ObjectiveTo explore the therapeutic effect and mechanism of Guipitang on rats with myocardial ischemia. MethodFifty SD rats were divided into five groups： a control group， a model group， low and high-dose Guipitang （7.52， 15.04 g·kg^-1） groups， and a trimetazidine group （0.002 g·kg^-1）. By intragastric administration of vitamin D₃ and feeding rats with high-fat forage and injecting isoproterenol， the rat model of myocardial ischemia was established. After drug treatment of 15 d， an electrocardiogram （ECG） was performed to analyze the degree of myocardial injury. A fully automatic biochemical analyzer was used to detect the changes in the serum levels of total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， triglyceride （TG）， and low-density lipoprotein cholesterol （LDL-C）. Hematoxylin-eosin （HE） staining and Masson staining were used to observe myocardial histopathological changes. TdT-mediated dUTP nick end labeling （TUNEL） staining was used to detect cardiomyocyte apoptosis. Western blot was adopted to detect the protein levels of extracellular signal-regulated kinase 1/2 （ERK1/2）， phospho-ERK1/2 （p-ERK1/2）， p38 mitogen-activated protein kinase （p38 MAPK）， phospho-p38 MAPK （p-p38 MAPK）， B-cell lymphoma-2 （Bcl-2）-associated X （Bax）， Bcl-2， and cleaved cysteine aspartate proteolytic enzyme （cleaved Caspase-3）. ResultCompared with the control group， the ECG S-T segment decreased in the model group. The serum levels of TC， TG， and LDL-C were increased significantly （P<0.05）. The arrangement of myocardial tissue was disordered， and the proportion of cardiomyocyte apoptosis increased. The protein levels of cleaved Caspase-3， Bax， and p-p38 MAPK in the heart were increased， and the Bcl-2 expression was decreased （P<0.05）. Compared with the model group， the S-T segment downward shift was restored in the low and high-dose Guipitang groups and trimetazidine group， and the levels of TC， TG， and LDL-C were decreased. The protein expression of cleaved Caspase-3 and Bax in the heart dropped， and p-p38 MAPK and p-ERK1/2 protein expressions increased significantly （P<0.05）. The degree of myocardial injury was alleviated， and the proportion of cardiomyocyte apoptosis decreased. Bcl-2 protein expression was increased significantly in the low-dose Guipitang group （P<0.05）. ERK1/2 and p38 MAPK proteins had no significant difference among different groups. ConclusionGuipitang could alleviate myocardial injury and inhibit cardiomyocyte apoptosis in rats by activating the expression of ERK1/2 and p38 MAPK.

Objective To identify meaningful objective examination methods by analyzing the results of vari-ous objective examinations of children with recurrent vertigo(RVC).Methods Fifty children with RVC(29 in ver-tigo attacking group,21 in vertigo non-attacking group)and 20 children without RVC were selected.All partici-pants underwent a series of relevant objective examinations,the results of each examination were statistically ana-lyzed and the characteristic differences of each examination between the RVC group and the control group were ob-tained.Results ① The abnormal rate of sleep SpO2,high stimulation rate ABR and AHI in the RVC group were significantly higher than those in the control group(P＜0.05).② The abnormal rate of sleep SpO2 and high stimu-lation rate ABR in the vertigo attacking group were higher than those in the vertigo non-attacking group.There was a statistical difference between the two groups(P＜0.05).③ Pure tone audiometry(or conditioned play audiome-try),acoustic immittance,cranial MRI,positional test and vHIT were normal in both RVC group and normal con-trol group.Conclusion Continuous sleep SpO2 and high stimulation rate ABR are correlated with RVC,especially RVC during vertigo attacking.AHI is correlated with RVC,but not with the onset of vertigo.Clinically,continu-ous sleep SpO2 monitoring,PSG and high stimulation rate ABR can be used as auxiliary examinations for the diagno-sis of RVC.

Objective:To explore the relationship between sleep status and the disease in children with recurrent vertigo（RVC） by analyzing the objective sleep condition of children with recurrent vertigo. Methods:According to the diagnostic criteria of RVC, 50 children with RVC and 20 normal controls without RVC were selected. According to the vertigo questionnaire score, the RVC group was divided into mild, moderate and severe groups according to severity. Continuous polysomnography（PSG） was performed for all participants, and SPSS 25.0 statistical software was used to analyze the monitoring results. Results:①There were significant differences in sleep time of each period, total sleep time and sleep efficiency between RVC group and control group（P<0.05）, but there was no significant difference in sleep latency（P>0.05）. The specific manifestations were that the proportion of sleep time in N1 and N2 phases increased, the proportion of sleep time in N3 and REM phases decreased, the total sleep time and sleep efficiency decreased in RVC group. ②The abnormal rate of sleep apnea hypopnea index, that is, the proportion of AHI≥5 times/h and the abnormal rate of lowest blood oxygen saturation in RVC group were higher than those in normal control group. There was significant difference between the two groups（P<0.05）. ③There were significant differences in the proportion of AHI≥5 times/h and lowest SpO2 among mild group, moderate group and severe group（P<0.05）. ④There was no significant correlation between the degree of vertigo and the abnormal rate of AHI in children with RVC, but there was a negative correlation between the degree of vertigo and the abnormal rate of lowest SpO2 in children with RVC. Conclusion:Children with RVC are often accompanied by sleep disorders, clinicians should pay attention to both the symptoms of vertigo and sleep condition in children. Polysomnography is non-invasive and operable, providing a new idea to the auxiliary examination of RVC in children. It is of certain clinical significance for the comprehensive treatment of children with RVC to actively improve vertigo symptoms and pay attention to improving sleep quality.
Humans ; Child ; Polysomnography ; Sleep Apnea, Obstructive/diagnosis* ; Sleep ; Dizziness ; Vertigo/diagnosis*

Objective:To explore the effect of music relaxation training combined with Huangqi Jianzhong Decoction oral administration and foot bath on fatigue status and quality of life in patients with cancer related fatigue.Methods:A total of 90 patients with cancer related fatigue in our hospital from January 2019 to October 2020 were selected. The patients were divided into 2 groups by random number table method, with 45 in each group. Both groups were given health and diet education. The control group was given music relaxation training, and the observation group took Huangqi Jianzhong Decoction oral administration and foot bathing on the basis of the control group. Both groups have a course of treatment of 4 weeks, a total of 3 courses. The TCM syndrome scores were observed before and after treatment, and the Piper Fatigue Score (PFS) was used to evaluate fatigue status, and the Karnofsky functional state score was used to evaluate the quality of life of patients, evaluation of clinical efficacy.Results:After treatment, 43 patients in the observation group and 42 patients in the control group were analyzed. The total effective rate of the observation group was 83.72% (36/43), which was significantly higher than 64.29% (27/42) of the control group ( χ2=4.18, P=0.041). After treatment, the TCM syndrome scores in the observation group was significantly lower than that of the control group ( t=2.48, P=0.015). After treatment, the Karnofsky functional state score in the observation group was significantly higher than that of the control group ( t=2.83, P=0.006). After treatment, the emotion score (4.35±1.02 vs. 5.03±1.01, t=3.09), feeling score (4.31±1.06 vs. 5.00±1.02, t=3.06) and total score (4.23±1.07 vs. 4.87±1.10, t=2.72) in the observation group were significantly lower than those in the control group ( P<0.01). Conclusion:Music relaxation training combined with Huangqi Jianzhong Decoction oral administration and foot bathing can alleviate the fatigue state of CRF patients and improve the quality of life.

Objective:To investigate the changes of quadriceps femoris thickness with the length of stay in intensive care unit (ICU) in patients with sepsis, and to evaluate the diagnostic value of muscle changes in mortality.Methods:A prospective study was conducted, and 92 patients with sepsis who were admitted to the ICU of the Affiliated Hospital of Jining Medical College from January 2020 to December 2021 were enrolled. The thickness of quadriceps femoris [including the quadriceps femoris muscle thickness at the midpoint of the anterior superior iliac spine and the upper edge of the patella (M-QMLT), and at the middle and lower 1/3 of the patella (T-QMLT)] measured by ultrasound 1 day (D1), 3 days (D3), and 7 days (D7) after admission to the ICU were collected. The atrophy rate of quadriceps femoris was calculated 3 and 7 days after admission to the ICU compared with 1 day [(D3-D1)/D1 and (D7-D1)/D1, (TD3-TD1)/TD1 and (TD7-TD1)/TD1, respectively]. The demographic information, underlying diseases, vital signs when admission to the ICU and in-hospital mortality of all patients were recorded, and the differences of the above indicators between the two groupswere compared. Multivariate Logistic regression was used to analyze the influence of quadriceps femoris muscle thickness and atrophy rate on in-hospital mortality of septic patients. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of quadriceps femoris muscle thickness and atrophy rate on in-hospital mortality of septic patients.Results:A total of 92 patients with severe sepsis were included, of which 41 patients died in hospital, 51 patients discharged. The in-hospital mortality was 44.6%. The muscle thickness of quadriceps femoris in severe septic patients decreased with the prolongation of ICU stay, and there was no significant difference between the two groups at the first and third day of ICU admission. The muscle thickness of quadriceps femoris at different measuring positions in the survival group was significantly greater than those in the death group 7 days after admission to the ICU [M-QMLT D7 (cm): 0.50±0.26 vs. 0.39±0.19, T-QMLT D7 (cm): 0.58±0.29 vs. 0.45±0.21, both P < 0.05]. The atrophy rate of quadriceps femoris muscle thickness at different measuring positions 3 and 7 days after admission to ICU in the survival group was significantly lower than those in the death group [(D3-D1)/D1: (8.33±3.44)% vs. (9.74±3.91)%, (D7-D1)/D1: (12.21±4.76)% vs. (19.80±6.15)%, (TD3-TD1)/TD1: (7.83±4.26)% vs. (10.51±4.75)%, (TD7-TD1)/TD1: (11.10±5.46)% vs. (20.22±6.05)%, all P < 0.05]. Multivariate Logistic regression analysis showed that M-QMLT D7, T-QMLT D7, (D3-D1)/D1, (D7-D1)/D1, (TD3-TD1)/TD1, (TD7-TD1)/TD1 were independent risk factors for in-hospital mortality (all P < 0.05). The results were stable after adjusting for confounding factors. ROC curve analysis showed that (TD7-TD1)/TD1 [area under the ROC curve (AUC) was 0.853, 95% confidence interval (95% CI) was 0.773-0.934] was superior to (D7-D1)/D1, T-QMLT D7, M-QMLT D7, (TD3-TD1)/TD1 and (D3-D1)/D1 [AUC was 0.821 (0.725-0.917), 0.692 (0.582-0.802), 0.683 (0.573-0.794), 0.680 (0.569-0.791), 0.622 (0.502-0.742)]. Conclusions:For septic patients in ICU, bedside ultrasound monitoring of quadriceps femoris muscle thickness and atrophy rate has a certain predictive value for in-hospital mortality, and a certain guiding significance in clinical treatment and predicting the prognosis of sepsis.

Objective:To explore the effects of quality control circle activity in the respiratory function exercise in patients with esophageal cancer.Methods:From June 2018 to June 2019, convenience sampling was used to select 96 patients with esophageal cancer admitted to the Cancer Hospital Affiliated to Zhengzhou University as the research object. According to the principle of computer randomization, patients were divided into experimental group and control group, with 48 cases in each group. Patients in control group were given nursing case based on enhanced recovery after surgery, and experimental group carried out quality control circle activity on the basis of the control group. The correct rate of breathing exercise and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC) were compared between the two groups of patients. Results:After intervention, the correct rate of respiratory function exercise in experimental group was higher than that in control group, and the difference was statistically significant ( P<0.05) . The FEV 1/FVC of experimental group was higher than that of control group one day before discharge, and the difference was also statistically significant ( P<0.05) . Conclusions:Quality control circle activity applied to patients after esophageal cancer surgery can increase the correct rate of patients' respiratory function exercise and effectively improve the patient's lung function.

Objective:To explore the effect of quality feedback theory combined with humanistic care on psychological status of patients undergoing lung volume reduction surgery.Methods:From January 2017 to January 2019, 68 patients with emphysema who underwent lung volume reduction surgery in Henan Provincial Chest Hospital were selected as the research object. The patients were divided into a control group (34 cases) and an observation group (34 cases) . The control group was given nursing based on quality feedback theory during the entire perioperative period of lung volume reduction surgery, and the observation group was given humanistic care combined with nursing based on quality feedback theory during the entire perioperative period of lung volume reduction. The psychological status [Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) score] were compared between the two groups before and after intervention.Results:Before the intervention, there was no significant difference in SAS and SDS scores between the two groups ( P>0.05) . After the intervention, the SAS and SDS scores of the two groups were both decreased, and the SAS and SDS scores of the observation group were lower than those of the control group, the differences were statistically significant ( P<0.05) . Conclusions:Quality feedback theory combined with humanistic care can promote the psychological status of patients undergoing lung volume reduction surgery.

Objective:To construct a perioperative nursing planning for patients with esophageal cancer based on the concept of enhanced recovery after surgery (ERAS) , so as to provide a basis for the development of ERAS nursing for patients with esophageal cancer during perioperative period.Methods:From November 2019 to September 2020, a perioperative ERAS nursing planning for patients with esophageal cancer was constructed through literature retrieval, field observation, Delphi expert consultation, and analytic hierarchy process.Results:A total of two rounds of expert consultations were conducted. The valid recovery rates of the questionnaire were 95.24% (20/21) and 100.00% (20/20) , and the expert authority coefficients were 0.89 and 0.93. The Kendall harmony coefficients were 0.25 and 0.34 ( P<0.01) . The perioperative enhanced recovery nursing planning for patients with esophageal cancer included 5 first-level indicators, 17 second-level indicators and 49 third-level indicators. Conclusions:The perioperative enhanced recovery nursing planning for patients with esophageal cancer is scientific and reliable, and can effectively standardize and guide the development of clinical nursing work.

Objective:To explore the feasibility of U6 and Cel-miR-39 as reference genes for quantitative detection of microRNA (miRNA) in cerebrospinal fluid (CSF) of tuberculous meningitis (TBM), and validate the difference of miRNAs between tuberculous and viral meningitis (VM).Methods:The remaining CSF specimens after routine examination were collected in Beijing Chest Hospital of Capital Medical University. A total of 36 TBM and 34 VM patients were enrolled based on the information in the medical records. Total RNA were extracted from the CSF samples, and Taqman based real-time quantitative PCR (RT-CR) analysis were performed to determine the concentration of the miRNAs in CSF. GeNorm, NormFinder and Bestkeeper software were used for stability analysis of the two reference genes. 2 -ΔCt method was used to determine the relative gene expression. Accordance of repeated tests was analyzed by Pearson correlation test. Continuous variables were compared by the t-test. Results:Among the 70 samples, the average cycle threshold (Ct) value of U6 was 30.40±3.30, while the average Ct value of Cel-miR-39 was 21.49±0.70. The expression level of Cel-miR-39 was higher than that of U6. Correlation analysis showed good accordance of the repeated tests among the reference genes and target genes analysis in the randomly selected 10 samples ( r>0.931, P<0.001). Based on the analyses results of the three software, including GeNorm, NormFinder and Bestkeeper, Cel-miR-39 presented better stability in RT-PCR analysis and was more suitable as a reference gene for miRNA quantitative determination in CSF sample of TBM patients. The relative expression levels of the three target miRNAs were calculated using Cel-miR-39 as the reference gene, and miR-126-3p (1.13±0.41 vs 3.34±0.82, t=2.452, P=0.016), miR-130a-3p (0.56±0.10 vs 2.59±0.70, t=2.960, P=0.004) and miR-151a-3p (0.64±0.25 vs 2.11±0.33, t=3.536, P<0.001) were showed significant lower expression levels in CSF in TBM group than that in VM group. Conclusions:Cel-miR-39 can be used as a reference gene for quantitative detection of miRNAs in CSF of TBM patients. Significant differences were detected in expression level of miR-126-3p, miR-130a-3p and miR-151a-3p between TBM and VM group.

Objective: To investigate the effect of nursing intervention on information-motivation-behavioral skill (IMB) model in patients with adjuvant chemotherapy after radical resection of upper thoracic esophageal squamous cell carcinoma. Methods: A total of 128 patients with adjuvant chemotherapy after radical resection of esophageal squamous cell carcinoma from December 2016 to June 2018 were enrolled. The random number table method was used to divide them into control group (64 cases) and study group (64 cases). The control group received routine nursing, and the study group took the IMB model of nursing intervention on the basis of the control group. The intervention time was 2 months. Postoperative rehabilitation (feeding time, time to get out of bed, and length of hospital stay), pre-intervention self-efficacy score (Strategies Used by People to Promote Health, SUPPH), European Organization for Research and Treatment of Cancer-Quality of Life-Core 30 Questionnaire (EORTC-QLQ-C30), complications (reflux esophagitis, chest cavity), the incidence of effusion, infection, anastomotic leakage, and satisfaction of nursing work were compared. Results: The feeding time of the study group was (3.39±0.72) d, the time of getting out of bed (2.26±1.02) d, the length of hospital stay (9.19±1.68) d, which was shorter than that of the control group (4.48±0.81), (4.07±1.55), (12.26±2.35) d, the difference was statistically significant (t=8.046, 7.804, 8.502, P<0.05). After intervention, the self-decision, self-decompression, and positive attitude scores of the two groups were higher than those before the intervention, and the study group was (11.19±1.28), (28.37±2.79), (39.98±5.01), respectively, higher than the control group. The differences were statistically significant (t= 7.239, 5.036, 5.057, P < 0.05). After intervention, the social function, emotional function, role function and physical function score of the two groups were higher than those before the intervention, and the study group were (69.02±6.87), (70.61±7.65), (69.68±6.80), (72.55±6.51). The scores were higher than those of the control group (61.13±7.03), (63.64±7.44), (60.22±7.05), and (65.86±6.08), and the difference was statistically significant (t=5.225-6.422, P<0.05). The complication rate was 7.81% (5/64) in the study group and 20.31% (13/64) in the control group. The difference was statistically significant (χ²=4.137, P <0.05). The nursing job satisfaction of the study group was 92.19% (59/64), which was higher than that of the control group 79.69% (51/64). The difference was statistically significant (χ²=4.137, P<0.05). Conclusions The intervention of IMB model in the treatment of patients with adjuvant chemotherapy after radical resection of upper esophageal squamous cell carcinoma can effectively improve their self-efficacy, reduce postoperative complications, shorten the postoperative rehabilitation time, and improve the quality of life of patients and improve the satisfaction of their nursing work.