Objective To compare the efficacy and adverse reactions of doxycycline and levofloxacin in children with macrolide non-responsive mycoplasma pneumonia(MUMPP).Methods Clinical data of 240 MUMPP children admitted to our hospital from November 2023 to July 2024 were retrospectively analyzed,and they were divided into doxycycline group and levofloxacin group according to drug use,with 120 cases in each group.The efficacy of the two groups were compared,the time when body temperature dropped to nor-mal after taking antipyretics,the time when cough was reduced,the time when lung riles were resolved,the length of hospital stay,the peripheral blood indicators[WBC,neutrophilic granulocyte percentage,C reactive protein(CRP),lactate dehydrogenase(LDH),D-dimer],the lung imaging recovery and the occurrence of ad-verse reactions.Results There was no significant difference in total effective rate between doxycycline group and levofloxacin group(93.33％vs.90.00％,P＜0.05).Compared with levofloxacin group,the duration of hospital stay in doxycycline group was shorter[(6.22±2.24)d vs.(7.39±2.47)d],and the duration of lung crackles disappeared longer[(4.47±2.06)d vs.(3.50±1.79)d],with statistical significance(P＜0.05).Af-ter treatment,the neutrophil percentage,CRP and LDH levels in the two groups were lower than before treat-ment,and the differences were statistically significant(P＜0.05).There was no significant difference in the incidence of adverse reactions between doxycycline group and levofloxacin group(15.83％vs.15.00％,P＞0.05).Conclusion Both doxycycline and levofloxacin have good efficacy in MUMPP children,with low inci-dence of adverse reactions and no serious adverse reactions.

AIM:To investigated the mechanism of action of Yiqi tongfu xiere prescription(YTX)in treating mice with lipopolysaccharide(LPS)-in-duced acute lung injury(ALI).METHODS:According to the random number table,24 C57BL/6 mice were divided into 4 groups:control group(Control),model group(LPS),low dose group(YTX-L)and high dose group(YTX-H).Except for the control group,the mice models of acute lung injury were established by intratracheal instillation of LPS solu-tion(5 mg/kg).The low and high dose treatment groups were given intragastric administration con-tinuously for 14 days.After 24 hours,the lung tis-sue,bronchoalveolar lavage fluid(BALF)and serum of the four groups were taken for follow-up detec-tion.The degree of pulmonary edema was evaluat-ed by wet weight coefficient(wet to dry ratio,W/D)of lung tissue.The degree of alveolar inflamma-tion and pulmonary fibrosis were evaluated by HE and Masson staining,and the contents of BALF and serum inflammatory cytokines IL-1β and IL-6 were detected by ELISA.The protein expressions of α-SMA,FN,Col-Ⅰ and Col-Ⅲ were measured by West-ern blot.Determination of α-SMA,FN,Col-Ⅰ,MAPK,NF-κB mRNA expression by RT-PCR method.RE-SULTS:Compared with LPS group,the contents of BALF,IL-1β and IL-6 in serum,Wmax D ratio,lung pathology,serum α-SMA,FN,Col-Ⅰ,Col-Ⅲ protein expression and α-SMA,FN,Col-Ⅰ,MAPK,NF-κB mRNA expression in treatment group were signifi-cantly lower than those in control group.CONCLU-SION:YTX can significantly reduce the levels of pul-monary fibrosis markers such as α-SMA,FN,Col-Ⅰand Col-Ⅲ by inhibiting the activation of MAPK/NF-κB signal pathway,and improve alveolar inflamma-tion and pulmonary fibrosis in mice with lung inju-ry,suggesting that YTX can treat acute lung injury and provide a theoretical basis for the clinical use of YTX.

BACKGROUND:Both calorie restriction and time-restricted feeding,as two common dietary patterns,have been shown to improve health by regulating metabolism.However,the difference between these dietary patterns,metabolic indices,as well as the gut microbiota still requires further attention.OBJECTIVE:To explore the differences of calorie restriction and time-restricted feeding on the metabolic indices and gut microbiota of mice.METHODS:The C57BL/6J mice were randomly divided into three groups of ad libitum,calorie restriction,and time-restricted feeding(n=6 per group)for 28 weeks of dietary intervention.Various parameters such as body weight,food intake,glucose tolerance,serum fasting insulin,Homeostasis Model Assessment of Insulin Resistance,and leptin were measured.The impact of different interventions on the gut microbiota structure in mice was explored using 16S rRNA sequence analysis.Key operational taxonomic units responsive to dietary interventions were identified through LEfSe analysis.RESULTS AND CONCLUSION:(1)Compared with the ad libitum group,the body weight,food intake,area under the glucose tolerance curve of the calorie restriction and time-restricted feeding groups were decreased(P＜0.01),and the serum leptin was decreased(P＜0.05).The fasting insulin level and serum leptin level of the calorie restriction group were decreased(P＜0.05)and were significantly lower than those of the time-restricted feeding group(P＜0.05);homeostasis model assessment of insulin resistance decreased in the calorie restriction group(P＜0.01).(2)Compared with the ad libitum group,the αdiversity of gut microbiota in the calorie restriction group and the time-restricted feeding group was decreased(P＜0.05),but the diversity of the time-restricted feeding group was slightly lower than that in the calorie restriction group.(3)There were 15 key operational taxonomic units related to calorie restriction and the time-restricted feeding intervention,of which 8 were positively correlated with metabolic phenotypes and their abundance decreased,and 3 were negatively correlated with metabolic phenotypes and their abundance increased(P＜0.05).OTU819 Lachnospiraceae_UCG-006 was positively correlated with body weight,area under the glucose tolerance curve,homeostasis model assessment of insulin resistance,and fasting insulin,while OTU1397 Muribaculaceae was negatively correlated with these indicators.The results show that both calorie restriction and the time-restricted feeding intervention can improve the weight and glucose metabolism of mice,and both intervention modes caused the remodeling of the gut microbiota,which helped to improve the metabolic disorders.

Objective:To explore the implementation method of the "daily-monthly-quarterly" quality control model based on total quality management (TQM) theory in nursing quality management, and evaluate its application effectiveness.Methods:A quasi-experimental research method was used. The quarterly quality control model employed at Shanxi Medical University Second Hospital from 2018 to 2019 was set as the control group, and the"day-month-quarter" quality control model based on TQM implemented from 2020 to 2022 was set as the observation group. The nurse practice environment assessment scores from 2018 to 2022 were analyzed; the nursing quality-sensitive indicators between the two groups were compared, including the incidence rate of overall adverse event, falls among hospitalized patients, pressure ulcers of stage 2 and above, unplanned extubations, and catheter-related infections (central venous catheter-related bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections).Results:The nurse practice environment assessment scores from 2018 to 2022 were (69.11 ± 19.66), (75.20 ± 18.70), (77.60 ± 17.65), (82.45 ± 16.44), and (88.00 ± 15.06). The differences compared to the previous year were statistically significant ( t=3.63-9.24, all P<0.05).After the intervention, the incidence rates of overall adverse events, falls among hospitalized patients, unplanned extubation, central venous catheter-related bloodstream infections, and ventilator-associated pneumonia in the control group were 0.385% (499/129 678), 0.072% (94/129 678), 0.051% (66/129 678), 0.037% (23/62 390), and 0.746% (43/5 761). Compared to 0.258% (551/213 851), 0.048% (103/213 851), 0.033% (71/213 851), 0.019% (19/98 642), and 0.444% (88/19 826) in the observation group. The differences were statistically significant ( χ2values were 3.89-42.83, all P<0.05). There were no statistically significant differences in the incidence rates of pressure ulcers of stage 2 and above and catheter-associated urinary tract infections (both P>0.05). Conclusions:The "daily-monthly-quarterly" quality control model based on TQM is beneficial in improving nursing quality and ensuring patient safety.

BACKGROUND:Both calorie restriction and time-restricted feeding,as two common dietary patterns,have been shown to improve health by regulating metabolism.However,the difference between these dietary patterns,metabolic indices,as well as the gut microbiota still requires further attention.OBJECTIVE:To explore the differences of calorie restriction and time-restricted feeding on the metabolic indices and gut microbiota of mice.METHODS:The C57BL/6J mice were randomly divided into three groups of ad libitum,calorie restriction,and time-restricted feeding(n=6 per group)for 28 weeks of dietary intervention.Various parameters such as body weight,food intake,glucose tolerance,serum fasting insulin,Homeostasis Model Assessment of Insulin Resistance,and leptin were measured.The impact of different interventions on the gut microbiota structure in mice was explored using 16S rRNA sequence analysis.Key operational taxonomic units responsive to dietary interventions were identified through LEfSe analysis.RESULTS AND CONCLUSION:(1)Compared with the ad libitum group,the body weight,food intake,area under the glucose tolerance curve of the calorie restriction and time-restricted feeding groups were decreased(P＜0.01),and the serum leptin was decreased(P＜0.05).The fasting insulin level and serum leptin level of the calorie restriction group were decreased(P＜0.05)and were significantly lower than those of the time-restricted feeding group(P＜0.05);homeostasis model assessment of insulin resistance decreased in the calorie restriction group(P＜0.01).(2)Compared with the ad libitum group,the αdiversity of gut microbiota in the calorie restriction group and the time-restricted feeding group was decreased(P＜0.05),but the diversity of the time-restricted feeding group was slightly lower than that in the calorie restriction group.(3)There were 15 key operational taxonomic units related to calorie restriction and the time-restricted feeding intervention,of which 8 were positively correlated with metabolic phenotypes and their abundance decreased,and 3 were negatively correlated with metabolic phenotypes and their abundance increased(P＜0.05).OTU819 Lachnospiraceae_UCG-006 was positively correlated with body weight,area under the glucose tolerance curve,homeostasis model assessment of insulin resistance,and fasting insulin,while OTU1397 Muribaculaceae was negatively correlated with these indicators.The results show that both calorie restriction and the time-restricted feeding intervention can improve the weight and glucose metabolism of mice,and both intervention modes caused the remodeling of the gut microbiota,which helped to improve the metabolic disorders.

AIM:To investigated the mechanism of action of Yiqi tongfu xiere prescription(YTX)in treating mice with lipopolysaccharide(LPS)-in-duced acute lung injury(ALI).METHODS:According to the random number table,24 C57BL/6 mice were divided into 4 groups:control group(Control),model group(LPS),low dose group(YTX-L)and high dose group(YTX-H).Except for the control group,the mice models of acute lung injury were established by intratracheal instillation of LPS solu-tion(5 mg/kg).The low and high dose treatment groups were given intragastric administration con-tinuously for 14 days.After 24 hours,the lung tis-sue,bronchoalveolar lavage fluid(BALF)and serum of the four groups were taken for follow-up detec-tion.The degree of pulmonary edema was evaluat-ed by wet weight coefficient(wet to dry ratio,W/D)of lung tissue.The degree of alveolar inflamma-tion and pulmonary fibrosis were evaluated by HE and Masson staining,and the contents of BALF and serum inflammatory cytokines IL-1β and IL-6 were detected by ELISA.The protein expressions of α-SMA,FN,Col-Ⅰ and Col-Ⅲ were measured by West-ern blot.Determination of α-SMA,FN,Col-Ⅰ,MAPK,NF-κB mRNA expression by RT-PCR method.RE-SULTS:Compared with LPS group,the contents of BALF,IL-1β and IL-6 in serum,Wmax D ratio,lung pathology,serum α-SMA,FN,Col-Ⅰ,Col-Ⅲ protein expression and α-SMA,FN,Col-Ⅰ,MAPK,NF-κB mRNA expression in treatment group were signifi-cantly lower than those in control group.CONCLU-SION:YTX can significantly reduce the levels of pul-monary fibrosis markers such as α-SMA,FN,Col-Ⅰand Col-Ⅲ by inhibiting the activation of MAPK/NF-κB signal pathway,and improve alveolar inflamma-tion and pulmonary fibrosis in mice with lung inju-ry,suggesting that YTX can treat acute lung injury and provide a theoretical basis for the clinical use of YTX.

Objective:To explore the implementation method of the "daily-monthly-quarterly" quality control model based on total quality management (TQM) theory in nursing quality management, and evaluate its application effectiveness.Methods:A quasi-experimental research method was used. The quarterly quality control model employed at Shanxi Medical University Second Hospital from 2018 to 2019 was set as the control group, and the"day-month-quarter" quality control model based on TQM implemented from 2020 to 2022 was set as the observation group. The nurse practice environment assessment scores from 2018 to 2022 were analyzed; the nursing quality-sensitive indicators between the two groups were compared, including the incidence rate of overall adverse event, falls among hospitalized patients, pressure ulcers of stage 2 and above, unplanned extubations, and catheter-related infections (central venous catheter-related bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections).Results:The nurse practice environment assessment scores from 2018 to 2022 were (69.11 ± 19.66), (75.20 ± 18.70), (77.60 ± 17.65), (82.45 ± 16.44), and (88.00 ± 15.06). The differences compared to the previous year were statistically significant ( t=3.63-9.24, all P<0.05).After the intervention, the incidence rates of overall adverse events, falls among hospitalized patients, unplanned extubation, central venous catheter-related bloodstream infections, and ventilator-associated pneumonia in the control group were 0.385% (499/129 678), 0.072% (94/129 678), 0.051% (66/129 678), 0.037% (23/62 390), and 0.746% (43/5 761). Compared to 0.258% (551/213 851), 0.048% (103/213 851), 0.033% (71/213 851), 0.019% (19/98 642), and 0.444% (88/19 826) in the observation group. The differences were statistically significant ( χ2values were 3.89-42.83, all P<0.05). There were no statistically significant differences in the incidence rates of pressure ulcers of stage 2 and above and catheter-associated urinary tract infections (both P>0.05). Conclusions:The "daily-monthly-quarterly" quality control model based on TQM is beneficial in improving nursing quality and ensuring patient safety.

Objective To investigate the relationship between the levels of serum CXC chemokine ligand 1(CXCL1)and phosphatase and tensin homology deleted on chromosome ten(PTEN)mRNA in patients with acute cerebral infarction and the severity and prognosis of the disease.Methods A total of 102 patients with acute cerebral infarction admitted to the hospital from March 2022 to March 2023 were enrolled in the study as the experimental group,and 85 healthy people who underwent physical examination in the hospital during the same period were enrolled as the control group.Serum samples of fasting venous blood were collected from people enrolled in the study.The serum CXCL1 level was detected by using enzyme-linked immunosorbent as-say.Real-time fluorescence quantitative PCR(qPCR)was used to detect the relative expression level of serum PTEN mRNA(hereinafter referred to as the level).According to the National Institutes of Health Stroke Scale(NIHSS)score,the patients in the experimental group were divided into three groups with different de-grees of neurological impairment(severe group,moderate group and mild group),and the serum CXCL1 and PTEN mRNA levels of the three groups were compared.According to the cerebral infarction volume evaluated by computed tomography(CT)or magnetic resonance imaging(MRI),the patients in the experimental group were divided into small infarction group,medium infarction group and large infarction group,and the serum CXCL1 and PTEN mRNA levels of the three groups were compared.According to the modified Rankin scale(mRS),the patients in the experimental group were divided into the good prognosis group and the poor prog-nosis group,and the serum CXCL1 and PTEN mRNA levels were compared between the two groups.Pearson correlation was used to analyze the correlation between serum CXCL1 and PTEN mRNA levels in patients with acute cerebral infarction.Multivariate Logistic regression analysis was used to analyze the factors affect-ing the prognosis of patients with acute cerebral infarction.Results The proportion of patients with a history of diabetes and hypertension and serum CXCL1 and PTEN mRNA levels in the experimental group were high-er than those in the control group,and the differences were statistically significant(P＜0.05).With the in-crease of the degree of neurological impairment,the serum CXCL1 level and PTEN mRNA level increased,and there were significant differences among the severe group,moderate group,and mild group(P＜0.05).With the increase of infarction size,the serum levels of CXCL1 and PTEN mRNA increased,and there were signifi-cant differences among small infarction group,medium infarction group,and large infarction group(P＜0.05).Compared with the good prognosis group,the poor prognosis group had significantly higher proportions of patients with a history of diabetes,a history of hypertension,and serum CXCL1 and PTEN mRNA levels(P＜0.05).There was a positive correlation between serum CXCL1 level and PTEN mRNA level in patients with acute cerebral infarction(r=0.479,P＜0.001).The levels of serum CXCL1 and PTEN mRNA,history of diabetes and hypertension were all influencing factors for the prognosis of patients with acute cerebral in-farction(P＜0.05).Conclusion The levels of serum CXCL1 and PTEN mRNA in patients with acute cere-bral infarction increase,which can be used to evaluate the disease severity and prognosis of patients.

Objective To investigate whether resveratrol alleviates hyperglycemia-induced cardiomyocyte hypertrophy by enhancing the expression of silent information regulation 2 homolog 1(SIRT1)to maintain mitochondrial homeostasis.Methods Rat cardiomyocytes H9c2 cells with or without lentivirus-mediated mRNA interference of SIRT1 were cultured in high glucose(HG)and treated with resveratrol for 72 h.The changes in superoxide dismutase(SOD)activity,malondialdehyde(MDA)content,reactive oxygen species(ROS)level,and relative surface of the cells were examined,and the mRNA expressions of atrial natriuretic factor(ANF)and brain natriuretic peptide(BNP)and protein expressions of SIRT1,mitochondrial fusion related proteins optic atrophy protein 1(OPA1)and mitofusin 2,mitochondrial division related proteins dynamin-related protein 1(DRP1)and fission protein 1(FIS1),and mitophagy-related proteins BNIP3L and LC3 were detected using RT-qPCR and Western blotting.Results HG exposure significantly decreased SOD activity,increased MDA content,ROS production,relative cell surface,and the mRNA expressions of ANF and BNP in the cardiomyocytes;the protein expressions of SIRT1,OPA1,mitofusin 2 and BNIP3L and LC3-Ⅱ/LC3-Ⅰ ratio were all decreased and the protein expressions of DRP1 and FIS1 increased in HG-exposed cells(P<0.01).All these changes in HG-exposed cardiomyocytes were significantly alleviated by treatment with resveratrol(P<0.05).The protective effects of resveratrol against HG exposure in the cardiomyocytes were obviously attenuated by transfection of the cells with si-SIRT1(P<0.05).Conclusion Resveratrol inhibits hyperglycemia-induced cardiomyocyte hypertrophy by reducing oxidative stress,the mechanisms of which involve enhancement of SIRT1 protein expression,regulation of mitochondrial fusion and division balance,and promoting BNIP3L-mediated mitophagy to maintain mitochondrial homeostasis in the cells.

Objective To investigate whether resveratrol alleviates hyperglycemia-induced cardiomyocyte hypertrophy by enhancing the expression of silent information regulation 2 homolog 1(SIRT1)to maintain mitochondrial homeostasis.Methods Rat cardiomyocytes H9c2 cells with or without lentivirus-mediated mRNA interference of SIRT1 were cultured in high glucose(HG)and treated with resveratrol for 72 h.The changes in superoxide dismutase(SOD)activity,malondialdehyde(MDA)content,reactive oxygen species(ROS)level,and relative surface of the cells were examined,and the mRNA expressions of atrial natriuretic factor(ANF)and brain natriuretic peptide(BNP)and protein expressions of SIRT1,mitochondrial fusion related proteins optic atrophy protein 1(OPA1)and mitofusin 2,mitochondrial division related proteins dynamin-related protein 1(DRP1)and fission protein 1(FIS1),and mitophagy-related proteins BNIP3L and LC3 were detected using RT-qPCR and Western blotting.Results HG exposure significantly decreased SOD activity,increased MDA content,ROS production,relative cell surface,and the mRNA expressions of ANF and BNP in the cardiomyocytes;the protein expressions of SIRT1,OPA1,mitofusin 2 and BNIP3L and LC3-Ⅱ/LC3-Ⅰ ratio were all decreased and the protein expressions of DRP1 and FIS1 increased in HG-exposed cells(P<0.01).All these changes in HG-exposed cardiomyocytes were significantly alleviated by treatment with resveratrol(P<0.05).The protective effects of resveratrol against HG exposure in the cardiomyocytes were obviously attenuated by transfection of the cells with si-SIRT1(P<0.05).Conclusion Resveratrol inhibits hyperglycemia-induced cardiomyocyte hypertrophy by reducing oxidative stress,the mechanisms of which involve enhancement of SIRT1 protein expression,regulation of mitochondrial fusion and division balance,and promoting BNIP3L-mediated mitophagy to maintain mitochondrial homeostasis in the cells.