ObjectiveTo investigate the role of proinflammatory cytokines tumor necrosis factor alpha （TNFα） and interleukin-1β （IL-1β） in rostral ventromedial medulla （RVM） in chronic postsurgical pain （CPSP） induced by skin/muscle incision and retraction （SMIR）. MethodsSD rats were randomly divided into 5 groups： ① Sham group； ② SMIR group； ③ SMIR+TNFα/IL-1β neutralizing antibody group； ④ SMIR+TNFα/IL-1β group and ⑤ SMIR+vehicle group. 50% paw mechanical withdrawal threshold （MWT） was measured by the up-down method， immunofluroscence was used to detect the TNFα and IL-1β expression and ELISA for the 5-Hydroxytryptamine （5-HT） level. ResultsSMIR elicited persistent nociceptive sensitization， upregulated TNFα and IL-1β expression in RVM neurons and astrocytes. Microinjection of TNFα or IL-1β neutralizing antibody into RVM inhibited the development of nociceptive sensitization and decreased the level of 5-HT in both RVM and spinal dorsal horn. While microinjection of recombinant TNFα or IL-1β into RVM enhanced the development of nociceptive sensitization and increased the level of 5-HT in both RVM and spinal dorsal horn. ConclusionUp-regulation of proinflammatory cytokines in RVM may contribute to SMIR induced CPSP by promoting 5-HT release.

Objective To explore the relationship of the systemic immune-inflammation index (SII) with heart failure incidence in elderly people with hypertension and its nursing implications. Methods According to the data of the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2010, a total of 5 607 hypertension patients aged 60 and above were screened out and divided into heart failure group with 437 cases and non-heart failure group with 5 170 cases. All the participants were divided into Q₁ to Q₄ groups based on their SII levels by using the quartile method, with Q₁ as the reference group. After gradually adjusting for potential confounding factors, the differences in prevalence rate of heart failure among four groups were explored by Logistic regression analysis, and subgroup analyses were conducted as well. Results There were significant differences in race, age, education level, income level, smoking history, drinking history, body mass index (BMI), C-reactive protein, estimated glomerular filtration rate (eGFR), hemoglobin, diabetes history and coronary heart disease history between the two groups (P < 0.05). Compared with the non-heart failure group, the heart failure group had significant lower lymphocyte and platelet counts, while the neutrophil count and SII were significantly higher (P < 0.05). The result of multiple Logistic regression analysis showed a positive correlation between the increase of SII and the prevalence rate of heart failure (P < 0.05). After adjusting for related confounding factors, the values of odds ratio (OR) and 95% confidence interval (95%CI) for prevalence rate of heart failure in patients with SII from the second to the fourth quartiles were 0.80 (0.57 to 1.11), 1.14 (0.84 to 1.56) and 1.38 (1.02 to 1.87) respectively (P_trend=0.006). Subgroup analyses were carried out according to gender, diabetes, coronary heart disease, hyperlipidemia and eGFR, and the results showed that among women without coronary heart disease, with eGFR≤90 mL/(min·1.73 m²) and with or without hyperlipidemia, participants with the highest quartile of SII (Q₄) had a significant higher risk of heart failure than those with Q₁ (P_trend < 0.05). Conclusion SII may be independently associated with the prevalence rate of heart failure in elderly people with hypertension, and has guiding significance for clinical and nursing work.

Objective:To explore the effect of nursing based on protective motivation theory in patients with chemotherapy after glioma resection.Methods:From June 2018 to June 2021, 120 patients with chemotherapy after glioma resection were selected from the Oncology Surgery of Jiangsu Taizhou People's Hospital by convenient sampling. The patients were randomly divided into the control group and the observation group with 60 cases each. The control group was given routine nursing, while the observation group carried out nursing based on protective motivation theory on the basis of routine nursing. The scores of the MOS Item Short Form Health Survey (SF-36), Health Promotion Lifestyle Profile-Ⅱ (HPLP-Ⅱ), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were compared before and after the intervention.Results:After intervention, the scores of SF-36 and HPLP-Ⅱ in the two groups were higher than those before intervention, and the scores in the observation group were higher than those in the control group, with statistically significant differences ( P<0.05). SDS and SAS scores were lower than those before intervention, and the scores in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Nursing based on protective motivation theory can improve the health behavior of patients with chemotherapy after glioma resection, eliminate their negative emotions, and improve their quality of life.

Objective:To investigate the status of viral reservoirs in prostate tissue of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to investigate the effect of highly active anti-retroviral therapy (HAART) on HIV-1 DNA in prostate tissue of HIV/AIDS patients.Methods:Twelve patients with HIV infection and hyperplasia of prostate who required surgical treatment and admitted to Guangzhou Eighth People′s Hospital from July 2017 to October 2019 were included. Blood and prostate specimens of these patients were collected, and HIV-1 RNA in plasma, CD4 + T lymphocyte count in peripheral blood and HIV-1 DNA level in prostate tissue were tested respectively. The independent sample t test or Mann-Whitney U test was used for statistical analysis. Results:Among the 12 patients, the CD4 + T lymphocytes was (519.8±121.5)/μL and HIV-1 DNA in the prostate tissue was 2 602 (365, 10 700) copies/10 6cells in six patients who had not started HAART. The CD4 + T lymphocytes was (182.8±69.7)/μL and the HIV-1 DNA in the prostate tissue was 144 (36, 563) copies/10 6cells in the six patients who underwent HAART for over six months. There were statistically significant differences in CD4 + T lymphocytes and HIV-1 DNA in the prostate tissue between the two groups ( t=-5.889 and Z=-2.082, respectively, both P<0.05). Conclusion:Prostate tissue can be used as an HIV-1 virus repository with or without HAART, and the size of the prostate tissue virus repository can be reduced by HAART after immune reconstitution.

Objective: To evaluate the clinical value of three-dimensional ultrasound VOCAL technique in evaluating gastric emptying function in children with functional dyspepsia (FD). Methods: Seventy-one children with FD who were treated in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2018 to June 2018 were enrolled as the study subjects (observation group), and 71 normal children without FD were selected as controls (control group). The gastric emptying, antral pyloric systolic contraction frequency and distal gastric contraction movement in different time groups were analyzed, and GET1/2 and 2h gastric residual situation before and after treatment in the observation group were compared. Results: The GET1/2 of the observation group was (60.2±12.69)min, and the gastric emptying rate of the observation group was (61.9±12.2)min and (72.0±12.3)min at 90min and 120min, which were significantly better than those of the control group, and the differences were statistically significant (t=19.092, 15.092, 14.882, P=0.016, 0.024, 0.033). The frequency of antral pyloric systolic contraction, gastric antrum contraction frequency and gastric antrum contraction amplitude were (1.1±0.7)times/min, (2.9±0.8)times/min, (1.0±0.6)cm, respectively.Compared with the control group, the differences were statistically significant (t=16.092, 21.224, 8.092, all P<0.05). In the observation group of 71 children: GET1/2 before treatment and after treatment were (68.1±11.8)min, (54.2±9.8)min, respectively.The gastric residual at 2h after treatment was (31.2±8.0)%, (22.1±7.0)%, respectively.The GET1/2 and 2h gastric residual rate of the children were significantly lower than before treatment, and the differences were statistically significant (t=18.983, 21.004, all P<0.05). Conclusion Three-dimensional ultrasound VOCAL technology can be used as an evaluation standard for FD in children.

Objective Toanalysisandcomparison MRImanifestationsofthepigmentedvillonodularsynovitis(PVNS)andgiant celltumoroftendonsheath(GCTTS),andfurthertoimprovethediagnosticaccuracyofthem.Methods 10patientswithPVNSand 20patientswithGCTTSconfirmedbyoperationandpathologywereanalyzedretrospectively.Allpatientswereexaminedwith MRI. Results Among10casesofPVNS,8caseswerelocatedinkneejoint,2infoot.5casesshoweddiffuseform,othersshowedfocal form.Comparedwiththesignalofskeletalmuscle,theproliferativesynovialappearedasisointensityonT1WI,mainlyisointensityor slighthyperintensityonT2WI.NodularhypointensityofT1andT2signalwereseenwithinthesynovialmembrane.Among20casesof GCTTS,18werelocalizedlesions,2werediffuselesions.Therewere3casesinkneejoint,8casesinhandsandfeetrespectively,1case inshoulderjoint.Among20casesofGCTTS,11caseswerenodularlesions,9caseswereirregularGshaped.Thelumpsappearedas isointensityorhypointensityonT1WI,andmostofthem wereslighthypointensityonT2WI.Conclusion The MRIsignalofPVNS andGCTTShaveoverlappinganddifference.Thelocation,morphologyoflesionscombinedwith MRIfindingscanimprovethediagnostic accuracyofthem.

BACKGROUND:Caspase plays a crucial role in the cellapoptosis, but the influence of different facial nerve injury on caspase 1, caspase 8, cyto-c protein expression and their correlation stil remain unclear.
OBJECTIVE:To construct facial nerve crush or distal transection injury models, observe the morphological changes of facial motoneurons, investigate death gene caspase 3, caspase 8, cyto-c expression, and analyze their correlation.
METHODS:Facial nerve crush or distal transection injury model was established in the right facial nerve of rats, while the left facial nerve served as normal controls. We observed the morphology and the death of facial motoneurons with toluidine blue staining and transmission electron microscope. Expressions of caspase 3, caspase 8 and cyto-c proteins were studied by immunohistochemistry analysis fol owing facial nerve injury.
RESULTS AND CONCLUSION:Both facial nerve distal transection and crush injury resulted in the death of facial motoneurons, and the death pattern was mainly apoptosis. Caspase 3, caspase 8 and cyto-c protein expressions were observed in the subnucleus of normal rat facial nucleus. cells of the distal transection group were stained more intensely than that of crush group. Expressions of these proteins began to increase at 3 days after the injuries. Caspase 3 and caspase 8 protein expression peaked at 14 days, whereas cyto-c protein expression peaked at 7 days after the injuries. Expressions of caspase 3, caspase 8 and cyto-c proteins were correlated with facial nerve injury type and injury time. Expressions of caspase 8 and cyto-c protein were correlated with expression of caspase 3 protein. The findings indicate that, caspase 8 and cyto-c contribute to activate caspase 3, and caspase cascade reaction plays an important role in the apoptosis of facial motoneurons.

Objective To explore the influence of nifedipine controlled release tablets com-bined with indapamide on renal function of elderly patients with refractory isolated systolic hyper-tension.Methods 96 elderly patients with isolated systolic hypertension were randomly divided in-to two groups according to the admission odd and even day,48 cases in each group.Control group was treated with nifedipine controlled release tablets,while the observation group was treated with nifedipine controlled release tablets combined with indapamide on the basis of control group.Result After treatment,blood pressure in both groups decreased,and decreasing range of blood pressure in observation group was significantly greater than the control group(P <0.05).There were signif-icant differences of serum creatinine,creatinine clearance rate and microalbuminuria detection result before and after treatment in observation group (P <0.05).Conclusion Nifedipine controlled re-lease tablets combined with indapamide can effectively reduce blood pressure and promote renal func-tion in elderly patients with refractory isolated systolic hypertension,so it is worthy of clinical popu-larization.

Objective To explore the influence of nifedipine controlled release tablets com-bined with indapamide on renal function of elderly patients with refractory isolated systolic hyper-tension.Methods 96 elderly patients with isolated systolic hypertension were randomly divided in-to two groups according to the admission odd and even day,48 cases in each group.Control group was treated with nifedipine controlled release tablets,while the observation group was treated with nifedipine controlled release tablets combined with indapamide on the basis of control group.Result After treatment,blood pressure in both groups decreased,and decreasing range of blood pressure in observation group was significantly greater than the control group(P <0.05).There were signif-icant differences of serum creatinine,creatinine clearance rate and microalbuminuria detection result before and after treatment in observation group (P <0.05).Conclusion Nifedipine controlled re-lease tablets combined with indapamide can effectively reduce blood pressure and promote renal func-tion in elderly patients with refractory isolated systolic hypertension,so it is worthy of clinical popu-larization.

Objective To study the influence of pulsed electromagnetic fields on the expression of type I collagen by bone marrow mesenchymal stem cells and it's mechanism. Methods The bone marrow mesenchymal stem cells of SD rats were isolated and cultured in vitro.The third passage cells were harvested and exposed to pulsed electromagnetic fields(PEMFs)at 15 Hz and 1 mT 8 h/d for 3 days.A semi-quantitative RT-PCR technique was used to measure the type I collagen mRNA expression;ELISA and immunohistochemitistry techniques were used to measure type I collagen expression.Inhibitors and promoters of the cAMP-dependent protein kinase A(cAMP-PKA)pathway were added.After the cAMP-PKA pathway had been inhibited or promoted,the effects of the PEMF on type I collagen expression were measured again using ELISA and immunohistoehemistry.Results PEMFs at 15 Hz and 1 mT induced significant promotion of the expression of type I collagen(P≤0.01)in comparison with the controls. The type I collagen expression was reduced when the cAMP-PKA pathway inhibitor H-89 was added,and raised when the promoter 8-Br-cAMP was added.Conclusion PEMFs at 15 Hz 1 mT can promote type I collagen expression of bone marrow mesenchymal stem cells.and the effect is correlated with the cAMP-PKA pathway.