Diarrhea-predominant irritable bowel syndrome （IBS-D） is a common digestive system disease with high prevalence and recurrence rates for years， high treatment costs， and serious impacts on patients' quality of life and economic burden. Therefore， it is important to explore new and safe treatment methods. The pathogenesis of IBS-D is complex， in which the gut-brain axis is a key factor. The gut-brain axis， a bidirectional signaling pathway connecting the gastrointestinal tract and the central nervous system， regulates gastrointestinal motility， secretion， and immune responses， playing a key role in the occurrence and development of IBS-D. Up to now， antidiarrheal agents， probiotics， and neurotransmitter modulators are the main methods for the clinical treatment of IBS-D. Although they can partially curb the progression of this disease， the therapeutic effects remain to be improved. Studies have confirmed that traditional Chinese medicine （TCM） has significant advantages in the treatment of IBS-D since it can regulate the gut-brain axis via multiple pathways and targets to improve the gastrointestinal motility and strengthen immune defenses. However， there is a lack of systematic reviews on the regulation of the gut-brain axis by TCM in the treatment of IBS-D. Based on the review of IBS-D-related articles published in recent years， this paper systematically summarized the relationship between the gut-brain axis and IBS-D and the role of TCM in the treatment， providing new ideas for the treatment of IBS-D.

Objective:To explore the antibacterial performance and mechanism of reticulated cruciform DNA nanomachines mimicking neutrophil extracellular traps (NETs).Methods:In this study, a cross-shaped DNA nanostructure was synthesized using the one-step method to form a network under the polymerization of magnesium ions. The network was used as a template for inlaying reduced Cu 0 to form reticulated DNA-templated copper nanoclusters (CuNPs). The cruciform DNA formation process was characterized by polyacrylamide gel electrophoresis (PAGE). The reticulated cruciform DNA nanomachine was characterized by atomic force microscopy (AFM) and energy dispersive spectrometer (EDS). The optimal concentrations of Cu 2+, Mg 2+and DNA in the reticulated cruciform DNA nanomachine was determined by plate coating experiments. The antibacterial performance of the reticulated cruciform DNA nanomachine against Escherichia coli ( E. coli), Staphylococcus aureus and Klebsiella pneumoniae was verified by plate coating experiments. The aggregation effect of E. coli was evaluated by crystal violet staining, and the changes on the membrane surface of E. coli were observed by scanning electron microscopy (SEM), in order to explore the antibacterial mechanism of the reticulated cruciform DNA nanomachine. Results:PAGE showed that the band migration distance of the four DNA strands was the smallest after co-incubation. AFM showed that the DNA structure was reticulated and evenly distributed, and the Cu, Mg, and P elements coexisted in the structure. The optimal concentrations of Cu 2+, Mg 2+, and DNA required for the synthesis of the reticulated cruciform DNA nanomachine were 1 mmol/L, 100 mmol/L, and 20 μmol/L, respectively. The reticulated cruciform DNA nanomachine had the ability to inhibit E. coli, Staphylococcus aureus and Klebsiella pneumoniae, with survival rates of 39.72%, 43.56% and 60.57%, respectively. The reticulated cruciform DNA nanomachine had an aggregation effect on E. coli. The surface of the bacterial film exhibited shrinkage and fractures. Conclusion:The reticulated cruciform DNA nanomachine constructed in this study can aggregate E. coli, leading to the shrinkage and fracturing of the bacterial film, and exhibiting antibacterial effects.

Objective:To observe the clinical efficacy of Qingzhenfang for plasmoby （chronic urticaria）， and to investigate its effect on cellular immune function. Method:One hundred and thirty-two cases patients were divided into control group and observation group evenly according to random number table. The 60 patients in control group finished the study because of 6 cases of dropout， loss of follow-up and withdrawal， and 62 patients in observation group finished the study. Patients in both groups got Yiebastine tablets， 10-20 mg/time， 1 time/day. Patients in control group additionally got Piminxiao capsule， 4 grains/time， 3 times/day， while patients in observation additionally got Qingzhenfang， 1 dose/day. The treatment continued for 8 weeks in both groups. Before the treatment， and at the second， fourth， and eighth week after treatment， scores of urticaria activity for 7 days （USA7） and total symptom score （TSS） were graded. Before and after treatment， scores of chronic urticaria quality of life scale （CU-Q2oL） and syndrome of rheumatic fever were graded. A follow-up of 3 months was conducted for the patients whose score of USA7 was less than 7 to record the recurrence. Complement 3 and 4 （C3， C4）， CD4⁺， CD8⁺ cells were detected， and Th17/ CD4⁺ and Treg/ CD4⁺， CD4⁺/CD8⁺ and Th17/Treg were calculated. Levels of peripheral blood interleukin-10 （IL-10）， IL-17 and IL-23 were detected， and safety was evaluated after the treatment. Result:At the second， fourth and eighth week after the treatment， scores of USA7， TSS， CU-Q2oL and syndrome of rheumatic fever in observation group were lower than those in the control group （P<0.01）. Levels of C3， C4， CD4⁺， Treg， CD4⁺/CD8⁺and IL-35 in observation group were higher than those levels detected in control group （P<0.01）， while levels of CD8⁺， Th17， Th17/Treg， IL-10， IL-17 and IL-23 were lower than those in the control group （P<0.01）. Recurrence rate was 25.58% （11/43） in observation group， lower than 48.48% （16/33） in control group （χ2=4.276， P<0.05）， and the clinical efficacy in observation group was superior to that in control group （Z=2.021， P<0.05）. Conclusion:Yaoyi Qingzhenfang can control the degree of disease and improve the quality of life for patients with chronic urticaria， with superior clinical efficacy. In addition， it can reduce recurrence rate， increase the levels of C3， C4， regulate cellular immune function， and reduce immune inflammatory response， so it is worthy of further clinical research and use.

Objective: A graded response system based on pediatric early warning score (PEWS) was constructed to provide a scientific basis for clinical intervention and management by clinical nurses. Methods: Domestic and foreign literature and the results of previous research were reviewed to build a preliminary framework of graded response strategies. Two rounds of expert consultation were conducted by Delphi method and the results were statistically analyzed. Meanwhile, the results were integrated into the electronic medical record system to form the PEWS grading response system. Results: The positive coefficient of experts in the first and second rounds of consultation both were 15/15, and the average of the expert authority coefficient was 0.87 and 0.89 respectively. The expert coordination degree Kendall′s W value was 0.292 and 0.301 respectively (P<0.05), indicating that the experts′ opinions tended to be consistent. Finally, four segmented response systems were formed, with PEWS scored on the scale of 0-1, 2, 3 and 4 or single 3 points. Conclusions The graded response system based on pediatric early warning score constructed by using Delphi expert consultation method can be used in clinic, which can promote the nurses′ participation in clinical intervention decision-making and improve the quality of nursing.

OBJECTIVETo observe the effects of low-intensity pulsed ultrasound (LIPUS) pretreatment on pulmonary expression of high mobility group box-1 (HMGB1) in a rat model of lung ischemia-reperfusion (IR).

METHODSThirty-two male SpragueDawley rats weighing 250-300 g were randomly divided (=8) into sham-operated group, lung IR group, LIPUS pretreatment group and pretreatment with α7-nicotinic cholinergic receptor (α7nAChR) antagonist group. In the sham-operated group, the left pulmonary hilum was dissociated without occlusion; in the other 3 groups, the left pulmonary hilum was occluded for 45 min followed by reperfusion for 180 min; LIPUS pretreatment for 30 min and intraperitoneal injection of methyllycaconitine (2 mg/kg), an α7nAChR antagonist, were administered before the operation. The wet/dry weight ratio (W/D) and pulmonary permeability index (LPI) of the lung tissue were measured, and the lung histopathology was observed and scored. The contents of interleukin-1 (IL-1) and IL-6 in the lung tissues were measured using ELISA, and the pulmonary expression of HMGB1 protein was detected using immunofluorescence assay and Western blotting.

RESULTSCompared with those in the sham-operated group, the W/D of the lung tissue, LPI, pathological scores, IL-1 and IL-6 contents in the lung tissue, and pulmonary HMGB1 expression all significantly increased in the other 3 groups ( < 0.05). LIPUS preconditioning significantly lowered the W/D values, LPI, pathological score, IL-1 and IL-6 contents and HMGB1 expression in the lung tissues following lung IR, and these effects were significantly inhibited by administration of methyllycaconitine.

CONCLUSIONSLIPUS preconditioning can reduce lung IR injury possibly by activating α7nAChR-dependent cholinergic anti-inflammatory pathway to reduce lung tissue HMGB1 expression.

Objective To discuss the influence of special nursing intervention for the quality of life of outpatients with chronic pelvic inflammatory disease. Methods Divided 80 patients into the observation group and the control group randomly, there were 40 cases in each group. Routine nursing, treatment and disease-related lecture were used in both the groups, while the combined therapy of Chinese and Western medicine was used in the observation group in addition. Evaluated the quality of life and the effects of treatment by the World Health Organization′s quality of surviving chart between the two groups after 3-month intertention and 6-month follow-up. Results The scores of quality of environment field, physiology field ,psychological field, sociological field, independence field and mental field in the observation group was (70.33+16.85 ) (70.38+18.80), (71.43+18.28),(70.13+19.08), (73.10+17.70) and (75.38+7.30) respectively, while in the control group was (61.38+16.17), (56.70+17.69), (43.13+19.77), (55.00+19.08), (53.75+16.45) and (49.80+17.26) respectively, the difference between the two groups was significant, the t values were 2.424-8.631, P < 0.05. The effective rate of treatment in the observation group was 95.00%(38/40), while in the control group was 82.5%(33/40), the difference was significant, U=2.507, P < 0.05. Conclusions Special nursing intervention can promote the quality of life ,effects of treatment and the satisfaction of treatment in outpatients with chronic pelvic inflammatory disease, improve their psychological state and the compliance.

Objective To investigate effect of sorafenib on serum hepatoma marker in patients with advanced hepatocellular carcinoma. Methods 101 patients with advanced hepatocellular carcinoma were selected, and divided into two groups.50 cases in control group were treated with routine clinical treatment, and 51 cases in experimental group were treated with sorafenib on the basis of control group.The survival time, adverse reactions, VEGF, CTGF, HIF-1 and OPN levels were compared after the treatment.Results The survival time of experimental group was higher than control group (P<0.05).Compared with control group, the serum levels of VEGF、CTGF,HIF-1, OPN,AFP, CEA, and CA199 in experiment group were lower (P<0.05,P <0.01).There were no significant differences of total adverse reactions between experimental group and control group. Conclusion Sorafenib can effectively prolong survival time of patients with advanced hepatocellular carcinoma, reduce serum VEGF, CTGF, HIF-1 alpha and OPN levels.

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.

Objective:To observe the clinical effect of deep insertion at Tianshu(ST 25)for colonic slow transit constipation(STC).Methods:120 cases of STC patients were randomly divided,60 cases in a deep insertion group,30 cases in an electroacupuncture group and 30 cases in a medication group by 2:1:1 ratio.The deep insertion group was treated with deep insertion at Tianshu(ST 25).The electroacupuncture group was treated with routine insertion at Tianshu(ST 25).The medication group was treated with oral administration of Lactulose oral liquid.The first voluntary defecation time,and constipation scores before the treatment,four weeks after the treatment and relevant scores of clinical symptoms were assessed in the three groups of the patients.Results:The scores of the clinical symptoms in improvement of constipation were better in the deep insertion group than in the electroacupuncture group and medication group,with differences in statistical significance(P<0.01).The unsuccessful numbers in the improvement of defecation and abdominal pain were also better in the deep insertion group than in the other two groups,and better in instant effect in the deep insertion.Conclusion:The improvement of STC clinical symptoms was better by deep insertion at Tianshu(ST 25)than by medication and routine acupuncture method at Tianshu(ST 25).

Objective To observe the relationship between morphological and hemodynamic changes of female internal genital organs in the patients with hypomenorrhea with transvaginal color Doppler ultrasound (TVCDS). Methods Thirty female patients with hypomenorrhea of unknown origin were studied, and 30 healthy women of eumenorrhea aged 20 to 40 years were selected as control group. The size and shape of uterus, ovaries, and the thickness of endometria of uterus were observed with TVCDS in follicular phase, ovulation phase, luteal phase and luteal atrophy phase, respectively. Hemodynamic parameters of ovarian artery, uterus artery and their branches were measured. At the same time, hormones of female were examined in 30 patients in follicular phase, ovulation phase and luteal atrophy phase, respectively. Results ①No difference of the size of uterus and ovaries, the thickness of endometria and the amount of egg follicles was found between two groups (P＞0.05). ②Compared with that in the control group, type C of endometria increased in hypomenorrhea group (P＜0.05). ③RI, PI and S/D of spiral arteries in hypomenorrhea group were higher than those in control group, but no significance in these parameters of uterine arteries, arcuate arteries and radiate arteries was found. RI of uterine arteries, arcuate arteries and radiate arteries decreased successively. ④RI, PI and S/D of ovarian arteries in hypomenorrhea group was higher than those in control group in ovulation phase (P＜0.05). Conclusion Reduction in blood supply of ovary and endometria may be the causes of hypomenorrhea with unknown origin. TVCDS can be used as a conventional examination method for these patients.