OBJECTIVE To investigate the effects and mechanism of polysaccharides from Hedyotis diffusa （HDP） on isoniazid （INH）-induced liver injury. METHODS Healthy transgenic zebrafish with liver-specific fluorescence were divided into normal group， model group （4 mmol/L INH）， HDP low-concentration group （4 mmol/L INH+50 mg/mL HDP） and HDP high- concentration group （4 mmol/L INH+100 mg/mL HDP）. After grouping treating， the liver fluorescence area， fluorescence intensity and pathological changes of liver tissue were observed. Human liver L02 cells were divided into normal group， model group （4 mmol/L INH）， HDP low-concentration group （4 mmol/L INH+2 mg/mL HDP）， and HDP high-concentration group （4 mmol/L INH + 4 mg/mL HDP）. After grouping treating， the cell viability was detected， and the levels of alanine transaminase （ALT）， aspartate transaminase （AST）， and the content of glutathione （GSH） as well as the expression levels of silent information regulator 1 （Sirt1）， nuclear factor-erythroid 2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1） and quinone oxidoreductase 1 （NQO1） proteins were detected. RESULTS Compared with the model group， the HDP low- and high-concentration groups showed varying degrees of increase in the fluorescence area and fluorescence intensity （except for HDP low-concentration group） of zebrafish liver （P＜0.05 or P＜0.01）， and the characteristics of liver injury and necrosis had been improved to varying degrees. Compared with model group， the survival rate of L02 cells， the content of GSH （except for HDP low-concentration group）， the protein expression levels of Sirt1 （except for HDP low-concentration group）， Nrf2， NQO1， HO-1 （except for HDP low-concentration group） were significantly increased in HDP low- and high-concentration groups （P＜0.05 or P＜0.01）， and the levels of ALT and AST （except for HDP low-concentration group） were significantly decreased （P＜0.05）； the number of survival cells significantly increased， while the number of damaged or dead cells significantly decreased. CONCLUSIONS HDP has a potential protective effect against INH-induced liver injury， the mechanism of which may be associated with activating Sirt1/Nrf2 signaling pathway， improving mitochondrial function and enhancing antioxidant capacity.

Objective:To explore the status quo of pediatric nurses' cognition of death education, and analyze its influencing factors, so as to provide experience and reference for carrying out death education in pediatric wards.Methods:In this study, 827 nurses from 15 children's hospitals in China were investigated by using the scale for evaluating the cognition of death education in medical staff prepared by Zhang Yan-gai, and the related factors affecting the cognition of death education were analyzed. SPSS 23.0 was used for independent-samples t-test and ANOVA analysis, and multiple regression equation was used to further analyze the relationship between the cognitive factors of death education in pediatric nurses. Results:The total score of death education cognition of pediatric nurses was (35.61±5.64) points, which was lower than the median score of 36 points. The degree of death education cognition of pediatric nurses was at the medium-low level. The results of correlation analysis showed that the professional title of nurses (regression coefficient: 0.064, P=0.045), the training demand for death education (regression coefficient: 0.300, P<0.001), and the way of understanding (regression coefficient: 0.018, P=0.003) were independent influencing factors of the death education cognition level of pediatric nurses. Conclusions:Pediatric nurse death education related theoretical knowledge should be improved through various professional trainings. The hospitals should include death education in pediatric nurse continuing education training plan to improve pediatric nurses' cognitive level of death education through a variety of ways and means, promote the application of death education activities carried out in pediatric ward in the hospice care, reduce deaths impact to nurse their own emotions, and alleviate parents' anxiety and painful experience, thereby improving medical satisfaction.

Objective:To explore the correlation among fear of cancer recurrence, illness perception and perceived social support in patients with oral cancer after surgery.Methods:This study was a cross-sectional study. From January to December 2021, 225 patients with oral cancer admitted to the Oral Surgery of the First Affiliated Hospital of University of Science and Technology of China were selected as the study subject by convenient sampling. The Fear of Cancer Recurrence Inventory (FCRI) , Brief Illness Perception Questionnaire (BIPQ) and Perceived Social Support Scale (PSSS) were used to investigate the patients. Pearson correlation was used to explore. Multiple linear regression was used to explore the correlation among fear of cancer recurrence and illness perception and perceived social support in patients with oral cancer after surgery. A total of 225 questionnaires were distributed, and 210 valid questionnaires were recovered, with a valid recovery rate of 93.3%.Results:Among 210 postoperative patients with oral cancer, the total scores of FCRI, BIPQ and Chinese version of PSSS were (96.58±13.80) , (48.00±11.87) and (41.85±12.50) respectively. The multiple linear regression showed that age, marital status, per capita monthly income of families, operation methods, illness perception and perceived social support were the influencing factors of fear of cancer recurrence in patients with oral cancer after surgery ( P<0.05) . Conclusions:Patients with oral cancer after surgery have a certain degree of fear of cancer recurrence, which is related to illness perception and perceived social support. Medical and nursing staff can improve patients ' illness perception and their perceived social support, so as to reduce their fear of cancer recurrence after oral cancer surgery.

From April 2017 to September 2019, the START (standardized reception, teaching, analysis, research, training) method was adopted to train 50 general practitioners at the community general practice teaching clinic of Shanghai Huangdu Community Health Service Center. After 3 months of training, the progress of clinical competence and teaching ability were assessed. After training, the scores of clinical skills and communication skills were significantly higher than those before training (P<0.01). The scores of medical history taking, clinical thinking and health education were higher than before (all P<0.01). But there was no significant difference in record writing and reception time management between those before and after training (all P>0.05). The scores of the ability for building physician-patient relationship, collecting information and providing feedback, understanding complaints from patients′ perspective, sharing information and obtaining informed consents were higher than that before training (all P<0.01). The teaching ability of plan design and teaching method were significantly improved compared with that before training (all P<0.01). The satisfaction rate of START method was 96.0%(48/50). The START method applied in community teaching clinic can significantly improve the clinical competency and teaching ability of general practitioners.

Objective To summarize the clinical outcomes of surgical correction of velophary geal insufficiency (VPI) with two procedures of radical intravelar veloplsties,and to discuss the indication selection of surgical technique.Methods 58 cases of various cleft palate were speech evaluated and diagnosed as mild to moderate VPI,who aged from 3 to 28 years (mean age 7.5 years).Group Ⅰ (36 cases) were performed surgery in the way of modified Furlow double-opposing Z-plasty.Group Ⅱ (22 cases) were performed surgery in the way of Sommerald radical IVV.All cases were followed up for 6 months to 1 year after surgery,with speech evaluation and objective examination of nasopharygoscopy and fixed position lateral X ray.The X-ray images of lateral view of velum was read through PACS image system.The effective work length of soft palate and the pharyngeal gap of the velum at rest and function were measured directly through PACS system.The data of each case before and after surgery were compared.Results 34 of 36 cases (94.50％) in modified-Furlow group and 21 of 22 cases (95.5％) in Sommerlad group finally recovered complete velopharyngeal closure.Compared between before and post operation,the effective work length of soft palate in modified Furlow group increased by 9.50±2.35 mm,the length in Sommerlad group increased by 7.50±3.32 mm.The differences were statistically significant by paired T test (P＜0.001).None of all cases complained nasal airway obstruction.Conclusions Both types of radical IVVs are highly effective to be recommended for surgical correction of mild to moderate VPI.Strict selection of surgical indication and excellent surgical skill are necessary for good treatment outcomes.

The regional education platform is important in the training and continuing education for general practitioners,which provides clinical training program to upgrade the competence of general practitioner,but it is still in the initial stage.This article introduces the construction and development of inservice training and education platform for general practitioners in Shanghai Jiading district,and introduces the specific function and main features of the platform.

Thirty-five general practitioners ( GPs) from Huangdu Subdistrict Community Health Center of Anting Township were trained for clinical skills and communication skills in consultation at outpatient department by using Leichester assessment package (LAP) from January 2016 to December 2016. The clinical skills and communication skills were assessed before and after 1 year of training.The results showed that compared to those before training the clinical skill and communication skill were significantly increased after the training.The scores of medical history taking , clinical reasoning and health education , as well as the scores of building doctor-patient relationship, collecting information and providing feedback , understanding complaints from patient perspective , sharing information and obtaining informed consents after the training were all higher than those before training (all P＜0.05).However, there were no significant differences in scores of history writing and interview time before and after training .The study showed that Leichester assessment package can effectively improve the training of clinical skills and communication skills for GPs, and it can be applied for future training .

The adverse reactions caused by traditional Chinese medicine have occurred frequently, but there is a lack of scientific,objective and standardized methods for safety evaluation of traditional Chinese medicine.In the process of preclinical evaluation of traditional Chinese medicine, it is imperative to form a set of scientific, standardized and feasible evaluation system of modem Chinese herbal drug.We established the preclinical safety evaluation system of modem Chinese herbal drug including the quality control system of samples for the preclinical safety evaluation, the toxicity evaluation system of modem Chinese herbal drug and its preparation and the evaluation management system, and standardized each research link of preclinical evaluation of traditional Chinese medicine.Whether from protecting patients' health and increasing the safety of clinical medication, or from enriching and improving traditional Chinese medicine science, developing traditional Chinese medicine and promoting mutual connection of traditional Chinese medicine and international medicine, it has important instructional significance and application value.

Objective To construct and implement the nursing quality information feedback system based on QUACERS model and control theory, and discuss its application effect and the problems that should be paid attention to and to provide operational cases and practical basis for nursing quality management. Methods Through literature review and expert consultation, the framework and content of nursing quality information feedback system were set up and implemented. The changes of the nursing quality and the repeated occurrence of nursing problems were evaluated before (2013) and after (2015) the implementation of this project. And in December 2015, a self-made questionnaire was conducted among the nurses in the hospital to evaluate the importance of the feedback and it′s effect of improving the nursing quality. And evaluate the timeliness and effectiveness of different feedback forms. Results 1 120 and 1 136 nurses were followed-up in 2013 and 2015 respectively. The scores of human resource management, clinical nursing service and nursing safety management were higher than before, and the repeated occurrence of nursing problems was lower than before. A total of 450 questionnaires were distributed, 438 copies were collected, the effective recovery rate was 97.33%. Ratings for the importance of each item was from 3.37 to 4.57. Ratings for the effect of improving the quality of care was 3.79 to 4.39. The percentage of quality information received by nurses was more than 95%, and the average score of feedback timeliness was 4.29 to 4.53. Conclusions Quality information feedback system based on QUACERS model can cover multiple dimensions of quality management, and it was conducive to obtaining comprehensive information;Combined with multiple feedback forms can improve the effect of information feedback.

Objective To establish a method for detection Tp0259 gene by PCR .To provide basis of diagnosis infection of trepo‐nema pallidum by detection Tp0259 gene .Methods Gene sequences of Tp0259 was obtained from Genebank and analysis by bioin‐formatics .Specific primers were designed .The whole genome was extracted from testis specimens of the New Zealand rabbits infec‐ted by treponema pallidum and control groups .The gene of Tp0259 was amplified by PCR under the optimization reaction condi‐tions which was selected by many tests ,using the new construction of amplification method to detect the common pathogenic micro‐organism in urinary and reproductive tract infection .Results Specific bands of 646 bp was appeared only in New Zealand rabbits which was infected by treponema pallidum ,while none was in the control group and other pathogenic microorganisms .Conclusion Detection the Tp0259 gene could be used to diagnose infection of treponema pallidum .