OBJECTIVE To explore the mechanism of Compound lizard powder reducing cisplatin resistance in gastric cancer by regulating glycolytic activity based on phosphoinositide 3-kinase（PI3K）/protein kinase B（Akt） signaling pathway. METHODS Human gastric cancer MKN45 and MKN45/DDP （cisplatin-resistant） cells were cultured in vitro and intervened with different mass concentrations of cisplatin （0.1， 0.2， 0.4， 0.8， 1.6， 3.2 μg/mL） to detect the survival rate， half inhibitory concentration （IC50） and drug resistance index. MKN45/DDP cells were inoculated subcutaneously in the right anterior axilla of nude mice to prepare a transplanted tumor model of gastric cancer. After successful modeling， they were randomly divided into model group， cisplatin group （0.002 g/kg）， Compound lizard powder group （2.8 g/kg） and combination group （the same dose as each single drug group）， with 8 nude mice in each group. Each administration group was given relevant solution， twice a week （cisplatin， i.p.） or twice a day （Compound lizard powder， i. g.）， for 4 consecutive weeks. During the experiment， the body weight of nude mice was monitored， and tumor volume and inhibitory rate of tumor were calculated. The levels of inflammatory factors （tumor necrosis factor- α， interleukin-6） in tumor tissue， the mRNA and protein expressions of multidrug resistance-associated protein 1 （MRP1）， P-glycoprotein （P-gp）， glucose transporter-1 （GLUT1） and lactate dehydrogenase A （LDHA）， as well as the protein expressions of PI3K， phosphorylated PI3K （p-PI3K）， Akt， phosphorylated Akt （p-Akt）， hexokinase-2 （HK2） and pyruvate kinase M2 （PKM2） were all detected. RESULTS With the intervention of different concentrations of cisplatin， the survival rate of MKN45/DDP-resistant cells was significantly higher than that of MKN45 parent cells （P＜0.05）. IC50 value of MKN45/DDP and MKN45 cells were（1.052 0±0.221 9） and （0.372 1±0.238 0）μg/mL， and the drug resistant index was 2.827. Compared with the model group， cisplatin group， Compound lizard powder group and combination group all had certain inhibitory effects on the tumor growth in nude mice； the inhibitory rates of tumor increased significantly （P＜0.05）； the levels of inflammatory factors， the mRNA and protein expressions of MRP1， P-gp， GLUT1 and LDHA （except for cisplatin group）， the phosphorylation levels of PI3K and Akt protein （except for cisplatin group） as well as the protein expressions of HK2 and PKM2 were decreased significantly， while the combination group was significantly better than the cisplatin group （P＜0.05）. CONCLUSIONS Compound lizard powder may inhibit tumor growth in transplanted tumor model nude mice with gastric cancer-resistant cells by reducing the secretion of tumor-related inflammatory factors， inhibiting the expression of glycolysis， drug resistance-related proteins and genes， inhibiting the activation of the PI3K/Akt signaling pathway， thus having a certain effect of enhancing cisplatin efficacy and reversing drug resistance.

Objective To explore the targets and pathways of Cynanchum wilfordii for treatment of ulcerative colitis(UC).Methods UPLC-QE-MS was used to identify the components of Cynanchum wilfordii ethanol extract,and their targets were screened using public databases for construction of the core protein-protein interaction(PPI)network and GO and KEGG enrichment analyses.Forty male C57 mice were randomized into normal control group,model group,mesalazine group and Cynanchum wilfordii group(n=10),and in the latter 3 groups,mouse UC models were established by treatment with 2.5%DSS and the latter 2 groups drug interventions by gavage.The therapeutic effect was evaluated by recording body weight changes and DAI score.Pathological changes of the colon tissue were observed with HE and AB-PAS staining,and JAK2 and STAT3 protein expressions were detected with Western blotting.The metabolites and metabolic pathways were identified by metabonomics analysis.Results We identified 240 chemical components in Cynanchum wilfordii alcoholic extracts,including 19 steroids.A total of 177 Cynanchum wilfordii targets,5406 UC genes,and 117 intersection genes were obtained.JAK2 and STAT3 were the core targets and significantly enriched in lipid and atherosclerosis pathways.Cynanchum wilfordii treatment significantly increased the body weight and decreased DAI score of UC mice(P<0.05),alleviated intestinal pathologies,and decreased JAK2 and STAT3 protein expressions in the colon tissues.Most of the 83 intersecting differential metabolites between the control,model and Cynanchum wilfordii groups were identified as glycerophospholipids,arachidonic acid,and amino acids involving glycerophospholipid metabolism and other pathways.Correlation analysis suggested that the core targets of Cynanchum wilfordii for UC participated in regulation of the metabolites.Conclusion Cynanchum wilfordii alleviates lipid and amino acid metabolism disorders to lessen UC in mice by regulating the core targets including JAK2 and STAT3 and the levels of endogenous metabolites.

Objective To explore the targets and pathways of Cynanchum wilfordii for treatment of ulcerative colitis(UC).Methods UPLC-QE-MS was used to identify the components of Cynanchum wilfordii ethanol extract,and their targets were screened using public databases for construction of the core protein-protein interaction(PPI)network and GO and KEGG enrichment analyses.Forty male C57 mice were randomized into normal control group,model group,mesalazine group and Cynanchum wilfordii group(n=10),and in the latter 3 groups,mouse UC models were established by treatment with 2.5%DSS and the latter 2 groups drug interventions by gavage.The therapeutic effect was evaluated by recording body weight changes and DAI score.Pathological changes of the colon tissue were observed with HE and AB-PAS staining,and JAK2 and STAT3 protein expressions were detected with Western blotting.The metabolites and metabolic pathways were identified by metabonomics analysis.Results We identified 240 chemical components in Cynanchum wilfordii alcoholic extracts,including 19 steroids.A total of 177 Cynanchum wilfordii targets,5406 UC genes,and 117 intersection genes were obtained.JAK2 and STAT3 were the core targets and significantly enriched in lipid and atherosclerosis pathways.Cynanchum wilfordii treatment significantly increased the body weight and decreased DAI score of UC mice(P<0.05),alleviated intestinal pathologies,and decreased JAK2 and STAT3 protein expressions in the colon tissues.Most of the 83 intersecting differential metabolites between the control,model and Cynanchum wilfordii groups were identified as glycerophospholipids,arachidonic acid,and amino acids involving glycerophospholipid metabolism and other pathways.Correlation analysis suggested that the core targets of Cynanchum wilfordii for UC participated in regulation of the metabolites.Conclusion Cynanchum wilfordii alleviates lipid and amino acid metabolism disorders to lessen UC in mice by regulating the core targets including JAK2 and STAT3 and the levels of endogenous metabolites.

Objective:To investigate the efficacy and safety of dermal anchoring method combined with low energy electron beam irradiation in the removal of chest wall keloids.Methods:Clinical data of patients with medium and large-sized chest wall keloids treated in Plastic Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2015 to May 2021 were analyzed retrospectively. The keloid was completely removed from the superficial fascia layer, and a small patch of scar dermis tissue was retained in the center of the keloid. When the cutting edge was sutured, the above-mentioned dermis tissue was anchored to achieve tension reduction. Then low energy electron beam irradiation treatment was carried out within 24 h after surgery, with an irradiation range of 5-10 mm from the incision edge and a subcutaneous depth of 2 cm. The lesions were irradiated for 3 times, with a 24 h interval between each exposure. The total irradiation dose was 20 Gy. The width, severity of hyperplasia (expressed in height), and recurrence of keloids at 3, 6, and 12 months after surgery were recorded. Patient satisfaction was evaluated one year after surgery (with a total score of 10 points, 0-3 points of dissatisfaction, 4-7 points of general satisfaction, 8-10 points of great satisfaction), and the incidence of radiation complications was observed. SPSS 25.0 software was used for statistical analysis of the data, with measurement data represented by Mean±SD. Repeated measurement analysis of variance was conducted for the same variable at different periods, and counting data was represented by %. χ2 test was used for group comparison. P<0.05 indicated the difference with statistical significance. Results:A total of 39 patients with 39 scars were included. There were 15 males and 24 females, aged (30.9±9.5) years. The preoperative scar width was (43±5) mm (rang 38-48 mm), and the scar volume was 20.0 mm×38.0 mm×7.5 mm-80.0 mm×48.0 mm×1.6 mm. After the surgery, the wound showed a mild protrusion with minimal exudation, and the wound was dry and clean after irradiation. The scar width at 3, 6, and 12 months after surgery was (1.3±0.5), (1.8±0.5), and (2.9±0.5) mm, respectively, with statistically significant difference ( P<0.01); the severity of scar hyperplasia was (0.9±0.3), (1.3±0.3), and (1.8±0.3) mm, with statistically significant difference ( P<0.01); the recurrence rates of keloids were 12.8% (5 cases), 23.1% (9 cases), and 25.6% (10 cases), respectively, with no statistically significant difference ( P>0.05). The patient satisfaction score at 1 year after surgery was 2-10, average of 7. There were 4 cases (10%) of dissatisfaction, 10 cases (26%) of general satisfaction, 25 cases (64%) of great satisfaction. No radiotherapy complications occurred. Conclusion:Dermal anchoring method combined with low energy electron beam irradiation can achieve good therapeutic effects in the removal of chest wall keloids. The recurrence rate of keloids is low, and patient satisfaction is high.

Objective:To investigate the efficacy and safety of dermal anchoring method combined with low energy electron beam irradiation in the removal of chest wall keloids.Methods:Clinical data of patients with medium and large-sized chest wall keloids treated in Plastic Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2015 to May 2021 were analyzed retrospectively. The keloid was completely removed from the superficial fascia layer, and a small patch of scar dermis tissue was retained in the center of the keloid. When the cutting edge was sutured, the above-mentioned dermis tissue was anchored to achieve tension reduction. Then low energy electron beam irradiation treatment was carried out within 24 h after surgery, with an irradiation range of 5-10 mm from the incision edge and a subcutaneous depth of 2 cm. The lesions were irradiated for 3 times, with a 24 h interval between each exposure. The total irradiation dose was 20 Gy. The width, severity of hyperplasia (expressed in height), and recurrence of keloids at 3, 6, and 12 months after surgery were recorded. Patient satisfaction was evaluated one year after surgery (with a total score of 10 points, 0-3 points of dissatisfaction, 4-7 points of general satisfaction, 8-10 points of great satisfaction), and the incidence of radiation complications was observed. SPSS 25.0 software was used for statistical analysis of the data, with measurement data represented by Mean±SD. Repeated measurement analysis of variance was conducted for the same variable at different periods, and counting data was represented by %. χ2 test was used for group comparison. P<0.05 indicated the difference with statistical significance. Results:A total of 39 patients with 39 scars were included. There were 15 males and 24 females, aged (30.9±9.5) years. The preoperative scar width was (43±5) mm (rang 38-48 mm), and the scar volume was 20.0 mm×38.0 mm×7.5 mm-80.0 mm×48.0 mm×1.6 mm. After the surgery, the wound showed a mild protrusion with minimal exudation, and the wound was dry and clean after irradiation. The scar width at 3, 6, and 12 months after surgery was (1.3±0.5), (1.8±0.5), and (2.9±0.5) mm, respectively, with statistically significant difference ( P<0.01); the severity of scar hyperplasia was (0.9±0.3), (1.3±0.3), and (1.8±0.3) mm, with statistically significant difference ( P<0.01); the recurrence rates of keloids were 12.8% (5 cases), 23.1% (9 cases), and 25.6% (10 cases), respectively, with no statistically significant difference ( P>0.05). The patient satisfaction score at 1 year after surgery was 2-10, average of 7. There were 4 cases (10%) of dissatisfaction, 10 cases (26%) of general satisfaction, 25 cases (64%) of great satisfaction. No radiotherapy complications occurred. Conclusion:Dermal anchoring method combined with low energy electron beam irradiation can achieve good therapeutic effects in the removal of chest wall keloids. The recurrence rate of keloids is low, and patient satisfaction is high.

Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.

Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.

Objective:To investigate the cultural construction of Traditional Chinese Medicine(TCM) hospitals in Hunan province, for reference in their cultural construction.Methods:A questionnaire was designed according to TCM Hospital Cultural Construction Guidelines by the National Traditional Chinese Administration.From May to June 2020, the questionnaire was used to survey the present situation, existing problems and development suggestions of TCM cultural construction at TCM hospitals of and above the county level in Hunan province. The data were analyzed by descriptive analysis.Results:The survey covered 117 public TCM hospitals in the province and 87 questionnaires were recovered, a rate of 74.4%. In terms of cultural construction in these institutions, various programs were in place at a relatively high proportion in the core cultural value construction. The development of behavioral norms teaching and inheritance was in place at a relatively low proportion, namely 78.8% at tertiary TCM hospitals, 51.8% at secondary TCM hospitals, and only 16.7% at secondary level-B TCM hospitals. In terms of environmental image construction, various programs were in place at a relatively high proportion, yet focusing on themed cultural wall posters culturol bulletin board and other forms of display. At present, the main problems were insufficient funding(86.9%) and talents(82.1%).Conclusions:TCM hospitals in Hunan province highly value the construction of cultural core value and environmental image, but their development in the code of conduct system and other connotation was weak.

Objective To explore the bone mineral density (BMD) status and its influencing factors in schizophrenia patients in order to provide basis for risk assessment in psychiatric nursing.Methods A total of 1,139 hospitalized schizophrenia patients were recruited and assigned into the medication group (n=652) and the non-medication group (n=487) according to previous antipsychotic drug history.T-score and Z-score of BMD were determined using Sunlight Omnisense 7000S Bone Densitometry.Blood calcium,blood phosphorus and serum prolactin levels were measured using fasting blood of ulnar vein.Results Differences in age,BMD,milk intake,level of activity,level of smoking,history of fall,history of fracture,serum Ca2+ and PRL were statistically significant between two groups(P＜0.05);there were significant differences in BMD rank distributions among schizophrenia patients with different courses of disease and lengths of taking antipsychotics (P＜0.001);multiple linear regression showed that influencing factors of BMD with statistical significance were courses of disease,lengths of taking antipsychotics,serum Ca2+,serum PRL,milk intake,level of activity,and level of smoking.Conclusion The BMD was lower in the medication group than that in the non-medication group,and the development of osteoporosis was correlated to various factors.Clinical nurses should master high-risk factors thoroughly and adopt intervention measures in a timely manner.

Objective: To explore the expression of myocardial levels of connexin 43(Cx43), Cx40 in experimental dog model of sympathomimetic atrial fibrillation (AF). Methods: 15 mongrels dogs were randomly divided into 3 groups: Control group, Rapid atrium pacing (RAP) group and RAP+isoprenaline (ISO) perfusion group. n=5 in each group. The hearts were taken to establish in vitro langendorff cardiac perfusion model. Atrial effective refractory period (AERP) and AF inducing rate were tested;intracellular expression and distribution of nerve growth factor (NGF) and tyrosine hydroxylase (TH) were examined by immunohistochemistry, total protein contents of Cx43 and Cx40 were measured by Western blot analysis, mitochondria morphology was observed by transmission electron microscope and mitochondria reactive oxygen species (ROS) generation was detected by fluorescent colorimetric method. Results: AERP was similar between Control group and RAP group (166±5.1) ms vs (160±3.2) ms which cannot induce AF; while it was shortened in RAP+ISO group (148±3.7) ms, P<0.05 which may successfully induce AF.Compared with Control group, mitochondria was slightly swollen in RAP group and the matrix was intact, while mitochondria was obviously swollen in RAP+ISO group and part of matrix was transparent; total protein contents of Cx43 and Cx40 were lower in both RAP group and RAP+ISO group, P<0.05; in addition, they were even lower in RAP+ISO group than RAP group, P<0.05. Compared with Control group and RAP group, RAP+ISO group had increased expression and distribution of NGF, TH and mitochondria ROS generation, P<0.05; NGF, TH and ROS in RAP group were higher than Control group, P<0.05. Conclusion: Sympathetic AF has been related to the contents and changes of myocardial levels of CX43 and Cx40; sympathetic nerve might trigger AF by oxidative stress induced down-regulation of myocardial CX43 and Cx40 in experimental dog model.