Objective:To evaluate the role of Toll-like receptor 4 (TLR4)/nuclear transcription factor κB (NF-κB) signaling pathway in long-term cognitive impairment induced by multiple exposures to sevoflurane anesthesia in neonatal rats.Methods:Seventy-five SPF healthy newborn Sprague-Dawley rats of either sex, aged 6 days, weighing 12-20 g, were divided into 3 groups ( n=25 each) using a random number table method: control group (group C), multiple exposures to sevoflurane anesthesia group (group S) and TLR4 inhibitor plus multiple exposures to sevoflurane anesthesia group (group I+ S). The rats in group S and group I inhaled 3% sevoflurane for 2 h at 6, 7 and 8 days after birth. TLR4 inhibitor TAK-242 10 mg/kg was intraperitoneally injected before each exposure to sevoflurane in group I, and the equal volume of normal saline was given instead in the other two groups. The spontaneous activity was evaluated by open field test on day 29 after birth, and the cognitive function was assessed by Morris water maze test on days 30-34 after birth. After the behavioral test, the blood samples from the abdominal aorta were collected, and then the rats were sacrificed under deep anesthesia to isolate the hippocampal tissues for measurement of the levels of S100β and neuron-specific enolase (NSE) in serum and hippocampal interleukin-1β (IL-1β), IL-6 and tumor necrosis factor α (TNF-α) (by enzyme-linked immunosorbent assay), expression of TLR4, NF-κB p65 and phosphorylated NF-κB p65 (p-NF-κB p65) (by Western blot) and for microscopic examination of the pathological changes of hippocampal CA1 region after HE staining. Results:Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the TLR4 expression was up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was increased, the levels of serum S100β protein and NSE and hippocampal IL-1β, IL-6 and TNF-α were increased ( P<0.05), and the pathological changes in the hippocampal CA1 region were aggravated in group S. Compared with group S, the escape latency was significantly shortened, the number of crossing the original platform was increased, TLR4 expression was down-regulated, the ratio of p-NF-κB p65/NF-κB p65 was decreased, the levels of S100β and NSE in serum and hippocampal IL-1β, IL-6 and TNF-α were decreased ( P<0.05), and the pathological changes in hippocampal CA1 area were significantly attenuated in group P. Conclusions:The mechanism by which multiple exposures to sevoflurane anesthesia induces long-term cognitive impairment is related to activation of TLR4/NF-κB signaling pathway and increase in hippocampal inflammatory responses in neonatal rats.

Objective:To evaluate the role of nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway in edaravone-induced attenuation of long-term cognitive impairment caused by long-time sedation with propofol in the neonatal rats.Methods:Eighty SPF healthy newborn Sprague-Dawley rats of both sexes, aged 7 days, weighing 15-20 g, were divided into 4 groups ( n=20 each) using a random number table method: control group (group C), propofol group (group P), edaravone+ propofol group (group EP) and Nrf2 inhibitor ML385+ edaravone+ propofol group (group MEP). Propofol 75 mg/kg was intraperitoneally injected once a day for 7 consecutive days in P group, EP group and MEP group, respectively, while the equal volume of medium/long chain fat emulsion injection was intraperitoneally injected in C group. Edaravone 3 mg/kg was intraperitoneally injected at 30 min before each propofol injection in EP and MEP groups, and ML385 15 mg/kg was intraperitoneally injected simultaneously in group MEP. The spontaneous activity was evaluated by the open field test on day 29 after birth, and the cognitive function was assessed by Morris water maze test on days 30-34 after birth. The rats were sacrificed after the end of water maze test, and brains were removed and hippocampal tissues were obtained for determination of reactive oxygen species (ROS) levels (by flow cytometry), superoxide dismutase (SOD) and malondialdehyde (MDA) levels (by enzyme-linked immunosorbent assay) and expression of Nrf2 and HO-1 (by Western blot) and for microscopic examination of the pathological changes in the hippocampal CA1 area (using HE staining). Results:There was no significant difference in the speed, distance and time of stay at the center of the open field among the four groups ( P>0.05). Compared with C group, the escape latency was significantly prolonged, the number of crossing the original platform quadrant was reduced, the levels of MDA and ROS were increased, the activity of SOD was decreased, the expression of Nrf2 and HO-1 was down-regulated ( P<0.05), and the pathological injury was observed in the hippocampal CA1 region in group P. Compared with P group, the escape latency was significantly shortened, the number of crossing the original platform quadrant was increased, the levels of MDA and ROS in the hippocampus were decreased, the activity of SOD was increased, the expression of Nrf2 and HO-1 was up-regulated ( P<0.05), and the pathological injury in the hippocampal CA1 region was significantly alleviated in EP group. Compared with EP group, the escape latency was significantly prolonged, the number of crossing the original platform quadrant was reduced, the levels of MDA and ROS were increased, the activity of SOD was decreased, the expression of Nrf2 and HO-1 was down-regulated ( P<0.05), and the pathological injury was aggravated in the hippocampal CA1 region in MEP group. Conclusions:The mechanism by which edaravone attenuates long-term cognitive impairment caused by long-time sedation with propofol is related to activation of Nrf2/HO-1 signaling pathway and inhibition of oxidative stress in the neonatal rats.

This article summarizes the pregnant women's readiness for discharge from five aspects, including the concept, research status at home and abroad, evaluation tools, influencing factors, and interventions of readiness for discharge, so as to provide reference for future research on pregnant women's readiness for discharge.

Objective:To explore the level of health-promoting lifestyle of parents of leukemia children and its main influencing factors, so as to provide a reference for improving health-promoting lifestyle of parents of leukemia children.Methods:From September 2019 to July 2020, convenience sampling was used to select 375 parents of children with leukemia who were treated in three hospitals in Henan as the research object. Parents of children with leukemia were investigated with the General Information Questionnaire and Health-Promoting Lifestyle ProfileⅡ (HPLP-Ⅱ) . Single factor and multiple linear regression were used to analyze the influencing factors of health-promoting lifestyle of parents of children with leukemia. A total of 375 questionnaires were distributed and 366 valid questionnaires were retrieved with the effective response rate of 97.6%.Results:Among 366 parents of leukemia children, the score of health-promoting lifestyle was (113.06±28.91) . Multiple linear regression analysis showed that the children's expectation for rehabilitation, monthly family income, and relationship with the child were the main influencing factors for health-promoting lifestyle of parents of leukemia children with a statistical difference ( P<0.05) . Conclusions:The health-promoting lifestyle level of parents of children with leukemia is at an intermediate level. The children's expectation for rehabilitation, monthly family income, and relationship with the child are the main factors that affect the health-promoting lifestyle of parents of children with leukemia. Medical and nursing staff should formulate targeted interventions based on the influencing factors of health-promoting lifestyles to improve the level of health-promoting lifestyles of parents of children with leukemia.

Objective:To investigate changes in the expression of Cosmc and T-synthase in peripheral B lymphocytes and in serum levels of galactose-deficient IgA1 (Gd-IgA1) in patients with Henoch-Sch?nlein purpura (HSP) .Methods:From January to August 2014, 56 patients with HSP were collected from outpatient or inpatient department of dermatology and venereology in the Second Hospital of Hebei Medical University, and were divided into 4 groups, including skin type group (22 cases) , joint type group (9 cases) , abdominal type group (12 cases) and renal type group (13 cases) . Twenty healthy volunteers served as healthy controls. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of Cosmc and T-synthase in peripheral B lymphocytes, and a lectin-based enzyme-linked immunosorbent assay (ELISA) to detect the serum level of Gd-IgA1. Comparisons among multiple groups were performed using one-way analysis of variance or Kruskal-Wallis H test, multiple comparisons were performed using least significant difference (LSD) - t test or Nemenyi test, and correlation analysis was performed using Spearman rank correlation analysis. Results:There was a significant difference in the duration from disease onset to the clinic visit ( χ2= 26.19, P < 0.05) among the skin type group (6.27 ± 3.09 d) , joint type group (5.56 ± 3.05 d) , abdominal type group (6.75 ± 3.75 d) , and renal type group (26.23 ± 14.12 d) , and the duration from disease onset to the clinic visit was significantly longer in the renal type group than in the other 3 groups (all P < 0.05) . The Cosmc mRNA expression significantly differed among the skin type group, joint type group, abdominal type group, renal type group and healthy control group (0.849 ± 0.239, 0.767 ± 0.181, 0.719 ± 0.183, 0.459 ± 0.121, 1.146 ± 0.232, F= 23.37, P < 0.05) , was significantly lower in the 4 patient groups than in the healthy control group ( P < 0.01) , and lower in the renal type group than in the other 3 patient groups (all P < 0.01) . There was no significant difference in the T-synthase mRNA expression in peripheral B lymphocytes among the patient groups and healthy control group ( F= 1.05, P > 0.05) . The serum level of Gd-IgA1 significantly differed among the skin type group, joint type group, abdominal type group, renal type group and healthy control group ( F= 7.06, P < 0.05) . Moreover, the Gd-IgA1 level was significantly higher in the patient groups than in the healthy control group (all P < 0.05) , and higher in the renal type group than in the other 3 patient groups (all P < 0.05) . The serum level of Gd-IgA1 in the HSP patients was significantly and negatively correlated with the mRNA expression of Cosmc ( rs=-0.50, P < 0.01) . Conclusion:Decreased mRNA expression of Cosmc and increased serum levels of Gd-IgA1 were observed in patients with HSP, and there was a negative correlation between the two indices.

Objective:To understand the current status of transitional nursing for children with chronic diseases in member units of pediatric regional medical consortium (referred to as medical consortium) in Henan Province and find out the existing problems to provide references for the construction of a systematic transitional nursing mode for children with chronic diseases.Methods:From December 2018 to April 2019, a self-made General Data Questionnaire and the Questionnaire on Current Status of Transitional Nursing for Children with chronic diseases were used to investigate current status of transitional nursing for children with chronic diseases among 76 member units of pediatric regional medical consortium in Henan Province by the convenient sampling method. A total of 158 questionnaires were recovered, and 144 valid questionnaires were collected, with an effective rate of 91.14%.Results:In the 144 respondents, 38.89% (56/144) of them indicated that they knew about the transitional nursing for children with chronic diseases, 95.83% (138/144) of them were willing to take the initiative to participate in the transitional nursing for children with chronic diseases and 26.39% (38/144) of them indicated that leadership attached importance to and supported the transitional nursing for children with chronic diseases. The content of transitional nursing for children with chronic diseases included home medicine guidance (81.58%) , continuous care guidance (77.63%) and rehabilitation guidance (73.68%) . The main approaches were telephone visits and the establishment of health records for children with chronic diseases.Conclusions:Transitional nursing for children with chronic diseases has been initially carried out in the member units of pediatric medical consortium in Henan Province. It is necessary to further enrich the content, enrich the approaches, explore the standardized system and construct an effective transitional nursing mode for children with chronic diseases that conforms to characteristics of the member units of pediatric medical consortium in Henan Province.

Objective:To construct the content and form of peer support for cervical cancer chemotherapy patients so as to form an operable peer support program for cervical cancer chemotherapy patients in line with my country's clinical reality.Methods:From November 2018 to November 2019, we initially formulated the peer support program for cervical cancer chemotherapy patients through literature review, qualitative research and questionnaire survey. The Delphi method was used to conduct two rounds of letter inquiries with 18 domestic experts who were familiar with cervical cancer peer support related fields to provide objective opinions and suggestions from different levels and angles.Results:The effective recovery rate of the two rounds of questionnaires was 100.00%, the expert authority coefficient was 0.858 and the Kendall harmony coefficients were 0.240 and 0.267. The final peer support program for cervical cancer chemotherapy patients included 4 first-level indicators (forms of peer support, emotional support, information support and social adaptation support) and 29 second-level indicators.Conclusions:The peer support program based on the Delphi method is scientific and feasible which provides a scientific basis for the peer support of cervical cancer chemotherapy patients.

Objective: To analyze the efficacy of HLA-haploidentical peripheral hematopoietic stem cell transplantation (haplo-PBSCT) following reduced intensity conditioning (RIC) regimen to treat the patients with hematological malignancies who were older than 50 years old. Methods: Eighteen patients with hematological malignancies over 50 years were enrolled, including 8 male and 10 female patients. The median age of all patients was 52 (range: 50–66) years. Of them, 8 patients had acute myeloid leukemia (AML) , 2 chronic myelocytic leukemia (CML) , 5 myelodysplastic syndrome (MDS) , 2 acute lymphoblastic leukemia (ALL) , and 1 aggressive natural killer cell leukemia (ANKL) . All patients received fludarabine, cytarabine and melphalan with rabbit anti-human thymocyte globulin (FAB+rATG regimen) and transplanted with high dose non-T cell-depleted peripheral hematopoietic stem cells from donors. Enhanced graft versus host disease (GVHD) prophylaxis and infection prevention were administered. Results: Fifteen days after transplantation, 16 patients achieved complete donor chimerism. One of them rejected the donor graft completely at thirty days after transplantation, and the other 2 patients had mixed chimerism 15 days after transplantation and converted to complete recipient chimerism at 30 days after transplantation. The cumulative incidence of acute GVHD (aGVHD) was 61.1% (95%CI49.6%-72.6%) . The incidence of grade Ⅱ-Ⅳ aGVHD was 35.4% (95%CI 21.1%-49.7%) , whereas grade III-IV was 13.8% (95%CI 4.7%-22.9%) . The 2-year cumulative incidence of chronic GVHD (cGVHD) rate was estimated at 38.2% (95%CI 25.5%-50.9%) . Patients were followed-up for a median of 14.5 months (range, 3-44 months) . The Kaplan Meier estimates of 2-year overall survival (OS) and disease-free survival (DFS) was 72.6% (95%CI 60.1%-85.1%) and 63.7% (95%CI 49.2%-78.2%) , respectively. The 2-year cumulative incidence of relapse and non-relapse-mortality (NRM) was 31.2% (95%CI 16.5%-45.9%) and 12.5% (95%CI 4.2%-20.8%) , respectively. Conclusion RIC-haplo-PBSCT protocol can achieve better results in patients with hematologic malignancies over 50 years old.

Objective? To explore the effects of transtheoretical model on patients after percutaneous coronary intervention (PCI). Methods? Totally 200 patients who received PCI and 1-4 cardiovascular stents in the 4 wards of the Department of Cardiology, Tenth People＇s Hospital of Shanghai between March and September 2018 were selected by convenient sampling and divided into the control group (n=100) and the intervention group (n=100) according to the random number table. The Short Form Health Survey (SF-36) was used to evaluate the effects of intervention. Results? The total SF-36 score, overall physical health score and overall mental health score were (84.17±15.67), (80.56±15.76) and (84.93±15.66), respectively after the intervention, higher than those of the control group (t=-21.44, -21.063,-34.729; P＜0.001), which were (62.58±13.24), (63.87±12.34) and (62.69±10.45), respectively. Conclusions? The transtheoretical model used in follow-up visits after PCI helps to improve patients＇ quality of life, which is worth promoting in clinical practice.

Objective To design and investigate the clinical effects of parallel double venous pots hemodialysis tubing set in patients with heparin-free hemodialysis.Methods Totally 120 patients who received hemodialysis therapy in our hospital from May,2014 to June,2016 were randomly divided into the experimental group (n=60) and the control group(n=60) via random number table.The experimental group received self-designed parallel double venous pots dialysis tubing set,while the control group received the normal dialysis tubing set.The number of preventive replacement of dialyzer and tubing set during heparin-free dialysis,the number of discarded tubing set due to coagulation and the time frame for the first tubing set were recoded from two groups.Results There were statistically significant differences in the number of discarded tubing set due to coagulation and the time frame for the first tubing between two groups(P＜0.05).Conclusion Parallel double venous pots dialysis tubing set can reduce the number of discarded tubing set due to coagulation,prolong the time frame for the first tubing.