Objective:To retrieve, evaluate, and summarize evidence on the assessment and management of diarrhea in hematopoietic stem cell transplantation (HSCT) patients both domestically and internationally, providing evidence-based support for clinical practice.Methods:According to the "6S" model, guidelines, clinical decisions, recommended practices, evidence summaries, systematic reviews, and expert consensus related to the assessment and management of diarrhea in HSCT patients were systematically retrieved from relevant databases and websites both domestically and internationally. The search period was from January 1, 2013 to November 30, 2023. Seven researchers conducted literature screening, quality evaluation, evidence extraction, and summarization.Results:A total of 15 articles were included, including four guidelines, three clinical decisions, two recommended practices, one evidence summary, two systematic reviews, and three expert consensus. Thirty-one pieces of evidence were summarized from seven aspects of multidisciplinary management, risk factor management, assessment and monitoring, medication intervention, diet and nutrition management, health education, and daily management.Conclusions:The best evidence for HSCT patient assessment and management summarized can provide reference for clinical practice, and nursing staff should carefully apply evidence based on the actual situation of patients.

Objective:To conjecture the correlation between fetal hydrothorax(FHT)and pregnancy outcome through the analysis of 95 fetuses with hydrothorax and their mothers.Methods:In this case series study, 95 FHT patients admitted to the Third Affiliated Hospital of Zhengzhou University from January 2016 to October 2022 were retrospectively analyzed.According to the pregnancy outcome, these patients were divided into the induced labor group (13 patients) and the delivery group (82 patients). General data and genetic examinations of patients in the induced labor group were analyzed to explore their pathogenesis and genetics.According to the neonatal Apgar score, patients in the delivery group were divided into the normal group and the asphyxia group.Fifteen indicators including the maternal age, gestational week at first diagnosis, maternal complications, FHT location, FHT severity, FHT outcome during pregnancy, fetal ascites, hydrops fetalis, other abnormal fetal structures, amniotic fluid volume, intrauterine treatment, gestational week of delivery, mode of delivery, sex of the newborn, and newborn birth weight in the 2 groups were comparatively analyzed by the chi-square test.With the neonatal Apgar score as the dependent variable, variables that had statistical significance during the univariate analysis were included in the regression analysis, and a multivariate binary Logistic regression equation was established to explore the factors affecting the pregnancy outcome.Results:There were significant differences in the FHT outcome during pregnancy (16/22/13 cases vs.2/18/11 cases, χ2=6.994, P=0.030), FHT severity (27/24 cases vs.9/22 cases, χ2=4.475, P=0.034), hydrops fetalis (14/37 cases vs.23/8 cases, χ2=17.012, P=0.001), amniotic fluid volume (21/30 cases vs.24/7 cases, χ2=10.228, P=0.001), intrauterine treatment (19/32 cases vs.2/29 cases, χ2=9.603, P=0.002), gestational week of delivery[(38.15±2.05) weeks vs.(34.83±3.14) weeks, t=5.748, P=0.001], and newborn birth weight[(3 325.00±637.41) g vs.(2 714.58±837.99) g, t=3.727, P=0.001]between the normal and asphyxia groups(all P<0.05). Among them, hydrops fetalis ( OR=7.070, P=0.020) and severe FHT ( OR=6.927, P=0.043) were risk factors for neonatal Apgar scores.Intrauterine treatment ( OR=0.062, P=0.027) and gestational week of delivery( OR=0.577, P=0.022) could be used as a protective factor for neonatal Apgar scores. Conclusions:Diagnosis of FHT during the early gestational weeks and multiple fetal structural abnormalities, especially hydrops fetalis, have higher probabilities of abnormal genetic examinations, and the fetal prognosis was poor.It is recommended to carry out chromosomal karyo type and microarray tests, as well as whole exome sequencing and detection of genetic syndromes(if necessary), to avoid unnecessary fetal treatment and improve the survival rate of perinatal infants after intrauterine treatment.The poor prognosis is related to hydrops fetalis and severe FHT; however, timely intrauterine treatment and prolonging pregnancy can improve the pregnancy outcome and increase the survival rate of perinatal infants.

Objective To clarify the impact of GATA2 overexpression on transcriptional expression in chicken preadipocytes.Methods Chicken preadipocytes ICP1 were cultivated,pCMV-myc-GATA2 or pCMV-myc plasmid was transfected,Western blot was used to verify the overexpression of GATA2 in cells,RNA-seq was used to study the changes in cell transcriptome expression caused by overexpression of GATA2,ChIP-seq was used to study the binding of GATA2 in the genome,Real time PCR was used to verify some differentially expressed genes,ChIP-PCR was used to verify the collection of GATA2 to TAF3 genes.Results Transfection of pCMV-myc-GATA2 allowed overexpression of GATA2 protein in ICP1 cells;overexpression of GATA2 resulted in up-regulation of 942 genes and down-regulation of 840 genes in ICP1 cells(P＜0.05),and enrichment analysis showed that differentially ex-pressed genes were associated with ribosome and mitochondrial structure and function(P＜0.01);GESA analysis showed that the expression of GATA2-overexpressing ICP1 cells showed up-regulation of RNA polymerase Ⅱ tran-scription initiation complex,ribosome biogenesis,propionate metabolism,and oxidative phosphorylation-related gene sets,and down-regulation of histone lysine N-methyltransferase,nuclear transcription repression complex formation,adipokines,and calcium ions signaling pathway-related gene sets.ChIP-seq in ICP1 cells identified 2833 GATA2-binding genomic peaks involving 2018 genes.motif analysis revealed GATA2-binding(T/A)GATA motifs;enrich-ment analysis showed that these genes are involved in embryonic development,signaling,cellular metabolism,and cell-cell interactions.Differently expressed genes and GATA2-binding genes were taken to intersect to obtain 105 genes,and enrichment analysis showed that these genes were associated with transcription,post-transcriptional regu-lation,cell-cell interactions,signaling,and cell cycle(P＜0.001).Conclusion GATA2 can at least bind to the genome of chicken preadipocytes to regulate their transcriptome expression patterns.

【Objective】 To study the effects of miR-30e-5p from bone marrow mesenchymal stem cell-derived exosomes(BMSC-exos) on high glucose (HG)-induced HK-2 cell pyroptosis and explore an alternative strategy to manage diabetic kidney disease (DKD). 【Methods】 BMSC-exos were isolated and internalized into HK-2 cells treated with HG to measure viability and cytotoxicity. The secretion of IL-1β and IL-18 was measured by ELISA. Pyroptosis was assessed by flow cytometry. The levels of miR-30e-5p, IL-1β, and IL-18 were measured. The expression of pyroptosis-associated cytokine proteins was determined. 【Results】 BMSC-exos decreased LDH, IL-1β, and IL-18 secretion and inhibited the expression of the pyroptosis-related factors (IL-1β, caspase-1, GSDMD-N, and NLRP3) in HG-induced HK-2 cells. Moreover, miR-30e-5p depletion in BMSC-exos promoted HK-2 cell pyroptosis. 【Conclusion】 BMSC-derived exosomal miR-30e-5p inhibits caspase-1-mediated pyroptosis in HG-induced HK-2 cells, which might provide a new strategy for treating DKD.

Objective:To evaluate the intervention effect of various drugs on glutathione (GSH) and superoxide dismutase (SOD) enzyme activity of rats kidney with acute nickel carbonyl poisoning.Methods:In January 2019, The 250 SPF male SD rats were randomly divided into normal control group ( n=10) , poisoned group ( n=40) and treatment groups ( n=200) according to the random number table method. And the treatment groups were divided into methylprednisolone group (20 mg/kg) , DDC group (100 mg/kg) , sodium selenite group (10 μmol/kg) , Shenfu huiyang decoction group (0.25 ml) and methylprednisolone combined with DDC group (100 mg/kg) , with 40 mice in each group. Except for the normal control group, rats in the other groups were exposed to nickel carbonyl for 30 min, at 4 h and 30 h after exposure, the rats in each treatment group were intraperitoneally injected with corresponding drugs, and kidney tissues were collected 3 d and 7 d after administration, with 10 mice in each group. The activities of GSH and SOD in kidney were measured by enzyme-linked immunosorbent assay, and using electron microscopy observe ultrastructure changes. Results:Compared to the control group, the activities of GSH and SOD enzyme of poisoned group were significantly decreased at 3 d or 7 d after 4 h or 30 h exposure, and the difference was statistically significant ( P=0.000, 0.031, 0.001, 0.033) , the epithelial nuclei of proximal convoluted tubules were pyknosis and lysosome hyperplasia in the cytoplasm. And compared to poisoned group, the activities of GSH and SOD enzyme of methylprednisolone+DDC group were significantly increased at treatment with 7 d after 4 h exposure, the difference was statistically significant ( P=0.022, 0.000) , and the activities of GSH and SOD enzyme of methylprednisolone and enzyme of methylprednisolone+DDC group were significantly higher at 7 days than at 3 days, the difference was statistically significant ( P=0.020, 0.017, 0.018, 0.033) . The results of electron microscopy showed that the cell nuclei and cytoplasmic organelles of proximal convolute tubule were almost restored to normal tissue level of both methylprednisolone group and methylprednisolone+DDC group. Conclusion:The methylprednisolone and methylprednisolone+DDC have obvious repair effect on renal enzyme activity level of rats with acute nickel carbonyl poisoning, and the treatment effect is better for a long time of medication.

Objective:To evaluate the intervention effect of various drugs on glutathione (GSH) and superoxide dismutase (SOD) enzyme activity of rats kidney with acute nickel carbonyl poisoning.Methods:In January 2019, The 250 SPF male SD rats were randomly divided into normal control group ( n=10) , poisoned group ( n=40) and treatment groups ( n=200) according to the random number table method. And the treatment groups were divided into methylprednisolone group (20 mg/kg) , DDC group (100 mg/kg) , sodium selenite group (10 μmol/kg) , Shenfu huiyang decoction group (0.25 ml) and methylprednisolone combined with DDC group (100 mg/kg) , with 40 mice in each group. Except for the normal control group, rats in the other groups were exposed to nickel carbonyl for 30 min, at 4 h and 30 h after exposure, the rats in each treatment group were intraperitoneally injected with corresponding drugs, and kidney tissues were collected 3 d and 7 d after administration, with 10 mice in each group. The activities of GSH and SOD in kidney were measured by enzyme-linked immunosorbent assay, and using electron microscopy observe ultrastructure changes. Results:Compared to the control group, the activities of GSH and SOD enzyme of poisoned group were significantly decreased at 3 d or 7 d after 4 h or 30 h exposure, and the difference was statistically significant ( P=0.000, 0.031, 0.001, 0.033) , the epithelial nuclei of proximal convoluted tubules were pyknosis and lysosome hyperplasia in the cytoplasm. And compared to poisoned group, the activities of GSH and SOD enzyme of methylprednisolone+DDC group were significantly increased at treatment with 7 d after 4 h exposure, the difference was statistically significant ( P=0.022, 0.000) , and the activities of GSH and SOD enzyme of methylprednisolone and enzyme of methylprednisolone+DDC group were significantly higher at 7 days than at 3 days, the difference was statistically significant ( P=0.020, 0.017, 0.018, 0.033) . The results of electron microscopy showed that the cell nuclei and cytoplasmic organelles of proximal convolute tubule were almost restored to normal tissue level of both methylprednisolone group and methylprednisolone+DDC group. Conclusion:The methylprednisolone and methylprednisolone+DDC have obvious repair effect on renal enzyme activity level of rats with acute nickel carbonyl poisoning, and the treatment effect is better for a long time of medication.

Diagnosis and treatment of Hill-Sachs combined with Bankart lesions in anterior dislocation of shoulder joint is a major clinical challenge in orthopedics, because it likely leads to a high recurrence rate of redislocation of shoulder joint, a serious damage to the shoulder joint, recurrent shoulder injury and dramatically disturbed quality of daily life. Although various means of clinical diagnosis and treatment are available for the lesions, they all have their own advantages and disadvantages. However, arthroscopic surgery of shoulder has achieved superior curative effects, gradually becoming the first choice and a mainstream treatment. This article reviews the current research progress in pathogenesis, diagnosis and arthroscopic treatment of Hill-Sachs combined with Bankart lesions in anterior dislocation of shoulder joint.

Objective:To assess the performance of liver and spleen stiffness measured by MR elastography (MRE) and their combined model in diagnosing liver fibrosis.Methods:From November 2018 to November 2019, 104 patients with chronic liver disease were prospectively enrolled in Beijing Friendship Hospital, all patients underwent MRE scans. Liver and spleen stiffness were measured from MRE elastograms. Liver biopsy was used to identify fibrosis stage (F0—F4). The differences among different fibrosis stages were analyzed by one-way ANOVA or independent samples t test. The Spearman rank correlation analysis was used to evaluate the correlation with fibrosis stages. Liver and spleen stiffness combined model was established by logistic regression. The ROC curve was used to evaluate the performance of the liver, spleen stiffness and combined model in staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4).The area under the ROC curve(AUC) was compared using Delong test. Results:The liver and spleen stiffness both showed significant differences among the 5 fibrosis stages ( F=64.058, 32.890, both P<0.001). The liver and spleen stiffness were positively associated with fibrosis stage ( r s=0.89, 0.69, both P<0.001). The AUC of liver stiffness in staging ≥F1, ≥F2, ≥F3 were 0. 91, 0.97, 0.93, respectively. The corresponding AUCs of the spleen stiffness were 0.81, 0.82, 0.85, respectively, which were statistically lower than those of liver stiffness ( Z=2.283, 4.085, 2.314, P=0.022,<0.001, 0.021). In diagnosing F4, the AUCs of liver and spleen stiffness were both 0.95. The AUCs of the liver and spleen combined model were 0.92, 0.97, 0.93, 0.96 in diagnosing ≥F1, ≥F2, ≥F3 and F4, with no significantly differences from liver stiffness (all P>0.05). Conclusions:The liver stiffness measured with MRE have better diagnostic performance than spleen stiffness in staging fibrosis. Parameters combined model slightly improves diagnostic value but without significant difference with liver stiffness in staging early fibrosis. Spleen stiffness evaluation is feasible in detecting cirrhosis.

Objective:To analyze the mediating role of self-esteem and control sources in readmission frequency and self-perceived burden of elderly patients with chronic heart failure(CHF).Methods:A total of 346 cases of elderly patients with CHF were included, using self-perceived burden scale(SPBS), self-esteem scale(SES) and multidimensional health locus of control scale(MHLC) to investigate.SPSS 20.0 software was employed to coduct Pearson and Spearman correlation analysis and multiple linear stepwise regression to construct the structural equation model.Process 2.13.2 plug-in was used to test the intermediate effect of Bootstrap.AMOS 23.0 was used for structural equation model and path analysis verification.Results:(1) The readmission frequency during the recent years of the elderly patients with CHF was 0-8, and M( P25, P75) was 1(1, 3). The mean score of self-esteem scale was (29.25±3.67), and the score of internal control in psychological control source was (22.67±3.85). The score of influential others was (26.45±3.38). The opportunity score was (19.84±3.82). The mean SPBS score was (22.19±9.49). (2) SPBS total score was significantly negatively correlated with self-esteem ( r=-0.359, P<0.01), positively correlated with opportunity control source ( r=0.169, P<0.01). Self-esteem was positively correlated with internal control( r=0.237, P<0.01), control of influential others( r=0.225, P<0.01). The readmission frequencies of CHF were significantly negatively correlated with self-esteem( r=-0.119, P<0.05) and internal control( r=-0.173, P<0.01), positively correlated with SPBS( r=0.219, P<0.01). (3) Multiple regression and structural equation model results showed that readmission, self-esteem and psychological control sources could account for 18.0% of the total variables of self-perceived burden.The relationship between readmission and self-perceived burden was mediated by self-esteem and locus of control, accounting for 20.00% of the total effect. Conclusion:Self-esteem and control sources are partially mediating the effect between readmission and self-perceived burden.By nursing intervention to improve the self-esteem level, positive coping strategies of internal control of elderly patients with CHF, the burden of self-perception may possibly be alleviated.

Objective:To investigate the status of core competency of newly recruited nurses in Traditional Chinese Medicine (TCM) hospitals during the standardized training period and explore its influencing factors.Methods:From March to April 2018, new recruits of nurses from various levels of TCM hospitals in 11 provinces or municipalities directly under the central government were selected to conduct a questionnaire survey, and the results of the survey were statistically analyzed.Results:728 questionnaires were actually recovered, including 723 valid questionnaires. The total score of the core competency of newly recruited nurses in the standardized training period of the TCM hospital is (160.42±37.25) . The results of single factor analysis showed that the differences in core competency scores of nurses with different educational backgrounds, graduated colleges and working stages were statistically significant ( P<0.05) . Correlation analysis showed that the scores of occupational identity of newly recruited nurses in TCM hospitals were positively correlated with the scores of core competency ( P<0.05) . Multiple linear regression analysis showed that the types of colleges, academic qualifications, working stages, and the sense of selfdetermination, self-efficacy, Sense of organizational influence, consistency in the occupational identity were the influencing factors of nurses' core competency ( P<0.05) . Conclusions:The core competency of newly recruited nurses in TCM hospitals is affected by the types of colleges, academic qualifications, working stages, and the sense of self determination, self-efficacy, sense of organizational influence, consistency in the occupational identity. Targeted measures should be taken to improve the core competency and professional identity of newly recruited nurses, so that can enhance the cohesion of the nursing team and improve the overall level of nursing.