridium genus,the Actinobacillus genus,the Trichoderma genus,the Rumen genus UCG014,the NB1n order,the Eubacterium genus,the UCG008 of the Trichoderma family and the Clostridium order may be potential risk factors for IBD(OR＞1,P＜0.05);No pleiotropy or significant heterogeneity of instrumental variables genes was found.Conclusion The intestinal flora may have a dual effect on IBD.It may be a protective factor or increase the risk of IBD.The specific mechanism of action still needs to be further explored.

Objective Two-sample Mendelian randomization(TSMR)was used to explore the causal relationship between inflammatory bowel disease(IBD)and gut microbiota(GM).Methods GM was taken as the exposure factor,and two subtypes of IBD,Crohn's disease(CD)and ulcerative colitis(UC),were selected as the outcome factors.The potential causal relationship between IBD and gut microbiota was screened by TSMR statistical method.Results The results of comprehensive multiple analysis showed that 15 kinds of intestinal microbiota might be related to IBD.Among them,the Gastroenterococcaceae,Eulogicum,Clostridium 1,Agnobacter,Ruminococcus 2 and Ruminococcaceae UCG009 may be potential protective factors for IBD(OR＜1,P＜0.05);The UCG-011 of the Alfalfa family,the UCG001 of the Clostridium genus,the Actinobacillus genus,the Trichoderma genus,the Rumen genus UCG014,the NB1n order,the Eubacterium genus,the UCG008 of the Trichoderma family and the Clostridium order may be potential risk factors for IBD(OR＞1,P＜0.05);No pleiotropy or significant heterogeneity of instrumental variables genes was found.Conclusion The intestinal flora may have a dual effect on IBD.It may be a protective factor or increase the risk of IBD.The specific mechanism of action still needs to be further explored.

Medical image is a powerful tool to assist doctors in the diagnosis and treatment planning.Nowadays,the segmentation of medical images is no longer limited to manual segmentation methods.Traditional methods and deep learning methods have been used to achieve more accurate results in medical image segmentation.Herein some innovative medical image segmentation methods in recent years are reviewed.By elaborating on the innovations of deep learning methods(SAM,SegNet,Mask R-CNN,and U-NET)and traditional methods(active contour model and threshold segmentation model),the differences and similarities between them are compared.The summary of medical image segmentation methods and the prospect is expected to help researchers better grasp and familiarize themselves with research status and development trend.

BACKGROUND:Mesenchymal stem cell-derived exosomes may play a crucial role in tissue damage repair,and miRNA is an important component of exosomes for therapeutic effects.Among them,miR-29b-3p has the effect of reducing cell apoptosis,promoting axonal regeneration,and angiogenesis. OBJECTIVE:To study the protective effect of adipose-derived mesenchymal stem cell-derived exosome via miR-29b-3p on a neural cell injury model simulated by H2O2-treated PC12 cells,and explore the relevant mechanisms. METHODS:(1)First,the collagenase digestion method was used to extract rat adipose-derived mesenchymal stem cells.Adipose-derived mesenchymal stem cells were transfected with miR-29b-3p mimics and inhibitors.Exosomes were extracted from the culture supernatant by ultracentrifugation and identified so as to construct adipose-derived mesenchymal stem cell-derived exosomes with high expression and knockdown miR-29b-3p.(2)By constructing a neural cell injury model simulated by PC12 cells treated with H2O2,the relevant mechanisms of the protective effect of adipose-derived mesenchymal stem cell-derived exosome via miR-29b-3p on the simulated neuronal cell injury model were studied. RESULTS AND CONCLUSION:(1)Adipose-derived mesenchymal stem cell-derived exosome had a typical cup-shaped shape and a diameter distribution in the range of 50-140 nm,expressed membrane proteins Alix,CD63,and TSG101,which were specific markers on the surface of exosomes,and could be successfully ingested by PC12 cells.(2)Adipose-derived mesenchymal stem cell-derived exosome pretreatment could reduce cell apoptosis induced by H2O2 treatment in PC12 cells,and this protective effect was enhanced with the increase of miR-29b-3p expression in the exosomes and weakened with the decrease of miR-29b-3p expression in the exosomes.The mechanism of its effect was related to adipose-derived mesenchymal stem cell-derived exosome via miR-29b-3p promoting the expression of anti-apoptotic protein Bcl-2 and inhibiting the expression of apoptotic protein Bax.

Objective:To explore urological nurses' knowledge, attitude and behavior about early activities in patients undergoing radical cystectomy and the influencing factors, and provide a reference for early activities to be successfully carried out in patients undergoing radical cystectomy.Methods:Totally 240 urological nurses from 10 hospitals in Guangdong Province were selected using convenient sampling and investigated with the general information questionnaire and the urological nurse's knowledge, attitude and behavior about early activities in patients undergoing radical cystectomy questionnaire between October and December 2018. Multiple linear regression was used to analyze the influencing factors.Results:The urological nurses' knowledge, attitude, and behavior scores about early activities of patients undergoing radical cystectomy were (3.42±1.23) , (30.40±3.18) and (10.65±2.20) . Multiple linear regression showed that job title was the influencing factor of urological nurses' knowledge towards early activities in patients undergoing radical cystectomy ( P<0.05) ; working years in urology department, job title and whether they received early activity-related training were the influencing factors of urological nurses' attitude towards early activities in patients undergoing radical cystectomy ( P<0.05) ; whether their department carried out accelerated rehabilitation surgery and whether they received early activity-related training were the influencing factors of urological nurses' behavior about early activities in patients undergoing radical cystectomy ( P< 0.05) . Conclusions:Nurses have a good attitude towards early activities of patients undergoing radical cystectomy, but their knowledge reserves and behaviors are not satisfying. It is necessary to strengthen the training of nurses on the knowledge of early activities, formulate an early activity plan based on multi-disciplinary cooperation, and promote the proper and effective implementation of early activities in clinical practice.

Objective? To expLore the diaLecticaL nursing abiLity and training among practice nursing students of TraditionaL Chinese Medicine coLLeges and universities so as to provide a reference for education reform and practice management of coLLeges and universities. Methods? In March 2018, we seLected 308 practice nursing undergraduates of schooL of nursing in Nanjing University of Chinese Medicine practicing at designated hospitaLs as subjects by purposive sampLing. ALL of them were investigated with the seLf-designed diaLecticaL nursing abiLity and training of practice nursing students of TraditionaL Chinese Medicine coLLeges and universities questionnaire. In this study, a totaL of 308 questionnaires were sent out and 254 vaLid questionnaires were coLLected. ResuLts? The scores of the diaLecticaL nursing abiLity of nursing students seLf-evaLuation questionnaire before and after practice were (4.91±1.90) and (4.72±1.92) respectiveLy with no statisticaL difference (t=1.379, P=0.170). Practice nursing students' master of diaLecticaL nursing basic knowLedge ranged from 69.29% to 89.76%. ConcLusions? Practice nursing students have the Low abiLity of diaLecticaL nursing. Practice hospitaLs shouLd improve the cuLtivate awareness and teaching LeveL, and satisfy nursing students' training needs so as to improve the diaLecticaL nursing abiLity of them.

Objective To investigate the correlation between incidence rate of tinnitus and noise exposure time,age,hearing condition in noise exposure workers.Methods A total of 1 985 noise exposure workers (age between 20～60 years old;working length between 1 ～30 years) in a large dockyard were randomly selected as the subject of this study with 1 831 male workers and 154 female workers in average 36.3±8.25 years old.The average noise exposure time was 9.1±6.50 years and pure tone threshold of final candidates in sound-proofed environment was evaluated (at 0.25～8 kHz).The subjects were divided into four groups according to the subjective tinnitus level:mild tinnitus,moderate tinnitus,severe tinnitus and no tinnitus to analysis the correlation among incidence rate of tinnitus and noise exposure time,age,hearing condition,etc.Results Among all 1 985 subjects enrolled the occurrence rate of tinnitus was 20.55％ (408/1 985),with 367 acquired mild tinnitus(89.95％),39 acquired moderate tinnitus (9.56％) and 2 for severe tinnitus (0.49％).Mild tinnitus and moderate tinnitus showed a multi-step raising according to noise exposure time.Mild tinnitus increased continually with age while moderate tinnitus showed an accumulation in age group over 55 years old.Female was less likely to be annoyed by tinnitus than male.Conclusion Tinnitus can be early warning of auditory damage by noise exposure;older male group with longer noise exposure time is more vulnerable to tinnitus.Tinnitus acquired in noise environment is more likely to be mild.

Objective To evaluate the effects of the different treatments for vitiligo in the special sites. Methods 122 cases (375 leuk oplakiae) of vitiligo in special sites were randomly divided into 5 groups:hair germ grafting (HGG) group (42 cases), resurfacing (RS) group (52 cases), follicular scraping injection (FSI) group (35 cases), liquid nitrogen freezing (LNF) group (30 cases) and external medication (EM) group (45 cases). Efficacy of the treatments was observed and evaluated in different groups and all the data were statistically analyzed. Results Effective rates were 97.1 % in HGG group, 94.7 % in RS group, 59.7 % in FSI group, 57.1 % in LNF group and 45.6 % in EM group.There were very significant differences between different groups ( ? 2 = 111.7, P

AIM:To study the expressions of galectin-3 and the possible anti-infectious function in genital tract of female mouse. METHODS:The expressions of galectin-3 mRNA in different reproductive tissues were analyzed by RT-PCR. The mouse model of genital tract infection was constructed by injection of LPS and Freunds adjuvant incomplete into the vaginal mucous. The expression pattern of galectin-3 protein was detected by immunohistochemistry. RESULTS:The expression of galectin-3 mRNA was detected in the uterus,vagina,oviduct and ovary of normal adult mouse. The galectin-3 protein was expressed in the genital tract mucous of epithelial cell surface and uterine gland. After stimulation with LPS,the expression of galectin-3 protein was significantly up-regulated compared to normal control and adjuvant control (P