Objective To evaluate the application efficacy of structured symptom intervention program in patients with chronic kidney disease(CKD)during the peri-dialysis period.Methods A non-simultaneous control study was conducted on 151 peri-dialysis outpatients having not yet initiated dialysis and being followed up who were subjected with convenience sampling from Department of Nephrology of Second Affiliated Hospital of Army Medical University from April to September 2024.According to the time period of their visits,the patients who visited from April to June 2024 were assigned into a control group(n=75),and those from July to September 2024 into an experimental group(n=76).The control group received conventional symptom intervention(telephone symptom reporting+health education),while the experimental group received the intervention as the control group and a structured symptom intervention program covering 4 evidence-based modules:symptom identification,assessment,intervention,and outcome.The efficacy of above treatments was evaluated before and at 3 months after intervention.Dialysis symptom index was used to assess the degree of symptom distress and the number of symptoms.MOS 36-Item Short Form Health Survey(SF-36)was employed to evaluate the quality of life.The differences in clinical indicators and endpoint events were compared between the 2 groups after intervention.Results The experimental group obtained more significant reduction in the total score of symptom distress than the control group(P=0.021).After intervention,the number of symptoms was decreased in both groups(P<0.001),but no statistical difference was observed between the groups.The score of mental health dimension in SF-36 was obviously improved in the experimental group(P=0.004),which was notably better than that in the control group(P=0.033).The experimental group exhibited significantly higher prealbumin level than the control group(P=0.019),and stable albumin level,which was significantly decreased in the control group(P=0.035).The incidence of endpoint events was remarkably lower in the experimental group than the control group(P=0.028).Conclusion The structured symptom intervention program implements intervention through a closed-loop symptom module,which can effectively alleviate the symptom distress of patients during the peri-dialysis period,improve mental health and reduce the short-term risk for endpoint events.

Objective:To evaluate the effects of different exercises on patients with chronic kidney disease based on network Meta-analysis so to provide a basis for medical and nursing staff to develop exercise programs.Methods:Randomized controlled trials on the effects of different exercises on patients with chronic kidney disease were electronically searched in databases such as Web of Science, PubMed, Embase, Cochrane Library, China Biology Medicine disc, WanFang Data, and China National Knowledge Infrastructure. The search period was from January 1, 2000, to March 1, 2023. Two researchers conducted literature screening, data extraction, and literature quality evaluation independently. The data was analyzed by using R software in conjunction with the gemtc package and plotted by using Stata software.Results:A total of 52 articles were included, with a cumulative sample size of 3 127 cases, involving three types of exercise (aerobic, resistance, and combined). The network Meta-analysis showed statistically significant differences between the three exercise methods and routine nursing in delaying renal function progression and improving cardiovascular endurance ( P<0.05). In controlling blood pressure and improving walking ability, the effects of three exercise methods were all superior to routine nursing, and the differences were statistically significant ( P<0.05). The area under the cumulative ranking probability curve showed that aerobic exercise>resistance exercise>combined exercise in terms of delaying renal function progression. In controlling blood pressure, resistance exercise>aerobic exercise>combined exercise. In terms of improving cardiovascular endurance, aerobic exercise>resistance exercise>combined exercise; In terms of improving walking ability, resistance exercise>combined exercise>aerobic exercise. Subgroup analysis showed that ≥ 24 weeks was the optimal intervention period for aerobic exercise. Resistance exercise intervention for ≥ 12 weeks could lower blood pressure, and intervention for ≤12 weeks could improve walking ability. However, when the intervention time was longer than 24 weeks, combined exercise had an excellent effect. Conclusions:Aerobic exercise is an excellent way to delay renal function progression and improve cardiovascular endurance. Resistance exercise is the optimal exercise method for controlling blood pressure and improving walking ability. Medical and nursing staff should choose appropriate types of exercise based on the patient's medical needs.

Objective:To systematically review and synthesize qualitative studies on the experiences of information communication in the treatment decision-making process for patients with end-stage renal disease (ESRD) .Methods:Electronic databases, including PubMed, CINAHL, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, WanFang data, and VIP, were searched for studies on information communication experiences among ESRD patients during their treatment decision-making process up to March 1, 2023. The quality of the included studies was evaluated using the 2016 version of the Joanna Briggs Institute's qualitative research quality assessment criteria. A Meta-synthesis approach and NVivo 12.0 software were utilized for data synthesis.Results:Eleven studies were included, from which 28 themes related to information communication were extracted, integrated into six new categories, and synthesized into three consolidated findings: attitudes towards information communication during the treatment decision-making process for ESRD patients, needs for information communication during the treatment decision-making process, and the impact of information communication on treatment decision-making for ESRD.Conclusions:Information communication is crucial in the decision-making process for ESRD patients regarding treatment. Healthcare professionals should encourage patient involvement in information communication, meet their information needs, and establish diversified mechanisms of information communication to guide patients in choosing the best treatment options.

Objective:To explore the effects of Jianpi Bushen Jiedu Prescription on the proliferation and migration of hepatocellular carcinoma cells; To discuss its possible mechanism.Methods:Using human highly metastatic liver cancer cell line (HCCLM3) as the research object, they were randomly divided into control group and TCM group (100, 200, 400, 800, 1 600, 3 200 μg/ml Jianpi Bushen Jiedu Prescription) and Western medicine group (2.5, 5, 10, 20, 40 μmol/L sorafenib) using a random number table method. Cell viability was detected using cell counting reagent (CCK-8) method; HCCLM3 cells were divided into control group and TCM (Jianpi Bushen Jiedu Prescription 800 μg/ml) group and combined group (Jianpi Bushen Jiedu Prescription 800 μg/ml +sorafenib 20 μmol/L). Western blot method was used to detect the protein expressions of kinase/signaling transducer and transcriptional activator (JAK2/STAT3) pathway related proteins (p-JAK2, JAK2, p-STAT3, STAT3) in each group.Results:Compared with the control group, viability and mobility of HCCLM cell in TCM group and Western medicine group decreased ( P<0.01 or P<0.05); compared with the control group, the protein expressions of P-JAK2, JAK2, P-STAT3 and STAT3 in the TCM group and the combined group decreased ( P<0.05), and the JAK2 protein expression in the combined group was lower than that in the TCM group ( P<0.05). Conclusion:Jianpi Bushen Jiedu Prescription can inhibit the proliferation and migration of HCC cells by regulating JAK2/STAT3 pathway.

Depression is a mental disorder with high morbidity, disability and relapse rates. Ginkgo biloba extract (GBE), a traditional Chinese medicine, has a long history of clinical application in the treatment of cerebral and mental disorders, but the key mechanism remains incompletely understood. Here we showed that GEB exerted anti-depressant effect in mice through regulating gut microbial metabolism. GBE protected against unpredictable mild stress (UMS)-induced despair, anxiety-like and social avoidance behavior in mice without sufficient brain distribution. Fecal microbiome transplantation transmitted, while antibiotic cocktail abrogated the protective effect of GBE. Spatiotemporal bacterial profiling and metabolomics assay revealed a potential involvement of Parasutterella excrementihominis and the bile acid metabolite ursodeoxycholic acid (UDCA) in the effect of GBE. UDCA administration induced depression-like behavior in mice. Together, these findings suggest that GBE acts on gut microbiome-modulated bile acid metabolism to alleviate stress-induced depression.
Humans ; Mice ; Animals ; Depression/drug therapy* ; Gastrointestinal Microbiome ; Plant Extracts ; Ginkgo biloba

Extra-articular distal tibial fractures as a result of high-energy damage are often comminuted or displaced, frequently accompanied by severe soft tissue injuries.Poor blood supply and various complications make the treatment more difficult,affecting life quality of the patients.The main goals of the treatment are to abtain a healed,well-aligned fracture,functional range of motion of the ankle joint and minimizing complications.It is generally recommended that surgical treatment be performed in the proper context of local conditions to facilitate early functional exercise.Plate fixation and intramedullary nail fixation are the common options for closed fractures.This article focuses on the two treatment methods and some important auxiliary technologies in both domestic and foreign, hoping to provide some references for clinical treatment.

Objective To investigate the health status of the seafarers in Yantai port,and to analyze the influential factors of chronic diseases,so as to provide reliable evidence for the development of related prevention and treatment measures.Methods Medical check-up data of 10 200 seafarers from our hospital were random selected for the study,and the collected data were classified and analyzed.Results The morbidity rate of chronic diseases among the seafarers in Yantai port was 34.62％.Statistical analyses indicated that hypertension,hyperlipidemia,coronary heart disease,fatty liver,diabetes,cholecystitis,depression and other chronic diseases were the main disorders that affected the health of the seafarers.Conclusions Greater efforts should be made to strengthen health education and mental consultation,enhance the 3-level prevention and health care,and have regular health examinations,with the aim to achieve early detection,early diagnosis and early treatment,so that the health of the seafarers could be better assured.

Objective To investigate the health status of the seafarers in Yantai port,and to analyze the influential factors of chronic diseases,so as to provide reliable evidence for the development of related prevention and treatment measures.Methods Medical check-up data of 10 200 seafarers from our hospital were random selected for the study,and the collected data were classified and analyzed.Results The morbidity rate of chronic diseases among the seafarers in Yantai port was 34.62％.Statistical analyses indicated that hypertension,hyperlipidemia,coronary heart disease,fatty liver,diabetes,cholecystitis,depression and other chronic diseases were the main disorders that affected the health of the seafarers.Conclusions Greater efforts should be made to strengthen health education and mental consultation,enhance the 3-level prevention and health care,and have regular health examinations,with the aim to achieve early detection,early diagnosis and early treatment,so that the health of the seafarers could be better assured.

Objective To explore the mechanism for the increase in reactive oxygen species regulated by p47phox of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase subunit in peripheral blood mononuclear cells (PBMCs) after oxygen therapy in premature infants.Methods According to different volume fractions of oxygen,premature infants less than 32 weeks were divided into 3 groups:fractional concentration of inspired oxygen (FiO2) ＜ 30％ was low concentration oxygen group,FiO2 between 30％ and 40％ as middle concentration oxygen group,and FiO2 ＞ 40％ as high concentration oxygen group.Premature infants less than 32 weeks without oxygen was control group.After 48 h,3 mL blood was collected via radial artery from each group,PBMCs and serum were separated.Then intracellular reactive oxygen species (ROS) by confocal laser scanning microscopy,malondialdehyde (MDA) within serum by thiobarbituric acid colorimetric,and the location and activation rate of p47phox through immunofluorescence.Results After premature infants were exposed to oxygen,as the oxygen volume fraction was increasing,ROS and MDA gradually rised.More PBMCs with p47phox translocated to membrane,then the translocation rate of p47phox also increased.Compared with the control group,ROS were significantly higher(q =4.48,6.5,16.22,all P ＜ 0.05) among the other 3 groups ; MDA significantly increased as well(q =5.08,8.22,12.76,all P ＜ 0.05) ; the activation rate of p47phox also had significant differences (x2 =134.008,P ＜ 0.05);compared with the middle concentration oxygen group,the high concentration oxygen group had higher ROS and MDA(q =15.03,4.53,all P ＜ 0.05) ; the activation rate of p47phox increased significantly(x2 =19.26,P ＜ 0.05).Conclusions After oxygen exposure,p47phox translocated to membrane may regulate the NADPH oxidase-derived ROS increase in extremely premature infants.

Objective: To investigate the innate immune response of influenza virus-infected glial cells,the transcription levels in chemokines in mouse microglia and astrocytes were detected which pre-infected by human H1N1 or avian H5N1 influenza viruses.Methods: The glial cells isolated from neonatal mice cerebral cortex were cultured and further microglia and astrocytes were purified.The primary mouse microglia and astrocytes were infected in vitro by H1N1 or H5N1 influenza viruses in a multiplicity of infection (MOI) 2.Eight hours post infection,the influenza virus nucleoprotein (NP) was detected by immunofluorescence to identify the proportion of infected cells.The cellular RNA were extracted at 6 h and 24 h to detect the transcriptional level of chemokines by semi-quantitative RT-PCR.Results: More than 95% of the microgha and astrocytes which isolated from mice were infected.The transcription levels of CCL-3,CCL-5,CXCL-2,CXCL-9 and CXCL-10 from infected microglia and astrocytes were upregulated.Futhermore,the mRNA level of CXCL-10 increased much more.In addition,avian H5N1 influenza virus could induce more stronger upregulation of those chemokines than human H1N1 did.Conclusion: The mouse microglia and astro cytes which are infected by H1N1 influenza virus or H5N1 influenza virus could induce upregulation of transcription level of chemokines.