ObjectiveTo investigate the effect of Ziziphi Spinosae Semen-Albiziae Flos on the nucleotide-binding oligomerization domain，NOD-like receptor thermal protein domain associated protein 1 （NLRP1）/chemokine ligand 1 （CXCL1）/chemokine receptor 2 （CXCR2） pathway in the hippocampus of the rat model of chronic unpredictable mild stress （CUMS）-induced depression. MethodA total of 120 male SD rats were randomized into blank，CUMS，CUMS + low-，medium-，and high-dose （4，8，16 g·kg^-1） Ziziphi Spinosae Semen-Albiziae Flos，and CUMS + venlafaxine hydrochloride （0.008 g·kg^-1） groups，with 20 rats in each group.The rat model of depression was established by solitary feeding combined with CUMS.The behaviors and spatial learning and memory abilities of rats were examined by sugar water consumption test，tail suspension test，forced swimming test，and Morris water maze test.Quantitative real-time PCR （Real-time PCR） and Western blot were employed to determine the expression of factors associated with the NLRP1/CXCL1/CXCR2 pathway in the hippocampus.Enzyme-linked immunosorbent assay was employed to determine the levels of tumor necrosis factor-α （TNF-α），interleukin （IL）-18，IL-1β，and IL-6 in the hippocampus.The immunofluorescence assay was used to measure the levels of reactive oxygen species （ROS） in the hippocampus. ResultCompared with the blank group，the CUMS group showed decreased preference to sugar water and times of crossing the platform （P<0.01），and increased immobility time of tail suspension，forced swimming floating time，and escape latency （P<0.01）.Compared with the CUMS group，the administration of Ziziphi Spinosae Semen-Albiziae Flos and venlafaxine hydrochloride alleviated the effects of CUMS on the above-mentioned behaviors and spatial learning and memory abilities of the rats （P<0.05，P<0.01）.Compared with the blank group，the CUMS group showed up-regulated protein levels of NLRP1，CXCL1，and CXCR2 （P<0.01） and elevated levels of IL-18，IL-1β，TNF-α，and IL-6 （P<0.01） in the hippocampus.The treatment with Ziziphi Spinosae Semen-Albiziae Flos and venlafaxine hydrochloride attenuated the activation of NLRP1/CXCL1/CXCR2 signaling pathway and lowered the levels of inflammatory cytokines in the hippocampus of CUMS rats （P<0.05，P<0.01）.In addition，Ziziphi Spinosae Semen-Albiziae Flos lowered the level of ROS in the hippocampus （P<0.05，P<0.01）. ConclusionZiziphi Spinosae Semen-Albiziae Flos can mitigate the depressive behaviors of the rat model of CUMS-induced depression by inhibiting the activation of NLRP1/CXCL1/CXCR2 signaling pathway.

Objective:To retrieve, evaluate, and summarize the best evidence for peripherally inserted central catheter (PICC) related thrombosis in children.Methods:Guideline websites, relevant society websites, and databases at China and abroad were searched for guidelines, evidence summaries, expert consensuses, and systematic reviews related to thrombosis before and after PICC catheterization in children published up to June 30, 2021 based on evidence-based nursing. The quality of the literature was independently evaluated by 2 researchers with reference to Appraisal of Guidelines for Research and Evaluation InstrumentⅡ and the criteria of the Joanna Briggs Institute (JBI) in Australia (2016) . Data were extracted from the literatures that met the standards through expert demonstration, and the evidence was graded and recommended according to the JBI evidence pre-grading system (2014 edition) .Results:A total of 11 articles were included, including 4 guidelines, 1 systematic review, 1 expert consensus, and 5 evidence summaries. 27 pieces of evidence were summarized from 7 aspects: organizational management, catheter selection, blood vessel selection and puncture, location of catheter tip, physical prevention, drug prevention, and evaluation.Conclusions:This paper summarizes and analyzes the best evidence for PICC-related thrombosis in children and provides an evidence-based reference for the clinical application and practice of PICC-related thrombosis in children.

Objective:To explore the pain perception and cognition of children with malignant tumor and their parents during the disease treatment.Methods:Using the convenient sampling method, a total of 179 children with malignant tumors and their 179 parents who were admitted to the day ward of Hematology and Oncology Center of Beijing Children's Hospital, Capital Medical University from June 2017 to February 2019 were selected as the research objects. The children and their parents were surveyed by using the self-developed Pain Questionnaire for Children with Malignant Tumor and the Pain Questionnaire for Parents of Children with Malignant Tumor. A total of 179 questionnaires were distributed, 179 valid questionnaires were recovered, and the effective recovery rate was 100.0%.Results:The incidence of pain during treatment in 179 parents and 179 children was 100.0% (179/179) and 98.3% (176/179) , respectively. The average scores of 179 parents and 179 children who considered the most severe pain during disease treatment were respectively (5.82±2.30) and (5.41±2.09) , and the average pain scores were (4.04±1.90) and (3.95±1.66) , respectively. There were statistically significant differences in pain perception between children and their parents during lumbar puncture/thecal injection, bone puncture, PICC catheter placement, indwelling needle puncture and venous blood collection ( P<0.05) . A total of 77.1% (138/179) of parents and 65.4% (117/179) of children had concerns about the use of analgesics, respectively. Conclusions:There is a high consistency between the severity of pain experienced by parents and the children's feelings during treatment. However, the parents feel that the unbearable treatment-related pain during the treatment of the disease is higher than that of children, and they are more passive than children in the attitude of receiving analgesics. Medical staff can listen to their parents' opinions during pain assessment, pay attention to education of parents before treatment-related operations, take measures to reduce or even avoid the occurrence of treatment-related pain and strengthen the training of pain relief measures.

Objective:To retrieve and summarize the best evidence of peripherally inserted central catheters (PICC) related bloodstream infection prevention and to evaluate the evidence, so as to provide reference for clinical implementation of preventive measures for catheter-related bloodstream infection.Methods:National Institute for Health and Care Excellence (NICE) , National Guideline Clearinghouse (NGC) , Guidelines International Network (GIN) , Scottish Intercollegiate Guidelines Network (SIGN) , Australian Joanna Briggs Institute (JBI) Evidence-based Health Centre Database, UpToDate, BMJ Best Practice, Cochrane Library, China National Knowledge Infrastructure (CNKI) , Wanfang and related professional websites such as Infusion Nursing Society (INS) , Medlive and official website of the National Health Commission were searched for all clinical decisions, guidelines, expert consensus, evidence summary and systematic reviews related to the prevention of PICC catheter-related bloodstream infections. The retrieval time limit was from the establishment of the databases to May 2021. Four researchers evaluated the quality of the literature, and two researchers extracted and summarized the evidence.Results:A total of 9 articles were included, including 1 clinical decision, 1 standard of practice, 4 guidelines and 3 evidence summaries. Finally, 29 pieces of evidence were included from 5 dimensions, including organization management, infusion tool selection, catheterization maintenance and use, health education and extubation.Conclusions:The summary of the best evidence for the prevention of PICC related bloodstream infection covers a wide range of areas. Managers and clinical medical staff should apply the evidence according to the specific medical situation to reduce the occurrence of clinical PICC catheter-related bloodstream infection.

Objective:To analyze the public demands for information about congenital birth defects in “Baidu zhidao” based on word frequency retrieval.Methods:Based on discussion between obstetrics and gynecology experts and epidemiological experts, the key words related to congenital birth defects were determined and the search strategy was formulated. Python 2.7 was used for web crawler search. Questions related to congenital birth defects were obtained on the “Baidu zhidao” platform, and then the R 4.0.2 software was used to process the data, complete the semantic analysis of keywords and statistical analysis of word frequency, and draw word cloud graph and polar chart to describe the key results.Results:A total of 16668 non-repetitive questions were retrieved from “Baidu zhidao” platform, and the frequency of semantic words was 15 371. Among them, 35.02% were the names and symptoms of congenital birth defects. In addition, the frequency of congenital heart disease was the highest (26.09%). The results of subject analysis of key words of birth defects showed that the average word frequency of diagnosis and treatment semantic words (49.55) was significantly higher than that of etiology and prevention semantic words (12.47). In addition, the key words of examination, cause, treatment, development and heredity were more frequently used in the semantic words related to the seven types of systemic malformations.Conclusion:The public in China has a high demand for information on congenital birth defect related diseases, and their causes, prevention and treatment, especially congenital heart disease.

Objective:To investigate the complication and compliance of different supine time and the degree of obedience in children with leukemia after intrathecal chemotherapy.Methods:A total of 553 children with leukemia after intrathecal chemotherapy from April 1, 2017 to March 28, 2019 in Beijing Children′s Hospital Affiliated to Capital Medical University were selected. Children who received intrathecal injection from April 1, 2017 to December 31, 2017 were selected as control group(274 cases), from January 1, 2018 to March 28, 2019 were selected as research group(279 cases). The children in research group were supine 2 hours but control group were supine 4 hours after intrathecal. The complications that occurred after injection and within one week after injection and compliance were observed.Results:Finally, 457 children included in this study, there were 235 cases in research group and 222 cases in control group. The number of cases of limb numbness and local pressure reddening in the research group and the control group were 18, 20 and 31, 34, respectively, with statistically significant differences between the two groups( χ2 values were 4.74, 5.07, P<0.05). After intrathecal injection, the patients' compliance with the time of supine removal was completely acceptable to the research group, relatively acceptable, acceptable, and required efforts to adhere to the number of cases were 65, 83, 42, 45, respectively, while the control group were 34, 50, 76, 62, respectively, the differences were significant ( χ2 value was 30.04, P<0.05). Conclusions:Supine for 2 hours after intrathecal injection can reduce the incidence of complications and improve compliance, which is safe and feasible. So, supine for 2 hours after intrathecal injection is recommended.

Objective To explore the occurrence of pain in the treatment of children with malignant tumors and their perception and cognition of pain, and provide a reference for strengthening pain management and formulating clinical nursing measures. Methods Totally 179 children with malignant tumors admitted in the daytime wards of a Class Ⅲ Grade A children's hospital in Beijing from June 2017 to October 2018 were selected and investigated with the self-made pain questionnaire for children with malignant tumors. Totally 179 questionnaires were distributed and collected in this study, accounting for an effective recovery rate of 100％. Results The incidence of pain in the 179 children was 98.3％ (176/179). The severest pain score was (5.41±2.09), and the average pain score was (3.95±1.66). Pain involved the abdomen, lower limbs, oral mucosa, bones and joints, waist, back, upper limbs, chest, perianal mucosa, neck, head and face, perineum, ear, nose, throat and eyes. Totally 83.8％(150/179) of the children informed the medical staff in time when the pain occurred, hoping to get analgesic treatment; 35.2％ of the children were willing to receive analgesics. In the 179 Children, the children believed that 84.6％ of the pain was related to the treatment procedure; 46.6％ (82/179) was related to the disease itself; and the most unbearable treatment procedure was lumbar puncture/ intrathecal injection. Conclusions Children with malignant tumors have a higher incidence and severity of pain during the treatment of the disease, and the pain is widespread. Most children hope to receive analgesic treatment, but they do not have enough knowledge about analgesics. Medical staff should pay attention to the pain of children with malignant tumors, strengthen pain management, and take measures to reduce and even avoid treatment-related pain.

Objective:To evaluate the effect of acupoint stimulation on the prevention of anticipatory chemotherapy-induced nausea and vomiting by using Cochrane systematic review method.Methods:Wanfang database, China National Knowledge Infrastructure (CNKI) , VIP Chinese Science and Technology Journal Full-text Database, SinoMed, Cochrane Library, PubMed, EMbase, Elsevier, Springer, ClinicalKey for Nursing were searched by computer, which were supplemented by Internet retrieval, and the retrieval time was from set of these databases to November 2019. All randomized controlled trials and semi-randomized controlled trials that explored acupoint stimulation for the prevention of anticipated chemotherapy-induced nausea and vomiting were collected. The quality was evaluated by reference to Cochrane Handbook 5.1.0, and the data were analyzed with RevMan 5.0 software.Results:A total of 5 papers were included (544 adult tumor inpatients, 269 in the intervention group and 275 in the control group) , of which 2 were randomized controlled trials and 3 were semi-randomized controlled trials. All literatures were grade B in quality. There were 3 kinds of acupoint stimulation involved, which were auricular therapy, acupoint massage and acupoint application. Meta-analysis results showed that only the subgroup analysis of acupoint application (184 patients) showed that the intervention group was superior to the control group in terms of the control effect of chemotherapy-induced nausea and vomiting ( RR=1.12, 95% CI 1.03-1.23, P=0.01) . Other results showed no statistically significant difference between the intervention group and the control group, either in the Meta-analysis of all literatures, or in the subgroup analysis based on different types of nausea and vomiting, different time of occurrence, whether the intervention group combined with antiemetic drugs or auricular therapy intervention ( P>0.05) . In the Meta-analysis of adverse reactions, 3 literatures analyzed the occurrence of adverse reactions, among which 2 literatures did not observe adverse reactions, and 1 literature showed that the incidence of adverse reactions in the intervention group (22%) was lower than that in the control group (52%) . In the Meta-analysis of depression scores, two literatures (260 patients) evaluated depression scores, using random effect model. The results showed that the depressive symptoms score of the intervention group was lower than that of the control group ( MD=-11.72, 95% CI -19.82-3.62, P=0.005) . In the Meta-analysis of quality of life, 2 literatures evaluated the improvement of quality of life. Since the data could not be combined and only descriptive analysis was performed, the results suggested that auricular therapy could improve quality of life of patients. Conclusions:Acupuncture point stimulation is not yet considered to relieve anticipatory chemotherapy-induced nausea and vomiting, but it does not increase the risk of adverse reactions and it can reduce depressive symptoms.

Objective: To evaluate combined robotic and endoscopic surgery in the third space for gastric submucosal tumors(SMTs). Methods: Combined surgery in 4 patients were compared with 19 patients who underwent laparoscopic wedge resection between Aug 2017 and Feb 2018. Results: R₀ resection was achieved in all combined surgery patients. The operation time was longer (112±29 )min vs. (93±11 ) min (t=2.338, P<0.05), but less blood loss, (11±6)ml vs.(59±6)ml (t=15.102, P<0.01). In combined surgery group, there was a larger tumor over resected tissue percentage, 65.4%±28.2% vs.22.8%±19.6% ( t=3.680, P<0.05). Combined surgery group patients were with earlier first breaking wind (3±1.4) d vs.(4.1±0.9) d (t=2.026, P>0.05), and shorter hospital stay (6.5±1.3) d vs.( 8.5±0.6) d (t=4.902, P<0.01), but a little higher hospitalization costs(57 651±10 097)rmb vs.(42 620±5 086)rmb (t=4.508, P<0.01). There were no major postoperative complications occurred in neither groups, nor tumor recurrences after 3-month follow-up. Conclusion Combined robotic and endoscopic surgery in the third space for submucosal gastric tumors is a novel operation with short operation time, less blood loss and good result.

OBJECTIVE: To explore the effects of bone marrow mesenchymal stem cells (BMSCs) in different concentrations on the balance of regulatory T cell/T-helper cell 17 (Treg/Th17). METHODS: BMSCs were isolated from SPF grade male Wistar rats with age of 3 weeks old and weight of 50 g. BMSCs were cultured and identified when they were expanded to the 4th generation. CD4⁺ T lymphocytes were isolated from SPF grade male Wistar rat with age of 6 weeks old and weight of 200 g and assayed for cell purity by flow cytometry. BMSCs were divided into 0.5-fold concentration group, basal concentration group, 2-fold concentration group and 4-fold concentration group by their concentrations of 1×10⁵/well, 2×10⁵/well, 4×10⁵/well and 8×10⁵/well, which were cultured with CD4⁺ T lymphocytes for 72 hours, respectively. Then the proportion of Treg cells and Th17 cells in each group was detected by flow cytometry, and cytokines were detected by cytometric bead array. RESULTS: The purities of BMSCs and CD4⁺ T lymphocytes were both higher than 95%. In the co-culture of BMSCs and CD4⁺ T lymphocytes, the proportions of Treg cells were statistically different among different concentration groups of BMSCs (F = 10.071, P = 0.001), in which BMSCs in 2-fold concentration group had the strongest ability to promote the Treg cells proliferation. The proportion of Treg cells in 2-fold concentration group was significantly higher than that in 0.5-fold concentration group, basal concentration group and 4-fold concentration group [(9.24±2.68)% vs. (3.87±0.38)%, (5.16±1.69)%, (3.86±0.36)%, all P < 0.01]. The level of interleukin-10 (IL-10) was lowest in 0.5-fold concentration group, and it was significantly lower than that in basal concentration group, 2-fold concentration group and 4-fold concentration group (ng/L: 39.80±14.48 vs. 148.43±64.49, 156.40±59.27, 126.92±42.95, all P < 0.05). Transforming growth factor-β (TGF-β) was the highest in basal concentration group, and it was significantly higher than that in 0.5-fold concentration group, 2-fold concentration group and 4-fold concentration group [ng/L: 3.17 (1.88, 5.74) vs. 0.71 (0.32, 1.38), 1.22 (0.47, 2.97), 0.52 (0.37, 1.23), all P < 0.05]. The proportions of Th17 cells were statistically different among the different concentration groups (F = 21.069, P = 0.000), with the highest proportion in basal concentration group which was significantly higher than that in 0.5-fold concentration group or 4-fold concentration group [(0.89±0.08)% vs. (0.64±0.15)%, (0.37±0.10)%, both P < 0.01], but no significant difference was found as compared with 2-fold concentration group [(0.83±0.06)%, P > 0.05]. However, the expressions of IL-17 and IL-6 were not different among the different concentration groups respectively (IL-17: χ² = 0.550, P = 0.760; IL-6: χ² = 0.010, P = 0.995). CONCLUSIONS BMSCs in moderate concentrations [(2-4)×10⁵/well] could promote proliferation both in Treg cells and Th17 cells, but no change could be found in higher concentrations of BMSCs (8×10⁵/well). However, the changes in related cytokines were not synchronized with Treg/Th17 cells.
Animals ; Cytokines/metabolism* ; Male ; Mesenchymal Stem Cells/metabolism* ; Rats ; Rats, Wistar ; T-Lymphocytes, Regulatory/metabolism* ; Th17 Cells/metabolism*