As a type of experiential psychotherapy,Satir communication model can help the individual system and the family system achieve a state from dysfunction to healthy function,which can enrich the intervention connotation of family support and provide a new direction for the realization of full-life circle care.This paper aims to introduce the concept,core elements,common treatment techniques,application and effects,current challenges and relevant suggestions of Satir communication model in the nursing field from the perspective of family support,in order to provide references for the localization development and clinical integration of Satir communication model in the field of nursing in China.

Gestational diabetes mellitus(GDM) is one of the most common complications during pregnancy, with increasing incidence in recent years, significantly affecting the health of both mothers and their offspring across generations. The exact pathogenesis of GDM remains unclear; However, growing evidence suggests that dysbiosis of gut microbiota is involved in the development of GDM, and further influences the establishment of microbiota in the next generation through vertical transmission. This article summarizes the differences in gut microbiota between GDM mothers and their offspring compared to healthy controls. In addition, we also discuss the impact of gut microbiota dysbiosis on metabolic health in GDM offspring and potential mechanisms involved, aiming to provide a reference for targeting gut microbiota in the prevention and treatment of GDM and its complications in offspring.

Objective To compare and analyze the differences between customized models and commercial universal models in the segmentation of organs-at-risk in cervical cancer,and to investigate the feasibility of customized models.Methods A retrospective analysis was conducted on 270 cervical cancer patients.Senior clinicians manually delineated organs-at-risk,including the bladder,rectum,small intestine,pelvic bone marrow,femoral heads,and kidneys.The cases were randomly selected to develop customized models,with 202 cases allocated to the training set,38 cases to the test set,and 30 cases to the validation set.The universal and customized models were used for segmentation on the test set,and the automatic segmentation results obtained by the two models were compared with manual segmentation results to assess the performance of the customized model.Results Both customized model and universal model had comparable DSC values to manual segmentation,demonstrating satisfactory delineation outcomes(DSC values ranging from 0.7 to 0.9).However,in terms of deviation of centroid and 95％Hausdorff distance,the customized model surpassed the universal model.Conclusion Compared with the universal model,the customized model offers superior accuracy in delineating the structures of organs-at-risk in cervical cancer.As the customized model is optimized based on specific datasets,it provides precise support for clinical decision-making and holds promising applications in the treatment of cervical cancer.

ObjectiveTo determine whether HBV DNA polymerase is associated with T-cell failure and thus mediates the immune escape of HBV-related hepatocellular carcinoma （HCC） tumor cells， and to investigate the specific molecular mechanisms. MethodsLiver cancer cell lines Huh7 and HepG2 stably transfected with HBV DNA polymerase expression plasmid with Flag （Flag-HBV-P） and intercellular adhesion molecule-1 （ICAM1） were co-cultured with Jurkat cells， and MTT assay， qRT-PCR， and ELISA were used to measure Jurkat cell proliferation， activation （CD69 expression）， and secretion of the cytokine IFN-γ. RNA-seq was used to screen for differentially expressed immune-associated molecules between stably transfected cell lines and control cells， and mRNA half-life and protein half-life assays were used to determine the specific levels of the immune-associated molecules that were affected by HBV DNA polymerase. Related websites were used to predict the transcription factors that may bind to the promoter region of this immune-associated molecule， Western blot was used to verify the effect of transcription factors on the immune-associated molecule， and rescue experiment was used to determine whether HBV DNA polymerase affects the expression level of the immune-associated molecule through this transcription factor. The independent-samples t test was used for comparison between two groups. ResultsThe experimental group had significant reductions in Jurkat cell proliferation， activation， and cytokine secretion compared with the control group （all P<0.01）. Compared with the control group， the experimental group （Huh7 and HepG2 cell lines） had significant reductions in the mRNA and protein expression levels of ICAM1 （all P<0.01）. Website prediction identified the ICAM1 promoter and preliminarily highlighted NFKB1， RELA， and STAT3. Compared with the control group， the experimental group （Huh7 and HepG2 cell lines） had a significant reduction in the protein expression level of p65 （all P<0.01）. After p65 overexpression， there was a significant increase in the protein expression level of ICAM1， and after the expression of p65 was reduced， there was a significant reduction in the protein expression level of ICAM1 （all P<0.01）. In the rescue experiment， there was no significant difference in the protein expression level of ICAM1 between the control group and the experimental group after p65 overexpression （all P>0.05）. After the overexpression of ICAM1， there were no significant differences in the proliferation， activation， and cytokine secretion of Jurkat cells between the control group and the experimental group （Huh7 and HepG2 cell lines） （all P>0.05）. ConclusionHBV DNA polymerase downregulates the level of ICAM1 to mediate HCC immune escape by inhibiting the expression of p65 in NF-κB.

Objective:To investigate the etiological diagnostic value of metagenomic sequencing in central nervous system (CNS) infectious diseases.Methods:A total of 170 patients with central nervous system infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020 were selected as the study subjects according to inclusion and exclusion criteria. General clinical data and pathogen test results were collected. All included patients underwent routine examination and mNGS test, and were divided into the conventional method test group and mNGS test group according to the test results. The measurement data conforming to normal distribution were represented by ± s; The measurement data that did not conform to normal distribution were represented by median and interquartile range. The classification data were expressed by the number of cases and percentage( n,%), and were compared by χ2 test or Fisher's exact test. Consistency test was represented by Kappa value. The detection of pathogenic microorganisms by the two methods and the rule of pathogen spectrum were compared and analyzed. Results:The overall positive rate of mNGS in CNS infectious diseases was higher than that of conventional methods (58.23% vs. 18.82%), and the difference was statistically significant ( P<0.01). Among the 20 samples which were both positive by the two methods, 10 cases were completely pathogenic, 5 cases were partially consistent and 5 cases were completely inconsistent. In the detection of tuberculous nervous system infection, the positive rates were 66.7%, 53.8%, 44.0%, 40.0%, 4.0% in blood T-SPOT, cerebrospinal fluid mNGS, ADA, Mycobacterium tuberculosis DNA and tuberculous specific antibody, respectively. The positive rate of acid-fast staining was 0. The positive rate of mNGS combined with conventional method was 80.8%. Conclusions:The detection rate of mNGS in CNS infection is better than that of conventional methods. However, it does not show obvious superiority in the detection rate of Mycobacterium tuberculosis associated nervous system infection. In general, mNGS detection of pathogenic bacteria is more extensive, which is conducive to a thorough and comprehensive understanding of the bacterial characteristics of central nervous system infection. The combination of the two methods can make up for the deficiency of clinical routine detection to a certain extent, and can maximize the detection rate.

Objective:To systematically review the relationship between CYP3A4*1G gene polymorphism and the analgesic effect of fentanyl-related drugs.Methods:The related literature about the effect of gene polymorphism on analgesic effect of fentanyl-related drugs published at home and abroad was searched in PubMed, Embase, Cochrane Library, CNKI, Wanfang and China Biomedical Literature databases from database establishment to August 2019. According to the inclusion and exclusion criteria, two researchers screened the literature independently, extracted the data and evaluated the methodological quality. Data analysis was performed by Review Manager 5.1 software.Results:Six literature was enrolled with 1 050 cases, including 543 cases of wild-type homozygote (CC), 437 cases of heterozygote (CG) and 70 cases of mutant homozygote (GG). The results showed that there was no significant difference in pain score between the three groups in a pairwise comparison at 24 hours after operation (all P > 0.05), but the consumption of fentanyl-related drugs in GG group was lower than that in CC group and CG group, and the differences were statistically significant [GG group vs. CC group: standardized mean difference (SMD) = -0.78, 95% CI -1.03- -0.52, P<0.01; GG group vs. CG group: SMD = -0.61, 95% CI -0.87- -0.35, P<0.01]. Conclusions:CYP3A4*1G gene polymorphism can affect the postoperative analgesia effect of fentanyl-related drugs. With the same analgesic effect, the consumption of fentanyl-related drugs in GG patients is reduced.

Objective To systematically evaluate the effect of metformin on the prognosis of patients with breast cancer. Methods The databases including PubMed, Embase, Cochrane Library, ClinicalTrials, ScineceDirect, CBM, CNKI, Wanfang database and VIP were electronically searched from their inception to April 18, 2018 to collect the studies about the effect of metformin on the prognosis of patients with breast cancer. According to the inclusion and exclusion criteria, two reviewers screened the literatures independently, extracted data and assessed methodological quality. The meta-analysis was performed by using Review Manager 5.1 software. Results A total of 2 randomized controlled trials and 17 cohort studies involving 8929 patients were included. The meta-analysis showed that compared with control group, the metformin group marked increase in pathologic complete remission (pCR) rate (RR=2.97, 95％CI 1.80-4.90, P<0.01) and cancer-specific survival (CSS) time was prolong significantly (RR= 0.70, 95％CI 0.57-0.87, P= 0.001). Subgroup analysis of the overall survival (OS) time according to different areas showed that the metformin group's OS time was prolong significantly (Europe and America studies subgroup: RR=0.75, 95％CI 0.65-0.86, P<0.01; Asian studies subgroup:RR=0.48, 95％CI 0.37-0.61, P<0.001). Conclusion The use of metformin is positive for the prognosis of patients with breast cancer, it may improve the pCR rate, CSS and OS time of patients.

Objective To systematically evaluate the efficacy of the lienal polypeptide injection combined with chemotherapy or radiotherapy on the short-term efficacy, Karnofsky score, immune function and adverse reactions in treatment of various cancers. Methods The databases of PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP were retrieved from database establishing time to January 2017, and the randomized controlled trials (RCT) about lienal polypeptide injection combined with radiotherapy or chemotherapy in the treatment of advanced cancer were collected. The quality assessment was conducted and eligible trials were included in the Meta-analysis. Results A total of 23 articles were included, involving 1658 patients. The patients were divided into treatment group (lienal polypeptide injection combined with chemotherapy or radiotherapy, 842 cases) and control group (chemotherapy or radiotherapy alone, 816 cases). Results of Meta-analysis showed that the short-term effective rate (RR = 1.20, 95％ CI 1.07-1.33, P = 0.001), the improvement rate of Karnofsky score (RR = 1.77, 95％ CI 1.43-2.19, P < 0.05) and immune function related indicators: CD3+ (MD = 9.48, 95％ CI 6.76-12.20, P < 0.01), CD4+ (MD = 7.54, 95％ CI 5.38-9.71, P < 0.01), NK cells (MD = 4.47, 95％CI 3.45-5.48, P < 0.01) and CD4 +/CD8 + (MD = 0.33, 95％ CI 0.25-0.42, P < 0.01) in the treatment group were significantly higher than those in the control group, and the differences were statistically significant. The incidence of nausea and vomiting (RR = 0.51, 95％ CI 0.35-0.73, P = 0.0002) and bone marrow suppression (RR = 0.41, 95％ CI 0.25, 0.68, P = 0.0006) in the treatment group were significantly lower than those in the control group, and the differences were statisticallysignificant. There was no statistical difference in CD8+ level and the incidence of neurotoxicity, diarrhea, oral mucositis and hepatic injury between the two groups (all P > 0.05). Conclusion Lienal polypeptide injection combined with radiotherapy or chemotherapy is superior to conventional radiotherapy or chemotherapy alone in the treatment of cancer, which can improve the quality of life of patients with tumors, reduce the incidence of nausea and vomiting and bone marrow suppression induced by the treatment.

Objective To investigate the appropriate compatibility of appropriate compatibility of sevoflurane and propofol for patients with mild cognitive impairment (MCI) undergoing posterior lumbar interbody fusion in order to protect their cognitive function.Methods Eighty patients, 41 males, 39 females, aged 65-75 years, BMI 17-26 kg/m2, ASA physical status Ⅰ or Ⅱ, scheduled to undergo elective posterior lumbar interbody fusion, were to be scored according to Montreal cognitive assessment (MoCA), mini mental state examination (MMSE), dementia scale (CDR) and daily living ability scale (ADL) to identify patients with MCI before the surgery.They were randomly assigned to 4 groups (n=20 each) using a random number table: TCI propofol 2.0-2.5 μg/ml group (group P), TCI propofol 1.2 μg/ml+sevoflurane 0.6 MAC group (group PS1), TCI propofol 0.6 μg/ml+sevoflurane 0.9 MAC group (group PS2), 1.0-1.5 MAC sevoflurane group (group S).MoCA and MMSE were used to evaluate the cognitive function of patients 1 d before the operation (T0), after patients become wide-awake (T1), 3 d and 7 d after operation (T2 and T3).Apolipoprotein J (ApoJ) concentration related to cognitive function in blood samples, which were drawn at T0-T3 would be measured with ELISA method.Results Compared with T0, the scores of MMSE and MoCA in four groups decreased significantly (P＜0.05) at T1, the scores of MMSE and MoCA in group S decreased significantly (P＜0.05) at T2;compared with T1, the score of MMSE in the four groups increased significantly at T2, T3 (P＜0.05).The scores of MMSE at T1, T3 in group S decreased significantly compared with groups P, PS1 and PS2 (P＜0.05).The scores of MoCA at T2, T3 in group S decreased significantly compared with groups P, PS1 and PS2 (P＜0.05).Compared with T0, the concentration of plasma ApoJ in the four groups increased significantly at T1 (P＜0.05).Compared with T1, the concentration of plasma ApoJ in the four groups decreased significantly at T2 and T3 (P＜0.05).Compared with group PS1, the concentration of plasma ApoJ at T1, T3 increased significantly in groups S and group PS2 (P＜0.05).Conclusion TCI propofol 1.2 μg/ml combined with 0.6 MAC sevoflurane group is the appropriate compatibility of sevoflurane and propofol for patients with MCI undergoing posterior lumbar interbody fusion,because it has less negative influence on cognitive function and lower concentration of plasma ApoJ.

Objective To evaluate the effects of different ratios of medicine dosage for propofol and sevoflurane on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods Ninety-six patients of both sexes,aged 65-75 yr,weighing 60-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective lower limb fracture operation under general anesthesia,with mild cognitive impairment before surgery,were assigned into 4 groups (n =24 each) using a random number table:propofol group (group P),sevoflurane group (group S) and different ratios of medicine dosage for propofol and sevoflurane groups (group PS1 and group PS2).Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients at 1 day before operation (T0) and 7 days after operation (T1).Venous blood samples were collected at T0 and T1 for determination of the concentrations of plasma apolipoprotein J (ApoJ) and soluble CD14 (sCD14) by enzyme-linked immunosorbent assay.Results Compared with group S,MMSE and MoCA scores were significantly increased and plasma concentrations of ApoJ and sCD14 were decreased at T1,and the incidence of postoperative cognitive dysfunction was decreased in P,PS1 and PS2 groups (P＜0.05).Compared with group PS1,MMSE and MoCA scores were significantly decreased and the plasma concentrations of ApoJ and sCD14 were increased at T1,and the incidence of postoperative cognitive dysfunction was increased in P and PS2 groups (P＜0.05).MMSE and MoCA scores were significantly lower and plasma concentrations of ApoJ and sCD14 were higher at T1 than at T0 in S,P and PS2 groups (P＜0.05),and there was no significant difference in the parameters mentioned above between T1 and T0 in group PS1 (P＞0.05).Conclusion Combination of propofol 1.2 μg/ml given by target-controlled infusion and 0.7-1.2％ sevoflurane inhalation for maintenance of anesthesia does not aggravate the postoperative cognitive dysfunction in elderly patients with mild cognitive impairment.