Objective To analyze the nutritional status and risk factors of disease condition grading in patients with chronic obstructive pulmonary disease (COPD), and to provide the reference for clinical diagnosis and treatment.. Methods A total of 518 patients with COPD who were admitted to the hospital from February 2020 to February 2023 were selected as the study subjects (COPD group). Among the 520 cases of non-COPD patients in respiratory and critical care wards were included in control group . The patients with COPD were divided into 265 cases in malnutrition group and 253 cases in normal nutrition group according to the nutritional status. The nutritional status of patients with different disease condition grades was observed . The basic information and clinical examination status were compared between both groups, and multivariate logistic regression analysis was used to explore the risk factors of malnutrition in patients with COPD. Results The nutritional indicators of BMI, IBM and ALB in COPD group were lower than those in control group (P<0.05). The higher the disease condition grade , the lower the levels of nutritional indicators (P<0.05). The proportions of smoking history, number of acute exacerbations ≥twice a year, comorbidity types≥4, ALB<35 g/L, CRP≥60 mg/L, CAT score≥10 points and FEV1/FVC<50% in malnutrition group were higher than those in normal nutrition group while the proportion of ventilator use was lower than that in normal nutrition group (P<0.05) . Multivariate Logistic regression analysis showed that the number of acute exacerbations≥ twice a year, comorbidity types≥4, CRP≥60 mg/L and FEV1/FVC<50% were independent risk factors of malnutrition in patients with COPD, and ventilator use was a protective factor (P<0.05). Conclusion The nutritional status of COPD patients is poor , and the more serious the disease condition grade , the worse the nutritional status . The number of acute exacerbations , types of concurrent diseases , CRP , FEV1/FVC are all influencing factors of malnutrition in COPD patients.

Purpose To investigate the expression of pro-tein of relevant evolutionary and lymphoid interest domain-con-taining 1(PRELID1)in gastric cancer tissues and to analyze its effect on prognosis,and the mechanism of influencing the prolif-eration and invasion ability of gastric cancer cells.Methods Using TCGA data and clinical data of 111 patients with gastric cancer,we analyzed the relationship between the expression of PRELID1 and clinicopathological parameters and the impact on clinical prognosis.The biological function of PRELID1 was pre-dicted by bioinformatics,and further verified by in vitro and in vivo experiments.Lentivirus was applied to regulate the level of PRELID 1 in gastric cancer cell line(MGC803)in vitro,and its effect on the proliferation,migration,and invasion of gastric cancer cells was observed.The nude mouse subcutaneous tumor-igenesis was used to observe the effect of PRELID1 on the growth of gastric cancer tissue in vivo.Results The expression of PRELID1 was significantly higher in gastric cancer tissues than that in the adjacent tissues(P＜0.001)and was positively cor-related with the cell proliferation indicator Ki67(P＜0.001).Cox regression model analysis showed that the high expression of PRELID 1 was an independent risk factor affecting the 5-year survival rate after radical gastrectomy(HR=2.336;95％CI=1.354-4.029).Gene enrichment results showed that the func-tion of PRELID1 was related to proliferation and JAK/STAT sig-naling.CCK-8 and Transwell experiments found that up-regula-tion of PRELID1 promoted the proliferation(P=0.016),mi-gration(P=0.016)and invasion(P=0.025)of gastric cancer cells,while down-regulation inhibited the proliferation(P=0.026),migration(P=0.048)and invasion(P=0.029).Subcutaneous tumor formation experiments in nude mice found that up-regulation of PRELID1 promoted the growth of gastric cancer tissue(P=0.047),while down-regulation was the oppo-site(P=0.005).Western blot detecting gastric cancer cells and gastric cancer tissues found that up-regulation of PRELID1 promoted the expression of JAK and STAT proteins(all P＜0.05),while down-regulation inhibited them(all P＜0.05).Conclusion The high expression of PRELID1 associated with poor prognosis may regulate the proliferation,migration and in-vasion of gastric cancer cells by up-regulating JAK/STAT signa-ling in gastric cancer.

Objective To compile nursing guidelines for diabetic patients undergoing ultrasound-guided islet transplantation through percutaneous portal vein puncture and catheterisation,providing valuable insights for the care of such patients during the surgical procedure.Methods Between December 2017 to September 2023,a total of 27 patients underwent 44 surgical procedures for ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation at our hospital.Nursing assistance was provided preoperatively,intraoperatively and postoperatively for all the procedures.Results All 27 patients who had undergone 44 surgical procedures successfully went through the ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation.Among the 44 surgical procedures,3(6.8%)resulted in upper abdominal and liver area pain,nausea and vomiting during surgery,8(18.2%)had transient increase of portal vein pressure during transplantation,and 6(13.6%)encountered active bleeding following the removal of the portal vein catheters.None of the patients developed delayed portal vein bleeding or complication such as portal vein thrombosis after the surgery.Conclusions Nursing interventions play a crucial role in ensuring the successful outcomes of ultrasound-guided islet transplantation.Following measures are the keys and they play an important roles in ensuring the smooth completion of ultrasound-guided islet transplantation:preoperatively,carefully assess the condition of recipients and provide them with psychological supports and patient education.Intraoperatively,closely monitor the vital signs,portal vein pressure and blood glucose as well as to prevent complications.Postoperatively,implement the nursing measures to prevent the recipients from postoperative bleeding of portal vein.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive and incomplete reversible airflow limitation, and COPD is mainly caused by small airway lesions and seriously endangers human health due to its high incidence rate and mortality rate. At present, the occurrence of COPD can be effectively prevented by detecting the characteristics of small airway lesions, so the study of small airway lesions has positive significance in the prevention and early intervention of COPD. This paper reviews the research progress on characteristics, detection methods and diagnosis and treatment methods of small airway lesions in COPD, so as to provide a theoretical basis for clinical research.

Chronic obstructive pulmonary disease (COPD) is a common respiratory system disease, with high incidence rate and mortality. So far, the pathogenesis of COPD has not been clearly determined. Microinflammatory state refers to the growth and reproduction of certain pathogens in the body due to bacteria, viruses and fungi infections, which causes inflammatory response of local tissues and the whole body, it is manifested by a slight and continuous increase of inflammatory marker proteins and inflammatory cytokines in systemic circulation. This article reviewed the literature on microinflammatory state and COPD. It is concluded that microinflammatory state will lead to the imbalance of proinflammatory and anti-inflammatory mechanisms, which can cause ischemic and hypoxic destruction and injury of lung tissue cells, and further aggravate lung injury. The common inflammatory factors such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL) in microinflammatory state are closely related to the severity of COPD, which may promote disease progression, continuously affect lung function, arterial blood gas and nutritional status of patients.

Objective:To explore the effect of WeChat-based education and rehabilitation program (WERP) on anxiety, depression, quality of life in patients with non-small cell lung cancer (NSCLC) after radical resection for lung cancer.Methods:From June 2018 to May 2020, convenience sampling was used to select 200 patients with NSCLC who underwent radical resection for lung cancer in the First People's Hospital of Wenling as the research subject. According to the random number table, the patients were divided into the WeChat group and the control group, with 100 cases in each group. The control group was given routine nursing, and the WeChat group received WERP. The scores of Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) were compared between the two groups before and after the intervention.Results:After the intervention, the HADS anxiety and depression scores in the WeChat group were lower than those in the control group, and the QLQ-C30 overall health and function scores were higher than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:WERP is an effective way to relieve anxiety and depression in patients with NSCLC after radical resection for lung cancer and improve their quality of life.

Objective To investigate the effect of Shenxiong glucose injection on platelet reactivity during aspirin treatment in patients with acute ischemic stroke.Methods A total of 263 patients with acute ischemic stroke admitted to 12 hospitals from January 2014 to December 2016 were enrolled prospectively.They were randomly divided into aspirin group and aspirin + Shenxiong glucose injection group.The changes of platelet maximum aggregation rate induced by 4 platelet aggregating agents (arachidonic acid,adenosine diphosphate,collagen and platelet activating factor) were detected before and after the treatment.Results There were no significant differences in the demographic data and baseline clinical characteristics between the aspirin group (n =132) and the Shenxiong glucose injection + aspirin group (n =131).At baseline,the maximum aggregation rate of platelet induced by arachidonic acid and platelet activating factor in Shenxiong glucose injection + aspirin group was significantly higher than that in the aspirin group (all P ＜0.05).On the 6th day after treatment,the maximum aggregation rate of platelets induced by the 4 aggregating agents in the Shenxiong glucose injection + aspirin group was significantly lower than that in the aspirin group (all P ＜ 0.001).Conclusion Shenxiong glucose injection had a significant inhibitory effect on platelet reactivity during aspkin treatment in patients with acute ischemic stroke.

Objective To study the impact of individualized birth process management on birth outcomes of low-risk parturient unipara .Methods 729 parturient women were divided into the experimental group ( n=503 ) and the control group ( n=226 ) .The free position during labor was used in the control group . In the experimental group , individualized labor movements and pre-delivery positions were provided to improve the birth outcome .The incidence of emergency cesarean section and use of obstetric forceps were compared between groups .Results A total of 468 parturient women in the experimental group were in spontaneous labor , with an incidence of 93.04%;198 parturient women in the control group were in spontaneous labor , with an incidence of 87.6%.The use of obstetric forceps in the experimental group was 1.59%, which was lower than 3.98%in the control group .Twenty-six parturient women in the experimental group went through emergency cesarean section , with an incidence of 5.17%; nineteen parturient women in the control group went through emergency cesarean section , with an incidence of 8.41%.The difference was significant between groups (χ2 =6.97 ,P<0.05 ) .The most frequent labor position in the experimental group was semireclining position , with an incidence of 90.46%.The least use labor position was kneeling-squatting position , with an incidence of 4.57%.Conclusions The Individualized birth process management can significantly decrease the rate of emergent cesarean and forceps delivery .

Objective To establish a high-performance liquid chromatography (HPLC) method with diode array detection to simultaneously determine carbamazepine,phenytoin,and phenobarbital in serum.Methods Extraction solvent (800μl ethylene acetate) and sample (0.2 ml) was mixed,extracted for 2 min,and centrifuged (3500 r/min,4 minutes).A volume (600 μl) of extract liquor was volatilized to dryness in water bath with the volatilization temperature 75 ℃,then was redissolved with 1.0 ml mobile phase.Analysis conditions was column temperature 30°,mobile phase (methanol∶ water =40∶60),and detection wavelength of 254 nm.Three metabolites were effectively separated.Results Under the optimized condition,calibration curves of three metabolites were linear in the ranges of (1.52 ～ 120 mg/L) and the correlation coefficients were not less than 0.999.The detection limits (S/N =3) were in the range of 0.4 ～ 1.5 mg/L.The spiked recoveries were in the range of 91.3％ ～ 111％ with relative standard deviations (RSD) less than 5％.Conclusions The optimal pretreatment condition for the sample was established.The chromatographic separation and the detection condition were optimized.The method was sensitive and accurate,and could meet the need of monitoring serum drug concentration.

Objective To demonstrate the efficacy and safety of Hangzhou tacrolimus capsule(Saishi Tac capsule, Hangzhou Zhongmei Huadong Pharmaceutical Co. Ltd, China) in Chinese kidney transplant recipients. Methods Multicenter, randomized open-labeled, prospective controlled clinical trial was performed in de novo Chinese kidney transplant recipients. According to including and excluding criterions, 65 kidney recipients from 9 transplant centers were enrolled. The mean age of recipients was (36.53 ± 5.71 ) years, and 8 received living donor transplantion. The time of cold ischemia and warm ischemia was (4.08 ± 5.43) h and (3.90 ± 2.15) min respectively. The number of mismatched HLA was (2.1 ± 0.8). The recipients accepted Saishi Tac capsule + mycophenolate steroid 60 days, followed by 5-10 μg/L until the terminal observation time point (12 weeks after transplantation). The efficacy and safety were estimated during the period. The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection. Graft survival and renal function (evaluated by serum creatinine) were the secondary endpoints. Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study, such as infection, hepatic damage, hypertension, hyperlipema, diabetes mellitus and other adverse affairs.Results The dose of Tac at 1 st, 2nd, 4th and 8th week postoperation was (6.54 ± 1.69), (6.39 ±1.45),(6.73± 1.25), (6.25 ± 1.02) and (6.03 ± 1.16) mg, corresponding values to the C0 were (8.24±2.09),(9.39± 1.35),(9.93± 1.87),(7.23± 1.16) and (6.43± 1.26) μg/L. During 12weeks of follow-up, the incidence of biopsy-confirmed acute rejection was 12.3% (8/65), among which 6 cases were reversed by implosive therapy. The survival rate of graft kidney was 96.9% (63/65). The incidence of hypertension and hepatic damage was both 7.7% and morbidity of lung infection was 7.6%. There were 3 patients (4.6%) complicated with hyperlipema and diabetes mellitus respectively. Conclusion During the first 3 months of treatment Saishi Tac capsule was safe and effective to Chinese kidney transplant recipients.