ObjectiveTo optimize the processing technology of honey bran-fried Rosae Laevigatae Fructus（h-RLF）， formulate relevant quality standards， and explore its improving effect and mechanism on mice with ulcerative colitis（UC） induced by dextran sodium sulfate（DSS）. MethodsTaking the content of polysaccharides and water-soluble extract as the indexes， L₉（3⁴） orthogonal test was used to optimize parameters of the amount of honey bran， frying time and frying temperature. The quality of 15 batches of h-RLF decoction pieces was evaluated according to the optimized process， and the inspection limit standard was preliminarily drawn up. Eighty SPF male Kunming mice were randomly divided into 8 groups， including the blank group， model group， mesalazine group（0.13 g·kg^-1）， RLF group（3.77 g·kg^-1）， bran-fried RLF group（3.77 g·kg^-1）， h-RLF low， medium and high dose groups（1.89， 3.77， 7.54 g·kg^-1）， with 10 mice in each group. The mice in the blank group were free to drink pure water， and the other groups were free to drink 3% DSS solution for 7 days to prepare UC mouse model. Each treatment group was given corresponding drugs by intragastric administration， and the blank and model groups were given equal volume of normal saline. The body weight of mice was recorded daily and the disease activity index（DAI） was calculated. After the administration， the colon tissues of mice were collected to observe the pathological changes by hematoxylin-eosin（HE） staining. The levels of tumor necrosis factor（TNF）-α， interleukin（IL）-1β， IL-6 and IL-10 in the colon of mice were detected by enzyme-linked immunosorbent assay（ELISA）. Western blot was used to detect the expression levels of phosphorylation nuclear transcription factor-κB p65（p-NF-κB p65）， Toll-like receptor 4（TLR4）， p-p38 mitogen-activated protein kinase（p-p38 MAPK）， p-extracellular signal-regulated kinase（p-ERK） and p-c-Jun N-terminal kinase（p-JNK） proteins in colon tissues. ResultsThe optimum processing technology of h-RLF was 20 g honey bran per 100 g RLF， and stir-frying at 200 ℃ for 8 min. The limit standard under the examination of h-RLF was preliminarily formulated as follows：the polysaccharide content should not be less than 25% based on anhydrous glucose（C₆H₁₂O₆）， the content of water-soluble extract should not be less than 38%， the moisture content should not be more than 12.0%， the total ash content should not be more than 5.0%， and the acid-insoluble ash content should not be more than 1.0%. The cluster heat map analysis showed that the quality of RLF from Huanggang， Hubei province was better. Animal experiments showed that compared with the blank group， the DAI score of the model group was significantly increased， the levels of TNF-α， IL-1β and IL-6 in the colon tissue were significantly increased， the IL-10 level was significantly decreased， the colonic mucosa was seriously damaged， accompanied by a large number of inflammatory cell infiltration， tissue congestion and a significant reduction in glands， and the expression levels of p-NF-κB p65， TLR4， p-p38 MAPK， p-ERK and p-JNK proteins were significantly increased（P<0.01）. Compared with the model group， each administration group could alleviate the symptoms of colonic ulcer， the structure of colonic crypt was basically intact， and the glands were arranged in an orderly manner. Among them， the high-dose group of h-RLF had a better effect， which could significantly reduce the DAI score and the levels of TNF-α， IL-1β and IL-6 in colon tissue（P<0.01）， and significantly increase the level of IL-10（P<0.01）， alleviate the colonic mucosal injury， and effectively inhibit the expression levels of p-NF-κB p65， TLR4， p-p38 MAPK， p-ERK and p-JNK proteins（P<0.01）. ConclusionThe key parameters of the processing technology of h-RLF are determined， and the optimized technology is stable and feasible. The established quality standard is simple and reliable， and can be used for the quality control. h-RLF can effectively alleviate DSS-induced UC， and its mechanism may be related to inhibiting the activation of NF-κB/TLR4/MAPK pathway.

Objective:To investigate the clinical outcome of endovascular treatment vs. drug treatment in patients with symptomatic non-acute long-segment occlusion of the internal carotid artery. Methods:Based on prospective cohort registration research data, patients with symptomatic non-acute long-segment occlusion of internal carotid artery were retrospectively included. They were divided into a drug treatment group and an endovascular treatment group according to the actual treatment received. The latter was further divided into a successful recanalization group and an unsuccessful recanalization group. The endpoint events included ipsilateral ischemic stroke, any stroke, and all-cause death. Multivariate logistic regression analysis was used to compare the endpoint events between groups during the perioprocedural period (within 30 days), and multivariate Cox proportional hazards model was use to compare the endpoint events between the groups during the long-term follow-up. Results:A total of 684 patients were included, of which 570 (83.33%) were male, median aged 63 years (interquartile range, 56-70 years). Three hundred and fifty-three patients (51.6%) received drug treatment; 331 (48.4%) received endovascular treatment, of which 161 (48.6%) had successful recanalization. The median follow-up time was 1 223 days (interquartile range, 646.5-2 082 days), with 109 patients (15.9%) experiencing stroke recurrence events (including 87 ipsilateral ischemic stroke) and 78 (11.4%) experiencing all-cause mortality. The risk of any stroke during the perioprocedural period in the successful recanalization group was significantly higher than that in the drug treatment group (odds ratio 3.679, 95% confidence interval 1.038-13.036; P=0.044), but the risk of ipsilateral ischemic stroke recurrence (risk ratio 0.347, 95% confidence interval 0.152-0.791; P=0.012) and all-cause mortality (risk ratio 0.239, 95% confidence interval 0.093-0.618; P=0.003) during the long-term follow-up were significantly lower than those in the drug treatment group. Conclusions:In patients with symptomatic non-acute long-segment occlusion of the internal carotid artery, endovascular treatment can increase the risk of stroke recurrence within 30 days, but successful recanalization can reduce the risks of long-term ipsilateral ischemic stroke recurrence and all-cause mortality.

Objective:To construct a set of quality evaluation index system of "Internet + nursing" with clear evaluation criteria with the service objects as the evaluation subject and Service Quality model as the theoretical framework, and to provide an objective basis for the quality evaluation of "Internet + nursing".Methods:CNKI, Wanfang databases, VIP, PubMed, and Web of Science were searched from establishment to November 2021. The article determined the quality evaluation items of "Internet + nursing" based on the perspective of service objects by means of literature analysis, field research and Delphi expert inquiries. Analytic hierarchy process was used to confirm the weight of each indicator.Results:In this study, 22 experts were consulted for 2 rounds.The effective recovery rate of the two rounds of questionnaires were 100%. The judgment basis coefficient was 0.936, familiarity coefficient was 0.945 and authority coefficient was 0.941; in the first round, the Kendall harmony coefficients assigned to the importance of the first and second level indicators were 0.187 and 0.122, and the Kendall harmony coefficients assigned to the feasibility were 0.183 and 0.125; in the second round, the Kendall harmony coefficients assigned to the importance of the first and second level indicators were 0.241 and 0.190, and the Kendall harmony coefficients assigned to the feasibility were 0.218 and 0.166 (both P<0.01). The final evaluation index system for the "Internet + nursing" based on the perspective of service objects included 7 first-class indicators and 33 second-class indicators. Conclusions:The "Internet + nursing" quality evaluation index system constructed in this study based on the perspective of service objects is scientific, reliable and practical, which can be used as an evaluation tool for the current "Internet + nursing" quality evaluation and strategy optimization.

Objective:To investigate predictive factors for successful endovascular recanalization in patients with non-acute symptomatic internal carotid artery occlusion (SICAO), to develop a decision tree model using the Classification and Regression Tree (CART) algorithm, and to evaluate the predictive performance of the model.Methods:Patients with non-acute SICAO received endovascular therapy at 8 comprehensive stroke centers in China were included retrospectively. They were randomly assigned to a training set and a validation set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen important variables, and a decision tree prediction model was constructed based on CART algorithm. The model was evaluated using the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and confusion matrix in the validation set.Results:A total of 511 patients with non-acute SICAO were included. They were randomly divided into a training set ( n=357) and a validation set ( n=154) in a 7:3 ratio. The successful recanalization rates after endovascular therapy were 58.8% and 58.4%, respectively. There was no statistically significant difference ( χ2=0.007, P=0.936). A CART decision tree model consisting of 5 variables, 5 layers and 9 classification rules was constructed using the six non-zero-coefficient variables selected by LASSO regression. The predictive factors for successful recanalization included fewer occluded segments, proximal tapered stump, ASITN/SIR collateral grading of 1-2, ischemic stroke, and a recent event to endovascular therapy time of 1-30 d. ROC analysis showed that the area under curve of the decision tree model in the training set was 0.810 (95% confidence interval 0.764-0.857), and the optimal cut-off value for predicting successful recanalization was 0.71. The area under curve in the validation set was 0.763 (95% confidence interval 0.687-0.839). The accuracy was 70.1%, precision was 81.4%, sensitivity was 63.3%, and specificity was 79.7%. The Hosmer-Lemeshow test in both groups showed P>0.05. Conclusion:Based on the type of ischemic event, the time from the latest event to endovascular therapy, proximal stump morphology, the number of occluded segments, and the ASITN/SIR collateral grading constructed the decision tree model can effectively predict successful recanalization after non-acute SICAO endovascular therapy.

Abstract: Objective To investigate the expression of serum C-C chemokine 22 (CCL22) and its receptor C-C chemokine receptor 4 (CCR4) in patients with chronic hepatitis B (CHB), and its correlation with liver function indicators and disease progression. Methods A total of 96 patients with CHB who were treated in Neijiang Traditional Chinese Medicine Hospital from October 2021 to November 2022 were recruited as the observation group, and divided into mild group (n=43), moderate group (n=36) and severe group (n=17) , according to the progress of the disease. In addition, 50 healthy people who underwent physical examination in the same hosiptal were selected as the control group. The levels of serum CCL22 mRNA, CCR4 mRNA and liver function indicators [alanine aminotrans-ferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB)] were measured. Pearson correlation analysis was performed to analyze the correlation between serum CCL22 and CCR4 levels and liver function indicators and disease severity, and logistic regression was applied to evaluate the factors affecting the progress of CHB patients. Results Compared with the control group, the levels of CCL22 mRNA, CCR4 mRNA, ALT, AST and TBIL in the observation group were obviously higher (P<0.05), the level of ALB was obviously lower (P<0.05); the expression levels of serum CCL22 mRNA, CCR4 mRNA, ALT, AST and TBIL in mild, moderate and severe groups increased in turn, while the expression level of ALB decreased in turn, with significant differences between groups (P<0.05); The levels of serum CCL22 mRNA and CCR4 mRNA were positively correlated with liver function indicators ALT, AST, TBIL levels, and negatively correlated with ALB level (P<0.05); Both CCL22 mRNA and CCR4 mRNA were positively correlated with the severity of the disease (r=0.646, 0.516, P<0.001); the expression levels of CCR4 mRNA, ALT, AST, TBIL and ALB were all factors affecting the development of CHB patients (P<0.05). Conclusions The expression of CCL22 and CCR4 in serum is closely related to liver function index and severity of CHB patients, which can provide reference for clinical evaluation and symptomatic treatment.

Objective:To analyze the monitoring results of skeletal fluorosis in coal-burning type endemic fluorosis areas in Guizhou Province, and evaluate the effectiveness of comprehensive treatment of coal-burning type endemic fluorosis in the affected areas.Methods:In 2009, 2014, and 2019, monitoring of skeletal fluorosis was carried out in six counties (cities, districts) of Renhuai City, Qixingguan District, Dafang County, Qianxi City, Puding County, and Pu'an County in Guizhou Province. Age stratification was conducted in each county (city, district) for permanent residents aged 25 and above, and survey subjects were selected for X-ray examination of skeletal fluorosis.Results:The detection rates of skeletal fluorosis in 2009, 2014, and 2019 were 51.48% (798/1 550), 34.88% (308/883), and 6.51% (60/922), respectively, showing a decreasing trend year by year (χ 2trend = 505.83, P < 0.001), decreased by 44.97 percentage points from 2009 to 2019. The age distribution of patients with skeletal fluorosis was mainly in the age group of 55 years and older, with annual proportions of 53.88% (430/798), 56.49% (174/308), and 78.33% (47/60), all higher than 50%. In 2009, 2014, and 2019, 483, 222 and 21 cases of mild skeletal fluorosis were detected, and 315, 86, and 39 cases of moderate to severe skeletal fluorosis were detected. There was a statistically significant difference in disease grading among different years(χ 2 = 32.63, P < 0.001). Among them, there were statistically significant differences in the grading of skeletal fluorosis in Qixingguan District, Qianxi City, Puding County, and Pu'an County(χ 2 = 14.56, 12.24, 35.01, 23.35, P < 0.05). Conclusions:The detection rate of skeletal fluorosis in Guizhou Province decreases year by year, and the prevention and control effect is significant. Patients with skeletal fluorosis are mainly in the age group of 55 years and older, and the proportion of patients with moderate to severe skeletal fluorosis is increasing. We should continue to monitor and manage the treatment of current patients with skeletal fluorosis.

Objective:To investigate the oral health knowledge awareness, attitude and behavior of children in endemic fluorosis areas of Guizhou Province, and evaluate the effectiveness of health education, so as to provide a scientific basis for improving oral health.Methods:In September 2020, 6 counties (cities and districts) were selected as survey sites from the historical fluorosis medium and severe areas in Guizhou Province. One township/village primary school was selected from each survey site to carry out health education activities for one school year. A questionnaire survey was conducted among students from grades 1 to 6 to analyze the changes in children's oral health knowledge, attitude, and behavior before and after health education and their influencing factors.Results:Before and after health education, the awareness rate of children's oral health knowledge increased from 79.22% (7 744/9 775) to 94.38% (9 169/9 715), the recognition rate of children's importance of oral health increased from 89.26% (3 490/3 910) to 95.88% (3 726/3 886), and the formation rate of children's oral health behavior increased from 62.59% (6 118/9 775) to 80.38% (7 809/9 715), with an increase of 15.16, 6.62 and 17.79 percentage points, respectively, the differences were statistically significant (χ 2 = 975.62, 15.17, 756.29, P < 0.001). The analysis of influencing factors showed that whether to stay, gender, and ethnic characteristics could significantly affect the overall score ( t = - 3.94, - 3.86, - 3.62, P < 0.001). Conclusion:The implementation of oral health education in endemic fluorosis areas in Guizhou Province has significantly improved the health knowledge, attitude and behavior of oral health among children in endemic fluorosis areas.

Objective:To investigate the awareness of iodine deficiency disorders prevention and control knowledge among residents in Guiyang City, as well as the behavioral and attitude characteristics of iodized salt consumption, and to determine the focus and direction of future health education on iodine deficiency disorders.Methods:From 0 : 00 to 24 : 00 on May 15, 2021 (the National Day for Prevention and Control of Iodine Deficiency Disorders), through the "Guizhou Disease Control" WeChat official account, the questionnaire was randomly distributed to the residents of Guiyang City who paid attention to the official account in the form of award-winning contest and returned. The survey content included general demographic data, iodine deficiency disorders prevention and control knowledge among residents and the behaviors and attitudes towards iodized salt consumption. The awareness rate of iodine deficiency disorders prevention and control knowledge among residents and the correct rate of their behaviors and attitudes towards iodized salt consumption were calculated.Results:A total of 3 078 valid questionnaires were collected in this survey. The awareness rate of iodine deficiency disorders prevention and control knowledge among residents was 51.3% (9 467/18 468), with a score of (51.26 ± 14.30) points; the correct rate of behavior and attitude towards iodized salt consumption was 93.0% (11 446/12 312), with a score of (92.97 ± 13.13) points. There was a statistically significant difference in the awareness rate of iodine deficiency disorders prevention and control knowledge among residents of different age groups (χ 2 = 23.03, P < 0.001). There were statistically significant differences in the correct rates of behavior and attitude towards iodized salt consumption among residents of different ages, ethnic groups, and professions (χ 2 = 9.66, 4.88, 24.73, P < 0.05), with lower correct rates in the ≥61 years old group, Han minority people and students. The main channels for obtaining knowledge on iodine deficiency disorders prevention and control were promotional materials (59.3%, 1 825/3 078), newspapers and magazines (56.8%, 1 747/3 078), television (56.6%, 1 743/3 078), and the internet (56.2%, 1 731/3 078). Conclusions:The correct rate of behavior and attitude towards iodized salt consumption among residents in Guiyang City is relatively high, but the awareness rate of iodine deficiency disorders prevention and control knowledge is low. We should strengthen health education for residents, especially the elderly, ethnic minorities, and students, and attach importance to promoting the safety of iodized salt and the necessity of long-term iodine supplementation.

Objective:To investigate the role and mechanism of microRNA-499 (miR-499) regulating α-myosin heavy chain (α-MHC) and β-myosin heavy chain (β-MHC) gene axis in septic myocardial dysfunction (SMD) and its significance.Methods:Sixty healthy adult male Sprague-Dawley (SD) rats were divided into phosphate buffered saline (PBS) control group (PBS group), lipopolysaccharide (LPS) induced SMD model group (LPS group), miR-499 agonist pretreatment group (agomir+LPS group), and miR-499 inhibitor pretreatment group (antagomir+LPS group) by random number table, with 15 rats in each group. SMD rat model was reproduced by intraperitoneal injection of LPS 10 mg/kg. The PBS group was intraperitoneally injected with the same amount of PBS. The two pretreatment groups were injected with agomir 30 mg/kg or antagomir 80 mg/kg through the caudal vein for 3 days, once a day. PBS group and LPS group were not pretreated. Echocardiography was detected 5 hours after LPS injection, and relevant indexes were recorded. The expression of miR-499 in plasma and myocardial tissue was detected by real-time quantitative polymerase chain reaction (qPCR). Western blotting was used to detect the protein expressions of α-MHC and β-MHC in myocardial tissue. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of heart failure, was measured by electrochemiluminescence.Results:Compared with the PBS group, the rats in LPS group were depressed. Additionally, LPS down-regulated the level of miR-499 in plasma and myocardial tissue, decreased α-MHC expression in myocardial tissue and up-regulated the expression of β-MHC. Echocardiography showed that left ventricular ejection fraction (LVEF), left ventricle fractional shortening (LVFS), cardiac output (CO), stroke volume (SV) and heart rate (HR) decreased by 49.1%, 59.2%, 48.8%, 39.4% and 15.9%, respectively, and the level of plasma NT-proBNP increased significantly in LPS group, indicating that LPS could induce cardiac dysfunction in rats. Compared with the LPS group, after pretreatment with agomir to overexpress the miR-499, LVEF and LVFS were significantly increased [LVEF: 0.662±0.020 vs. 0.323±0.024, LVFS: (36.16±1.43)% vs. (20.20±1.32)%, both P < 0.01], which suggested that the cardiac function of rats was improved in agomir+LPS group. At the same time, pretreatment with agomir significantly down-regulated the β-MHC protein expression (β-MHC/GAPDH: 0.74±0.04 vs. 2.97±0.34, P < 0.01), significantly up-regulated α-MHC protein expression (α-MHC/GAPDH: 1.59±0.05 vs. 0.74±0.14, P < 0.01), and significantly decreased the plasma NT-proBNP level (ng/L: 114.49±6.85 vs. 334.13±4.36, P < 0.01). After pretreatment with antagomir to inhibit the expression of miR-499, echocardiography showed that LVEF and LVFS were significantly lower than those in the LPS group [LVEF: 0.297±0.021 vs. 0.323±0.024, LVFS: (19.38±1.52)% vs. (21.20±1.32)%, both P < 0.01], which suggested that the cardiac function of rats was significantly inhibited. At the same time, pretreatment with antagomir significantly down-regulated α-MHC protein expression in myocardial tissue (α-MHC/GAPDH: 0.63±0.03 vs. 0.74±0.14, P < 0.01), significantly up-regulated β-MHC protein expression (β-MHC/GAPDH: 3.03±0.47 vs. 2.97±0.34, P < 0.01), and significantly increased the level of plasma NT-proBNP (ng/L: 373.91±4.23 vs. 334.13±4.36, P < 0.05). Conclusions:miR-499 could regulate the expression of α-MHC and β-MHC which improved cardiac dysfunction caused by sepsis. Targeted regulation of miR-499 expression may be an effective way to treat SMD.

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.