Objective:To predict the possible targets and signaling pathways of Jiangtang Xiaoke Granules in the treatment of diabetes mellitus (DM) using computer network pharmacology and molecular docking technology.Methods:The active components and targets of Jiangtang Xiaoke Granules were collected by ETCM; the targets of DM were searched from the databases of DisGeNET and GeneCards, and the intersections of the two were taken to draw a Venny diagram; String database was used for gene transformation and network interaction analysis; the network diagram was constructed with Cytoscape3.6.0; the predicted results were supported by molecular docking technology; GO and KEGG analysis was performed through Metascape database.Results:A total of 128 active components of Jiangtang Xiaoke Granules were screened, with 607 corresponding targets, 1 240 DM related targets, and 53 core targets. Molecular docking showed that the active components had good binding energy with the core targets. GO analysis yielded 46 functional items and KEGG analysis yielded 15 pathways.Conclusion:Jiangtang Xiaoke Granules regulate glucose homeostasis by participating in a variety of biological processes through multiple components, and multiple targets, including affecting lipids and atherosclerosis, Alzheimer disease, AMPK signaling pathway, Apelin signaling pathway, and glucagon signaling pathway.

Objective:To investigate the association of metabolic syndrome(MS) with cardiovascular disease(CVD) mortality and all-cause mortality in peritoneal dialysis patients.Methods:A retrospective analysis was performed on patients who underwent peritoneal dialysis from January 1, 2013 to July 31, 2021 in the Shaoxing People′s Hospital. Patients were divided into MS group and non-MS group. The differences in baseline biochemical variables, comorbidities, and clinical outcomes between the two groups were compared. Kaplan-Meier method was used to obtain survival curves, the Cox regression model was used to evaluate the influence of MS for survival rates, and the inverse probability of treatment weighting(IPTW) was used to eliminate influence of the confounders in the groups.Results:A total of 494 peritoneal dialysis patients were enrolled in this study, which were divided into MS group( n=266) and non-MS group( n=228). The total median follow-up time was(31±22) months. At baseline, the standard mean difference( SMD) in smoking history, drinking history, CVD history, prevalence of chronic glomerulonephritis, left ventricular ejection fraction, B-type natriuretic peptides, hemoglobin, blood calcium, hypersensitive C-reactive-protein, intact parathyroid hormone, ultrafiltration and 4 h dialysate/plasma creatinine in the two groups were greater than 0.1. Their SMD decreased to under 0.1 after IPTW, showing a good balance between the two groups. The analysis of the survival curve of Kaplan Meier showed that the cumulative survival rate and cumulative CVD survival rate in MS group were significantly lower than those in non-MS group before and after IPTW( P<0.05). After IPTW was used to eliminate the effect of confounders, multivariate Cox regression analysis still displayed that MS was an independent risk factor for all-cause mortality( HR=1.824, 95% CI 1.121-2.968, P=0.015) and CVD mortality( HR=2.470, 95% CI 1.324-4.609, P=0.004)in peritoneal dialysis patients. Conclusion:The prevalence of metabolic syndrome is high in peritoneal dialysis patients. MS is an independent risk factor for all-cause mortality and CVD mortality in peritoneal dialysis patients.

Objective:To investigate the multilocus sequence typing feature of the virulence-associated genes of Staphylococcus aureus(S. aureus) separated from the clinical specimens of a multi-center cohort children in Guangzhou area. Methods:A total number of 412 Staphylococcus aureus strains isolated from 2 059 non-repeated fecal specimens of children by three groups′ researchers in Guangzhou Women and Children′s Medical Center from August 2018 to November 2018. While collecting specimens, patient clinical information is also properly collected and preserved. After extracting the DNA of the strain, the virulence-associated genes were detected by polymerase chain reaction (PCR), including the staphylococcal enterotoxin (SE) genes ( sea, seb, sec, sed, see) and the Panton-Valentine leucocidin-encoding gene ( pvl).The multi-locus sequence typing (MLST) method was performed to reveal the MLST feature of these genes and the statistical difference were examined by the the χ 2 test. Results:Among the 412 isolates of S. aureus, 256 strains (256/412, 62.1%) contains at least one SE gene. Among the enterotoxin gens, the sec (125/412, 30.3%), seb(98/412, 23.8%)and sea (66/412, 16.0%)genes were the three most prevalent members of SEs. The frequency of pvl gene in Staphylococcus aureus was 18.7%(77/412).Among them, the frequency of Staphylococcus aureus sea gene isolated from patients with gastroenteritis (58/319, 18.2%) was significantly higher than that from the non-gastroenteritis group (8/93, 8.6%)(χ2=4.912, P=0.027). The frequency of Staphylococcus aureus pvl gene isolated from the patients with pneumonia (8/21, 38.1%) was greater than that from the non-pneumonia group (6/47, 12.8%)(χ2=4.252, P=0.039). In addition, the virulence-associated gene of S. aureus was closely related to the specific ST type, 82.4% (28/34) of ST6 carried sea gene, all ST338 and ST59 carried seb gene, 96% (48/50) ST45 carried sec gene, and the pvl gene carrying rate of ST338 was 5/5. Conclusions:The SEA toxin produced by ST6 Staphylococcus aureus may be closely related to the diagnosis of gastroenteritis in children. The frequency of pvl virulence gene in Staphylococcus aureus in children with community-acquired pneumonia was higher than that in the non-pneumonia group, and closely related to the CC59.

Objective:To explore the effect of the teaching model based on the theory of planned behavior in intern nursing students of the Department of Hematology.Methods:From May 2018 to May 2020, 80 intern nursing students in the Department of Hematology from the Yantai Affiliated Hospital of Binzhou Medical University were selected as the research object by the convenience sampling method. Intern nursing students were randomly divided into a control group and an observation group, with 40 cases in each group. The control group adopted conventional nursing teaching, and the observation group conducted a nursing teaching model based on the theory of planned behavior on the basis of the control group. This study compared the two groups of nursing students' nursing skills assessment scores, core competence, empathy ability and personal evaluation of teaching effect.Results:The nursing skill assessment score and Core Competency Scale score of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the total empathy ability score and scores in each dimension of the two groups were higher than those before the intervention, and those of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of 5 items of personal evaluation of teaching effect of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The teaching model based on the theory of planned behavior has a good effect when applied to practical nurses in the Department of Hematology, which can improve their nursing skills, core competence, empathy ability, and increase the satisfaction of the nursing students with the teaching effect.

Objective:To investigate the association of serum magnesium with cardiovascular disease (CVD) and all-cause mortality in peritoneal dialysis patients.Methods:A retrospective study was performed in patients who initiated peritoneal dialysis from January 1, 2013 to July 31, 2019 in the Shaoxing People's Hospital. According to the standard of serum magnesium, the patients were divided into control group (Mg≥0.7 mmol/L) and low-magnesium group (Mg<0.7 mmol/L). The differences in baseline biochemical variables, comorbidities, medications, and clinical outcomes between the two groups were compared. Logistic regression was used to analyze the related factors of hypomagnesemia. Kaplan-Meier survival analysis and Fine-Gray model were used to compare the difference in cumulative survival rate between the two groups. Cox regression model and competitive risk model were used to analyze the risk factors of all-cause mortality and CVD mortality.Results:A total of 381 peritoneal dialysis patients were enrolled in this study. Among them, 321 patients were in control group and 60 patients in low-magnesium group. The total median follow-up time was 27(15, 43) months. There were significant differences in serum albumin, magnesium, phosphorus, intact parathyroid hormone, low-density lipoprotein chloesterol, high sensitivity C-reactive protein and 4-hour dialysate-to-plasma creatinine (4 h D/Pcr) between the two groups. CVD was the main cause of death in patients on peritoneal dialysis. Multivariate logistic regression analysis showed that hypoalbuminemia ( OR=0.901, 95% CI 0.831-0.976, P=0.011), hypophosphatemia ( OR=0.217, 95% CI 0.080-0.591, P=0.003), higher hsCRP ( OR=1.276, 95% CI 1.066-1.528, P=0.008), and higher 4 h D/Pcr ( OR=1.395, 95% CI 1.014-1.919, P=0.041) were independent risk factors for patients with hypomagnesemia. Kaplan-Meier survival curve analysis showed the cumulative survival rate of patients in low-magnesium group was significantly lower than that of control group (Log-rank χ2=5.388, P=0.020). Fine-Gray model analysis showed the cumulative CVD survival rate of low-magnesium group was significantly lower than that of control group ( Gray=6.915, P=0.009). Multivariate-corrected Cox regression model and competitive risk model analysis showed that higher serum magnesium level was a protective factor for all-cause mortality and CVD mortality when serum magnesium was used as a continuous variable ( HR=0.137, 95% CI 0.020-0.946, P=0.044; SHR=0.037, 95% CI 0.002-0.636, P=0.023, respectively). Hypomagnesemia was an independent risk factor for all-cause mortality and CVD mortality when serum magnesium was used as categorical variable ( HR=1.864, 95% CI 1.044-3.328, P=0.035; SHR=2.117, 95% CI 1.147-3.679, P=0.029, respectively). Conclusions:Hypomagnesemia is susceptible to peritoneal dialysis patients with hypoalbuminemia, hypophosphatemia, higher hsCRP and higher peritoneal transport characteristics. Hypomagnesemia is an independent risk factor for CVD mortality and all-cause mortality in peritoneal dialysis patients.

Objective:To explore the effects of periodic target teaching combined with scenario simulation training in teaching for practical nurses in Cardiac Care Unit (CCU) .Methods:From January 2017 to December 2018, we selected practical nurses of CCU in the Yantai Affiliated Hospital of Binzhou Medical University by convenience sampling as the research object. Interns from January to December 2017 were in control group ( n=45) , and interns from January to December 2018 were in observation group ( n=51) . Control group implemented the traditional teaching model. On the basis of traditional teaching model, observation group applied the periodic target teaching combined with scenario simulation training. After one month of practice, we compared the theoretical and operational performance of interns between two groups and their satisfaction with teaching. Results:After one month of practice, the theoretical and operational performance of interns of observation group were higher than those of control group with statistical differences ( P<0.05) . Satisfaction with teaching of observation group was higher than that of control group also with a statistical difference ( P<0.05) . Conclusions:Periodic target teaching combined with scenario simulation has a good application effect in CCU interns which can improve the examination results of interns and their satisfaction with teaching.

Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin,sNGAL) and cardiovascular events in patients with chronic kidney disease(CKD).Methods 300 patients with CKD were divided into two groups according to the level of sNGAL:high sNGAL group (n=158) and low sNGAL group (n=142).The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve,and the correlation between sNGAL and cardiovascular risk factors,cardiovascular events in patients with chronic renal disease was analyzed.Influencing factors of cardiovascular events in CKD patients was analyzed.Results There were significant differences in the data about BMI,diabetes proportion,CKD staging,eGFR,hsCRP,24h proteinuria,HDL,iPTH,phosphate and blood calcium between the two groups (P＜0.05).The 3-year cumulative survival rate of high sNGAL group(77.2％) was significantly lower than that of low sNGAL group(96.5％),and the 3-year incidence of cardiovascular events (37.9％) was significantly higher than that of low sNGAL group (9.8％) (P＜ 0.05).AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR(0.636),age (0.504),serum calcium (0.545),HDL(0.594) and LDL (0.508,all P＜0.05).There was a significant correlation between sNGAL and eGFR,HDL,BMI,hs-CRP,iPTH and phosphate (P＜ 0.05).Both univariate and multivariate fact ors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P＜0.05),((HR=1.976 and 1.588,95％ CI=1.443-2.724 and 1.144-2.143,respectively,P=0.O00 and 0.000)).Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased.sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.

Objective To investigate the infection and epidemiological characteristics of group A rotavirus (RV-A)and adenovirus in children with diarrhea in Guangzhou. Methods The colloidal gold technique was used to detect RV.A and adenovirus antigen in 2,171 stool samples from children with diarrhea in Guangzhou Women and Children′s Medical Center from January to December 2015,and the data were statistically analyzed. Results Among the 2,171 patients,the positive rate of RV-A infection was 17.96%and that of adenovirus infection 8.66%, and the co-infection rate of both virus was 3.45%. The positive rates between different genders were not significantly different(P > 0.05);the infectious time peak of RV-A was January(40.78%),followed by December(39.24%) and February(32.61%)and that of adenovirus infection was July(15.89%)and May(15.79%). The infectious peak of RV-A and adenovirus was December(7.29%),followed by January(7.01%). The peak age of infection ranged from 1y to 3y. Conclusion RV-A and adenovirus are the main pathogens of children diarrhea ,and the onset of virus infection has obvious seasonal change.

Objective To study the effect on renal function about repeated use of contrast media , and whether alprostadil has protective effect towards contrast-induced nephropathy ( CIN) .Methods 80 adult patients who had ever received contrast examination and scheduled to have PCI within 1 month were randomly divided into two groups: the simple hydration group and the hydration plus alprostadil therapy group.The serum level of creati-nine,urea, Cystatin C, Urineβ-microglobulin and creatinine clearance were recorded and compared between the two groups , and were observed before and after repeated exposure of contrast medium.The incidence of CIN was analyzed .Results Compared with pre-contrast levels , serum levels of urea, creatinin, Cystatin C and Urine β-microglobulin all elevated after single and repeated contrast media use in patients in the simple hydration group ( P<0.05 ) .The incidence of CIN did not differ after single or repeated contrast used (2.5%vs.15.0%, P>0.05).After repeated contrast exposure compared with patients with simple hydration , patients in the alprostadil group had repeated serum levels of urea [(7.4 ±2.3) mmol/L vs.(9.1 ±2.6) mmol/L], creatinia [(87.2 ±25.6) μmol/L vs.(96.9 ± 25.8) μmol/L], Cystatin C [(0.8 ±0.3) mg/L vs.(1.4 ±0.3) mg/L] and Urine β-microglobulin [(207.0 ±31.9 ) μg/L vs.(279.3 ±37.3 ) μg/L] were all lower with higher creatinin clearance [(92.2 ±24.2) ml/min vs.(78.2 ±27.5) ml/min](all P<0.05).The incidence of CIN in patients with alprostadil did not differ after single or repeated contrast used (2.5%vs.7.5%, P>0.05).The incidence of CIN in patients treated with alprostadil had no difference compared with patients with simple hydration after repeated contract (7.5% vs.15.0%, χ2 =0.501,P=0.479).Conclusions Contrast media can cause damage to renal function .Short-term repeated use of contrast media can further worsen renal function without significant increase in CIN rates .Alprostadil may have renoprotective effect towards CIN .

Objective To investigate the relationship between different left ventricular pacing sites and clinical benefit in heart failure patients treated with cardiac resynchronization therapy (CRT).Methods Clinical data of 52 patients of CRT-P/D (pacing and defibrillation) implantation were collected.According to the left ventricular lead implantation sites,52 cases were divided into anterior wall (10 cases),lateral wall (15 cases),posterior wall (16 cases),and posterior base group (11 cases).The efficacy of CRT was evaluated by Minnesota life quality score,left ventricular function and remodeling index.Results In addition to the anterior wall group,Minnesota life quality score of the other groups were significantly lower than preoperative group (P ＜ 0.05).Compared to pre-CRT implantation,left ventricular end diastolic diameter (LVEDD) of the anterior wall and posterior basal group 3 months after CRT implantation had no statistical significance (P ＞ 0.05);the rest groups were lower than preoperative group (P ＜ 0.05).Left ventricular ejection fraction (LVEF) in posterior wall group was increased after CRT implantation 3 months compared to the preoperative group (P ＜0.05).LVEF in anterior wall group was increased only in the 12 months after CRT implantation (P ＜ 0.05).LVEF in the rest groups was increased comparing to the preoperation at 6 and 12 months postoperation (P ＜0.05).CRT non-response rate in anterior wall group was significantly higher than that in the other groups (P ＜ 0.05).CRT response ratio was significantly increased in side,posterior and posterior basal wall compared to the anterior Wall group (P ＜ 0.05).And there were no statistical significance among side wall,posterior wall and basal wall group (P ＞ 0.05).△ QRSd was higher in side wall,posterior wall and posterior basal group after CRT implantation 3 months than anterior wall group (P ＜ 0.05),△ QRSd in posterior basal group was lower than the other two groups (P ＜0.05).Conclusions Left ventricular electrode should be implanted at the side wall and posterior wall firstly,secondly at the posterior basal wall,and avoid at the anterior wall of the left ventricle.