Objective To investigate the application effect of a refined early diet plan in patients with distal gastric cancer after laparoscopic radical surgery.Methods By convenience sampling method,46 patients with laparoscopic radical gastrectomy for distal gastric cancer admitted to a tertiary hospital in Zhejiang Province from July to December 2023 were selected as an experimental group,while 49 patients admitted from January to June 2023 as a control group.The experimental group was administered with the refined early diet plan,and the control group was administered with conventional methods.The intervention period was from the first day after surgery to discharge.The differences of the first postoperative defecation time,perioperative thirst and hunger score,postoperative hospitalization time,hospitalization cost,postoperative complications and the incidence of readmission 30 days after surgery were compared between the 2 groups.Results 42 patients in the experimental group and 49 patients in the control group completed the study.First postoperative exhaust time(t=4.922,P＜0.001),first postopera-tive defecation time(Z=-2.440,P=0.015),perioperative thirst score(Z=-8.024,P＜0.001),perioperative hunger score(Z=-8.192,P＜0.00 1),postoperative hospitalization time(Z=-7.622,P＜0.001)and hospitalization cost(Z=-4.522,P＜0.001)were lower than those of the control group,and the difference was statistically significant.There was no significant difference in complication rate and 30-day readmission rate between the experimental group and the control group(P＞0.05).Conclusion The refined early diet plan is safe and effective for early recovery of patients after laparoscopic radical gastrectomy for distal gastric cancer,promoting intestinal function recovery,shortening hospital stay,reducing hospital costs,and improving patients'subjective comfort.

Objective To investigate the application effect of a refined early diet plan in patients with distal gastric cancer after laparoscopic radical surgery.Methods By convenience sampling method,46 patients with laparoscopic radical gastrectomy for distal gastric cancer admitted to a tertiary hospital in Zhejiang Province from July to December 2023 were selected as an experimental group,while 49 patients admitted from January to June 2023 as a control group.The experimental group was administered with the refined early diet plan,and the control group was administered with conventional methods.The intervention period was from the first day after surgery to discharge.The differences of the first postoperative defecation time,perioperative thirst and hunger score,postoperative hospitalization time,hospitalization cost,postoperative complications and the incidence of readmission 30 days after surgery were compared between the 2 groups.Results 42 patients in the experimental group and 49 patients in the control group completed the study.First postoperative exhaust time(t=4.922,P＜0.001),first postopera-tive defecation time(Z=-2.440,P=0.015),perioperative thirst score(Z=-8.024,P＜0.001),perioperative hunger score(Z=-8.192,P＜0.00 1),postoperative hospitalization time(Z=-7.622,P＜0.001)and hospitalization cost(Z=-4.522,P＜0.001)were lower than those of the control group,and the difference was statistically significant.There was no significant difference in complication rate and 30-day readmission rate between the experimental group and the control group(P＞0.05).Conclusion The refined early diet plan is safe and effective for early recovery of patients after laparoscopic radical gastrectomy for distal gastric cancer,promoting intestinal function recovery,shortening hospital stay,reducing hospital costs,and improving patients'subjective comfort.

OBJECTIVE To explore the effect and mechanism of the alcoholic extract from Scabiosa comosa against hepatic fibrosis （HF）. METHODS Intragastrical administration of carbon tetrachloride was given to induce HF model. By observing the pathological changes in liver tissue， mRNA and protein expressions of HF indexes [α-smooth muscle actin （α-SMA）， collagen type Ⅰ] and phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） pathway-related factors were detected， and the improvement effects and possible mechanism of low-dose， medium-dose and high-dose （50， 100， 200 mg/kg） of alcoholic extract from S. comosa on HF model rats were investigated. Drug-containing serum was prepared by intragastrical administration of alcoholic extract from S. comosa at a concentration of 1 800 mg/（kg·d） （calculated by the amount of raw material）. The effects of drug- containing serum of alcoholic extract from S. comosa on the expression of miRNA-21 were observed through the intervention of HSC-T6 cells with low， medium and high concentrations of drug-containing serum of alcoholic extract from S. comosa （diluted to 10%， 15%， 20%）. miRNA-21 mimics or inhibitors were used to transfect HSC-T6 cells， and the mRNA and protein expressions of factors related to the PI3K/Akt signaling pathway were detected. RESULTS The results of in vivo experiments showed that low， medium and high doses of alcoholic extract from S. comosa significantly ameliorated the histopathological changes in liver tissue of HF rats， and the percentage of collagen was significantly reduced （P＜0.01）； mRNA and protein expressions of the indicators related to HF as well as PI3K and Akt were significantly reduced （P＜0.01）， and mRNA and protein expressions of phosphatase and tensin homolog deleted on chromosome ten （PTEN） were increased in liver tissue of rats （P＜0.01）. The results of in vitro experiments showed that drug-containing serum of alcoholic extract from S. comosa significantly inhibited the expression of miRNA-21 at low， medium and high concentrations （P＜0.01）； whereas after transfection with miRNA-21 mimics， it was found that miRNA-21 mimics significantly increased mRNA and protein expressions of PI3K and Akt （P＜0.01）， while significantly decreased mRNA and protein expressions of PTEN （P＜0.01）； after transfection with miRNA-21 inhibitor， the changes of above indexes were opposite to the above results （P＜0.01）. CONCLUSIONS Alcoholic extracts of S. comosa may inhibit the PI3K/Akt signaling pathway by affecting the expression of miRNA-21， so as to achieve the effect of anti-hepatic fibrosis.

Background::The conversion of adenosine (A) to inosine (I) through deamination is the prevailing form of RNA editing, impacting numerous nuclear and cytoplasmic transcripts across various eukaryotic species. Millions of high-confidence RNA editing sites have been identified and integrated into various RNA databases, providing a convenient platform for the rapid identification of key drivers of cancer and potential therapeutic targets. However, the available database for integration of RNA editing in hematopoietic cells and hematopoietic malignancies is still lacking.Methods::We downloaded RNA sequencing (RNA-seq) data of 29 leukemia patients and 19 healthy donors from National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) database, and RNA-seq data of 12 mouse hematopoietic cell populations obtained from our previous research were also used. We performed sequence alignment, identified RNA editing sites, and obtained characteristic editing sites related to normal hematopoietic development and abnormal editing sites associated with hematologic diseases.Results::We established a new database, "REDH", represents RNA editome in hematopoietic differentiation and malignancy. REDH is a curated database of associations between RNA editome and hematopoiesis. REDH integrates 30,796 editing sites from 12 murine adult hematopoietic cell populations and systematically characterizes more than 400,000 edited events in malignant hematopoietic samples from 48 cohorts (human). Through the Differentiation, Disease, Enrichment, and knowledge modules, each A-to-I editing site is systematically integrated, including its distribution throughout the genome, its clinical information (human sample), and functional editing sites under physiological and pathological conditions. Furthermore, REDH compares the similarities and differences of editing sites between different hematologic malignancies and healthy control.Conclusions::REDH is accessible at http://www.redhdatabase.com/. This user-friendly database would aid in understanding the mechanisms of RNA editing in hematopoietic differentiation and malignancies. It provides a set of data related to the maintenance of hematopoietic homeostasis and identifying potential therapeutic targets in malignancies.

Objective To investigate the role and mechanism of action of Scabiosa atropurea in inhibiting the proliferation of hepatic stellate cells using cell experiment. Methods A total of 20 Wistar rats were randomly divided into control group and administration group, with 10 rats in each group. The rats in the control group were given normal saline by gavage, and those in the administration group were given Scabiosa atropurea by gavage to prepare drug-containing serum. HSC-T6 cells were incubated with the serum from the control group (10%) or the low-, middle-, and high-dose serum containing Scabiosa atropurea (10%, 15%, and 20%, respectively). MTT assay was used to observe the effect of different drug concentrations on cells in different periods of time; flow cytometry was used to measure cell apoptosis; qRT-PCR and Western blot were used to measure the mRNA and protein expression levels of fibrosis markers (α-SMA, collagen Ⅰ) and PI3K/Akt signaling pathway-related factors in hepatic stellate cells (HSCs). A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t - test was used for further comparison between two groups. Results Compared with the control group, the low-, middle-, and high-dose serum containing Scabiosa atropurea groups had a significant reduction in the OD value of cells (all P < 0.05) and a significant increase in the overall apoptosis rate of cells (all P < 0.05). The results of qRT-PCR showed that compared with the control group, the low-, middle-, and high-dose serum containing Scabiosa atropurea groups had significant reductions in the mRNA expression levels of α-SMA, collagen Ⅰ, PI3K, and Akt and a significant increase in the mRNA expression level of PTEN (all P < 0.05); Western blot showed that compared with the control group, the low-, middle-, and high-dose serum containing Scabiosa atropurea groups had significant reductions in the protein expression levels of α-SMA, collagen Ⅰ, PI3K, Akt, and p-Akt and a significant increase in the protein expression level of PTEN (all P < 0.05). Conclusion The Mongolian medicine Scabiosa atropurea can inhibit the proliferation of HSC-T6 cells and promote their apoptosis, possibly by regulating fibrosis markers and the PI3K/Akt signaling pathway to exert an anti-liver fibrosis effect.

Objective To analyze the compliance and influencing factors of patients with mental disorders complicated with diabetes treatment in a third-class general hospital of Nantong City, and to provide theoretical basis for improving the compliance of patients with mental disorders complicated with diabetes treatment. Methods Among of 148 patients with mental disorders combined with diabetes admitted to our hospital from January 2021 to June 2022 were selected and divided into poor compliance group and good compliance group according to the investigation of diabetes treatment compliance. The blood glucose control of the two groups was compared, and clinical data of patients were collected from the medical record system. The independent risk factors affecting the compliance of patients with mental disorders and diabetes were analyzed. Results The levels of FBG, PBG and HbA1c in poor compliance group were significantly lower than those in good compliance group (P<0.05). The results showed that poor cognition of the disease (OR=2.649), paranoid psychosis (OR=0.371), low self-awareness and attitude score (OR=0.618), poor blood glucose control (OR=2.914) were independent risk factors affecting the compliance of patients with mental disorders and diabetes mellitus (P<0.05). Conclusion The compliance of patients with mental disorders combined with diabetes in the treatment of diabetes is not high and the control of blood sugar is not good. Mental health service outlets should be added to actively control the blood sugar of patients, focusing on paranoid mental patients and strengthening the publicity and education of guardians, which can improve the treatment compliance of patients and contribute to the prognosis of patients.

Objective:To evaluate the accuracy of airway ultrasonic parameters in predicting difficult mask ventilation (DMV) in obese patients.Methods:Ninety-six patients of both sexes, aged >18 yr, with body mass index of 28- <40 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective surgery under general anesthesia with endotracheal intubation, were selected. The airway was evaluated at 1 day before surgery to record the thyromental distance, modified Mallampati classification and upper lip bite test classification. Before anesthesia induction, the mandibular condylar motion, longitudinal cross-sectional area and transverse diameter of the tongue were measured by ultrasound, and the tongue volume was calculated. Mask ventilation was performed after anesthesia induction, DMV classification was recorded, DMV was defined as DMV classification Ⅲ and Ⅳ, and the patients were divided into non-DMV group (NDMV group) and DMV group. Spearman correlation analysis was used to analyze the correlation between each parameter and DMV, the receiver operating characteristic (ROC) curve was used to evaluate the accuracy of each parameter in predicting DMV, and the cut-off value was determined based on the principle of Jorden index at maximum. Results:Ninety-six patients were finally included in the study, with 64 patients in NDMV group and 32 patients in DMV group. Compared with NDMV group, the increase in age, modified Mallampati grade, upper lip biting test grade, longitudinal cross-sectional area of tongue, transverse diameter of tongue and volume of tongue were significantly increased, and the thyromental distance and mandibular condylar motion were decreased in DMV group ( P<0.05). Age ( r=0.283), modified Mallampati grade ( r=0.668), upper lip biting test classification ( r=0.826), tongue longitudinal cross-sectional area ( r=0.598), tongue transverse diameter ( r=0.578) and tongue volume ( r=0.707) were positively correlated with DMV ( P<0.01), and thyromental distance ( r=-0.623) and mandibular condylar motion ( r=-0.666 ) were negatively correlated with DMV ( P<0.05). The area under curve (95% confidence interval) of tongue longitudinal cross-sectional area, tongue transverse diameter, tongue volume, and mandibular condylar motion for DMV prediction were 0.870 (0.780-0.961), 0.858 (0.768-0.948), 0.937 (0.864-1.000), 0.912 (0.835-0.990), respectively ( P<0.01), and the predicted cut-off values were 22.61 cm 2, 4.29 cm, 100.60 cm 3 and 1.18 cm, respectively, the sensitivity was 90%, 83%, 90% and 90%, respectively, the specificity was 80%, 80%, 95% and 95%, respectively. Conclusions:Tongue volume and mandibular condylar motion measured by ultrasound are highly accurate in predicting DMV in obese patients. Tongue volume> 100.60 cm 3 or mandibular condylar motion< 1.18 cm suggests a high risk of DMV.

OBJECTIVE：To study the improv ement effects of Mongolian medici ne eligen- 7 on hepatic fibrosis （HF）and its mechanism. METHODS ：Taking rat hepatic stellate cells HSC-T 6 as research object ，the cells were divided into model group （blank serum ）and low-dose ，medium-dose and high-dose groups of eligen- 7 containing serum （10％，15％ and 20％ eligen-7 containing serum ）. Transforming growth factor β solution（0.2 mg/mL）was added into the cells for 48 h to induce liver fibrosis model，and then added into the corresponding blank or drug-contained serum. The optical density （OD）of cells in each group was measured and inhibition rate of cell proliferation was calculated （after treated for 24，48 and 72 h）. The apoptotic rate and cycle distribution of cells were detected ；mRNA and protein expression of type Ⅰ collagen（Collagen Ⅰ），α-smooth muscle actin （α-SMA），phosphatidylinositol-3-kinase and protein-serine-threonine kinase （PI3K/Akt）signaling pathway related factors （PI3K， Akt，PTEN）were also detected （after treated for 24 h）. Wistar rats were further divided into blank group ，model group and low-dose，medium-dose and high-dose groups of eligen- 7（135，270，405 mg/kg），with 10 rats in each group. Blank group and model group were given 0.5％ sodium carboxymethyl cellulose solution intragastrically ；other groups were given relevant medicine intragastrically，once a day ，for consecutive 10 weeks. After last intragastric administration ，the pathomorphological changes of liver tissue were observed ；mRNA and protein expression of Collagen Ⅰ，α-SMA，PI3K，Akt and PTEN were detected in liver tissue. RESULTS ：Compared with model group ，OD value （except for medium-dose and high-dose groups of eligen- 7 containing serum）and the proportion of cells at S phase in administration groups were decreased significantly （P＜0.01）；late apoptotic rate ， early apoptotic rate （except for low-dose group ），total apoptotic rate and the proportion of cells at G 2/M phase increased significantly（P＜0.01）；mRNA and protein expression of Collagen Ⅰ，α-SMA，PI3K and Akt in cells and liver tissue were decreased significantly （P＜0.05 or P＜0.01），those of PTEN were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ： Eligen-7 shows the effect of anti-hepatic fibrosis ， themechanism of which may be related to regulating the activity of PI 3K/Akt signaling pathway and promoting the apoptosis of hepatic stellate cells.

Objective To establish the diversification nursing education mode,provide standardized training for rotation nurses and evaluate its effects in rotation nurses training,so as to improve the integral level of nursing team.Methods A total of 36 rotation nurses trained in Department of Internal Medicine of the Fourth People's Hospital of Nantong were selected as the research object from July 2011 to January 2016 by cluster sampling method. The standardized training was carried out by focusing on training excellent clinical teachers, unifying theory textbooks for new nurses,formulating standardized teaching and assessment plan,implementing the teaching of cases combined with theoretical knowledge,teaching nurses to set up noble values,structuring a harmonious team atmosphere. And then,the self-efficacy,core competence,theory,operation,clinical working ability and anxiety of rotation nurses were compared before and after training.Results The score of self-efficacy of rotation nurses after training (2.41±0.13) was higher than that before training (1.85±0.15) with a significant difference (t=19.002,P<0.01). The score of core competence significantly increased from (121.90±5.07) before training to (145.67±7.57) after training (t=19.794,P<0.01). The scores of theory,operational skill, clinical working ability significantly increased from (77.86±4.40),(79.47±4.99) and (68.58±3.19) before training to (88.28±5.44),(90.92±4.75) and (83.31±5.20) after training with significant differences (t=9.564, 10.732,12.618;P<0.01). The score of anxiety after training (30.94±4.85) was lower than that before training (41.75±12.11) with a significant difference (t=-7.401,P<0.01) .Conclusions The diversification nursing education can improve the comprehensive ability of rotation nurses by training excellent clinical teachers, unifying theory textbooks for new nurses,formulating standardized teaching and assessment plan and so on. It is worthy of popularization and application in clinical teaching.