Objective:To explore the impact of self-disclosure on demoralization syndrome in patients with permanent enterostomy for colorectal cancer, so as to provide reference for clinical nursing interventions for those patients.Methods:From January to May 2023, convenience sampling was used to select 207 patients with permanent enterostomy for colocrctal cancer of the Wound Ostomy Clinic of Laoshan Campus of the Affiliated Hospital of Qingdao University as the research subjects. A survey was conducted on patients using the General Information Questionnaire, Distress Disclosure Index, Social Support Rating Scale, and the Demoralization Scale Mandarin Version.Results:Among 207 patients with permanent enterostomy for colorectal cancer, the scores of self-disclosure, social support, and demoralization syndrome were 35.00 (26.00, 47.00) , 32.00 (26.00, 39.00) , and 35.00 (23.00, 47.00) , respectively. A total of 128 patients (61.8%) were in moderate demoralization, and 37 patients (17.9%) were in severe demoralization. Multiple linear regression analysis showed that place of residence, self-care of stoma, self-disclosure, and social support were the influencing factors for demoralization syndrome in patients with permanent enterostomy for colorectal cancer ( P<0.05) . Conclusions:Patients with permanent enterostomy for colorectal cancer have a high overall score of demoralization syndrome, and a high proportion of patients with moderate to severe demoralization. Medical and nursing staff should focus on patients in remote rural areas and those with poor self-care abilities to stomas, develop targeted intervention measures to improve patients' negative emotions, enhance their self-disclosure, and pay attention to strengthening social support to relieve their demoralization syndrome, thereby improving their quality of life.

Objective:To analyze the effect of short collection time of digital positron emission tomography/computed tomography(PET/CT)on image quality,detected lesion and semi-quantitative parameters,and explore the feasibility of clinical application of short collection time of step by step collection mode.Methods:The digital PET/CT images of 63 subjects were retrospectively analyzed.All of them adopted PET/CT scan to conduct PET/CT examination for whole body according to the collection mode of step by step type and list-mode scan protocol.The reconstruction was implemented according to the different collection time of each bed,and they were divided into 90 s/bed group,60 s/bed group,45 s/bed group and 30 s/bed group.The 90s/bed was used as control group to compare the detection rate of the small lesion of each group("the shorter diameter of smaller radioactive concentration lesion of PET image and the lesion of CT image"was less than 0.5 cm)in PET images,and to measure the objective data of original tumor lesion,and to compare the maximum value(SUVmax),peak value(SUVpeak)and mean value(SUVmean)of standardized uptake value(SUV),noise(SD),metabolic tumor volume(MTV)and total lesion glycolysis(TLG).The signal-noise ratio(SNR),contrast noise ratio(CNR)and target-to-background ratio(TBR)were calculated and compared.The one-way analysis of variance(ANOVA test)was adopted to conduct comparison of inter groups for the image data of 4 groups.The Bland-Altman consistency test was adopted to analyze semi-quantitative parameters of intra group.The Likert 5 scores method was adopted to conduct subject evaluation for the quality of images.The Kappa test was adopted to evaluate the consistency of images.Results:The subjective scores of image quality of 4 groups were all≥3 points,and the consistency of image quality among the four groups was very well(Kappa=0.8,P<0.05).Compared with 90s/bed group,the detection rate of small lesions of other three groups were 100%.The differences of SUVmax,SUVpeak,SUVmean,SD,TLG and MTV of semi-quantitative indicators among 4 groups were not significant(P>0.05).There were significant differences in CNR,SNR and TBR of objective indicators of 18F-FDG PET image quality among 4 groups(F=31.741,34.199,12.021,P<0.001),respectively.There were no significant differences in noise between 60s/bed group and 90s/bed group,and between 45s/bed group and 90s/bed group,respectively.The noise of image of 30s/bed group appeared increase.The Bland-Altman consistent analysis of intra group basically was within 95%confidence interval(CI).Conclusions:The short collection time of step by step mode of digital PET/CT has very good clinical application.

Objective:To investigate the relations of clinical manifestations with sequence numbers detected in the cerebrospinal fluid of varicella-zoster virus (VZV) encephalitis/meningitis patients based on metagenomic next-generation sequencing (mNGS).Methods:Fifty-four VZV encephalitis/meningitis patients admitted to Department of Neurology, Harrison International Peace Hospital from January 2016 to October 2022 were selected. Sequence numbers of VZV in the cerebrospinal fluid of these patients were detected by mNGS; these patients were divided into low-detected sequence number group (≤1 000) and high-detected sequence number group (>1 000) accordingly. Differences in clinical manifestations, auxiliary examination results, treatments and prognoses were compared between the two groups.Results:Twenty-six patients were into low-detected sequence number group and 28 patients were into high-detected sequence number group. Compared with the low-detected sequence number group, the high-detected sequence number group had significantly older age (48.0 [35.5, 65.3] years vs. 63.0 [54.0, 71.8] years), higher proportion of patients using immunosuppressants (0.0% vs. 14.3%), lower proportion of those with meningeal irritation signs (46.2% vs. 17.9%), higher proportions of those with abnormal mental behaviors (15.4% vs. 42.9%), epilepsy (3.8% vs. 28.6%), and consciousness disorders (11.5% vs. 42.9%), greater cerebrospinal fluid pressure (150.0 [127.5, 177.5] mm H 2O vs. 185.0 [152.5, 210.0] mm H 2O), higher electroencephalogram positive rate (11.8% vs. 47.7%), and higher poor prognosis rate at discharge (26.9% vs. 66.7%, P<0.05). Conclusions:The clinical phenotype of the low-detected sequence number group tends to meningitis, while that of the high-detected sequence number group tends to encephalitis. Patients with high-detected sequence numbers have high cerebrospinal fluid pressure and abnormal electroencephalogram, enjoying poor prognosis.

ObjectiveUncommon medicinal herbs are valuable medicinal resources， but their identification is a difficult problem in Chinese medicine due to their particularity and complexity. It is， therefore， urgent to establish a method for the identification of uncommon medicinal herbs. In this study， DNA signature sequence （DSS） tags were used to establish a specific polymerase chain reaction （PCR） identification method for Hibisci Cortex， the origin plant of Hibisci Cortex， and its adulterants. MethodThe candidate DSS tags were obtained from the chloroplast genome sequence analysis， and the DSS tags were verified by DNA sequencing. The specific identification primers for H. syriacus were designed based on the obtained reliable DSS tags. The PCR reaction conditions were optimized， and the tolerance and feasibility were investigated. ResultA DSS tag for identification of H. syriacus was obtained from the comparison of sequencing results of the amplified products with DSS， which revealed the distinguishing characteristics of Hibisci Cortex and its adulterants. A pair of specific primers for H. syriacus was designed according to the DSS tag. After PCR amplification and gel electrophoresis with the primers， a single bright band of about 270 bp was observed from H. syriacus， which did not appear in the four adulterants. ConclusionA DSS tag obtained in this study can be used to identify H. syriacus. The specific primers designed based on this DSS tag can accurately and simply identify the original plant of Hibisci Cortex and its adulterants， which provides a new method and idea for the molecular identification of genuine and counterfeit products of Hibisci Cortex.

BACKGROUND: In the present study, a novel tissue engineering bone graft including platelet rich plasma gel (PRP gel), human umbilical mesenchymal stem cells (HUMSCs) and nanohydroxyapatite/polyamide 66 (nHA-PA66) was constructed. We explored whether the composite scaffolds could enhance the angiogenesis and bone repair capacity in rat femoral large bone defect (LBD). This study aimed to provide evidence for the clinical application of the composite scaffold in LBD treatment. METHODS: PRP was prepared, the platelets and growth factors were measured. HUMSCs were isolated and identified.the osteogenic capacity of PRP in vitro was measured. Then HUMSCs-PRP-gelHA-PA66 composite scaffolds were synthesized and observed. The proliferation and osteogenesis differentiation of HUMSCs on the composite scaffold was measured. The angiogenic capacity of PRP in vitro was measured by capillary-like tube formation assay. Finally, the angiogenesis and bone repair capacity of the composite scaffolds was measured in rat LBD. RESULTS: PRP contained high level of platelets and growth factors after activation, and promoted osteogenic and angiogenic differentiation in vitro. The HUMSCs-PRP-gelHA-PA66 composite scaffold was porosity and promoted the proliferation and osteogenesis differentiation of HUMSCs. At 12th weeks, more micro-vessels and new bone were formed around the composite scaffolds compared with other groups, the defect was almost repaired. CONCLUSION Our study for the first time identified that the combination of PRP gel, HUMSCs and nHA-PA66 scaffold could significantly promote angiogenesis and bone regeneration in rat LBD, which may have implications for its further application in clinical LBD treatment.

OBJECTIVE：To compare the protective effect of atomization inhalation and intraperitoneal injection of edaravone on acute lung injury in smoke inhalation lung injury model rats. METHODS ：Thirty male SD rats were divided into normal control group（group A ），injury group （group B ），intraperitoneal injection group （group C ），low-dose aerosol inhalation group （group D），high-dose aerosol inhalation group （group E ）according to random numble table ，with 6 rats in each group. Group B-E were placed in smoke generator containing pine sawdust to induce smoke inhalation lung injury model. In group A ，the operation was the same as above except that the pine sawdust was not placed. Thirty minutes after modeling ，group C were injected intraperitoneally with edaravone 18 mg/kg（every 70 min，4 times in total ）. Group D and E inhaled edaravone 9，1.8 mg/kg（every 60 min，lasting for 10 min each time ，4 times in total ）. The rats were treated by no means in group A and group B. Six hours after last medication，arterial blood gas analysis was performed ，and the lung wet to dry ratio （W/D）and water content of lung tissue were calculated. The levels of TNF-α，IL-6 and IL- 10 in serum were detected by double antibody ELISA. The contents of MDA ，MPO， SOD and Caspase- 3 in lung tissue were determined by ELISA and other methods. HE staining was used to observe the pathological changes of lung tissue. The apoptotic rate of cells in lung tissue were determined by TUNEL assay. RESULTS ：No abnormality was found in lung tissue of group A ；in group B ，hemorrhage and edema were found in lung tissue ，alveolar structure was difficult to identify，and inflammatory cells and red blood cell infiltration were seen. Above symptoms of rats in group C-E were improved to different extent. Compared with group A ，PaO2/FiO2 and SOD content of lung tissue were decreased significantly in other groups （P＜0.05）；water content of lung tissue ，W/D，serum contents of TNF-α，IL-6 and IL- 10，the contents of MDA ，MPO and Caspase-3 in lung tissue ，apoptotic rate were increased significantly （P＜0.05）. Compared with group B ，PaO2/FiO2 and serum contents of IL- 10 were increased significantly in administration groups （P＜0.05）；water content of lung tissue ，W/D，serum contents of TNF-α and IL-6，the contents of MDA ，MPO and Caspase- 3 in lung tissue ，apoptotic rate were significantly decreased，in dose-dependent manner （P＜0.05）. CONCLUSIONS ：Edaravone has a certain protective effect on smoke inhalation lung injury model rat. It can reduce the production and release of inflammatory mediators and/or cytokines ，reduce the peroxide damage and inhibit cell apoptosis in a dose-dependent manner. The effect of atomization inhalation is more obvious than that of intraperitoneal injection.

RANKL/RANK/OPG axis is important in bone metabolism regulation, and becomes a popular research area in bone diseases. RANKL is a critical part of RANKL/RANK/OPG axis, and widely required in bone metabolism research. However, the yield of recombinant soluble human RANKL (hRANKL) in Escherichia coli is much lower than mouse RANKL (mRANKL). In this study, by adjusting and stabilizing the pH value of LB medium at 7.5, lowering the inducing temperature to 16 ℃ and optimizing the lysis program, the yield of soluble hRANKL increased by approximately 5 to 12-fold over the non-adjusted group. Our experiment effectively enhanced soluble hRANKL expression in E. coli and might constitute a meaningful attempt to obtain soluble expression of recombinant protein in E. coli.

OBJECTIVE:To study the metabolites,distribution,metabolic type and the possible activity of harpagide which is the active component from Scrophularia ningpoensis in rats in vivo. METHODS:4 SD rats were divided into blank group (ul-tra-pure water) and administration group (harpagide reference solution),2 in each group,ig,160 mg/kg,twice a day,for 3 d. Urine and feces were collected every 12 h before administration and the first administration;sample blood 8 mL was taken after 0.5,1 h of last administration;heart,liver,spleen,lung,kidney,stomach and small intestine were taken. The blood,urine,fe-ces and other tissue solutions were prepared,HPLC-MS was conducted to detect and identify the harpagide metabolites in rats in vi-vo and presume metabolic pathways,and PharmMapper software was used to predict metabolites activity. RESULTS:12 harpagide metabolites were identified in rats in vivo,the form of prototypes and metabolites were distributed in heart,liver,spleen,lung, kidney,stomach and small intestine. The metabolic type mainly included hydrolysis,dehydration,reduction,methylation,sul-fation,glucuronic acid binding,grade A coumaric acid binding,etc. The 12 compounds may have activities in the treatment of epi-lepsy,amyotrophic lateral sclerosis,diabetes,stroke,etc. CONCLUSIONS:Harpagide may be effective in the form of prototypes and metabolites. The study has provided basis for attributing the origins of metabolite,studying the effective form of S. ningpoensis clarifying its pharmacological mechanism and processing mechanism.

Objective To evaluate the value of CTA in assessing congenital heart disease and related heterotaxy syndrome.Methods A total of 20 patients with congenital heart disease and heterotexy syndrome underwent CTA and 3-dimensional reconstructions.And intracardiac and extracardiac abnormalities were assessed.Results Three cases were left isomerism,two of which were bi-lobed left lungs and trilobed right lungs,and another one was bi-lobed lungs.The most common associated cardiovascular anomalies included single ventricle (n=2),atrial septal defect (n=2),ventricular septal defect (n=1),transposition of the great arteries (n=2),pulmonary artery stenosis (n=2),atresia (n=1),persistent left superior vena (n=1),no hepatic segment of inferior vena cava (n=1).The rest 17 cases were right isomerism.All of them were trilobed lungs.Associated cardiovascular anomalies included single ventricle (n=9),double outlet of right ventricle (n=2),endocardial cushion defect (n=6),atrial septal defect (n=10),patent foramen ovale (n=1),ventricular septal defect (n =8),transposition of the great arteries (n =14),pulmonary artery stenosis (n =16),atresia (n =1),pulmonary venous drainage (n=6),persistent left superior vena (n=7),no hepatic segment of inferior vena cava (n=2).Conclusion CTA can clearly show the structure of heart,great vessels,chest and abdomen which is a useful tool to accurately assess congenital heart disease and related heterotaxy syndrome for medical or surgical management.

Objective To explore the clinical application value of left atrial function with feature tracking cardiac magnetic resonance imaging (FT-CMR) by evaluating preliminarily left atrial strain and strain rate in patients with atrial fibrillation. Methods Thirty patients with paroxysmal atrial fibrillation, thirty patients with persistent atrial fibrillation and twenty-two healthy subjects were enrolled. All the subjects underwent cardiac magnetic resonance imaging with the real steady-state free precession(SSFP) sequence. FT-CMR parameters included left atrial strain and strain rate parameters, left atrial volume and function parameters were detected by using offline cardiovascular analysis software, respectively. Left atrial strain and strain rate parameters included left atrial total strain(Εs), passive strain(Εe), active strain(Εa), peak positive strain rate(SRs), peak early negative strain rate(SRe)and peak late negative strain rate(SRa). Volume and function parameters included maximum of left atrial volume(LAVmax), minimum of left atrial volume(LAVmin), total left atrial emptying fraction(LATEF), passive left atrial emptying fraction(LAPEF)and active left atrial emptying fraction(LAAEF). The differences in the general data among the paroxysmal atrial fibrillation group, the persistent atrial fibrillation group and the control group were compared by usingχ2 test or ANOVA analysis. The differences in all parameters between the atrial fibrillation group and the control group, the paroxysmal atrial fibrillation group and the persistent atrial fibrillation group were compared by using independent t test. Left atrial strain and strain rate parameters on an intra-observer and inter-observer were determined by intraclass correlation coefficient(ICC)analyses. Results Compared to control group, LAVmax and LAVmin in atrial fibrillation group were significantly increased(t=9.737,7.889,P<0.001);The LATEF and LAPEF had no significant difference, the LAAEF in two groups had statistically significant difference(t=-4.762,P<0.001).The absolute value of Es, Ee, Ea, SRs, SRe, SRa in atrial fibrillation group were significantly reduced than in control group(t=-7.732,-6.610,-6.493,-7.546, 6.864, 5.917,P<0.001). Compared with paroxysmal atrial fibrillation group, LAVmax and LAVmin in persistent atrial fibrillation group were increased obviously, LATEF and LAPEF were significantly decreased, and the differences were statistically significant(t=-4.575,-5.524, 4.002, 4.028,P<0.001).The LAAEF in two groups had no statistically significant difference. Compared with strain and strain rate in two groups, absolute value of Es, Ee, Ea, SRs, SRe, SRa in persistent atrial fibrillation group significantly decreased than in paroxysmal atrial fibrillation(t=4.310, 3.128, 4.465, 5.496,-3.290,-3.863,P<0.001). The intra-group and inter-group had well correlation coefficients between the observers in the left atrial strain and strain rate parameters of the subjects(ICC=0.85—0.94,0.81—0.90). Conclusions FT-CMR technique can be used to assess the left atrial strain and strain rate in patients with atrial fibrillation;Left atrial reservoir, conduit and booster-pump functions in patients with atrial fibrillation were impaired. Patients with persistent atrial fibrillation had worse left atrial function throughout the entire cardiac cycle compared with those with paroxysmal atrial fibrillation.