Objective:To explore the effectiveness of the Shewhart control chart-based assessment and early warning system in prevention of medical device-related pressure injury(MDRPI).Methods:152 critically ill patients admitted to Hebei Central Hospital from January 2020 to December 2021 were selected and divided into a control group and an observation group based on different methods of assessing MDRPI risk,with 76 cases in each group.The control group adopted the Braden scale to assess the risk of MDRPI.The observation group adopted a safety early warning system based on Shewhart control charts to assess the risk of MDRPI in patients.Nursing measures were undertaken according to MDRPI risk grade in both groups.The occurrence of adverse events of MDRPI,nursing safety quality and nursing comprehensive quality were compared between the two groups.Results:The incidence rate of head,neck and face adverse events of MDRPI and the total incidence of adverse events of MDRPI of the patients in the observation group were lower than those in the control group(x2=4.802,5.758,P<0.05).The safety quality and comprehensive quality of nursing of 20 nurses in the observation group were higher than those in the control group(t=6.654,7.172,P<0.05).Conclusion:The application of assessment and early warning system based on Shewhart control chart in clinical nursing management can effectively reduce the incidence of MDRPI adverse events and improve the quality of nursing safety and comprehensive nursing.

AIM:To investigate the impact of hippocampal protein phosphatase 1 regulator subunit 17(Ppp1r17)down-regulation on drinking-related behavior in mice,and to explore the protein kinase B(PKB/AKT)/glyco-gen synthase kinase-3β(GSK-3β)/cAMP response element binding protein(CREB)signaling pathway of Ppp1r17 in the development of alcohol dependence.METHODS:Forty male C57BL/6J mice were randomly divided into four groups(n=10):control group,shPpp1r17① group,shPpp1r17② group and shPpp1r17③ group.The mRNA and protein expression levels in the hippocampal tissues were evaluated after 3 weeks of AAV-shPpp1r17 injection.Twenty male C57BL/6J mice were randomly divided into a control group and a shPpp1r17 group(n=10).An open-field test,conditioned place prefer-ence(CPP)test and righting reflex test were performed.Furthermore,the localization and expression of AAV-shPpp1r17 were detected after 3 weeks of AAV-shPpp1r17 injection.Twenty male C57BL/6J mice were randomly divided into four groups(n=5):the empty virus+water group,the empty virus+EtOH group,the shPpp1r17+water group and the shPpp1r17+EtOH group.The EtOH group mice drank 9%alcohol continuously for 30 d.The protein expression levels of Ppp1r17,p-AKT,AKT,p-GSK-3β,GSK-3β,p-CREB and CREB were detected by Western blot.RESULTS:(1)The results of qPCR showed that Ppp1r17 was successfully suppressed by shPpp1r17.(2)The behavioral results showed that the shPpp1r17 group mice exhibited enhanced exercise ability and reduced anxiety-like emotions,and the downregulation of Ppp1r17 increased CPP scores and reduced the sensitivity of the mice to alcohol.(3)Immunofluorescence showed that AAV-shPpp1r17 was specifically expressed in the hippocampus.(4)Western blot analysis revealed that Ppp1r17 and the p-AKT/AKT,p-GSK-3β/GSK-3β and p-CREB/CREB ratios were significantly increased after treatment of EtOH.Howev-er,the protein expression of Ppp1r17 was significantly reduced,and the AKT/GSK-3β/CREB pathway was activated after knockdown of Ppp1r17 in the hippocampus.CONCLUSION:Ppp1r17 may suppress CREB phosphorylation through the AKT/GSK-3β/CREB pathway,thereby influencing alcohol drinking preference and locomotor behavior in mice.

Objective:To investigate effect of neferine(NeF)on myocarditis in heart failure(HF)rats by regulating CC-che-mokine ligand 2/CC chemokine receptor 2(CCL2-CCR2)signaling axis.Methods:HF rat model was constructed by ligating left ante-rior descending branch,and randomly separated into HF group,different doses of NeF groups(5 mg/kg,10 mg/kg,20 mg/kg),20 mg/kg NeF+CCL2 group,another 10 rats without ligating left anterior descending branch were regarded as sham surgery group.After treatment,cardiac function[left ventricular end systolic diameter(LVESD),ejection fraction(EF),left ventricular ejection fraction(LVEF)]were evaluated.Serum indicators[brain natriuretic peptide(BNP),IL-1β,N-terminal B-type natriuretic peptide(NT-pro BNP),TNF-α]were detected.Myocardial tissue was isolated and expressions of TNF-α and IL-1β,pathological damage,collagen deposition,expressions of CCL2 and CCR2 proteins were detected.Results:Compared with sham surgery group,HF group showed a decrease in myocardial cells,infiltration of inflammatory cells,and severe deposition of collagen fibers,LVESD,serum BNP,NT-pro BNP,TNF-α,IL-1β levels,myocardial tissue TNF-α,IL-1β expressions,collagen area ratio,CCL2,CCR2 protein expressions were greatly increased,LVEF and EF were greatly decreased(P<0.05).Compared with HF group,central muscle tissue damage and collagen fiber deposition were reduced in different doses of NeF groups,LVESD,serum BNP,NT-pro BNP,TNF-α,IL-1β levels,myocardial tissue TNF-α,IL-1β expressions,collagen area ratio,CCL2,CCR2 protein expressions were greatly decreased,LVEF and EF were greatly increased,with differences between groups(P<0.05).After CCL2 intervention,compared with 20 mg/kg NeF group,myocardial tissue damage and collagen fiber deposition were worsened,LVESD,serum BNP,NT-pro BNP,TNF-α,IL-1β levels,myocardial tissue TNF-α,IL-1β expressions,collagen area ratio,CCL2,CCR2 protein expressions were greatly increased,LVEF and EF were greatly decreased(P<0.05).Conclusion:NeF regulates CCL2-CCR2 signaling axis,inhibits myocar-ditis in HF rats,and improves cardiac function.

Objective We investigated the effects of ICAM5 in the hippocampus on the alcohol drinking preference of mice,and the potential mechanisms.Methods An alcohol two-bottle choice model was developed in 8-week-old male C57BL/6J mice,which were randomly divided to two groups:water group and alcohol group.The protein expression of ICAM5 in the hippocampus,amygdala,and medial prefrontal cortex was detected.An ICAM5-overexpressing adeno-associated virus was constructed and injected into the hippocampus by stereotaxic method.The expression level of ICAM5 protein in the hippocampus was detected by immunofluorescence and Western blot.We then detected the alcohol preference and locomotor activity of mice with a conditioned place preference(CPP)experiment,open field test,and loss-of-righting reflex test.Western blot analysis was used to identify the neuron F-actin/G-actin ratio.Using Golgi staining,the morphology of dendritic spines was identified.Results The expression of ICAM5 in the hippocampus of alcohol two-bottle choice model mice in the alcohol group was considerably lower than that of the water group(P＜0.001).The specific expression of ICAM5 in the hippocampus of mice was observed by fluorescence microscopy.In the open field experiment,the staying time and moving distance of the AAV-ICAM5 group were significantly increased compared with those of the control group(P＜0.01).In the CPP experiment,the residence time of AAV-ICAM5 mice in the alcohol-paired compartment was significantly lower than that of control mice(P＜0.001).In the loss-of-righting reflex experiment,overexpression of ICAM5 significantly reduced sedation latency(P＜0.01),but significantly shortened the duration of sedation(P＜0.001).Compared with AAV-mCherry+Water group,the ratio of F-actin/G-actin in the hippocampus was significantly increased after drinking(P＜0.01),but after ICAM5 overexpression,their F-actin/G-actin ratio was significantly decreased(P＜0.001).Compared with AAV-mCherry+Water group,the density of dendritic spines in the hippocampal CAI region was increased(P＜0.001),but the density of dendritic spines in the AAV-ICAM5+Alcohol group was significantly decreased(P＜0.01).Conclusions ICAM5 modulated the expression of cytoskeleton proteins to change the structural plasticity of dendritic spines,which contributed to alcohol-drinking and locomotor behavioral changes in mice.

Objective To investigate the application value of ultrasonic measurement of optic nerve sheath diameter (ONSD) in patients with craniocerebral trauma. Methods A total of 100 patients with craniocerebral trauma were selected as research subjects and randomly divided into control group and study group, with 50 patients in each group. Patients in the control group received invasive intracranial pressure (ICP) monitoring, while patients in the study group received invasive ICP monitoring combined with ultrasonic measurement of ONSD. Both groups were treated according to their actual conditions. The general information and treatment status of the two groups were observed, and the general information, ICP monitoring results, and ONSD ultrasonic measurement results of different ICP patients in the study group were compared. The correlation between ONSD and ICP in patients with craniocerebral trauma was analyzed, and the diagnostic efficacy of ONSD for ICP elevation in patients with craniocerebral trauma was also analyzed. Results At 28 days after treatment, the mean arterial pressure of the study group was higher than that of the control group, while the heart rate and respiratory rate were lower than those of the control group(P < 0.05). The mechanical ventilation time and ICU stay of the study group were shorter than those of the control group, the amount of mannitol used was less than that of the control group, and the ICP and 28-day mortality rate after treatment were lower than those of the control group (P < 0.05). Patients with ICP≥22 mmHg had higher ICP than those with ICP < 22 mmHg, and ONSD before and after the use of mannitol in different positions was greater than that in the ICP < 22 mmHg group (P < 0.05). There was a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma (r=0.723, P < 0.001). The results of receiver operating characteristic curve analysis showed that the optimal cutoff value of ONSD for diagnosing ICP elevation was 5.25 mm, and the area under the curve was 0.879. Conclusion The combination of ICP monitoring and ultrasonic measurement of ONSD in the treatment of patients with craniocerebral trauma can effectively improve patients' vital signs, shorten the duration of mechanical ventilation and ICU stay, reduce the amount of mannitol used, and reduce the 28-day mortality rate. There is a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma, and ONSD has a high diagnostic efficacy for ICP elevation.

Objective To investigate the underlying mechanism of Huayu Xiaozheng granule(HYXZ)in the treatment of ectopic pregnancy(EP).Methods The potential ingredients and targets of HYXZ were identified and screened.PPI network,GO enrichment and KEGG pathway analysis were established to understand the potential and intricate mechanism of HYXZ in treating EP.The effects of HYXZ on HTR-8/SVneo cells migration and invasion were detected by wounding healing assay and transwell migration assay respectively,as well as the influence of HYXZ granule on JAK/STAT pathway and associated proteins were assessed by western blot under the control of JAK/STAT pathway inhibitor and agonist.Results A total of 375 active ingredients,45 known targets and 207 predicted targets of HYXZ were obtained.A PPI network has constructed to know the relationship of 252 common targets of drug targets and disease targets,from which we screened out 15 key targets:STAT3,MMP9,TLR4,HIF1A and others.Scratch test showed that HYXZ inhibited the migration of the HTR-8/SVneo cells cells in a time and dose-dependent manner;Transwell test showed that the number of transmembrane cells decreased significantly(P<0.05)after 48 h with various concentrations of HYXZ;Western blot experiment showed that the expression of JAK/STAT pathway protein decreased significantly(P<0.05);and the expression of its related proteins uPA,HIF1and N-cadherin were inhibited(P<0.05),the tendency of which was consistent with the inhibitor AG490,but opposite to the agonist IL-6.Conclusion HYXZ inhibited JAK/STAT pathway,and associated proteins uPA,HIF1A and N-cadherin,thereby suppressing the mobility and invasiveness of the HTR-8/SVneo cells,which is conductive to clarify the mechanism of HYXZ in the treatment of early EP.

Humans ; Herpesvirus 4, Human ; Wiskott-Aldrich Syndrome ; Epstein-Barr Virus Infections/complications* ; Smooth Muscle Tumor/therapy* ; Hematopoietic Stem Cell Transplantation

Patients with radioactive enteritis generally have certain intestinal microecological imbalance. Traditional Chinese Medicine (TCM) has showed good advantage in regulating intestinal microbial flora. In clinical practice, patients are treated based on syndrome differentiation of heat toxin damaging collaterals, cold-heat mixed syndrome, spleen deficiency and dampness stagnation, spleen and kidney yang deficiency, yin deficiency and body fluid deficiency. The Baitouweng Decoction, Wumei Pill, Sijunzi Decoction are the common prescriptions. TCM can promote the balance of intestinal microecology and treat digestive diseases such as radioactive enteritis, by improving the abundance of intestinal flora, inhibiting the level of inflammatory cytokines, and playing the role of probiotics and immune regulation.

Objective:To explore the characteristics, diagnosis, and treatment of precursor B-cell acute lymphocytic leukemia with C- MYC rearrangement (preBLL) in children. Methods:The clinical data in 2 cases of childhood preBLL in Department of Hematology, Children′s Hospital Affiliated to Capital Institute of Pediatrics in June and August 2019 were summarized and analyzed.Results:Both cases were acute lymphoblastic leukemia with precursor B-cell immunophenotype.Hepatosplenomegaly and peripheral white blood cells were significantly increased, and the morphology of bone marrow was L3. C- MYC rearrangement was discovered by cytogenetic tests.Both children have received the treatment of the mature B-cell tumor protocol (FAB/LMB96), and early remission was developed in 1 case with TP53 gene mutation but relapsed thereafter and died finally.Another case had reached sustained complete remission after treatment. Conclusions:Children with preBLL is rare, and routine C- MYC rearrangement should be performed in children with Precursor B-cell lymphoblastic leukemia whose morphology of bone marrow was L3.Its treatment needs to be further studied, and multi-center clinical trials need to be actively conducted to analyze and summarize large numbers of cases to identify effective protocol and improve the prognosis.

Objective:To explore a method of improving the nursing service ability after total hip arthroplasty (THA) among nurses in villages and towns medical health institutions under the county medical community model and to evaluate its effects.Methods:From June 1 2018 to September 30 2019, we took Department of Orthopedics, Dazhu County People's Hospital of Dazhou of Sichuan Province, as the core, and united with county medical community built by villages and towns medical health institutions with the country in organizing the nursing theoretical knowledge and specialist service ability training after THA for 140 nurses of villages and towns medical health institutions within county medical community. Before and after training, we carried out the theoretical test and practice ability test in trainers, and implemented the consistency analysis in scores of nursing assessment scales for specialist service so as to evaluate the subjective training effect. We also compared the incidence of postoperative complications, functional recovery of hip joint as well as the satisfaction among 30 THA patients before (October 2017 to September 2018) and after (October 2018 to September 2019) training so as to explore the clinical effect.Results:Before and after training, scores of theoretical achievements of nurses of villages and towns medical health institutions were 60 (56, 62) and 82 (79, 85) respectively, and scores of practice ability were 52 (47, 62) and 86 (81, 91) respectively with statistical differences ( P<0.01) . After training, the incidence of postoperative complications was lower than that before training (6.67% vs. 26.67%) ; the postoperative satisfaction, scores of Harris Hip Score (HHS) one month and three months after surgery were higher than those before training [90.00% vs. 66.67%, (73.1±6.00) vs. (57.6±6.67) , (86.6±4.49) vs. (74.5±6.20) ]among 30 THA patients with statistical differences ( P<0.05) . Conclusions:Training with the county medical community model can improve the nursing service ability of nurses in villages and towns medical health institutions among THA patients, postoperative function of hip joint of THA patients as well as patient satisfaction.