Objective:To examine the influence of physical function status on supportive care needs (SCNS) in patients with primary liver cancer (PLC) and to explore the mediating roles of perceived social support and anxiety-depression, with the aim of providing evidence for nursing interventions to improve patients' care experience.Methods:A convenience sampling method was used to select PLC inpatients admitted to The First Affiliated Hospital of Jinan University between December 2022 and February 2024. Data were collected using a general information questionnaire, the 34-item Supportive Care Needs Survey-Short Form, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, and the Karnofsky Performance Status Scale to conduct a cross-sectional survey. Pearson correlation analysis was performed to examine associations among SCNS, perceived social support, anxiety-depression, and physical function status. Structural equation modeling was used to assess the mediating effects of perceived social support and anxiety-depression on the relationship between physical function status and SCNS.Results:A total of 304 patients were enrolled, including 260 males and 44 females, 31 cases aged 18-40 years old, 160 cases aged 41 to 60 years old, and 113 cases over 60 years old. The mean total SCNS score was (98.32 ± 21.75) points, the mean anxiety-depression score was (23.31 ± 9.64) points, the mean perceived social support score was (56.62 ± 13.05) points, and the mean physical function status score was (66.28 ± 12.31) points. Pearson correlation analysis showed that physical function status was negatively correlated with SCNS and anxiety-depression ( r =-0.509, -0.447; both P<0.05) and positively correlated with perceived social support ( r =0.439, P<0.05). Physical function status had a direct effect of 60.74% on SCNS, with specific mediating effects of perceived social support and anxiety-depression accounting for 23.15% and 11.85%, respectively, and a chain mediating effect of 4.26%. Conclusions:Patients with PLC exhibited a moderately high level of supportive care needs. Physical function status not only exerted a direct negative effect on SCNS but also indirectly influenced SCNS through the chain mediation of perceived social support and anxiety-depression. Clinical medical staff should focus on enhancing patients' perception of social support and effectively alleviating anxiety and depressive symptoms, thereby reducing supportive care needs to some extent.

Objective:To examine the influence of physical function status on supportive care needs (SCNS) in patients with primary liver cancer (PLC) and to explore the mediating roles of perceived social support and anxiety-depression, with the aim of providing evidence for nursing interventions to improve patients' care experience.Methods:A convenience sampling method was used to select PLC inpatients admitted to The First Affiliated Hospital of Jinan University between December 2022 and February 2024. Data were collected using a general information questionnaire, the 34-item Supportive Care Needs Survey-Short Form, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, and the Karnofsky Performance Status Scale to conduct a cross-sectional survey. Pearson correlation analysis was performed to examine associations among SCNS, perceived social support, anxiety-depression, and physical function status. Structural equation modeling was used to assess the mediating effects of perceived social support and anxiety-depression on the relationship between physical function status and SCNS.Results:A total of 304 patients were enrolled, including 260 males and 44 females, 31 cases aged 18-40 years old, 160 cases aged 41 to 60 years old, and 113 cases over 60 years old. The mean total SCNS score was (98.32 ± 21.75) points, the mean anxiety-depression score was (23.31 ± 9.64) points, the mean perceived social support score was (56.62 ± 13.05) points, and the mean physical function status score was (66.28 ± 12.31) points. Pearson correlation analysis showed that physical function status was negatively correlated with SCNS and anxiety-depression ( r =-0.509, -0.447; both P<0.05) and positively correlated with perceived social support ( r =0.439, P<0.05). Physical function status had a direct effect of 60.74% on SCNS, with specific mediating effects of perceived social support and anxiety-depression accounting for 23.15% and 11.85%, respectively, and a chain mediating effect of 4.26%. Conclusions:Patients with PLC exhibited a moderately high level of supportive care needs. Physical function status not only exerted a direct negative effect on SCNS but also indirectly influenced SCNS through the chain mediation of perceived social support and anxiety-depression. Clinical medical staff should focus on enhancing patients' perception of social support and effectively alleviating anxiety and depressive symptoms, thereby reducing supportive care needs to some extent.

Objective To investigate the mechanism of Guizhi Tongluo Tablets(GZTLP)on improving atherosclerosis in APOE knockout mice by regulating neutrophil extracellular trapping nets(NETs).Methods After modeling,24 APOE knockout mice aged 8 weeks were randomly divided into 4 groups:GZTLP high-dose group,low-dose group,model control group and normal control group,with 6 mice in each group.GZTLP was given 1.87 mg·g-1 and 0.47 mg·g-1 intragastric administration in high-dose group and low-dose group,respectively.The normal control group and model control group were given 0.9%sodium chloride solution intragastric administration for 6 weeks,and the lipid plaque deposition in aorta was observed by gross oil red O staining.Lipid deposition in aortic root was observed by oil red O staining.The pathological changes of lipid plaques in aortic root were observed by HE staining.The levels of interleukin-1β(IL-1β)and tumor necrosis factor α(TNF-α)in peripheral blood of mice were detected by enzyme-linked immunosorbent assay(ELISA).The expression of lymphocyte antigen 6G(Ly6G),myeloperoxidase(MPO)and citrulinated histone(Cit-H3)in plaques of the aortic arch and the colocalization of Ly6G,MPO and Cit-H3 were detected by immunofluorescence assay.Results Compared with the normal control group,the aorta of mice in the model control group showed serious lipid plaque deposition,morphological damage,and a large number of inflammatory cells infiltration,the contents of serum inflammatory factors IL-1β and TNF-α were increased,and the protein expressions of Ly6G,Cit-H3 and MPO were significantly increased.Compared with model control group,GZTLP group reduced the amount of lipid plaque deposition in aorta,the arrangement of aortic cells was more regular,the inflammatory cell infiltration was improved,and the contents of serum inflammatory factors IL-1β and TNF-α were significantly decreased(P<0.05).The colocalization and the protein expression of Ly6G,MPO and Cit-H3 were significantly decreased in aortic tissues(P<0.01).Conclusions GZTLP can improve atherosclerosis,and its mechanism may be related to the inhibition of neutrophil extracellular trapping nets.

Objective:To analyze the effect of optical zone diameter in orthokeratology contact lenses on the efficacy of treatment.Methods:A total of 100 myopic patients (196 eyes) who wore Paragon CRT keratoplasty lenses with a diameter of 10.5 mm were retrospectively included in this study. These patients, consisting of 47 males and 53 females, were admitted to The Affiliated Hospital of Hangzhou Normal University between November 2020 and November 2022. Their ages ranged from 8 to 13 years. Their refractive errors ranged from -0.75 DS to -4.00 DS for spherical errors and from -0.25 DC to -1.50 DC for cylindrical errors. The corrected visual acuity was ≥ 0.6, and the initial axes were between 23.40 mm and 25.83 mm. The patients were grouped according to the different diameters of the optical zones of their lenses. Fifty patients (98 eyes) with an optical zone of 5.0 mm were included in the 5.0 group, and another 50 patients (98 eyes) with an optical zone of 6.0 mm were included in the 6.0 group. The general sociological and disease-related characteristics of the two groups were recorded. Logistic linear regression analysis was performed on the data with differences to obtain the therapeutic effect of different optimal zone diameters in orthokeratology contact lenses.Results:After 1 year of wearing, there was no statistically significant difference in the average non-invasive tear film break-up time between the two groups ( P > 0.05). The 5.0 group exhibited significantly lower values for the surface regularity index (0.35 ± 0.09), surface asymmetry index (0.69 ± 0.21), axial length [(0.19 ± 0.04) mm], and relative peripheral refraction [(-0.65 ± 0.20) D, (-0.84 ± 0.26) D, (-0.48 ± 0.13) D, (-0.76 ± 0.23) D, (-0.77 ± 0.21) D, (-0.56 ± 0.17) D] compared with the 6.0 group ( t = 5.94, 3.34, 4.64, 2.03, 2.07, 4.23, 2.27, 2.25, 5.55, all P < 0.05). Conversely, the uncorrected visual acuity [(0.71 ± 0.20) LogMAR] and spherical equivalent [(-0.25 ± 0.05) D] were significantly higher in the 5.0 group compared with the 6.0 group ( t = 3.31, 13.64, both P < 0.05). After 1 year of wearing, the diameter and area of the optical zone in the 5.0 group [(3.35 ± 0.28) mm and (7.50 ± 1.10) mm2] were significantly lower than those in the 6.0 group [(3.68 ± 0.38) mm and (8.50 ± 1.50) mm2, t = 6.92, 5.32, 11.16, all P < 0.05]. Furthermore, the overlapping treatment zone area to pupil area ratio (TZR) in the 5.0 group (0.53 ± 0.16) was significantly lower than that in the 6.0 group [(0.81 ± 0.19), t = 11.16, P < 0.05]. The results of logistic linear regression analysis and Pearson calculation showed that the TZR was positively correlated with the optical zone diameters of orthokeratology contact lenses ( P < 0.05). There was no significant difference in the incidence of complications between the 5.0 group [8.16% (8/98)] and the 6.0 group [12.24% (12/98), χ2 = 0.89, P > 0.05). Conclusion:The 1-year dynamic change in eye axis indicates that myopia correction is more effective and safe when the diameter of the optical zone in keratoplasty is 5.0 mm compared with when the diameter of the optical zone is 6.0 mm. Evaluating the efficacy of corneal reshaping lenses in different optical zones using statistical TZR can guarantee myopia control results. At the same time, this study demonstrates significant innovation and scientific validity, which can offer new ideas and methods for the research and application of orthokeratology contact lenses.

OBJECTIVE To investigate the regulatory effects of couplet medicinals of Atractylodes macrocephala-Aucklandia lappa on gut microbiota and short-chain fatty acids （SCFAs） in the diarrhea-type irritable bowel syndrome （IBS-D） rats with spleen deficiency. METHODS The IBS-D rat model with spleen deficiency was induced by intragastric administration of Senna alexandrina combined with restraint stimulation. The model rats were divided into model group， positive control group （pinaverium bromide 1.5 mg/kg）， A. macrocephala-A. lappa low-dose， medium-dose and high-dose groups （0.7， 1.4， 2.8 g/kg）， with 6 rats in each group. Another 6 healthy rats were taken as the blank control group. The blank control group and the model group were given normal saline intragastrically， and other groups were given relevant drug liquid intragastrically， once a day， for consecutive 14 days. The general characteristics of rats and fecal water content were observed， and intestinal sensitivity [evaluating by abdominal wall withdrawal reflex （AWR） threshold] and the intestinal propulsion rate were determined. The serum levels of 5- hydroxytryptamine（5-HT）and SP were detected， and the pathological changes of colon tissue were observed； the protein expressions of 5-HT-3 receptor（5-HT3R）， 5-HT4R and 5-HT transporter（SERT） in colon tissue of rats were detected. 16S rRNA sequencing was performed for the feces of rats in blank control group， model group and A. macrocephala-A. lappa high-dose group； the contents of acetic acid， propionic acid and butyric acid in the feces of the rats were determined. RESULTS Compared with the model group， the body weight after 7 and 14 days of medication， fecal water content， AWR threshold， and the protein expressions of 5-HT4R and SERT in colon tissue were increased significantly in the A. macrocephala-A. lappa medium-dose and high-dose groups （P＜0.05 or P＜0.01）； serum contents of 5-HT and SP， intestinal propulsion rate （except for A. macrocephala-A. lappa medium-dose group）， the protein expression of 5-HT3R in colon tissue were decreased significantly （P＜0.01）； diarrhea relief， mental state recovery， and partially recovery of the structure of colon tissue were all found； moreover， the diversity and species number of gut microbiota were reduced in A. macrocephala-A. lappa high-dose group and the content of butyric acid in fecal samples was significantly reduced （P＜0.05）. CONCLUSIONS The compatibility of A. macrocephala and A. lappa can improve intestinal motility and sensitivity of IBS-D model rats with spleen deficiency， and alleviate diarrhea. This may be related to improving changes in intestinal microbiota structure， reducing 5-HT expression and butyric acid content， and increasing 5-HT4R and SERT expression.

Humans ; Amyloidosis ; Amyloid ; Cardiomyopathies

Objective:To explore the effect of intervention model based on comprehensive nutrition management on glucose and lipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:104 GDM patients admitted to Shanxi Bethune Hospital from February 2022 to March 2023 were randomly divided into control group and experimental group, with 52 cases in each group. The control group implemented routine management measures and nutrition guidance, while the experimental group implemented an intervention model based on comprehensive nutrition management on the basis of routine management. The indexes of glucose and lipid metabolism (glycosylated hemoglobin, fasting blood glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride and low density lipoprotein cholesterol), pregnancy outcome, self-management ability and self-efficacy were compared between the two groups before and after intervention.Results:Before the intervention, there was no significant difference in general situation, glucose and lipid metabolism index, self-management ability and self-efficacy between the two groups ( P>0.05). After the intervention, the level of glucose and lipid metabolism index in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The incidence of adverse pregnancy outcome in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The scores of self-management ability and self-efficacy in the experimental group were significantly higher than those in the control group, with statistical significance ( P<0.05). Conclusion:The intervention model based on comprehensive nutrition management can effectively improve the glucose and lipid metabolism index and pregnancy outcome of GDM patients, and significantly improve their self-management ability and self-efficacy related to nutrition management, which has high clinical application and promotion value.

Background: and Purpose The relationships among interleukin (IL)-10 levels, anxiety, and cognitive status after stroke remain controversial. We aimed to determine the associations of serum IL-10 levels with poststroke anxiety (PSA) and poststroke cognitive impairment (PSCI). Methods: We recruited 350 patients with stroke, of whom only 151 completed a 1-month follow-up assessment. The Mini Mental State Examination (MMSE) and Hamilton Anxiety Scale (HAMA) were used to assess the cognitive status and anxiety, respectively. Serum IL-10 levels were measured within 24 hours of admission. Results: IL-10 levels were significantly lower in the PSA group than in the non-PSA group, and they were negatively associated with HAMA scores (r=-0.371, p<0.001). After adjusting for all potential confounders, IL-10 levels remained an independent predictor of PSA (odds ratio=0.471, 95% confidence interval=0.237–0.936, p=0.032). IL-10 levels were strongly correlated with behavior during interviews, psychic anxiety, and somatic anxiety. Patients without PSCI had higher IL-10 levels were higher in non-PSCI patients than in PSCI patients, and they were positively associated with MMSE scores in the bivariate correlation analysis (r=0.169, p=0.038), and also with memory capacity, naming ability, and copying capacity.However, IL-10 did not predict PSCI in the univariable or multivariable logistic regression. Conclusions Low IL-10 levels were associated with increased risks of PSA and PSCI at a 1-month follow-up after stroke. Serum IL-10 levels may therefore be helpful in predicting PSA.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.