Objective:To construct a risk prediction model for unplanned readmission of patients undergoing cardiac resynchronization therapy (CRT) and verify the performance of the model.Methods:Using convenience sampling, patients who underwent CRT at the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from July 2017 to July 2020 were selected as the modeling group ( n=279) and the internal validation group ( n=120). CRT patients admitted to the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from August 2021 to August 2022 due to the same or related diseases were selected as the external validation group ( n=86). Multivariate Logistic regression was used to explore the influencing factors of unplanned readmission of CRT patients and establish the prediction model. The fitting effect and discrimination of the model were evaluated through the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve. The nomogram was established based on R-4.1.2 and Rstudio software. Results:The multivariate Logistic regression analysis showed that creatinine, left atrial diameter, pulmonary artery systolic pressure, New York Heart Association (NYHA) classification, and body mass index (BMI) were risk factors for unplanned readmission in CRT patients, with statistically significant differences ( P<0.05). The prediction model formula was: P=1/{1+exp[- (0.792×creatinine+1.408×left atrial inner diameter+0.887×pulmonary artery systolic pressure+0.769×NYHA classification-0.970×BMI-2.266) ]}. The area under the ROC curve was 0.874, the maximum value of the Jordan index was 0.636, the optimal threshold was 0.256, the sensitivity was 0.826, and the specificity was 0.810. The accuracy of internal validation and external validation was 90.00% and 90.70%, respectively. Conclusions:The constructed prediction model for unplanned readmission of CRT patients has good predictive performance, and the visualized nomogram improves the practical performance of the model. It helps medical and nursing staff identify high-risk groups of unplanned readmission of CRT patients in the early stage and provides a basis for formulating nursing strategies for different risk groups.

Objective:To construct a stratified nursing prevention strategy for delirium in ICU patients to provide reference for the prevention of delirium in ICU patients.Methods:Preliminary items were screened based on evidence-based medicine method. After discussion by the research group, the first draft of stratified nursing prevention strategy for ICU patients with delirium was formed. Using the Delphi method, a total of two rounds of correspondence with 15 experts were conducted. Combined with expert opinions, a stratified nursing prevention strategy for delirium in ICU patients was constructed.Results:The effective recovery rates of the two rounds of questionnaires were 93.75% and 100.00%, respectively. The expert authority coefficients were respectively 0.893 and 0.897, and the Kendall's harmony coefficients of indicators at all levels were 0.203-0.213 ( P<0.01) . Finally, a delirium stratified nursing prevention strategy for ICU patients was formed, including 5 first-level indicators, 12 secondary indicators and 28 tertiary indicators. Conclusions:The stratified nursing prevention strategy constructed in this study is based on evidence-based and Delphi method, which is scientific, reliable, practical and targeted. It can provide reference for the prevention of delirium in ICU patients.

Objective:To construct an ICU-acquired weakness training program for ICU nurses based on Gagne learning theory.Methods:From March to August 2021, the ICU-acquired weakness training program for ICU nurses was constructed through literature review, semi-structured interview, and Delphi expert consultation.Results:Among two rounds of expert consultation, 16 and 20 valid questionnaires were recovered respectively, and the expert authority coefficients were 0.897 and 0.903, and the Kendall harmony coefficients were 0.312 and 0.323, respectively, and the differences were all statistically significant ( P<0.01) . The ICU-acquired weakness training program for ICU nurses included 3 first-level indicators (training objectives, training process and content, training form) , 16 second-level indicators, and 41 third-level indicators. Conclusions:The ICU-acquired weakness training program for ICU nurses based on Gagne learning theory is scientific and reliable, and can provide a reference for ICU nurses' ICU-acquired weakness training.

Potassium 2-(1-hydroxypentyl)-benzoate (d,l-PHPB), a new drug candidate for ischemic stroke at the phase II clinic trial, has been shown to protect neurons by inhibiting oxidative injury and reducing neuron apoptosis in previous studies. But the mechanisms of d,l-PHPB remain to be studied. In this study, a neuron-astrocytes co-culture system was used to elucidate the roles of astrocytes in neuroprotection of d,l-PHPB under oxygen-glucose deprivation/reoxygenation (OGD/R) condition. Our data showed that d,l-PHPB reduced neuronal apoptosis in mono-culture system and this effect was enhanced in neuron-astrocyte co-culture system under the OGD/R condition. Meanwhile, d,l-PHPB obviously increased the levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), which were mainly secreted from astrocytes, in the co-culture system after OGD/R. The PI3K/AKT and ERK signaling pathways as well as the p-TRKA/B receptors were involved in the process. In addition, the levels of TNF-and IL-1secreted from astrocytes after OGD/R were markedly reduced after d,l-PHPB treatment, which was mainly due to the suppression of phosphorylated p38. In conclusion, the present study demonstrates that the neuroprotective effects of d,l-PHPB were improved by astrocytes, mainly mediated by increasing the release of BDNF/NGF and attenuating inflammatory cytokines.

Objective:To investigate the super selective transhepatic arterial embolization (TAE) for effects of cyst volume and liver function in patients with symptomatic polycystic liver disease (PLD), and provide a reliable basis for clinical diagnosis and treatment. Methods: 14 cases of symptomatic patients with PLD were selected from October 2014 to October 2015 in our hospital using super selective hepatic arterial embolization. The upper abdomen was performed CT scan one year after surgery, and the volume of patients with liver cyst was tested. We observed the changes of total volume of liver before TAE and postoperative kidney function, adverse reactions, and the improvements after four months’ follow-up.Results: The angiography for the 14 patients showed liver volume increased in different degrees. It also showed that blood supply was mainly hepatic artery wall branch. There were different sizes of liver round unstained area. There was consistent between CT examination and unstained area in polycystic liver swollen area. The difference of the total volume of the liver cyst was statistically significant in 14 cases of the patients with PLD before TAE treatment and after 12 months’ treatment (t=2.8627,P<0.05). 14 cases of the patients with PLD after TAE before treatment and after 1 week’s laboratory tests, the difference was not statistically significant among AST, ALT, ALB and TBIL (t=0.0441,t=0.3316,t=0.0722,t=1.9855;P>0.05). Compared with the preoperative, there was little effect on liver function by TAE. After 3 to 12 months, symptoms gradually improved and physical rating increased. The improvement rate was 100% after 12 months and the physical score was from 90 to 100 points. The embolism syndrome in 14 cases of patients gradually disappeared after 1 to 5 days, and five days later the symptoms disappeared. Conclusions: There is a significant effect for symptomatic polycystic liver patients with TAE. It can improve efficacy and reduce patient suffering with a low recurrence rate. It is worthy of clinical application.

Objective To investigate the clinical efficacy of entecavir combined with danshen dripping pill for the treatment of chronic hepatitis B with hepatic fibrosis. Methods A total of 46 cases of chronic hepatitis B with hepatic fibrosis in our hospital were randomly divided into control group and observation group. The control group were treated with entecavir. The observation group were treated with entecavir combined with danshen dripping pill.The HBV-DNA negative rate, serum fibrosis markers (Serum HA,LN,PCⅢ,CⅣ) before and after treatment of two groups were com-pared. Results The HBV-DNA negative rate of observation group was 95.7%, which was significantly higher than 65.2% of control group (P<0.05). The serum fibrosis markers of two groups before treatment had no significant differ-ence(P>0.05). Serum HA,LN,PCⅢ,CⅣlevels of observation group after treatment were significantly lower than control group(P<0.05). Conclusion Entecavir combined with danshen dripping pill treatment for chronic hepatitis B with hep-atic fibrosis has exact effect. It can effectively reduce inflammatory activity,improve microcirculation and slow fibrosis down. It’s worthy of clinical widely used.

Objective:The clinical value of used in oral cavity repair were summarized to guide clinical practice. Methods:Retrospective analysis the clinical information of 144 cases(prefabricated posts:86 cases and metal posts:58 cases) who received oral cavity repair in our hospital between January 2010 and January 2012. Discuss the applications and clinical effects. Results:After 1 to 2 ears of follow-up, into a successful repair success rate of fiber post and metal post(93.02%v.s.79.31%, P=0.015), advance into a fiber post success rate is significantly higher than metal post, Repair the cause of the failure of the two groups, however, fall off and fracture was statistically difference(x2=5.51, P<0.019), the fiber pile of biomechanics is better than metal post, loss is the main reason for the advance into the fiber pile repair failure. Conclusions:As a new material in the oral cavity repair, prefabricated posts has been widely used and is worthy of further promotion.

This study was aimed to construct eukaryotic expression vectors carrying the small hairpin RNA (shRNA) targeting TRPC6 gene and investigate the effect of TRPC6 knockdown on puromucin aminonucleoside (PAN)-induced podocyte injury. Two DNA sequences containing the small hairpin structure targeting TRPC6 were designed, synthesized and then inserted into the green fluorescence protein (GFP)-contained plasmids (pGC) to establish the plasmids pGCsi-TRPC6A and pGCsi-TRPC6B. Plasmids expressing scrambled shRNA were used as negative control and named pGCsi-NC. These plasmids were transfected into a conditionally immortalized murine podocyte cell line by using liposome. Flow cytometry was used to examine the transfection efficiency. TRPC6 mRNA and protein expression levels were detected by RT-PCR and Western blotting. Cultured podocytes were divided into four groups: control group, PAN treatment group, PAN+TRPC6 shRNA transfected group and PAN+scrambled shRNA transfected group. The paracelluar permeability to BSA was evaluated by Millicell-PCF Inserts and cell viability was measured by the trypan blue assay. Immunofluorescent assay was used to observe the distribution of α-actinin-4 and α-tubulin. The results showed that the transfection efficiency of the shRNA expression vector was about 45%. Expression levels of TRPC6 mRNA and protein were downregulated after transfection with pGCsi-TRPC6A and pGCsi-TRPC6B. Knocking down TRPC6 gene could effectively reverse the PAN-induced increase in the paracelluar permeability to BSA. The distribution of α-actinin-4 and α-tubulin was disrupted after treatment with PAN, which was reversed by knocking down TRPC6 gene. It was concluded that knocking down TRPC6 gene could effectively prevent podocytes from the permeability increase induced by PAN, which may be related to the regulation of podocyte cytoskeleton.
Animals ; Cell Membrane Permeability ; drug effects ; physiology ; Cell Survival ; drug effects ; physiology ; Cells, Cultured ; Gene Knockdown Techniques ; Mice ; Mice, Knockout ; Podocytes ; drug effects ; physiology ; Puromycin Aminonucleoside ; pharmacology ; TRPC Cation Channels ; genetics ; metabolism

This study was aimed to construct eukaryotic expression vectors carrying the small hairpin RNA (shRNA) targeting TRPC6 gene and investigate the effect of TRPC6 knockdown on puromucin aminonucleoside (PAN)-induced podocyte injury. Two DNA sequences containing the small hairpin structure targeting TRPC6 were designed, synthesized and then inserted into the green fluorescence protein (GFP)-contained plasmids (pGC) to establish the plasmids pGCsi-TRPC6A and pGCsi-TRPC6B. Plasmids expressing scrambled shRNA were used as negative control and named pGCsi-NC. These plasmids were transfected into a conditionally immortalized murine podocyte cell line by using liposome. Flow cytometry was used to examine the transfection efficiency. TRPC6 mRNA and protein expression levels were detected by RT-PCR and Western blotting. Cultured podocytes were divided into four groups: control group, PAN treatment group, PAN+TRPC6 shRNA transfected group and PAN+scrambled shRNA transfected group. The paracelluar permeability to BSA was evaluated by Millicell-PCF Inserts and cell viability was measured by the trypan blue assay. Immunofluorescent assay was used to observe the distribution of α-actinin-4 and α-tubulin. The results showed that the transfection efficiency of the shRNA expression vector was about 45%. Expression levels of TRPC6 mRNA and protein were downregulated after transfection with pGCsi-TRPC6A and pGCsi-TRPC6B. Knocking down TRPC6 gene could effectively reverse the PAN-induced increase in the paracelluar permeability to BSA. The distribution of α-actinin-4 and α-tubulin was disrupted after treatment with PAN, which was reversed by knocking down TRPC6 gene. It was concluded that knocking down TRPC6 gene could effectively prevent podocytes from the permeability increase induced by PAN, which may be related to the regulation of podocyte cytoskeleton.

To investigate the protective effects of eplerenone on adriamycin-induced renal injury and the possible mechanisms involved, 36 male Sprague-Dawley rats were randomly divided into control group, adriamycin nephropathy (AN) group and eplerenone-treated group (100 mg·kg(-1)·d(-1) eplerenone). Blood pressure, 24-h urinary protein, serum potassium, sodium and creatinine were measured 28 days after adriamycin injection (a single tail intravenous injection of 6.5 mg/kg adriamycin). The morphological changes of renal tissues were observed by light and electron microscopy. Immunohistochemistry and Western blotting were performed to examine the expression of TGF-β(1) and desmin in renal cortex. The results showed that 28 days after adriamycin injection, there were no significant changes in the level of serum potassium, sodium, creatinine concentrations and blood pressure values in the rats of the three groups. Meanwhile, the 24-h proteinuria excretion in the AN group was significantly higher than that in the control group (P<0.01), but that in the eplerenone-treated group was substantially reduced when compared with that in the AN group (P<0.05). Mild mesangial cell proliferation and matrix expansion, diffuse deformation and confluence of foot processes in podocytes were found in the AN group. By contrast, rats in the eplerenone-treated group exhibited obvious attenuation of these morphological lesions. The protein expression of TGF-β(1) and desmin in the AN group was markedly up-regulated in contrast to that in the control group (P<0.01), whereas that in the eplerenone-treated group was much lower than in the AN group (P<0.05). It was concluded that eplerenone may ameliorate the proteinuria and the development of pathological alteration in adriamycin-induced nephropathy presumably via the inhibition of cytokine release, and restore the morphology of podocytes independent of its blood pressure-lowing effects.