OBJECTIVE To investigate the improvement effect and mechanism of Buyang huanwu tang on idiopathic pulmonary fibrosis （IPF） model rats. METHODS The rats were randomly divided into normal group， model group， pirfenidone group （positive control， 0.162 g/kg）， Buyang huanwu tang low-， medium- and high-dose groups （6.435， 12.87， 25.74 g/kg）， with 6 rats in each group. Except for the normal group， IPF model was established in the remaining groups by intratracheal injection of bleomycin sulfate. On the second day after successful modeling， medication was administered once a day for 28 consecutive days. After the last medication， the appearance and morphology， pathological changes， and fibrosis status of the lung tissues in rats were observed. cyclin-dependent kinase inhibitor 2A （P16）， P21， transforming growth factor-β1 （TGF-β1）， Smad3， Smad7， epidermal growth factor （EGF）， epidermal growth factor receptor （EGFR）， matrix metalloproteinase 12 （MMP-12）， chemokine ligand 2 （CCL2） and interleukin-4 （IL-4） protein expression in lung tissue were all determined. RESULTS Compared with the normal group， the lung tissue of rats in the model group exhibited gray-white color， harder texture， obvious bruising and cysts. Additionally， alveolar septa were significantly thickened， their structural integrity severely compromised， accompanied by pronounced infiltration of inflammatory cells and severe pulmonary fibrosis. Collagen volume fraction， protein expressions of P16， P21， TGF-β1， Smad3， EGF， EGFR and （IL-4） in lung tissue significantly increased （P＜0.05 or P＜0.01）， while Smad7， MMP-12 and CCL2 protein expressions were significantly decreased （P＜0.05 or P＜0.01）. Compared with the model group， the appearance， pathological morphology， and fibrosis degree of rat lung tissue in Buyang huanwu tang groups were significantly improved， and the above quantitative indicators were significantly reversed （P＜0.05 or P＜0.01）. CONCLUSIONS Buyang huanwu tang can ameliorate IPF in rats， and its underlying mechanism may be associated with the inhibition of TGF-β1/Smad signaling pathway activity and the attenuation of cellular senescence.

ObjectiveTo investigate the role of the Wnt1/β-catenin signaling pathway in the intervention of medicated serum of Buyang Huanwutang （BYHWT） in endothelial-to-mesenchymal transition （EndMT） of human pulmonary artery endothelial cells （HPAECs） as well as its related mechanisms. MethodMedicated serum of BYHWT was prepared by gavage to New Zealand rabbits with a dosage of 53.36 g·kg^-1·d^-1 after decocting the medicine as usual. In addition， the same volume of normal saline was used to prepare blank serum. The HPAECs were cultured in vitro， and then induced by the transforming growth factor-β₁ （TGF-β₁） to establish the EndMT model. Five groups were established： blank group （10% blank serum）， model group （TGF-β₁+10% blank serum）， low-dose BYHWT group （TGF-β₁+2.5% medicated serum+7.5% blank serum）， medium-dose BYHWT group （TGF-β₁+5% medicated serum+5% blank serum） and high-dose BYHWT group （TGF-β₁+10% medicated serum）. Through Western blot， the expressions of Wnt1， β-catenin， and glycogen synthase kinase-3β （GSK-3β） were detected. In order to further clarify the mechanism of the Wnt1/β-catenin signaling pathway in the intervention of the medicated serum of BYHWT in inhibiting EndMT， the overexpression of β-catenin was confirmed by polymerase chain reaction after plasmid of overexpression β-catenin was constructed and transfected into the HPAECs. The HPAECs were intervened by 10% medicated serum with the optimal effect in previous studies. Then， they were divided into another five groups： the blank group （10% blank serum）， the model group （TGF-β₁+10% blank serum）， the BYHWT group （TGF-β₁+10% medicated serum）， the BYHWT+overexpression plasmid control group （TGF-β₁+10% medicated serum+blank plasmid） and the BYHWT+β-catenin overexpression plasmid group （TGF-β₁+10% medicated serum+β-catenin）. Apart from that， cell proliferation ability was detected by the methyl thiazolyl tetrazolium （MTT） method and cell migration ability by scratch assay and Transwell assay together. Immunofluorescence was adopted to detect the expressions of platelet endothelial cell adhesion molecule （PECAM-1/CD31）， vascular endothelial cadherin （VE-cadherin）， fibroblast-specific protein 1 （FSP1）， and α-smooth muscle actin （α-SMA）. ResultIn comparison to the blank group， the expressions of Wnt1 and β-catenin were significantly increased （P<0.01） while the expression of GSK-3β significantly decreased （P<0.01） in the model group. In comparison to the model group， the expressions of Wnt1 and β-catenin were significantly decreased （P<0.01） while the expression of GSK-3β was significantly increased （P<0.01） in the high-dose BYHWT group. The expression of β-catenin was significantly decreased （P<0.01） while the expression of GSK-3β was significantly increased （P<0.01） in the medium-dose BYHWT group. There was no significant difference in these indexes of the low-dose BYHWT group. In comparison to the blank group， proliferation and migration abilities were remarkably increased （P<0.01） and the immunofluorescence intensities of CD31 and VE-cadherin were decreased， while those of FSP1 and α-SMA were increased in the model group. In comparison to the model group， proliferation and migration abilities were significantly decreased （P<0.01） and the immunofluorescence intensities of CD31 and VE-cadherin were increased， while those of FSP1 and α-SMA diminished in the BYHWT group. Beyond that， the change trend of those indexes in the BYHWT+β-catenin overexpression plasmid group was consistent with that in the model group. In comparison to the BYHWT+overexpression plasmid control group， proliferation and migration abilities were significantly increased （P<0.01） and the immunofluorescence intensities of CD31 and VE-cadherin were decreased， while those of FSP1 and α-SMA were increased in the BYHWT+β-catenin overexpression plasmid group. ConclusionMedicated serum of BYHWT can inhibit EndMT of HPAECs by the Wnt1/β-catenin signaling pathway.

Objective:To systematically review and integrate the real feelings and needs of caregivers of children with liver transplantation.Methods:The computer search was conducted on China National Knowledge Infrastructure, China Biology Medicine disc, VIP, Wanfang Data, PubMed, Scopus, Web of Science, SDS, PsycINFO, CINAHL and Embase to collect qualitative studies on the real experiences of caregivers of children with liver transplantation. The search period was from establishment of the databases to July 31, 2023. The quality of the included literature was evaluated using the qualitative research appraisal tool of Australia Joanna Briggs Institute Evidence-based Health Care Center, and the results were analyzed using the Meta-integration method.Results:A total of eight articles were included, and 35 research results were extracted, which were summarized into 10 new categories and integrated into four results, namely, the dilemma of multiple challenges, complex emotional experience, multi-dimensional care needs and positive coping strategies.Conclusions:The caregivers of children with liver transplantation are faced with great pressure and difficulties in the process of care, and they are eager for multifaceted support. Medical staff should pay attention to the inner experience and needs of caregivers and construct supportive intervention programs to reduce their physical and mental burden and improve the quality of care for children with liver transplantation.

Objective:To retrieve, evaluate, and integrate the best evidence for the management of neurogenic bowel dysfunction (NBD) in spinal cord injury patients both domestically and internationally, providing a basis for relevant evidence-based practices.Methods:The guidelines, expert consensus, clinical decision-making, and systematic review of NBD management for spinal cord injury patients were electronically searched in various databases and professional association websites at home and abroad. The search period was from database establishment to March 31, 2023.Results:A total of 13 articles were included, including five guidelines, five evidence summaries, two expert consensus, and one clinical decision-making. A total of 33 recommendations for NBD management in spinal cord injury patients were summarized from five aspects of medical history assessment, medication management, physical therapy, diet and exercise, and health education.Conclusions:The best evidence for NBD management in spinal cord injury patients summarized is scientific and practical. Medical and nursing staff should selectively apply the best evidence based on clinical practice.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To explore the effect of well-being therapy on fatigue and self-management efficacy of leukemia patients undergoing chemotherapy.Methods:From January 2018 to December 2019, totally 76 leukemia patients who undergoing chemotherapy were divided into experimental group and control group according to the enrolled time, with 38 cases in each group. Patients in the control group recieved routine nursing, the experimental group carried out well-being therapy. Before and after intervention, the effects were assessed by Cancer fatigue scale-Chinses version (CFS-C) and Strategies used by people to promote health-Chinses version (SUPPH-C), respectively.Results:After intervention, the physical fatigue, affective fatigue, cognitive fatigue, and total fatigue scores in CFS-C were 7.64±3.63, 7.28±1.60, 5.19±1.24 and 20.11±3.96 in the experimental group, significantly lower than those in the control group (9.57±3.52, 8.76±2.60, 6.08±1.62 and 24.41±3.86); the positive coping, stress reduction, making decisions, and total scores in SUPPH-C were 57.56±9.72, 40.11±5.99, 12.17±1.95 and 109.83±11.69 in the experimental group, significantly higher than in the control group (50.54±10.80, 36.70±7.62, 10.86±2.10 and 98.11±14.13), the difference was statistically significant ( t value was 2.119-3.856, P<0.05). Conclusion:Well-being therapy can effectively allivate cancer fatigue and promote self-management efficacy of leukemia patients undergoing chemotherapy.

Objective: To investigate the effect of early multi-dimensional cardiac rehabilitation (CR) nursing mode on patients after percutaneous coronary intervention (PCI). Methods: From August 2017 to July 2018, 100 patients with coronary heart disease (CHD) underwent PCI in the Department of Cardiology, the Third Affiliated Hospital of Sun Yat-sen University were selected as subjects. According to the random number table, the patients were divided into control group and observation group, 50 in each group. The control group received routine CR nursing intervention, and the observation group was given early multi-dimensional CR nursing mode for intervention. All patients were followed up for 6 months. The incidence of major cardiovascular adverse events (MACE) was observed 1 month and 6 months of follow-up. Patients with somatization were evaluated on the 2nd day after PCI and in the first month of follow-up using the Somatic Self-rating Scale (SSS). In the first month and the 6th month of follow-up, patient compliance was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results: During the study period, 3 patients were detached from each group, and there were 47 patients in both groups who completed the study. The incidence of MACE in the control group in 1 month and 6 months was 8.51% (4/47) and 4.26% (2/47), respectively. The incidence of MACE in the observation group was 10.64% (5/47) and 4.26%, (2/47) respectively. There was no significant difference in the incidence of MACE between the two groups (χ² value was 0.123, 0.000, P>0.05). In the first month of follow-up, the SSS scores of the control group (34.32±6.59) and the observation group (31.04±7.04) were lower than those of the second day after surgery (37.21±6.19, 37.43±7.29), and the difference was statistically significant (t value was 4.633, 2.660, P<0.05). The SSS scores of the observation group were lower than those of the control group, and the difference was statistically significant (t value was 2.330, P<0.05). In the first month of follow-up, there was no significant difference in MMAS-8 score between the two groups (P>0.05). In the 6th month of follow-up, the MMAS-8 score (5.72±0.62) in the control group was lower than the first month of follow-up (6.93±0.54), and the difference was statistically significant (t value was 10.028, P<0.05). The MMAS-8 score of the control group was lower than that of the observation group (6.89±0.58), and the difference was statistically significant (t value was 9.490, P<0.05). There was no significant difference in MMAS-8 score between the observation group in the first month of follow-up and the sixth month of follow-up (P>0.05). Conclusion Early multi-dimensional CR nursing mode has a limited effect on improving the incidence of MACE in patients after PCI, but it can effectively reduce the somatization symptoms of patients and maintain good medication compliance.

Objective: To investigate the impact of transitional care based on IMB model on caregivers of patients with hematological malignancies. Methods: A total of 200 patients with hematological neoplasms who were treated with chemotherapy in our hospital from May 2017 to September 2018 were selected, their caregivers were also selected as the research objects, and they were randomly divided into the study group with 82 cases and control group with 85 cases. The study group used a transitional care based on IMB model to intervene the patient caregivers, and the control group received routine nursing care. The general data questionnaire, the Caregiver Positive Feeling Scale (PAC), the Chinese version of Benefit Finding Scale (BFS), the nursing quality satisfaction questionnaire were used to investigate the caregivers. Results: After nursing intervention, the self-affirmation and self-expected dimension scores of PAC in the study group were 18.41±5.65, 18.87±4.23, which were higher than those in the control group (14.56±5.83, 15.24±4.59), the difference was statistically significant (t=2.476, 5.287, P<0.05 or 0.01). The acceptance, family relationship, personal growth, social relations and health behaviors dimension scores of BHS scale in the study group were 10.41±3.12, 9.87±3.93, 22.41±5.12, 10.22±3.52, 9.65±3.17, which were higher than those in the control group 9.06±3.87, 8.14±4.19, 19.51±5.24, 8.47±3.61, 7.52±3.74, the difference was statistically significant (t=2.476-3.963, P<0.05 or 0.01). The nursing satisfaction degree of caregivers in the study group was 75.61% (62/82), which was higher than that in the control group 42.35% (36/85), the difference was statistically significant (χ²=19.039, P < 0.01). Conclusions Transitional care based on the IMB model can improve the positive feelings in hematological neoplasms caregivers, enhance their benefit findings, and improve the quality of nursing care.

OBJECTIVETo find out and analyze differentially expressed miRNAs in the plasma of benzene exposed workers, and explore the potential roles of plasma miRNAs in the development of hematologic toxicity induced by benzene exposure.

METHODSBy individual matching, low blood cell group, unstable blood cell group and normal group of 10 benzene exposed workers in each group were taken as subjects. Microarray was used to find out differentially expressed miRNAs among three groups. Three miRNAs validated by real-time quantitative PCR. Target genes of 9 miRNAs with the high abundance and significant difference were predicted using Target scan, Picture and miRanda softwares. David 6.7 online platform was used to perform GO term enrichment and KEGG pathway analysis of those targets.

RESULTSMicroarray screened out that 138 miRNAs were differentially expressed. Three significant classes of differentially expressed miRNAs were found with the cluster analysis. The detected expressions of miR-638, let-7f-5p and miR-223-3p by relative RT-qPCR was consistent with the microarray date. Pathway analysis showed that the most enriched pathway was focal adhesion, with 6 potential functional targets, including SOS₂, VCL, CCND2, COL4A6, IGF1 and MAPK1.

CONCLUSIONWe have identified the plasma miRNA profile in benzene exposed workers, and further analysis indicates that focal adhesion-associated miRNAs play a potential role in hematologic toxicity induced by benzene exposure.

Adult ; Benzene ; adverse effects ; Female ; Humans ; Male ; MicroRNAs ; genetics ; Middle Aged ; Occupational Exposure ; adverse effects ; Oligonucleotide Array Sequence Analysis ; Young Adult

Objective To observe the effect applicated of endoscopic sinus joint laryngoscope in laryngeal microsurgery.Methods 68 patients with laryngeal lesions were randomly divided into the multi-mirror combination group (34 cases) and the single laryngoscope group (34 cases).The multi-mirror combination group was taken with laryngeal microsurgery under endoscopic Joint laryngoscope.The single laryngoscope group was only taken with laryngeal microsurgery under laryngoscope.The efficacy and surgical situation of the two groups were compared.Results The total effective rate of the multi-mirror combination group was 97.06％,which was significantly higher than that of the single-laryngoscope group (85.30％) (x2 =4.031,P ＜ 0.05).Compared with the case of surgery and complications and recurrence rate,the multi-mirror combination group was superior to the single laryngoscope group (all P ＜ 0.05).Conclusion The endoscopic joint laryngoscope has the function of expanding the scope of the operative field and increasing the focus and clarity,and also has the advantages of small traumatic for patients,fewer complications,low recurrence rate,easy operation and high accuracy.