Objective To investigate the spatiotemporal expression pattern of metabotropic glutamate receptor 4(mGluR4)in the mouse cochlear basilar membrane and its dynamic changes during postnatal development until hair cell synaptic maturation.Methods Ten healthy 3-month-old C57BL/6L wild-type mice(5 males,5 females,25～35 g)were bred to obtain offspring.Cochlear samples from postnatal days 1～30(P1～P30)were analyzed.Frequency-specific auditory brainstem response(ABR)thresholds were measured at 45.2,32.0,22.6,16.0,11.3,8.0,5.6,and 4.0 kHz in P12,P14,P16,P21,and P30 mice.Immunofluorescence assay combined with confocal laser scanning microscopy was used to scan cochlear whole-mount preparations.Spatiotemporal co-localization profiling of mGluR4 and synaptic markers Ctbp2 and Snap25 was observed,and quantitative comparisons of fluorescent puncta density were performed.Results ABR testing revealed undifferentiated waveforms in all P12 mice,while 70%of P14 mice exhibited well-defined Wave I.In P14,P16,P21 and P30,mice undergoing ABR testing,50%failed to exhibit ABR waveforms when stimulated by 45.2 kHz tones,and 87.5%showed no response to 32.0 kHz stimuli.Auditory response thresholds for other frequencies progressively decreased with increasing postnatal age.Immunolocalization demonstrated stronger mGluR4 expression in inner hair cells(IHCs)versus outer hair cells(OHCs).Distinct mGluR4 puncta were observed at IHC presynaptic active zones(co-localized with Snap25)as early as P11,but showed minimal overlap with CtBP2-labeled ribbons.Quantitative analysis revealed significantly higher mGluR4 puncta density at P30 compared to P14 synapses(P<0.05).Conclusion Postnatal upregulation of mGluR4 at IHC synaptic regions correlates with functional maturation.These findings suggest mGluR4 may modulate vesicular exocytosis regulation and exert pharmacological inhibition on glutamate release,potentially influencing synaptic plasticity during auditory pathway refinement.

The literature on the characteristics, commodity grade specifications and chemical composition of Angelicae Sinensis Radix was reviewed. It was found that the main factors affecting the changes of traits and chemical composition of Angelicae Sinensis Radix included origin, altitude, climate, soil, cultivation methods, processing and processing methods and storage methods. Among them, the volatile oil types and ferulic acid content of Angelicae Sinensis Radix produced in Minxian County of Gansu Province were better than those in some non-authentic producing areas, but some component differences remained to be verified; direct seeding and film mulching cultivation could improve the yield, volatile oil and polysaccharide content of Angelicae Sinensis Radix; continuous cropping may lead to rhizosphere soil problems of Angelicae Sinensis Radix, and rotation or intercropping could be considered; drying in the shade and smoking drying could retain the oil and aroma of Angelicae Sinensis Radix; wine stir-frying method could increase the content of Z-ligustilide, but stir-frying carbon may reduce the content of ferulic acid; high temperature and high humidity storage may affect the content of ligustilide. In the future, the quality evaluation system of Angelicae Sinensis Radix should be strengthened and improved, genuine research should be strengthened, and scientific field management methods and appropriate harvesting and processing methods should be established, so as to ensure the good clinical efficacy and stable and controllable quality of Angelicae Sinensis Radix.

Objective:To explore the effectiveness of blended learning in the clinical teaching of wound care clinic.Methods:Blended learning based on WeChat and offline CBL teaching method was constructed by applying evidence-based nursing. Totally 125 interns from the wound care clinic of our hospital were selected as subjects, among which 62 didn't receive the blended learning (control group), and 63 received the blended learning (observation group). At the end of the two-week practice, the effectiveness of the two teaching methods was compared. The objective evaluation was carried out in the forms of theory test, practice evaluation and comprehensive quality questionnaire combined with online self-test and offline practice. All data were analyzed by SPSS 20.0 statistical software.Results:The scores of theory test, practice evaluation and comprehensive quality assessment in the observation group were all higher than those in the control group ( P<0.001). Conclusion:The blended learning with WeChat as the medium can guide student active learning, consolidate the basic knowledge, improve the efficiency of teaching, stimulate the enthusiasm of practice, and improve the comprehensive quality. It's a clinical teaching method that can be used for reference.

【Objective】 To retrospectively analyze the transfusion records of COVID-19 patients from Feb to Mar 2020 in the Optical Valley Branch of Tongji Hospital in Wuhan, and summarize the clinical features and blood use of those patients. 【Methods】 1) The utilization of blood components in 81 blood recipients were collected and retrospectively analyzed; 2) Propensity score matching (PSM, by the clinical classification of COVID-19) was used to match the transfused and non-transfused patients according to the ratio of 1∶2, and the clinical features of the two groups were compared. 【Results】 The total transfusion rate in our hospital was 5.5%(81/1 463), among which 88.9%(72/81)transfused red blood cell (RBC). Ten patients received RBC transfusion > 20 U, consumed 48.3%(330/680)RBC, 57.5%(53 500/93 100)plasma, 36.2%(42/116)platelets, and 62.3%(114.25/183.25)cryoprecipitates due to ECMO or gastrointestinal bleeding. Compared to non-transfused patients, transfused patients showed worse lab-indexes related to inflammation, infection, and coagulation at admission, higher incidences of acute liver, kidney and cardiac injury, admission to the ICU and mortality(P<0.01). 【Conclusion】 The related functional indexes and prognosis of transfused COVID-19 patients were significantly worse than non-transfused ones. RBC transfusions were dominant, and massive blood transfusions were seldom.

Objective:To investigate the cognitive level of wearing and removing personal protective equipment in COVID-19 isolation wards of Wuhan Fangcang shelter hospital, and provide the scientific basis for the training of hospital protection. Methods:Cognitive level of wearing and removing personal protective equipment in Wuhan Fangcang shelter hospital were investigated by using a questionnaire which included 14 related scales, including putting on and off protective equipment, hand hygiene disinfection and so on.Results:The total scale score of non-medical workers was 48.82±9.65, which was lower than the total scale score of doctors (55.46±1.29) and nurses (55.0±2.36), P<0.05. The each score of 14 items in the scale of non-medical workers was all lower than those of doctors and nurses ( P<0.05). There were no significant differences in scale scores among doctors, nurses and medical technicians. The total score of the scale of non-medical workers in later period was 55.23±3.26, which was significantly higher than the total score of 44.50±10.14 in previous period, P<0.001. The total score of nurses and medical technicians in the later period was higher than those in the previous period, and the difference was statistically significant. There was no significant difference between the total score of the scale in the later period and that in the previous period. Conclusions:The cognition level of non-medical workers on wearing and removing personal protective devices was lower than those of doctors and nurses, strengthening the practice could improve cognition.

Objective To study the evaluation index system for home treatment quality of negative pressure therapy. Methods Two-round Delphi expert consultation method was used to consult 20 experts, so as to initially establishthe quality evaluation index system. Results An evaluation index system for home treatment quality of negative pressure therapy was formed, including 4 items of primary indexes, 13 items of secondary indexes and 30 items of tertiary indexes. Conclusions The evaluation index system for home treatment quality of negative pressure therapy in patients with chronic wounds has a clear hierarchy, the reliability of the research results is high, which provides a standardized reference for the objective evaluation of the work and the continuous improvement of nursing quality.

Objective To explore the clinical application value and nursing experience of Urgotul parcel technology used for the treatment of surface abscess incision and drainage of the wound. Methods A total of 150 patients with surface abscess incision and drainage of the wound who received treatment in our hospital wound care room divided into A group, B group and C group (each group had 50 cases). Considering the characteristics of outpatients and the requirements of ethics, A group of patients from January to May of 2017 received the technology of Urgotul parcel alginate dressing with silver, B group of patients from June to December of 2016 received the treatment by the Mesalt and C group of patients from November 2015 to May 2016 used petrolatum gauze. After the infection control, each group received the treatment by Urgotul. Observe the difference with wound healing time, infection control time, the pain score of removing the dressings and filling of dressings, the number and the cost of wound care of patients. Results In A group, the scores of infection control time, wound healing time, the pain score of removing the dressings and filling of dressings, the number and the cost of wound care were (5.1±1.4) days, (22.9± 6.5) days, (1.3 ± 0.9) points, (1.9 ± 1.2) points, (6.6 ± 1.9) times, (603.81 ± 116.82) yuan, B group were (6.7 ±1.4) days, (24.7±7.2) days, (1.8±1.0) points, (4.1±1.4) points, (11.5±3.3) times, (736.94±203.81) yuan, and C group were (11.1 ± 2.1) days, (31.7 ± 3.8) days, (4.62 ± 1.3) points, (2.4 ± 1.1) points, (31.7 ± 3.7) times, (1617.20 ± 303.98) yuan. The difference between the three groups was statistically significant (F=30.48-931.29, all P<0.01). In infection control time, the pain score of removing the dressings, the number and the cost of wound care A group was better than B group and C group (P<0.05). The wound healing time of A group was shorter than C group (P<0.01), but was the same as B group (P>0.05). Filling of dressings the patients in A group and C group felt less pain than B group (P<0.01), and the pain scores in both A group and C group are same (P>0.05). Conclusions Urgotul parcel technology is able to control infection effectively, promote wound healing, Alleviate the pain of changing medicine, reduce the times and costs of wound care, improve patient compliance for patients with surface abscess incision and drainage of the wound. So Urgotul parcel technology has a significant role in these patients.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the osteogenic differentiation of adipose-derived stem cells.Methods Adipose-derived stem cells were isolated,cultured and passed to next generations.The fourth adipose-derived stem cells were collected and seeded to the 96-well plates (2 × 105 cells/well) for culture in osteogenic induction medium,and were randomly divided into the control group and the hyperbaric oxygen (HBO) group.In the entire experiment,the control group was only kept in the 5％ CO2 incubator at a temperature of 37 ℃,while the HBO group was treated with HBO for 24 hours a day at the same culture conditions as the control group.(The HBO treatment cells were placed in the HBO chamber,which was washed with pure oxygen at a ventilation rate of 10 L/min for 15min.When oxygen flow rate was down-regulated to 2-3 L/min,the chamber was compressed for 20-25 min to a pressure of 2.5 ATA,which was maintained for 60 minutes.Then,uniform decompression was implemented for 20-25 minutes.At days 7,14 and 21,alkaline phosphatase activity of the cells was detected by alkaline phosphatase kit.At days14 and 21,osteocalcin concentration was detected by using the osteocalcin quantitative test kit,and at day 21,the calcified nodules were stained with Alizarin red.The data obtained were analyzed by 2 independent samples t test,paired sample t test and repeated test ANOVA.Results The cultured cells could express such mesenchymal stem cell markers as CD90 and CD105,but could not express hematopoietic markers such as CD34.After 7,14 and 21 days of culture,the activity of alkaline phosphatase in the HBO group was significantly increased,as compared with that of the control group A (P ＜ 0.01).Following culture for 14 and 21 days,the expression level of osteocalcin in the HBO group was significantly elevated,as compared with that of the control group (P ＜ 0.05).At day 21,the detection results by alizarin red staining showed that the number of calcified nodules for the HBO group was increased markedly as compared with that of the control group,and the calcified size became larger.Conclusions Treatment of HBO could increase osteogenic differentiation of adipose-derived stem cells.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the osteogenic differentiation of adipose-derived stem cells.Methods Adipose-derived stem cells were isolated,cultured and passed to next generations.The fourth adipose-derived stem cells were collected and seeded to the 96-well plates (2 × 105 cells/well) for culture in osteogenic induction medium,and were randomly divided into the control group and the hyperbaric oxygen (HBO) group.In the entire experiment,the control group was only kept in the 5％ CO2 incubator at a temperature of 37 ℃,while the HBO group was treated with HBO for 24 hours a day at the same culture conditions as the control group.(The HBO treatment cells were placed in the HBO chamber,which was washed with pure oxygen at a ventilation rate of 10 L/min for 15min.When oxygen flow rate was down-regulated to 2-3 L/min,the chamber was compressed for 20-25 min to a pressure of 2.5 ATA,which was maintained for 60 minutes.Then,uniform decompression was implemented for 20-25 minutes.At days 7,14 and 21,alkaline phosphatase activity of the cells was detected by alkaline phosphatase kit.At days14 and 21,osteocalcin concentration was detected by using the osteocalcin quantitative test kit,and at day 21,the calcified nodules were stained with Alizarin red.The data obtained were analyzed by 2 independent samples t test,paired sample t test and repeated test ANOVA.Results The cultured cells could express such mesenchymal stem cell markers as CD90 and CD105,but could not express hematopoietic markers such as CD34.After 7,14 and 21 days of culture,the activity of alkaline phosphatase in the HBO group was significantly increased,as compared with that of the control group A (P ＜ 0.01).Following culture for 14 and 21 days,the expression level of osteocalcin in the HBO group was significantly elevated,as compared with that of the control group (P ＜ 0.05).At day 21,the detection results by alizarin red staining showed that the number of calcified nodules for the HBO group was increased markedly as compared with that of the control group,and the calcified size became larger.Conclusions Treatment of HBO could increase osteogenic differentiation of adipose-derived stem cells.

Objective To evaluate the internal reliability of Psychosocial Function Evaluation for mental disabled people in day care unit. Methods 16 participants were evaluated twice by the same rater (social worker) in the unit at the Permanent stage and the Steering stage. Results Cronbach's α was greater than 0.7 in the both evaluation. The Spearman correlation coefficient between each dimension and total score were between 0.502 and 0.869. Conclusion The internal reliability of Psychosocial Function Evaluation is satisfactory for mental disabilities.