This report summarizes the nursing experience of a patient with acute myocardial infarction complicated by cardiogenic shock and frequent electrical storms.The key nursing interventions are outlined as follows.Formation of a multidisciplinary management team:a collaborative treatment plan was developed by assembling a multidisciplinary team of healthcare professionals.Activation of the hospital emergency response system:the hospital's emergency response protocols were promptly activated to ensure efficient emergency nursing care.Dynamic hemodynamic monitoring:circulatory support strategy guided by hemodynamic monitoring.Establish-ment of a malignant arrhythmia warning system:a warning system for malignant arrhythmias was implemented to standardize the emergency procedures for electrical cardioversion and defibrillation,thereby maximizing the time available for life support.Sequential antiplatelet and anticoagulation management:a sequential approach to antiplatelet and anticoagulation therapy was employed to effectively prevent the risks of thrombosis and bleeding.Focus on psychological care and rehabilitation training:emphasis was placed on psychological support and rehabilitation exercises to enhance the patient's comfort and exercise tolerance.The patient was hospitalized for 33 days and was discharged in improved condition.This translation is structured to reflect the conventions of academic writing,making it suitable for inclusion in a clinical report or research paper.

This report summarizes the nursing experience of a patient with acute myocardial infarction complicated by cardiogenic shock and frequent electrical storms.The key nursing interventions are outlined as follows.Formation of a multidisciplinary management team:a collaborative treatment plan was developed by assembling a multidisciplinary team of healthcare professionals.Activation of the hospital emergency response system:the hospital's emergency response protocols were promptly activated to ensure efficient emergency nursing care.Dynamic hemodynamic monitoring:circulatory support strategy guided by hemodynamic monitoring.Establish-ment of a malignant arrhythmia warning system:a warning system for malignant arrhythmias was implemented to standardize the emergency procedures for electrical cardioversion and defibrillation,thereby maximizing the time available for life support.Sequential antiplatelet and anticoagulation management:a sequential approach to antiplatelet and anticoagulation therapy was employed to effectively prevent the risks of thrombosis and bleeding.Focus on psychological care and rehabilitation training:emphasis was placed on psychological support and rehabilitation exercises to enhance the patient's comfort and exercise tolerance.The patient was hospitalized for 33 days and was discharged in improved condition.This translation is structured to reflect the conventions of academic writing,making it suitable for inclusion in a clinical report or research paper.

Objective To evaluate the effects of long voyage on crew's cardiac function.Methods A total of 47 crew members from a shipyard during the maintenance period of two ships with the same type from October 2017 to April 2018 were selected as research subjects.They were divided into experimental group(n=24)and control group(n=23).The first test was performed in all subjects within 5 days of enrollment.The experimental group participated in a 34-day seagoing voyage after the first test,while the control group continued to live on land and do regular physical exercise.All the subjects were tested again within 5 days after sailing.The submaximal exercise test was conducted according to the standard Bruce protocol.High definition impedance cardiogram was synchronously used to record heart rate and stroke output(SV)at rest.SV was continuously recorded to obtain its maximum value(SVmax)and the change of SV during exercise was analyzed.The exercise time,SV threshold,and SV threshold time were also recorded.Results There were no significant differences in the age,height,or weights at the beginning or end of the study between the two groups(P>0.05).At the end of the study,the exercise time of the experimental group was significantly shorter than that of the control group and the control group was prolonged(P<0.01).There was no significant difference in the SV threshold time,HR at rest,average resting SV,or SVmax between the two groups at enrollment(P>0.05).The SV threshold time at the end of the study was significantly shorter than that at enrollment in the experimental group,and there was a significant difference in the SV threshold time at the end of the study between the two groups(P<0.01).At the end of the study,the resting HR of the experimental group was significantly higher than that at enrollment and that of the control group(P<0.05);there were significant differences in the mean SV at rest and SVmax between groups and between intra-groups(P<0.05).Conclusion Long voyage can reduce the aerobic capacity and cardiac reserve of crew,and the preservation of aerobic exercise can improve the cardiac function and cardiac reserve.

A 9-year-old male child presented with red plaques on the left upper limb for more than 5 years without obvious subjective symptoms. Topical glucocorticoids and calcineurin inhibitors did not markedly improve his condition. Skin examination showed dark red map-like plaques with clear borders on the extensor side of the left upper limb, with a few white scales attached to the surface and satellite lesions at the edge. There were no obvious abnormalities in routine blood and urine tests or immunological examinations. Histopathological examination revealed dense infiltration of abundant lymphocytes and plasma cells in the upper and middle dermis, with some inflammatory cells infiltrating the fat septa and focal formation of lymphoid follicles; immunohistochemical study showed positive staining for CD3 in interfollicular regions, CD20 in the follicular center, and CD38 in plasma cells, as well as for IgG Kappa chain and IgG Lambda chain; periodic acid-Schiff staining and acid-fast staining both showed negative results. A diagnosis of childhood benign lymphoplasmacytic plaque was made. The patient was treated with topical halometasone cream once a day in the morning, topical tacrolimus ointment once a night, and oral traditional Chinese medicine for promoting blood circulation and removing blood stasis. After 6 months of follow-up, the skin lesions became slightly flat, slightly lighter in color, and no new lesions occurred. Treatment and follow-up were ongoing.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.

Objective: To investigate the effects of the interaction between occupational noise exposure and arterial stiffness on blood glucose, so as to provide insights into for early prevention of diabetes among workers exposed to occupational noise. Methods: A total of 518 noise workers were selected from a tobacco plant in Wuhan City. Participants' gender, age and work duration were collected using questionnaire surveys, and participants' height and weight were measured. Blood glucose and arterial stiffness were detected, and the noise intensity was measured in working environments with a personal noise dosimeter. The effects of occupational noise exposure, arterial stiffness and their interactions on blood glucose were examined using a multiple linear regression model. Results: A total of 518 workers were included, with 398 males (76.83%), a mean age of (40.85±10.68) years, a mean working age of (19.50±12.69) years, a mean body mass index of (23.66±3.31) kg/m2, and a mean blood glucose level of (5.15±0.99) mmol/L. There were 247 workers with occupational noise exposure (47.68%) and 175 workers with arterial stiffness (33.78%). Multiple linear regression analysis showed significant associations of noise (β'=0.112) and arterial stiffness (β'=0.168) with blood glucose, and there was an additive interaction between noise and arterial stiffness on blood glucose (β'=0.314). Conclusion The interaction between occupational noise and arterial stiffness affects blood glucose.

Objective:To investigate the effect of hysteroscopic cold knife technique on the treatment effect and postoperative inflammatory response in patients with intrauterine adhesion by regulating the expression of microRNA (miR)-29b.Methods:The clinical data of 166 patients with intrauterine adhesion in Zhejiang Medical and Health Group Hangzhou Hospital from January to December 2018 were retrospectively analyzed. Among them, 83 cases were treated by hysteroscopic cold knife technique (cold knife group) and 83 cases were treated by hysteroscopic electrosurgical operation (electrosurgical group). The operation time and hospitalization time were compared between 2 groups. The patients were followed up 3 months after operation, and the change of menstrual volume were observed; at the same time, the patient underwent hysteroscopy, and the changes of intrauterine morphology were observed in order to evaluate the efficacy; the interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and miR-29b relative expression in endometrial tissue were detected.Results:The operation time and hospitalization time in cold knife group were significantly shorter than those in electrosurgical group: (20.01 ± 1.93) min vs. (26.46 ± 2.25) min and (3.84 ± 1.43) d vs. (5.01 ± 1.18) d, and there were statistical differences ( t= 12.134 and 4.051, P<0.05). The menstrual volume and intrauterine morphology efficacy in cold knife group were significantly better than those in electrosurgical group, and there were statistical differences ( P<0.05). The IL-4 and miR-29b 3 months after operation in cold knife group were significantly higher than those in electrosurgical group: (33.54 ± 5.61) mmol/L vs. (21.34 ± 3.62) mmol/L and 1.59 ± 0.42 vs. 1.16 ± 0.31, the IL-8, TNF-ɑ and CRP were significantly lower than those in electrosurgical group: (18.23 ± 3.67) mmol/L vs. (31.59 ± 7.20) mmol/L, (9.41 ± 1.41) mmol/L vs. (12.64 ± 2.24) mmol/L and (7.58 ± 1.59) mg/L vs. (11.06 ± 2.15) mg/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result that IL-4 was positively correlated with miR-29b ( r=0.438, P<0.01), and the IL-8 and TNF-ɑ were negatively correlated with miR-29b ( r=-0.295 and -0.377, P<0.01). Conclusions:Hysteroscopy cold knife technique can shorten the operation time and hospitalization time of the patients with intrauterine adhesion, and significantly improve the curative effect by promoting the expression of miR-29b and anti-inflammatory factors.

Objective:To investigate the effects and mechanisms of Yinzhihuang oral liquid on mice with high-fat diet induced non-alcoholic fatty liver disease (NAFLD).Methods:Eighteen C57BL/6J female mice were divided into normal diet group, high-fat diet group and Yinzhihuang oral liquid group, with six mice in each group. After hematoxylin-eosin staining, oil red O staining and Masson staining, pathological scores of liver biopsy slices were calculated. Plasma levels of triacylglycerol, total cholesterol, total bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were tested. The composition of bile acid in mouse ileum content were measured by high performance liquid chromatography-tandem mass spectrometry, which included tauro-β-muricholic acid (TβMCA), ursodeoxycholic acid (UDCA) and cholic acid. The expression of farnesoid Ⅹ receptor ( FXR), fibroblast growth factor 15 ( FGF15), fibroblast growth factor receptor 4 ( FGFR4) genes at mRNA and protein levels and cytochrome P450 (CYP) 27a1, CYP7b1, CYP7a1 and CYP8b1 were detected by real-time quantitative polymerase chain reaction, Western blotting and immunohistochemistry, respectively. T test was used for statistical analysis. Results:The levels of plasma triacylglycerol, total cholesterol, total bilirubin, ALT and AST of Yinzhihuang oral liquid group were all lower than those of the high-fat diet group ((1.47±0.07) mmol/L vs. (1.90±0.13) mmol/L, (2.57±0.17) mmol/L vs. (6.84±0.23) mmol/L, (0.88±0.22) mg/dL vs. (2.06±0.25) mg/dL, (28.43±3.16) U/L vs. (87.15±23.27) U/L, (147.40±8.47) U/L vs. (289.00±12.66) U/L, respectively), and the differences were statistically significant ( t=3.90, 15.19, 4.31, 2.50 and 9.58, all P<0.05). The scores of adiposis and ballooning of hepatocytes of Yinzhihuang oral liquid group were lower than those of the high-fat diet group (1.00±0.26 vs. 2.33±0.33, 0.33±0.21 vs. 1.17±0.31, respectively), and the differences were all statistically significant ( t=3.90 and 4.90, both P<0.05). The levels of FXR antagonistic bile acids TβMCA and UDCA in ileal contents of Yinzhihuang oral liquid group were both higher than those of high-fat diet group ((4.95±0.68) nmol/g vs. (2.64±0.15) nmol/g, (7.86±1.84) nmol/g vs. (2.22±0.38) nmol/g, respectively), and the differences were statistically significant ( t=3.92 and 2.99, both P<0.05). The level of FXR agonistic bile acid cholic acid of Yinzhihuang oral liquid group were lower than that of the high-fat diet group ((4.69±0.46) nmol/g vs. (21.66±3.25) nmol/g), and the difference was statistically significant ( t=5.14, P<0.05). The expression of FXR, FGF15 in ileal tissues and FGFR4 in hepatic tissues at mRNA and protein levels of Yinzhihuang oral liquid group were all lower than those of the high-fat diet group (1.86±0.40 vs. 4.25±0.70, 9.99±2.82 vs. 75.17±23.41, 4.76±0.63 vs. 12.66±1.39, 2.20±0.14 vs. 5.30±0.25, 1.15±0.05 vs. 3.05±0.16 and 1.73±0.09 vs. 2.37±0.21, respectively), and the differences were statistically significant ( t=2.56, 2.76, 4.87, 10.90, 10.96 and 2.94, all P<0.05). The levels of CYP27a1 and CYP7b1 in the alternative pathway of bile acid synthesis in Yinzhihuang oral liquid group were both higher than those in the high-fat diet group (2.13±0.33 vs. 0.50±0.09 and 2.95±0.60 vs. 0.37±0.19), and the differences were statistically significant ( t=5.22 and 3.20, both P<0.05). But the expression level of CYP8b1 in the Yinzhihuang oral liquid group was lower than that in the high-fat diet group (2.38±0.41 vs. 8.63±2.20), and the difference was statistically significant ( t=2.80, P<0.05). Conclusion:Yinzhihuang oral liquid can reduce NAFLD by promoting bile acid synthesis through changing the components of intestinal bile acids in mice and inhibiting FXR-FGF15 signal pathway.

Objective To explore the effect of continuous suction by small pipe in trachea cannula for patients after tracheotomy.Methods Totally 60 patients with tracheotomy in Neurosurgery Ward and ICU, the Affiliated Hospital of School of Medicine of Ningbo University were included by purposive sampling from January 2015 to August 2016, and were divided into observation group (n=30) and control group (n=30) by random number table method. Tracheostomy mask joint oxygen Inhalation by heating humidifier was applied in both groups, without using breathing machine. Routine nursing methods of tracheotomy was carried out in the control group, while continuous suction by small pipe in trachea cannula were used in the observation group. Respiratory complications and nursing workload of the two groups were compared during the first week after tracheotomy.Results In observation group, there were 3 cases of irritative cough, 2 cases of respiratory hemorrhage, 3 cases of hypoxemia while sputum suctioning, and the complications rate was lower than control group(21, 14, 16), the differences were statistically significant (χ2=22.500, 12.273, 13.017;P<0.05). Times of suction in observation group and control group were (8.57±4.76) and (66.77±26.34), respectively, the difference was statistically significant (t=-11.908,P<0.01).Conclusions Continuous suction by small pipe in trachea cannula is a safe and effective method which could obviously reduce the respiratory complications while suctioning, decrease the times of endotracheal suction, as well as the workload of the nurse.

We wished to assess the role of chlamydia micro virus capsid protein Vp3 in recombinant molecules, chart its molecular evolution, screen the wild-type strain, and reveal its value in clinical research. Using a protein BLAST multiple-alignment program, we compared various strains of Chlamydia micro virus capsid protein Vp3 sequences. Using a "distance tree" of those results, we created a phylogenetic tree. We applied the Karplus-Schulz method of flexible-region analyses for highly conserved alignments of amino-acid sequences. Gamier-Robson and Chou-Fasman methods were employed to analyze two-level structures of sequences. The Emini method was used for analyses of the accessibility of surface epitopes. Studies of hydrophilic proteins were undertaken using Kyte-Doolittle and Hopp-Woods methods. Analyses of antigen epitopes helped to reveal the antigen index using the Jameson-Wolf method. All sequences in the six strains of chlamydia micro virus capsid protein Vp3 were highly conserved, with the main differences being between Vp3 protein in Chp1 and the other five strains of the micro virus. The viral strain of Vp3 protein was based mainly on micro-alpha helix structures, and multiple epitopes were noted in highly conserved regions. Vp3 protein was highly conserved structurally, and was an important protein of the chlamydiaphage capsid. Vp3 protein has a complicated molecular structure, highly conserved regions with strong immunogenicity, and has considerable research value.
Amino Acid Sequence ; Capsid Proteins ; chemistry ; genetics ; immunology ; Chlamydia ; genetics ; immunology ; Conserved Sequence ; Epitope Mapping ; Evolution, Molecular ; Molecular Sequence Data ; Recombination, Genetic