ObjectiveTo systematically and objectively characterize the pharmacological effects of Fufang Biejia Ruangan pills （FBRP） in the intervention of alcoholic liver disease （ALD） using acute and chronic ALD mouse models and to elucidate its molecular mechanisms. MethodFifty SPF-grade male BALB/c mice were randomly divided into the normal group， model group， and FBRP low-， medium-， and high-dose groups （9.6， 19.2， 38.4 mg·kg^-1）. Except for the normal group， the remaining groups were given 56° white wine by gavage to establish the acute ALD model， with samples collected after 4 weeks. Thirty SPF-grade male C57BL/6N mice were randomly divided into the normal group， model group， and FBRP medium-dose group （19.2 mg·kg^-1）. The chronic ALD mouse model was established using the Lieber-DeCarli method over a 10-week period. Inflammatory markers in liver tissues were assessed using hematoxylin-eosin （HE）， Sirius Red， oil red O staining， and enzyme-linked immunosorbent assay （ELISA）. Intoxication behaviors of each group were objectively evaluated through sobering-up time， net-catching， and pole-climbing tests. Further bioinformatics analyses based on clinical transcriptomic data were conducted to identify key targets and molecular mechanisms of FBRP in alleviating ALD through liver-brain dialogue， with experimental validation by ELISA， Western blot， and immunohistochemical staining. ResultCompared with the normal group, the levels of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） in liver tissues of mice in the acute and chronic ALD model groups were significantly increased （P<0.05）. Compared with the model group， the levels of AST and ALT in liver tissue of mice in FBRP groups were significantly decreased （P<0.05）. Compared with the normal group， the time of grasping the net and climbing the pole in the acute ALD model group was significantly decreased within 4 weeks （P<0.01）. Compared with the model group， the grasping and climbing time of FBRP high dose groups increased significantly within 4 weeks （P<0.05）. Compared with the normal group， the expression of high mobility group protein B1 （HMGB1） protein in liver tissue and prefrontal lobe tissue of mice in the chronic ALD model group was significantly increased （P<0.01）. Compared with the model group， the expression of HMGB1 protein in FBRP medium dose group was significantly decreased （P<0.05，P<0.01）. Compared with the normal group， the expression of brain-derived neurotrophic factor （BDNF） protein and the release of γ-aminobutyric acid （GABA） in the prefrontal cortex of the model group were significantly decreased （P<0.01）. Compared with the model group, the expression of BDNF protein and the release of GABA in the FBRP medium dose group were significantly increased （P<0.05）. ConclusionThis study revealed that FBRP improved key pathological changes in ALD by modulating liver-brain dialogue mediated by the HMGB1-BDNF axis. These findings provide experimental evidence for the clinical use of FBRP in treating ALD and offer new insights for the development of ALD therapeutic agents.

Objective:To analyze the research hotspots and trends in the field of pressure injury support surfaces both domestically and abroad and to provide references for future studies in this domain.Methods:Relevant literature on pressure injury support surfaces indexed in the Web of Science Core Collection, CNKI, Wanfang, and VIP database were retrieved, with the search spanning from January 1, 2010, to February 28, 2023. CiteSpace was utilized to perform a visualization analysis of the amassed data.Results:A total of 307 Chinese articles and 434 English articles were included in the analysis. The United States emerged as the country with the highest number of publications. The General Hospital of Eastern Military Command topped the list in China in terms of the number of publications. Chinese Journal of Modern Nursing and Journal of Tissue Viability were the journals with the highest publication frequencies in China and abroad, respectively. Jiang Qixia was the author with the highest number of publications in China, while Gefen secured this position internationally. The Chinese literature formed 12 clusters and the English literature formed 17, culminating in the identification of 8 meaningful categories (population, location, research type, risk factors, static support surfaces, dynamic support surfaces, intelligent monitoring, and effectiveness evaluation), among which intelligent monitoring was seen as a future research trend. Conclusions:Pressure injury support surfaces have been a research hotspot in recent years both domestically and internationally. It is recommended to promote the development of domestic research on pressure injury preventive care through strategies such as expanding the range of research populations, developing intelligent support surface devices conducive to promotion in collaboration with computer and artificial intelligence disciplines, and carrying out large-scale high-quality original research and corresponding quality improvement projects.

Objective:To study the value of shear wave elastography (SWE) combined with contrast-enhanced ultrasound (CEUS) in diagnosing the invasiveness of papillary thyroid microcarcinoma (PTMC), and analyze its risk factors.Methods:This study included 200 patients with pathologically confirmed PTMC who underwent surgery in Fenyang Hospital from January 2019 and June 2021. All were diagnosed with SWE and CEUS before surgery. The value of the two methods in diagnosing the invasiveness of PTMC was explored. The patients′ data were collected to screen the risk factors for the invasiveness of PTMC.Results:It was pathologically confirmed that among the 200 patients with PTMC, there were 112 cases with malignant nodules, 88 cases with benign nodules, 75 cases with cervical lymph node metastasis (including 71 cases with capsular invasion) and 125 cases without lymph node metastasis. CEUS parameters of malignant nodules were significantly higher than those of benign nodules ( P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE combined with CEUS to diagnose capsular invasion were 94.66%, 85.60%, 89.00%, 79.77% and 96.39%, with high consistency with the pathological results ( Kappa>0.75). Multivariate Logistic regression analysis showed that multiple foci, irregular shape, breakthrough capsule and small calcification were independent risk factors for the invasiveness of PTMC (VIF<3). The ROC curve results showed that the AUC of SWE combined with CEUS to diagnose capsular invasion was 0.772, and the diagnostic sensitivity and specificity were 73.91% and 80.56%. Conclusions:SWE combined with CEUS can significantly improve the diagnostic accuracy for the invasiveness of PTMC.

Objective:To develop a diagnostic analysis software for determining the type of acid-base balance disorder.Methods:Mathematical models were built based on Henderson-Hasselbalch equations and compensation formulas, to determine the important parameters of acid-base balance disorder, and to develope acid-base balance disorder analysis process. The software was compiled using the Visual Basic.NET programming language, and the installation package was generated after debugging. Acid-base balance disorder cases were searched by PubMed, Wanfang and CNKI databases from 1980 to 2015, and the blood gas parameters [pH, arterial partial pressure of carbon dioxide (PaCO 2), HCO 3- and anion gap (AG)] and the types of acid-base imbalance (literature results) were recorded. All cases were reanalyzed by software and the type of acid-base balance disorder was determined (software diagnostic type). Kappa-test and McNemar-test were performed for the two diagnostic results. Results:The "four parameters-four steps" analysis method was used as the analysis process to judge the types of acid-base balance disorder. "Four parameters" included pH, PaCO 2, HCO 3- and AG. "Four steps" were outlined by following aspects:①according to the pH, combined with PaCO 2 and HCO 3-, the primary types of acid-base balance disorder was determined; ② according to the compensation situation, double mixed acid-base balance disorder (DABD) was determined; ③according to AG value, three mixed acid-base disorders (TABD) were determined; ④ the ratio of ΔAG↑/ΔHCO 3-↓ was also calculated to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. The software had the characteristics of simple interface, convenient operation, rapid judgment, and comprehensive analysis. It could judge all acid-base balance disorder types excepted "AG normal metabolic acidosis combined metabolic alkalosis". The software was used to reanalyze 112 cases of acid-base balance disorder reported in the literature, with a consistent rate of 87.50% and better consistency of the diagnostic results (Kappa test: κ = 0.84, P < 0.01; McNemar test: χ2 = 0.87, P = 0.65). Conclusion:The software can be used as an important tool to judge the type of acid-base balance disorder, and provide clinicians with diagnostic reference, which have practical value and application prospect.

Objective The prognostic role of PD-L1 expression in surgically resected lung adenocarcinoma(ADC)remains controversial. The aim of present study was to investigate the prognostic value of PD-L1 combined with CD8 +TILs expression in pa-tients with resectable lung adenocarcinoma. Methods A total of 104 patients with lung adenocarcinoma who underwent radical resec-tion were enrolled at the Affiliated Tumor Hospital of Harbin Medical University from January 2009 to December 2012. Immunohisto-chemistry was used to detect the expression of PD-L1 and CD8 +TILs in primary tumor specimens. Its clinical pathological factors and its relationship with prognosis were statistical analysis. Results The positive expression rate of PD -L1 in tumor cells was 38. 5% (40/104),and the positive rate of CD8 +TILs was 44. 2% (46/104). There was a significant correlation between the expres-sion of CD8 +TILs and TNM stages of patients with resectable ADC. The Kaplan-Meier survival analysis showed that low expression of PD-L1 and high expression of CD8 +TILs were significantly associated with disease -free survival ( DFS) and overall survival ( OS),and could be used as an independent predictors for predicting prognosis of patients with resectable ADC. Conclusion The ex-pression of PD-L1 and CD8 +TILs in the postoperative specimens can help to judge the prognosis of patients. This study has certain significance for immunotherapy of PD-1/PD-L1 pathway in patients with surgically resected ADC.

Objective To explore the influence of family-integrated transition care on the daily living ability of discharged patients with stroke.Methods Seventy-eight patients with stroke who were admitted to Renmin Hospital of Wuhan University from May 2016 to October 2017 were selected by convenience sampling and were divided into a control group and a family-integrated transition care group (hereinafter referred to as transition care group).The patients in the control group received routine neurological health education,while those in the transition care group received a family-integrated transition care intervention in addition to routine neurological health education.The family-integrated transition care included team building,skills training for family members,family-integrated guidance for discharged patients,and regular visits.The scores of the modified Barthel index were compared between the two groups of patients at discharge,three months after intervention,and six months after intervention.Results Among the 71 patients that were finally included,35 cases were included in the control group,of which 17 cases were men (49％),18 cases were women (51％),and their mean age was (70.1±3.7) years;the transition care group comprised 36 cases,of which 18 cases were men (50％),18 cases were women (50％),and their mean age was (69.8±4.5) years.The baseline scores of the control group and transition care group on the day of discharge were (49.1 ± 7.5) and (49.7 ± 7.9),respectively,with no significant difference (P＞0.05).In terms of time effects,the scores of the patients in the two groups had statistically significantly improved at six months after discharge (P＜0.05).In the group comparison,the scores of the patients in the transition care group after the intervention were significantly higher compared to the scores of those in the control group (P＜0.05).In terms of time and inter-group effects,there was an interaction (P＜0.05),and therefore,the influence of time effects was excluded and the same timepoint was compared between the two groups.The scores at three months (63.9±8.8) and six months (76.9± 10.1) in the transition care group were higher than those in the control group (58.1 ±8.1 and 66.0 ±9.3,respectively).The difference was statistically significant (P ＜ 0.05).Conclusion Family-integrated transition care can effectively improve daily living ability and isworthy of promoting.

Cerebral stroke has a high incidence, mortality and disability rate, which lead to many se-quelae especially hemiplegia. Patients who got hemiplegia always had limb dysfunction and cannot live on their own, so the burden of taking care of patients are on the shoulder of caregivers. This paper reviewed the needs of caregivers from the following four parts: the classification of caregivers' needs, the influencing factors of the de-mand, the evaluation methods of the demand and the interventions that the caregivers need. From this article we know the needs of caregivers would change with the change of the state of patients, but their needs generally in-clude the disease knowledge, exercise guidance, emotion management, and community resource utilization, etc.

Objective To detect the physical and psychological function of traditional Chinese emotional nursing versus normal nursing on coronary heart disease patients. Methods Searching the major clinical databases of Cochrane library, PubMed, China National Knowledge Infrastructure, Wanfang database and VIP database to collect the relevant randomized controlled trial (RCT) about routine nursing combined with traditional Chinese medicine emotion care on coronary heart disease. After study selection, assessment and data extraction for RCT according to the inclusion and exclusion criteria, Meta-analysis were performed by using the RevMan5.2 software. Results Fourteen relevant studies as much as 1 164 patients were included in the study. Compared with the normal therapy, the figures support that the Chinese medicine emotional care group had a better curative effect (Z=6.74, P<0.01, OR=0.21, 95%CI:0.15-0.26), and the score of Hamilton Depression Scale (Z=8.84, P<0.01, MD=6.64, 95%CI:5.11-8.18), Self-Rating Depression Scale (Z=4.79, P<0.01, MD=8.21, 95%CI:4.89-11.66), and Self-Rating Anxiety Scale (Z=11.15, P < 0.01, MD=8.23, 95%CI:6.79-9.68) were all significantly decreased. Conclusions Compared to the conventional nursing combined with traditional Chinese emotional nursing and coronary heart diseaseroutine nursing care, the degree of depression and anxiety in patients is decreased significantly, and the total clinical efficacy is dramatically increased. However, the original study of quality constraints, muchmore high-quality, large sample of RCT is needed for further demonstration.

Objective To evaluate the significance and role of ultrasound parameters in the female stress urinary incontinence (SUI). Methods The changes of the distance of bladder neck mobility,posterior urethra-vesical angle,urethral angle and residual urine volume before and after the operation of transobturator tension-free vaginal tape surgery (TVT-O) for 46 cases of female SUI (experimental group ) by ultrasound were studied,and compared with 43 normal women (control group). Results The experimental group before the operation had the greater distance of bladder neck mobility and posterior urethra-vesical angle [(14.46 ± 1.28) mm, (124.87 ±2.95)°] than the control group [(7.47 ±0.55) mm, (107.83 ±3.24)°] (P ＜ 0.01 ), but the urethral angle [( 23.61 ± 2.28 )°] was smaller than the control group [(36.24 ±2.23 )°] (P ＜ 0.01 ). There was no significant difference in the distance of bladder neck mobility, posterior urethra-vesical angle, urethral angle and residual urine volume between the experimental group after the operation and the control group (P ＞ 0.05 ). The experimental group before the operation had the greater distance of bladder neck mobility and posterior urethra-vesieal angle than those after the operation [(7.84±0.76) mm, (108.74±3.63)°] (P ＜0.01), the urethral angle was smaller than that after the operation [(34.39 ± 3.46)°] (P ＜ 0.01 ), but the residual urine volume had no significant difference (P ＞ 0.05 ).Conclusions After the operation, there are some changes in the distance of bladder neck mobility, posterior urethra-vesical angle and urethral angle for the patients with female SUI,and these parameters can be restored the normal state,and have the relatively stable effect. The residual urine volume dosen't increase after the operation. Ultrasound has the advantage in objectively assessing the severity and recovery status after the operation exclusion of mental and psychological factors.

Objective Observing the effect of Shuganyishen formula on hormone-dependant metastatic breast cancer and the mechanisms of anti-resistance and endocrine therapy. Methods 226 ITT cases were divided into two cohorts by treatment. 126 cases were treated with the combination of Shuganyishen formula and standard western medicine including endocrine therapy, and 100 cases were treated with western medicine alone. The end points were time to progress (TTP) and overall survival and quality of life (QOF). The effect of Shuganyishen formula on growth of TAM-resistance cell line in vitro was observed. Results There were statistical significances of median TTP between combination and western medicine in Luminal A (ER+ /PR+, HER2-) as well as Luminal B (ER+/PR+, HER2+), but no significances of OS; The extent and incidence of hot flush, sweat and syndromes related to bone were decreased significantly in combination treated group. Shuganyishen formula could reverse resistance to TAM. Conclusion Patients with LuminalA and LuminalB metastatic breast cancer benefit from Shuganyishen formula, which maybe related with its reverse resistance to endocrine therapy.