Pulmonary fibrosis(PF)is a chronic progressive end-stage lung disease.However,the mechanisms un-derlying the progression of this disease remain elusive.Presently,clinically employed drugs are scarce for the treatment of PF.Hence,there is an urgent need for developing novel drugs to address such diseases.Our study found for the first time that a natural source of Prismatomeris connata Y.Z.Ruan(Huang Gen,HG)ethyl acetate extract(HG-2)had a significant anti-PF effect by inhibiting the expression of the transforming growth factor beta 1/suppressor of mothers against decapentaplegic(TGF-β1/Smad)pathway.Network pharmacological analysis suggested that HG-2 had effects on tyrosine kinase phosphorylation,cellular response to reactive oxygen species,and extracellular matrix(ECM)disassembly.Moreover,mass spec-trometry imaging(MSI)was used to visualize the heterogeneous distribution of endogenous metabolites in lung tissue and reveal the anti-PF metabolic mechanism of HG-2,which was related to arginine biosyn-thesis and alanine,asparate and glutamate metabolism,the downregulation of arachidonic acid meta-bolism,and the upregulation of glycerophospholipid metabolism.In conclusion,we elaborated on the relationship between metabolite distribution and the progression of PF,constructed the regulatory metabolic network of HG-2,and discovered the multi-target therapeutic effect of HG-2,which might be conducive to the development of new drugs for PF.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.

Objective:To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide, and to analyze the nursing of elderly inpatients with incontinence, so as to provide a reference for clinical intervention.Methods:On March 31, 2021, convenience sampling was used to select 14 675 elderly inpatients from 52 hospitals across the country as the research object. The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data, health status, incontinence, and skin nursing. Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results:Among 14 675 elderly inpatients, the prevalence rates of xerosis cutis, incontinence and incontinence-associated dermatitis were 38.78% (5 691/14 675) , 11.06% (1 623/14 675) and 1.91% (280/14 675) , respectively. The prevalence of mild, moderate and severe incontinence-associated dermatitis were 1.27% (186/14 675) , 0.55% (81/14 675) , and 0.09% (13/14 675) , respectively. Among the nursing of 1 623 elderly inpatients with incontinence, the items with low implementation rate were the use neutral lotion to clean skin (14.17%, 230/1 623) , use of skin protectant after moisturizing (17.68%, 287/1 623) , moisturizing after cleansing the skin (28.90%, 469/1 623) . The results of binomial Logistic regression analysis showed that xeroderma, fecal incontinence, urinary and fecal incontinence, ≥2 kinds of combined medication, and hospital stay >30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions:The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis, type of incontinence, ≥2 kinds of combined medication, and hospital stay >30 days.

Objective:To explore the effect of self-designed fixed support in the postoperative nursing of abdominal flap repair.Methods:From January 2016 to December 2019, 47 patients with hand tissue defects undergoing abdominal skin flap repair in Shajing People′s Hospital, Guangzhou Medical University were divided into control group (23 cases) and observation group (24 cases) by random digits table method. The control group was treated with traditional methods, and the observation group was treated with self-designed fixed support. The wound healing of abdominal flap, the wound tearing after flap operation, pedicle ulcer after flap operation and the patients' nursing satisfaction were compared between the two groups.Results:There were 7 cases of primary healing and 16 cases of secondary healing in the control group, 18 cases of primary healing and 6 cases of secondary healing in the observation group. The difference between the two groups was statistically significant ( χ2 value was 9.368, P<0.01). The incidence rate of the wound tearing after flap operation was 26.1% (6/23) in the control group and 0 (0/24) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 7.177, P<0.05). The incidence rate of pedicle ulcer after flap operation was 69.6% (16/23) in the control group and 33.3% (6/23) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 6.170, P<0.05). The patients' nursing satisfaction was (76.8±8.4)points in the control group and (90.4±6.5) points in the observation group.The difference between the two groups was statistically significant (t value was -4.640, P<0.01). Conclusions:The use of fixed support after the operation of abdominal flap is helpful to the wound healing, reduce the occurrence of wound tear and pedicle ulcer, and improve the satisfaction of nursing, which is worth popularizing.

Objective:To explore the clinical effect and nursing experience of papaverine intramuscular injection after finger replantation with self-designed hip intramuscular injection positioning device.Methods:Totally 216 cases of patients treated with palavering for anti-vasospasm after of severed fingers from January 2018 to December 2019 were randomly divided into control group (108 cases) and observation group (108 cases) by random number table method. The control group received intramuscular injection of buttock muscle according to the conventional method, and the observation group used the auxiliary intramuscular injection with self-designed glutei muscle positioning device. The incidence of postoperative hip indurations and ecchymosed, survival rate of and buttock were analyzed Pain scores were compared.Results:Totally 76 cases (70.37%) and 62 cases (48.15%) in the control group, 12 cases (11.11%) and 6 cases (5.56%) in the observation group. The difference between the two groups was statistically significant ( χ2 values were 78.545, 67.307, P<0.01). 78 cases (72.22%) survived in the control group and 96 cases (88.89%) survived in the observation group ( χ2 value was 11.416, P<0.01). After papaverine intramuscular injection, there was no significant difference in hip pain score between the two groups on the first and second day ( P>0.05), but there was significant difference between the two groups on the third to seventh day ( t values were 17.17 to 45.97, P<0.05). Conclusion:Palavering intramuscular injection can reduce the incidence of hip indurations and ecchymosed, relieve buttock pain and improve the survival rate of amputated finger, which is worthy of clinical application.

Objective:To observe the effect of long cycle application of Opdivo in patients with esophageal cancer whose programmed death ligand 1(PD-L1) test was negative and the nursing care of its related adverse reactions.Methods:For an elderly patient with advanced heterochronous esophageal cancer with only 40 cycles of Opdivo and negative PD-L1, detailed individualized nursing measures were made from the aspects of medication management, psychological guidance and observation of adverse reactions.Results:The vital signs of the patients were stable, the KPS score was increased from 60 to 80, the carcinoembryonic antigen was reduced from 15.36 μg/L to 9.45 μg /L, and the adverse reactions such as immune dermatitis and hypothyroidism were relieved.Conclusions:The nursing experience of patients treated with Opdivo for a long period has been obtained, and the corresponding nursing evidence support has been provided for the clinical application of navumab in the treatment of tumor.

Objective:To explore the causes of misdiagnosis and missed diagnosis of fetal liver, hemangioma by prenatal ultrasound, aimed at improving the diagnostic rate of fetal liver hemangioma by prenatal ultrasound.Methods:Six cases of misdiagnosed fetal liver hemangioma in Hunan Province Maternal and Child Health Hospital between January 2016 and October 2018 were selected. In these cases, live births were tracked until they were 6-24 months old, while autopsy was carried out on induced fetuses. These failed cases were analyzed retrospectively, in terms of their scanning methods, ultrasonographic features and pregnancy outcomes.Results:Three cases were misdiagnosed by perinatal ultrasound: the time for the first discovery of masses in these cases was 37 + 3 weeks, 39 + 5 weeks and 37 + 4 weeks respectively. All of these tissues appeared as mixed echogenic masses and were misdiagnosed as hepatoblastoma. The other three cases were categorized as prenatal ultrasound missed diagnosis: in one case, prenatal ultrasound examination failed to detect the disease in question during the whole pregnancy, while ultrasound examination revealed lesions 2 days after birth; the other case didn′t see the detection of hepatic hemangioma was not detected until the 40th week of pregnancy by ultrasound in another case, as prenatal ultrasound at 31 + 6 weeks and 37 + 4 weeks showed nothing abnormal; yet prenatal ultrasound examination of the third case showed no findings in which at 26 + 6 weeks pregnant, but ultrasound performed at 33 weeks into gestation suspected slightly hypoechoic area in the liver, which was indicated hepatic hemangioma by MRI. Among the 6 cases, 2 of the induced fetuses were confirmed as hepatic capillary tumor by autopsy and pathological examination by with the consents of their family; four live births were confirmed to be hepatic hemangioma by contrast-enhanced CT scan and clinical follow-up observation. Conclusions:Multi-angle and multi-section scanning technique should be adopted in prenatal ultrasound examination of fetal liver. Mean while observations must also be made of any changes in the hepatic vein and any displacement of the peripheral organs of the liver, while ultrasonic images and color Doppler flow imaging features of the lesions are further analyzed. These actions lead to an improvement in the diagnostic accuracy of fetal liver hemangioma, which serves as a useful clinical guide to active and effective intervention measures.

Objective To explore the effect of adriamycin on the characteristics of colony derived from human adrenal cortical carcinoma cells (ACC) SW-13.Methods Treatment with Adriamycin (ADM) was used in BALB/c-nude mouse tumor xenograft model established using the ACC cell line SW-13.The characteristic of colony was assessed for the formation rates,the percentagc of three colony types and growth curve of single cell.Hoechst33342 dyeing test was used to test drug resistance.Results The Single-cell colony formation rate of experimental group were significantly higher than control group (P ＜ 0.05),and the holoclone percentage of experimental group were significantly higher than control group (P ＜ 0.05).In the Hoechst33342 dyeing tcst,the fluorescence intensity of control was higher than experimental group.Conclusion The treatment of ADM in vivo is beneficial for the colony formations of ACC cell and the formations rate of holoclone,and can improve the ability of drug resistance of ACC cell SW-13.

Objective To explore the diagnostic value of ultrasonography and magnetic resonance imaging (MRI) in placenta accreta.Methods Totally 150 pregnancy women in Hunan Provincial Maternal and Child Health Care Hospital from January 2015 to December 2016 were selected into the clinical data.According to the location of the placenta in the uterus,150 pregnancy women were divided into the anterior (n =80) and posterior (n =70) groups.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasound and MRI were calculated.The sonographic and MRI features between placenta implantation and non placental implantation were compared.Results There were no statistically significant difference for ultrasound and MRI sensitivity (96.43％ vs 85.71％,P =0.89),specificity (88.46％ vs 96.15％,P =0.37),positive predictive value (81.82％ vs 92.31％,P =0.95) and negative predictive value (97.87％ vs 92.59％,P =0.42) in anterior group.The MRI sensitivity (96.67％ vs 66.67％,P＜0.01),positive predictive value (96.67％ vs 83.33％,P ＜ 0.01) and negative predictive value (97.50％ vs 78.26,P ＜0.01) in the posterior group were higher than those in the ultrasound.Ultrasound showed that the incidence of localexpansion of the uterus and the increased placental vessels in placenta accreta was higher than that in non placental accreta (x2 =26.92,26.83,and 63.77,P ＜ 0.01).MRI showed that the incidence of local swelling,increased placental vascularity and low T2 signaling rates in placenta accreta was higher than that in non placental accrete (x2 =23.75,17.46,18.86,P ＜ 0.01).Conclusions Ultrasonography and MRI has high diagnostic value in placenta accreta.MRI is superior in the diagnosis of placenta accreta in the posterior uterus than in the anterior uterus.

Objective To observe the therapeutic effect of heat-clearing and dampness-removing therapy combined with Bifico for ulcerative colitis ( UC) induced by trinitrobenzene sulfonic acid ( TNBS), and to explore its influence on tumor necrosis factor alpha ( TNF-α) and interleukin-10 ( IL-10) in rats. Methods Forty female adult Sprague-Dawley rats were evenly randomized into five groups, namely normal control group, model group, Bifico (175 mg/kg) group, Chinese medicine group(enema with Changdiqing 3.6/kg and oral use of Changyanling Recipe l) , and Chinese medicine plus Bifico group. After treatment, the damage of colonic mucous membrane was evaluated, and expression levels of IL-10 and TNF-α in colonic mucosa were observed through immunohistochemical assay. Results The degree of colonic mucosal injury was severer and the inflammation was more obvious in the model group than those in the normal control groups ( P<0.01) , and the above changes were relieved to various degrees in the medication group ( P<0.01 compared with those in the model group) . Chinese medicine plus Bifico group had better effect on reducing colonic mucosa damage index ( CMDI) and inflammation, and on promoting the healing of colonic mucosa than Bifico group and Chinese medicine group (P<0.05 ) . The expression level of TNF-α in the colonic mucosa was markedly increased while that of IL-10 was markedly decreased in the model group ( P<0.01 compared with those in the normal control group) . The medication groups could counteract the above changes in the colonic mucosa ( P<0.01 compared with those in the model group) . The combination group and Chinese medicine group had better effect on decreasing TNF-α expression level and on increasing IL-10 expression level than Bifico group ( P<0.05) . Conclusion IL-10 and TNF-α play an important role in the pathogenesis and development of ulcerative colitis. Chinese medicine combined with Bifico has satisfactory therapeutic effect on UC rats, and its mechanism may be related with the increase of IL-10 expression level and with the decrease of TNF-α expression level.