Objective To investigate the effect of minocycline(Mino)on the polarization of types M1/M2 microglia(pro-and anti-inflammatory type)in the spinal dorsal horn of rats with neuropathic pain(NP)induced by spinal nerve ligation(SNL)and its underlying mechanism.Methods A total of 36 adult male SD rats were randomly stratified into Sham-operation(Sham)group,SNL group and Mino+SNL group by stratified random sampling based on body weight.Mechanical pain threshold and cold nociceptive thresholds of rat hind paw were measured in 1 d before and 14 d after modelling.Spinal cord tissue at the lumbar 5(L5)segment was taken at 14 d after modelling,and the total number of microglia as well as the numbers of M1 and M2 microglia in the spinal dorsal horn were measured with immunohistochemistry and stereology.With aid of bioinformatics techniques,the core target in the spinal cord,Cst7,was selected.Then,the protein levels of microglia marker Iba-1,M1 microglia marker iNOS,M2 microglia marker CD206,Cst7 encoded protein cystatin F(CF)and pathway CatS/CX3CL1/CX3CR1 were detected with Western blotting.The expression levels of TNF-α,IL-6 and IL-10 in the spinal cord tissues were measured with ELISA.Results The mechanical pain and cold nociceptive thresholds were both significantly higher in the M+SNL group than the SNL group at 7～14 d after modelling(P＜0.01).The total number of microglia and the numbers of M1/M2 microglia in the spinal dorsal horn as well as the expression levels of CatS,CX3CL1,CX3CR1,TNF-α,IL-6,and IL-10 in the spinal cord tissues were obviously increased,and the expression level of CF was notably decreased in the SNL model group than the Sham group(P＜0.01).While,Mino treatment remarkably reversed above phenomena,with decreased total number of microglia and number of M1 microglia as well as expression levels of CatS,CX3CL1,CX3CR1,TNF-α and IL-6,and increased number of M2 microglia as well as CF and IL-10 levels when compared with the SNL group(P＜0.05).Conclusion Mino alleviates SNL induced neuropathic pain,probably through up-regulating CF in the microglia,and thus inhibiting the CatS/CX3CL1/CX3CR1 signaling pathway,promoting the conversion of microglia from type M1 to M2 to balance the imbalance in the M1/M2 polarization,and thus reducing neuroinflammation.

Objective To identify the potential categories of health management behaviors of patients with metabolic syndrome(MS),and to analyze differences in characteristics and influencing factors of patients across classes.Methods A random sample of 906 MS patients in southern Xinjiang were selected to investigate the current health management behaviors.The demographic information and Self-management Behaviors of MS patients results were collected.Latent profile analysis,univariate analysis,and unordered multi-categorical Logistic regression were used to identify the potential categories and predictors of health management behaviors in MS patients.Results The health management behaviors of 906 MS patients could be categorized into 3 groups:poor health management behaviors group(40.5％),health management behaviors medium-high medication management group(40.7％),and good health management behaviors group(18.8％).Compared with the good health management behaviors group,non-agriculture and animal husbandry,social support are protective factors for MS patients in the poor health management behaviors group.Self-efficacy is a protective factor for MS patients in the health management behaviors medium-high medication management group,and perceived stress is a risk factor for both categories.Conclusion The health management behaviors of MS patients are at a poor level.Nurses can carry out personalized health management according to different categories and their main influencing factors.

Objective:To explore the relationship between family function and neurodevelopment of preterm infants in the NICU.Methods:A total of 195 preterm infants in the NICU and their parents were selected from January to August 2020 in Children′s Hospital of Soochow University by convenience sampling method. A questionnaire survey was conducted using the general information questionnaire and Family Assessment Device. 0 to 6-year-old Children′s Neuropsychological Development Checklist were used to assess neurodevelopmental status of preterm infants in the third month after their discharge.Results:The development quotient of preterm infants in the NICU in the third month after discharge was 76.00(73.00, 81.00) points. The family function score was 146.00(131.00, 161.00) points. The total score of family function and item score were negatively correlated with development quotient ( r values were -0.646 to -0.505, all P<0.05). Hierarchical regression analysis showed that communication, problem solving, and behavior control accounted for 21.9% of neurodevelopmental variability in preterm infants. Conclusions:Nurses should promote the family function of preterm infants by improving family communication, problem solving and behavior control, thereby enhancing their neural development level.

Objective:To learn about the real experience of mothers of very low birth weight babies experiencing delayed breastfeeding.Methods:Using the objective sampling method, a total of 17 mothers of very low birth weight infants within 1 month of the discharge from the neonatal intensive care unit (NICU) of a Class Ⅲ Grade A children's hospital in Suzhou from April 2018 to February 2019 were selected for semi-structured depth Interviews, and Colaizzi phenomenological analysis method was used to sort out and analyze the interview data.Results:Through analysis and induction, the following four themes were finally condensed, which were missing the early establishment of breast-feeding time, tortuous course of breast feeding, bearing the pressure of breast-feeding and the imperfect breast-feeding support system.Conclusions:Delayed breast feeding is very common in very low birth weight infants, and the process of breast feeding is very difficult.In the future, the NICU system and continuous care service system can be improved to provide multi-angle and multi-level nursing support, so as to promote the early successful breast feeding of mothers with very low birth weight and maintain their physical and mental health development.

Objective To explore the changes of depression in patients with lung cancer and their impacts on the survival period,so to provide evidence for psychological treatment of patients with lung cancer.Methods 339 lung cancer patients diagnosed and treated in our hospital and other hospital from 2010 to 2013 were included.The depression status of patients was diagnosed by the Depression Scale of Epidemiological Research Center and followed up every year.To observe the changes of depressive symptoms during the survival period,and to evaluate the impact of depressive symptoms on the survival rate of patients.Results Among 339 participants,133 (39％) had depression symptoms at baseline and an additional 71 (21％) developed new-onset depression symptoms during treatment.At baseline,depression symptoms were associated with increased mortality (hazard ratio [HR],1.19,95％ CI:1.04-1.34).Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up:never depression symptoms (n =135),new-onset depression symptoms (n =71),depression symptom remission (n =46),and persistent depression symptoms (n =87).HRs were as follows:new-onset depression symptoms,1.36 (95％ CI:1.12-1.61),depression symptom remission,1.11 (95％ CI:0.97-1.25),and persistent depression symptoms,1.33 (95％ CI:1.09-1.57).Conclusions Among patients with lung cancer,longitudinal changes in depression symptoms are associated with differences in mortality.Symptom remission is associated with a similar mortality rate as never having had depression,which is lower than that in persistent and new-onset depression symptoms.

Objective To investigate the clinical effect of low-temperature plasma radiofrequency with endoscopic laryngoscope in the treatment of adult patients with laryngeal papilloma.Methods From January 2014 to April 2018,60 adult patients with laryngeal papilloma in Zhuji Central Hospital were enrolled in this study.According to the treatment methods,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with laryngoscope tweezers,and the observation group was treated by low temperature plasma radiofrequency with endoscopic laryngoscope.The operation time,intraoperative blood loss,hospitalization time and postoperative complications were recorded.The follow-up was performed on the first day after operation.The recurrence rate and average recurrence time were recorded.Results The average operation time in the observation group was (29.54 ± 4.52)min,which was significantly shorter than (38.85 ± 5.47)min in the control group (t =7.186,P =0.000).The intraoperative blood loss of the observation group was (1.24 ± 0.76) mL,which was significantly lower than (35.69 ± 5.88) mL of the control group (t =31.825,P =0.000).The length of hospital stay of the observation group was (3.83 ± 1.17) d,which was significantly shorter than (4.79 ± 1.47) d of the control group (t =2.798,P =0.006).The incidence rate of postoperative complication in the observation group was 3.33％ (1/30),which was significantly lower than 23.33％ in the control group (x2 =5.192,P =0.022).The mean duration of postoperative recurrence in observation group was (2.42 ± 0.57) months,which was significantly longer than (1.28 ± 0.36) months in the control group(t =9.261,P =0.000).The postoperative recurrenc.e rate of the observation group was 6.67 ％ (2/30),which was significantly lower than that of the control group [40.00 ％ (12/30),x2 =9.316,P =0.002].Conclusion Low temperature plasma radiofrequency with endoscopic laryngoscope in the treatment of adult patients with laryngeal papilloma has less trauma,and can extend the recurrence time,reduce the postoperative recurrence rate.

Objective To explore the role of the DACT2 gene in the occurrence and development of renal cell carcinoma(RCC).Methods The samples of RCC tissues and corresponding tumor-adjacent tissues after radical operation and normal kidney tissues were collected.The methylation specific PCR (MSP) and real time fluorescence reverse transcriptase-PCR (RT-PCR) methods were adopted to detect the methylation status and mRNA expression of DACT2.The streptavidin-peroxidase (SP) method labeled by immunohistochemistry peroxidase was used to examine the expression of β-catenin protein.Then the relationship between DACT2 gene methylation status and mRNA expression with the clinicopathologic characteristics was analyzed.The relationship between DACT2 gene methylation with mRNA and β-catenin expression was analysed,as well.Results The DACT2 mRNA relative expression level in RCC tissues was 0.427±0.025,which was significantly lower than (0.801±0.047) in tumor-adjacent tissues and (0.872±0.022) in normal tissue,the positive rate of DACT2 gene methylation in RCC tissues was 45.76%,which was significantly higher than 6.78% in tumor-adjacent tissues and 5.08% in normal tissues,the difference was statistically significant (P<0.05),while the difference between tumor-adjacent tissues and normal tissues had no statistical significance (P>0.05).The DACT2 gene mRNA expression level in RCC tissues and promoter area methylation occurrence rate had no obvious correlation with the clinical data such as patients age,gender,tumor size,clinical stage and Fuhrman grade (P>0.05).The DACT2 gene mRNA relative level in the methylation group was lower than that in the non-methylation group,the difference was statistically significant (P<0.05).The expression rate of β-catenin protein in cytoplasma in RCC tissues was higher than that in the tumor-adjacent tissues and normal tissues,the difference was statistically significant (P<0.05),moreover,DACT2 gen methylation had a positive correlation with β-catenin protein expression (r=0.324,P=0.012).Conclusion The decrease of DACT2 gene promoter area methylation and mRNA relative expression level may participate in the RCC occurrence,but has no relationship with RCC clinical progression.Methylation occurred in DACT2 gene promoter area may be one of reasons causing mRNA relative expression decrase.DACT2 gene methylation occurrence in RCC tissue might be related to the high expression of β-catenin.

Objectives: To explore weather oxygen uptake efficiency slope (OUES) may predict the prognosis in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods: The consecutive newly diagnosed IPAH patients in our hospital from 2010-11 to 2015-06 were prospectively enrolled and regular follow-up study was conducted to record cardiovascular events (death and lung transplantation). Kaplan–Meier curve, uni- and multivariate Cox regression analysis were performed to assess the survival rate in relevant patients. Results: A total of 210 IPAH patients at the mean age of (32±10) years were finished cardiopulmonary exercise test (CPET) and received regular follow-up study including 159 female. There were 31 patients died and 1 received lung transplantation over 41 months follow-up period. OUES was positively related to peak oxygen uptake (VO2)/body weight (r=0.71, P<0.0001). Multivariate analysis demonstrated that OUESI and NT-proBNP could independently predict the prognosis of IPAH patients. The 5-year survival rate in patients with OUESI≤0.52 L/(min?m2) was lower than those with OUESI>0.52 L/(min?m2) (41.9% vs 89.8%), P<0.0001.Conclusion: OUES as a submaximal CPET parameter may well predict the prognosis in IPAH patients.

Objective To characterize the clinicopathologic features,treatment efficacy and prognoses of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) in renal allografts.Methods Electronic medical records of Jinling Hospital were searched for PGNMID that was diagnosed during January 2008 to April 2017.Clinicopathologic features,treatment regimens and prognoses information were retrieved and analyzed.Results We identified 5 cases of PGNMID with clinical symptoms of proteinuria (5/5),serum creatinine elevation (4/5) or hematuria (4/5) 5 to 19 months after kidney transplantation.Various light microscopic features were observed,with predominantly membranoprolifeative pattern.Mild mesangial proliferation pattern could be observed in early stages of disease progression.Immunofluorescence revealed monoclonal IgG3κ in 3 patients and IgG3λ in another 2 cases.One case of PGNMID with normal light microscopy but monoclonal IgG deposits was verified by IgG and light-chain subtyping.In the 4 patients treated with rituximab or bortezomib,decreased proteinuria was achieved in all treated patients while the decreases in serum creatinine decrease were only observed in 2 patients At last follow-up,one patient was in dialysis and serum creatinine levels of other 2 patients were ＞265.2 μmol/L.Conclusion Membranoprolifeative pattern is the most frequently observed microscopic findings and IgG3 is the most frequent IgG subtype in PGNMID.PGNMID recurs shortly after kidney transplantation.Rituximab and/or bortezomib is conducive to decrease proteinuria while their efficacy to decrease serum creatinine is dubious.The most effective treatment protocol for PGNMID remains to be determined in larger samples.

Objective:To explore the effect of red blood cell distribution width (RDW) on long-term follow-up study in patients with acute pulmonary thromboembolism (APE).
Methods:A total of 214 consecutive patients with the first episode of APE admitted in our hospital from 2009-01 to 2012-12 were enrolled. The patients were divided into 2 groups:RDW≤15%group, n=202 and RDW>15%group, n=12. Baseline RDW was measured at admission, the follow-up study was conducted at 3, 6, 12 months thereafter, and then at once per year. The major primary end point was chronic thromboembolic pulmonary hypertension (CTEPH). The independent predictor for CTEPH occurrence was studied by uni-and multivariate logistic regression analysis and the predictive capability of RDWwas evaluated by ROC curve.
Results: All patients ifnished the follow-up study at the mean of (31±17) months. The overall occurrence rate of CTEPH was 7.5% (16/214), which was higher in RDW>15% group than that in RDW≤15% group (33.3% vs 5.9%, P=0.002). Multivariate logistic regression analysis indicated that with adjusted clinical data and other predictors, RDW>15%was still the strong predictor for CTEPH occurrence (OR=7.916, 95%CI 1.474-42.500, P=0.016). Adding RDW to the evaluating model, the predictive capability could be signiifcantly improved by ROC curve (AUC increased from 0.856 to 0.901, P<0.01).
Conclusion: Elevated RDW is the independent predictor for CTEPH occurrence in APE patients, which is helpful to estimate the prognosis and treatment strategy in APE patients.