OBJECTIVE To screen the potential active components of Polygonum orientale flower against myocardial ischemia- reperfusion injury （MIRI） in rats based on physiological and pathological states. METHODS SD rats were divided into normal control group， normal administration group， MIRI control group and MIRI administration group， with 5 rats in each group. After drug intervention or modeling and drug intervention， chromatographic separation plasma samples were collected， and chromatographic separation and mass spectrometry data collection were performed by using UPLC-Q-TOF/MS. The prototype components and metabolites were analyzed by comparing the reference substance maps， the maps of each plasma sample， and the relevant literature. At the same time， the common peaks in plasma samples of rats in normal administration group and MIRI administration group were identified. Combined with principal component analysis and orthogonal partial least square-discriminant analysis， the differential transitional components were screened out according to the value of variable importance in the projection （VIP）＞1， to speculate the potential active components of P. orientale flower in rats under physiological and pathological states. The SD rats were divided into control group， MIRI group， positive control group （Compound danshen tablets 0.2 g/kg， 3 times a day）， and potentially active compound groups （10 mg/kg， twice a day）， with 5 rats in each group. The rats in administration groups were given relevant medicine intragastrically， for 3 consecutive days. The activity of superoxide dismutase （SOD）， the leakages of lactate dehydrogenase （LDH）， creatine kinase isoenzyme-MB （CK-MB） and cardiac troponin Ⅰ （cTnⅠ） in plasma were detected after the last administration. RESULTS Twenty-six main chromatographic peaks were obtained from the total ion chromatogram of the extract of P. orientale flower， and 14 of them were determined， including gallic acid， catechin， protocatechuic acid and so on. There were fifteen （including 6 absorbed prototype components and 9 metabolites） and nineteen transitional components （including 6 absorbed prototype components and 13 metabolites） in the plasma sample of normal rats and MIRI rats. Eight transitional components were detected in both normal rats and MIRI rats， and the VIP values of kaempferol glucuronidation metabolites， quercetin carbonylation metabolites and N-p-paprazine to the corresponding peak were higher than 1. Compared with MIRI group， the activities of SOD were increased significantly in the plasma of MIRI rats in each potential active compound group （P＜0.01）， and the leakages of LDH， CK-MB， and cTnⅠ in the plasma of MIRI rats were reduced significantly （P＜0.01）. CONCLUSIONS The potential anti-MIRI active components in extract of P. orientale flower are N-p-paprazine， quercetin， kaempferol and kaempferol-3-O-β-D-glucoside.

Objective:To investigate the relationship and assess the value of serum polyadenosine diphosphate ribose polymerase 1 (PARP1) and forkhead box transcription factor O1 (FOXO1) with cerebral neurological function in patients with severe craniocerebral injury (SCI).Methods:The clinical data of 100 patients with SCI from February 2021 to October 2022 in Baoji High-Tech Hospital were retrospectively analyzed. The Glasgow coma score (GCS) on admission was recorded. According to the modified Rankin score (mRS) 3 months after discharge, the patients were divided into good recovery group (mRS 0 to 2 scores, 62 cases) and poor recovery group (mRS 3 to 5 scores, 38 cases). In addition, 50 individuals who underwent physical examinations in Baoji High-Tech Hospital during the same period were selected as the control group. The serum levels of PARP1 and FOXO1 were measured by enzyme-linked immunosorbent assay. Correlation analysis was performed using Spearman method. Multifactor Logistic regression was used to analyze the independent risk factors for poor cerebral neurological recovery in patients with SCI. The efficacy of PARP1 and FOXO1 in predicting the poor cerebral neurological recovery in patients with SCI was evaluated by the receiver operating characteristic (ROC) curve.Results:The PARP1 and FOXO1 in good recovery group and poor recovery group were significantly higher than those in control group: (4.14 ± 1.19) and (5.98 ± 1.02) μg/L vs. (2.13 ± 0.71) μg/L, (5.83 ± 1.22) and (7.57 ± 3.12) μg/L vs. (4.23 ± 1.34) μg/L, the indexes in poor recovery group were significantly higher than those in good recovery group, and there were statistical differences ( P<0.05). The mRS in poor recovery group was significantly higher than that in good recovery group: (3.92 ± 0.87) scores vs. (1.03 ± 0.80) scores, and there was statistical difference ( P<0.05). Spearman correlation analysis result showed that PARP1 and FOXO1 were positively correlated with mRS score in patients with SCI ( r = 0.673 and 0.646, P<0.05). Multifactor Logistic regression analysis result showed that the GCS, mRS, PARP1 and FOXO1 were independent risk factors for poor neurological recovery in patients with SCI ( HR = 1.039, 1.286, 1.439 and 1.389; 95% CI 1.003 to 1.076, 1.011 to 1.637, 1.029 to 2.012 and 1.009 to 1.912; P<0.05). ROC curve analysis result showed that the area under the curve (AUC) of PARP1 combination with FOXO1 in assessing poor cerebral neurological recovery in patients with SCI was significantly greater than the PARP1 and FOXO1 alone: 0.953 (95% CI 0.918 to 0.988) vs. 0.866 (95% CI 0.796 to 0.936) and 0.859 (95% CI 0.783 to 0.935), Z = 2.162 and 2.188, P = 0.031 and 0.029. Conclusions:The serum PARP1 and FOXO1 levels in patients with SCI are positively correlated with cerebral neurological recovery, and they have predictive value for cerebral neurological recovery status.

Objective:To explore the influence of substance abuse history on anxiety and depression of male prisoners during their imprisonment, and its relationship with violent behavior.Methods:A questionnaire survey was conducted among 1 455 prisoners from October to November 2019.Self-administered personal substance abuse history questionnaires were used to collect the information on substance abuse (alcohol, tobacco, and drug use). The generalized anxiety scale (GAD-7) and patient health questionnaire (PHQ-9) were used to investigate anxiety and depression.All subjects were divided into substance abuse group ( n=871) and non substance abuse group ( n=584) according to whether they had a history of substance abuse or not.SPSS 21.0 software was used for statistical analysis.The statistical methods were t-test, chi square test and Logistic regression analysis. Results:(1)The scores of GAD-7 ((4.95±5.88) vs (3.35±5.33), t=-5.407, P<0.01) and PHQ-9 ((6.69±6.50) vs (4.48±5.73), t=-6.821, P<0.01) scales in the substance abuse group were higher than those in the no-substance abuse group.(2)Somatic disease( β=0.700, OR=2.014, 95% CI=1.599-2.538, P<0.05), history of alcohol abuse( β=0.434, OR=1.543, 95% CI=1.176-2.025, P<0.05), history of tobacco abuse( β=0.387, OR=1.473, 95% CI=1.154-1.880, P<0.05), age ≤ 45( β=0.372, OR=1.450, 95% CI=1.118-1.881, P<0.05) were the risk factors of anxiety among prisoners.Somatic disease( β=0.686, OR=1.986, 95% CI=1.581-2.496, P<0.05), history of tobacco abuse( β=0.488, OR=1.629, 95% CI=1.286-2.063, P<0.05), age ≤ 45( β=0.484, OR=1.622, 95% CI=1.260-2.089, P<0.05), history of alcohol abuse( β=0.344, OR=1.410, 95% CI=1.073-1.854, P<0.05) were the risk factors of depression among prisoners.(3) Years of education ≤ 9 years( β=0.900, OR=2.459, 95% CI=1.855-3.261, P<0.05), age ≤ 45( β=0.788, OR=2.199, 95% CI=1.690~2.860, P<0.05), unmarried( β=0.683, OR=1.980, 95% CI=1.421-2.759, P<0.05), history of alcohol abuse( β=0.308, OR=1.361, 95% CI=1.053-1.758, P<0.05), history of drug abuse( β=0.557, OR=1.745, 95% CI=1.055-2.885, P<0.05) were risk factors for violent behavior of prisoners. Conclusion:The history of substance abuse may be a risk factor for anxiety and depression of prisoners during their imprisonment.Alcohol and drug abuse are both factors influencing the occurrence of violent behavior.

Objective:To explore the therapeutic effect of peroral endoscopic myotomy (POEM) for primary achalasia (AC) in patients aged over 60 years.Methods:Data of 146 patients aged ≥60 years (the elderly group) and 146 patients aged 18-59 years (the adult group) who received POEM from November 2010 to September 2019 at the Digestive Endoscopy Center of PLA General Hospital were retrospectively analyzed. Baseline data, surgery data, surgery-related complications and surgery-related efficacy were compared.Results:There was no significant difference in gender, Ling classification, HRM classification or previous treatment between the two groups ( P>0.05). All 292 patients successfully underwent POEM surgery. The clinical success (Eckardt score ≤3) rates in the elderly group and the adult group were 96.33% (105/109) and 96.77% (90/93), respectively with no significant difference between the two groups ( χ2=0.030， P>0.05). There was no significant difference in the length of myotomy between the two groups (7.09±2.49 cm VS 7.12±2.24 cm， t=0.472， P>0.05). Complications occurred in 26 cases (17.81%) in the elderly group and 21 cases (14.38%) in the adult group with no significant difference between the two groups ( χ2=0.634， P>0.05). There was no significant difference in the postoperative hospital stay (12.61±9.69 days VS 11.00±4.43 days, t=1.825, P>0.05) or the incidence of gastroesophageal reflux [43.33% (13/30) VS 51.52% (17/33), χ2=0.422, P>0.05] between the elderly group and the adult group. Conclusion:The efficacy of POEM for AC patients over 60 years old is equivalent to that of adult patients, and the incidence of complications is similar. POEM is safe and effective for AC patients over 60 years old.

Objective:To master the changing trend of drinking-water-borne endemic arsenic poisoning in Shanxi Province and the implementation of prevention and control measures, to evaluate the progress of elimination target, and to provide objective basis for the implementation of refined management.Methods:In 2018, according to the mid-term evaluation plan of the "Thirteenth Five-Year Plan for National Endemic Disease Control" and the requirements of the "Measures for Elimination Control and Evaluation of Key Endemic Diseases", in 157 disease affected villages or high arsenic villages of 16 counties (cities, districts) in the province, taking the administrative village as the unit, a census of all permanent residents was conducted to investigate the condition of current patients and find out the new cases of arsenic poisoning; the implementation of water improvement measures and the operation of water improvement project were investigated; one tap water sample was collected from each administrative village to detect the arsenic content in the water; and the elimination of arsenic poisoning was evaluated.Results:A total of 1 221 cases of drinking-water-borne endemic arsenic poisoning were investigated in the whole province, including 982 mild cases, 190 moderate cases and 49 severe cases, accounting for 80.43%, 15.56% and 4.01%, respectively; all the 1 221 cases were monitored and registered before 2011, no new cases were found. In the 157 investigated villages, the rate of water improvement was 94.90% (149/157), the average content of arsenic in water of village with water improvement was 0.022 3 mg/L, ranging from 0.000 5 to 0.193 9 mg/L; the qualified rate of water arsenic after water improvement was 83.89% (125/149), and the normal operation rate of water improvement project was 82.55% (123/149). Ten counties (cities, districts) had reached the elimination standard, and six counties (cities) had not reached the elimination standard.Conclusions:The prevention and control effect of control measures on drinking-water-borne endemic arsenic poisoning in Shanxi Province is remarkable, and there is no new case for many years. In the future, efforts should be made to improve water supply, carry out one village one policy refined management, ensure that all disease affected villages or high arsenic villages meet the national elimination standards, and achieve the goal of the special three-year program for prevention and control of endemic diseases.

Animals ; Apoptosis ; Brain/metabolism* ; Male ; Phosphatidylinositol 3-Kinases/metabolism* ; Rats ; Rats, Sprague-Dawley ; Subarachnoid Hemorrhage/drug therapy* ; Thyroxine/pharmacology*

Objective:To retrospectively analyze the effectiveness of Caprini thrombosis risk assessment model in assessing the risk of deep venous thrombosis (DVT) in orthopedic patients.Methods:Using the convenient sampling method, 52 orthopedic patients who were diagnosed with DVT in Anhui Provincial Hospital from April 2016 to March 2019 were selected as the DVT group. According to the ratio of 1 to 2, 104 patients with non-DVT in Department of Orthopedics were selected as the non-DVT group. The Caprini risk assessment model was used to carry out DVT risk scoring and risk classification, and the relationship between different risk grading and occurrence risk of DVT in patients was explored. Logistic regression was used to explore the risk factors of DVT in orthopedic patients.Results:The Caprini score of the DVT group was (12.25±4.26) , which was higher than (7.18±2.92) of the non-DVT group, and the difference was statistically significant ( t=7.727, P<0.01) . The difference between the DVT group and the non-DVT group in Caprini risk classification was statistically significant (χ 2=8.778, P<0.05) . In the Caprini risk classification, the risk of DVT in very high-risk patients was 7.099 (95% CI: 1.604-31.412) times higher than that in non-very high-risk patients. Logistic regression analysis showed that BMI≥25 kg/m 2, bed rest time≥72 h, lower extremity swelling, plaster/limb fixation, and selective lower extremity joint replacement surgery were 5 high-risk factors for patients with DVT ( P<0.05) . Conclusions:The Caprini risk assessment model has a good predict ability for the risk of DVT in orthopedic patients. Nursing staff can carry out targeted nursing intervention according to the high-risk factors of DVT. Stratified management of this model can also enable effective hierarchical prevention of DVT risk groups and ensure the safety of patients to the maximum extent, which is worthy of clinical application.

Objective? To develop an admittance index system for the clinical nursing teachers to standardize nurse training based on competency model. Methods? Totally 8 experts in nursing management and education and clinical nursing teachers from Beijing Tiantan Hospital, Capital Medical University were selected for consultation from December 2016 to December 2017 using purposive sampling. The admittance index system of clinical nursing teachers for standardized nurse training was drafted by literature analysis taking competency model as the theoretical basis. Delphi expert consultation method was used for expert consultation. Results? The experts' authority coefficient (Cr) was 0.816, and the Kendall's W of their opinions was 0.429 (P＜0.01). The developed admittance index system of clinical nursing teachers for standardized nurse training included 5 primary indexes and 17 secondary indexes. Conclusions? The higher the Cr, the more reliable the results are. The admittance index system provides a standard for the proper selection and accurate evaluation of clinical nursing teachers in standardized nurse training.

ObjectiveTo preliminarily construct a set of evaluation index system for specialized nursing in neurology by Delphi method. MethodsIn December 2018, 28 experts from 12 Class Ⅲ Grade A hospitals in China specialized in clinical nursing, nursing management and hospital quality management were selected as the subjects of inquiry. Two rounds of expert inquiries were conducted based on Delphi method. The contents of the questionnaire included letters to experts and expert consultation forms (evaluation index and items of safety and quality of nursing in neurology department) and Expert General Information Questionnaire. ResultsIn the two rounds of survey, the effective recovery rates were 100.00% and 85.71% respectively, the authority coefficients of experts were 0.920 and 0.840, and the coordination coefficients of experts' opinions were 0.210 and 0.236, respectively. Finally, an evaluation index system for neurological specialist nurses was established, which included 3 first-level indicators, 13 second-level indicators and 36 third-level indicators. ConclusionsThe evaluation index system of neurological specialist nurses is scientific and reliable, which can provide basis for the selection, training, use,assessment and management of neurological specialist nurses.

ObjectiveTo explore the application of network information platform in the standardized training of newly recruited nurses in Neurology Department and evaluate its effect. MethodsA total of 34 new nurses recruited by Beijing Tiantan Hospital affiliated to Capital Medical University in 2017 were selected as intervention group and trained through network information platform. A total of 38 newly recruited nurses from Neurology Department of the same hospital from 2015 to 2016 were selected as the control group and trained by routine training methods. The clinical nursing ability, specialty theory results and specialty skills results of the two groups of newly recruited nurses were compared. ResultsIn the intervention group, the self-evaluation leadership of newly recruited nurses was (11.23±1.79), the monitoring of critical patients was (21.56±2.78), the teaching and cooperation was (28.97±4.11), the planning and evaluation was (21.18±2.89), the communication and exchange was (31.82±3.75), the professional development was (32.08±3.54) and the total score was (146.8±6.72). The scores of the above items in the control group were (9.87±1.72), (19.13±2.61), (26.79±3.92), (19.68±2.95), (28.66±3.54), (30.00±3.94) and (134.13±7.25) respectively. There were significantly statistical differences between the two groups (t=-7.69 - -2.16; P＜ 0.05). In the intervention group, the peer evaluation leadership of newly recruited nurses was (10.23±1.79), the monitoring of critically ill patients was (20.97±2.77), the teaching and cooperation was (28.35±4.01), the planning and evaluation was (20.68±2.98), the communication and exchange was (31.47±3.54), the professional development was (31.64±3.33) and the total score was (143.36±6.39). The scores of the control group were (8.71±1.58), (18.07±2.36), (25.76±3.97), (19.08±3.03), (27.61±3.61), (28.55±4.07) and (127.79±6.73). There were significantly statistical differences between the two groups (t= -10.03 - -2.25; P ＜ 0.05). In the control group, the excellence rate and good rate of theoretical knowledge were 13.2%(5/38) and 36.8%(14/38) respectively, and the excellence rate and good rate of professional skills results were 10.5%(4/38) and 55.3%(21/38) respectively. In the intervention group, the excellence rate and good rate of theoretical knowledge were 23.5% (8/34) and 47.0%(16/34) respectively, and the excellence rate and good rate of professional skills results were 20.6%(7/34) and 58.8%(20/34) respectively. The academic and professional skills scores of the intervention group were higher than those of the control group with statistical difference (Z=-2.902, -2.908; P＜ 0.01). ConclusionsApplying the network information platform to standardize the training for newly recruited nurses in neurology department can improve their clinical nursing ability, the results of professional theoretical and practical skills.