Objective To understand the current status and influencing factors of patient perception for humanistic care in China hospitals,and to provide a basis for developing nursing humanistic care measures and improving the quality of nursing humanistic care services.Methods A total of 30,099 outpatients and inpatients from 107 hospitals in 30 provinces(autonomous regions and municipalities)from July to August 2022 as survey subjects.A general information questionnaire and the Relational Caring Questionnaire-Patient Form were used for a cross-sectional survey,and a single-factor analysis was used to analyze the influencing factors of patient relationship care.Results Finally,29 108 valid questionnaires were collected,and the effective questionnaire recovery rate was 96.7％.The patient evaluation of relationship care was(65.72±8.61)points.Single-factor analysis showed that gender,age,marital status,children's situation,education level,occupation,place of residence,average family income,medical insurance type,visiting department,and location of the visiting hospital,and whether or not surgery were influencing factors of patient relationship care(P＜0.05).Conclusion The evaluation score of caregiver-patient relationship care among Chinese hospital patients is above average,but there is still room for improvement in western and rural regions,seriously ill and outpatient patients,low-income and low-medical insurance reimbursement populations,and non-surgical patients.Medical institutions at all levels should optimize and improve nursing humanistic care services based on influencing factors,and further enhance patients'perception of nursing humanistic care.

Objective To compare the clinical outcomes of all-inside arthroscopic and open recon-struction of the anterior talofibular ligament(ATFL)and calcaneofibular ligament(CFL).Methods The clinical data of 51 patients with chronic lateral ankle instability(CLAI)and treated in our department between January 2017 and July 2021 were analyzed retrospectively.Among them,24 received ar-throscopic ATFL and CFL reconstruction(arthroscopy group),while 27 underwent conventional surgery(open group).The perioperative data including surgical time,intraoperative complications,hospitaliza-tion duration and time to resume normal walking were compared between the two groups.Moreover,postoperative CT examination was performed to evaluate the position of the bone tunnel.Before as well as 3 months,6 months,1 year,and 2 years after the operation,both groups were evaluated using the American Orthopedic Foot and Ankle Society Score(AOFAS),Karlsson score,visual analogue scale(VAS),drawer test,and inversion test.Meanwhile,the occurrence of complications was also recorded and compared.Results Both groups underwent the surgery successfully.The total length of incision and time to resume normal walking in the arthroscopy group were significantly shorter than the open group(P<0.05),while there was no significant difference between them in surgical time and hospital stay(P>0.05).Postoperative CT showed that in the arthroscopy group,1 case had suboptimal talus bone tun-nel position,while in the open group,1 had suboptimal calcaneus bone tunnel position and another suffered from suboptimal talus bone tunnel position,with the remaining bone tunnels located within the corresponding footprint area.All patients were followed up for 24 to 33 months.Significant improve-ment was observed in the average AOFAS score,Karlsson score,and VAS score in both groups after the operation(P<0.05),and both the drawer and inversion tests were of negative results.Three months postoperatively,the arthroscopic group had significantly better AOFAS,Karlsson and VAS score than the open group(P<0.05).Moreover,at 6 months postoperatively,the average AOFAS and Karlsson scores of the arthroscopy group were significantly superior to the open group(P<0.05).However,1 year and 2 years postoperatively,no significant differences were found between the two group in the AOFAS,Karlsson and VAS score(P>0.05).Moreover,no serious complications occurred during surgery and follow-up in both groups.Conclusion The efficacy of arthroscopic reconstruction of ATFL and CFL is comparable to open reconstruction in treating CLAI,with the former therapy resulting in faster recov-ery.

OBJECTIVE: Identifying novel strategies to prevent particulate matter (PM)-induced lung injury is crucial for the reduction of the morbidity of chronic respiratory diseases. The combined intervention represented by herbal formulae for simultaneously targeting multiple pathological processes can provide a more beneficial effect than the single intervention. The aim of this paper is therefore to design a safe and effective medicinal and edible Chinese herbs (MECHs) formula against PM-induced lung injury. METHODS: PM-induced oxidative stress, inflammatory response and apoptosis A549 cell model were used to screen anti-oxidant, anti-inflammatory and anti-apoptotic MECHs, respectively. A network pharmacology method was utilized to rationally design a novel herbal formula. Ultra performance liquid chromatography-mass spectrometer was utilized to assess the quality control of MECHs formula. The excretion of magnetic iron oxide nanospheres of the MECHs formula was estimated in zebrafish. The MECH formula against PM-induced lung injury was investigated with mice experiments. RESULTS: Five selected herbs were rationally designed to form a new MECH formula, including Citri Exocarpium Rubrum (Juhong), Lablab Semen Album (Baibiandou), Atractylodis Macrocephalae Rhizoma (Baizhu), Mori Folium (Sangye) and Polygonati Odorati Rhizoma (Yuzhu). The formula effectively promoted the magnetic iron oxide nanospheres excretion in zebrafish. The mid/high dose formula significantly prevented PM-induced lung damage in mice by enhancing the activity of SOD and GSH-Px, reducing the MDA and ROS level and attenuating the upregulation of pro-inflammatory cytokine (IL-6, IL-8, IL-1β and TNF-α), down regulating the protein expression of NF-κB, STAT3 and Caspase-3. CONCLUSION Our findings suggest that the effective MECHs formula will become a novel strategy for preventing PM-induced lung injury and provide a paradigm for the development of functional foods using MECHs.

Objective:To investigate the current situation and influencing factors of patients′ satisfaction with nursing humanistic care, and to provide reference for improving the quality of such care provided by hospitals.Methods:From July to August 2022, outpatients and inpatients in 30 provinces were selected by multi-stage stratified sampling as the survey objects. A cross-sectional survey was conducted on an online platform, using the general information questionnaire and Chinese version of methodist health care system nurse caring instrument revised by the research group. The latter instrument consists of 12 dimensions. namely care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family engagement, physical environment, spiritual environment and outcomes. Descriptive analysis was performed on the data collected by the questionnaires, and independent sample t-test and one-way ANOVA were used to analyze the influencing factors of patient satisfaction. Results:A total of 107 hospitals were selected for questionnaire survey, including 86 tertiary hospitals and 21 secondary hospitals, and 29 108 valid questionnaires were recovered. The patient satisfaction with nursing humanistic care scored (5.40±0.86); the top three dimensions were competence (5.50±0.89), emotional support (5.47±0.88) and helping/trusting relationship (5.46±0.86); the lowest scoring dimensions were teaching/learning (5.38±1.01), spiritual environment (5.36±1.04) and patient/family engagement (5.11±1.28). Differences with gender, age, marital status, child status, educational level, occupation, place of residence, economic region, per capita monthly income of the family, type of medical insurance, medical department visited and surgery or not presented significant differences on the patient satisfaction with nursing humanistic care scores ( P<0.05). Conclusions:The satisfaction of patients with hospital′s nursing humanistic care in China was at the middle to upper level. In the future, health education for patients should be strengthened, and a mode of family-engaged nursing humanistic care should be constructed in line with the Chinese cultural background. In the process of nursing services, the particularity of patient groups should be considered to better meet their needs.

Objective To investigate the effect ofmiR-27a-3p on proliferation,apoptosis and cell cycle of hepatoma cells.Methods A quantitative real-time polymerase chain reaction (qPCR) was used to detect differential expression of miR-27a-3p in normal hepatic epithelial cells (L02) and hepatoma cells (HepG2 and PLC).Cell experiment was divided into four groups:HepG2 overexpression cells,Mi-27a-3p overexpression group (Mi-27a) and negative control group (Mi-Con);PLC knockdown cells,Mi-27a-3p knockdown group (Miinhibitor-27a) and negative control group (Mi-inhibitor-Con).The expression of microRNA-27a-3p in each group after transfection was detected by qPCR analysis.MTT assay was used to detect the cell proliferation.Flow cytometry was used to detect the apoptosis and cell cycle.One-way ANOVA was used for multiple comparisons,and t-test was used to compare two groups.Results qPCR results showed that the expression levels of miR27a-3p in L02,HepG2 and PLC increased sequentially,and the relative expression levels were 1.07 ± 0.04,4.81 ± 0.64 and 11.31 ± 0.92,respectively (P ＜ 0.05).MTT assay showed that the cell viability of HepG2 cells transfected with miR-27a-3p overexpression plasrnid was significantly deereased compared with the negative control group (P ＜ 0.05).The apoptosis assay showed that the apoptosis rate of miR-27a-3p overexpression group was higher than the negative control group (P ＜ 0.05).The cell cycle results showed that the proportion of S phase cells in the miR-27a-3p overexpression cell group was significantly lower than the negative control group (P ＜ 0.05).Furthermore,microRNA-27a-3p knockdown validation in PLC cells showed that MTT,apoptosis and cell cycle tests results were opposite to the results of HepG2 overexpression cells,and the differences were statistically significant (P ＜ 0.05).Conclusion miR-27a-3p can significantly inhibit the proliferation of hepatoma cells,promote cell apoptosis,alter the cell cycle distribution,and may become a potential target in hepatocellular carcinoma therapy.

Objective To investigate the diagnostic value of splenic elasticity measured with real-time shear wave elastography (SWE) in liver cirrhosis patients with portal hypertension.Methods Totally 64 cirrhotic patients with portal hypertension (PH group) and 62 liver cirrhosis patients without portal hypertension (control group) were enrolled.The elasticity,the thickness and the length of the spleen of both groups were compared.The areas under the ROC curve (AUC) of the SWE elasticity,the thickness and the length of the spleen were compared with a DeLong test.The optimal cutoff value of SWE elasticity was obtained,and the sensitivity and specificity were calculated,respectively.Results The differences of the SWE elasticity,the thickness and the length of the spleen between the two groups were statistically significant (all P＜0.001).AUC of SWE elasticity,thickness and length of the spleen was 0.979 (95％ CI[0.944,0.989]),0.917 (95％CI [0.854,0.926] and 0.865 (95％CI [0.775,0.928]),respectively.The differences between each two parameters were statistically significant (all P＜0.05).The optimal cutoff value of the spleen SWE elasticity was 19.98 kPa,the sensitivity and the specificity was 95.78％ and 94.27％,respectively.Conclusion The diagnostic efficacy of spleen SWE elasticity was higher than that of spleen thickness and spleen length,therefore having better diagnostic value for liver cirrhosis patients with portal hypertension.

Objectives To explore the clinical diagnosis and treatment of Dieulafoy disease in children. Method The clinical features, endoscopic features and treatment of Dieulafoy disease in a child were reviewed. Results The 2-year-5-month old girl was admitted due to hematemesis for 7 hours. She was diagnosed of Dieulafoy disease by the typical endoscopic appearance. Gastroscopy showed that the lesion was located in gastric angle which was the predilection position of Dieulafoy disease. The small red blood vessels in the central part of the erosion area was exposed on the mucosal surface. The high frequency electrocoagulation under gastroscope was performed and effect was definite. Conclusion Dieulafoy disease is rare in children and lacks obvious clinical features. Endoscopic treatment has definite effect with little trauma and is the first choice of treatment.

BACKGROUND:Mesenchymal stem cells have a extreme prospect in orthopedics, which show great potential especially in the treatment of articular cartilage defect disease. Bone marrow is the main source of mesenchymal stem cells, and the iliac puncture is a conventional way to obtain bone marrow, but is restricted by the limited resources and strict technical requirements. Therefore, it is of great significance to explore new effective and convenient sources of mesenchymal stem cells. OBJECTIVE:To explore the feasibility of autologous mesenchymal stem cells derived from the joint drainage fluid after knee arthroscopy.METHODS: We selected eight patients who underwent arthroscopic surgery to collect joint drainage fluid by pre-made sterile blood bag before the wound closure. Precipitation with hydroxyethyl starch and density gradient centrifugation method were performed to isolate and culture mesenchymal stem cells from the joint drainage fluid. Cell morphology, growth curve, surface marker identification were observed and detected using flow cytometry. Then, adipogenic, chondrogenic and osteogenic differentiation of cells were induced and identified by oil red O, toluidine blue staining, and alizarin red staining, respectively. RESULTS AND CONCLUSION:The cultured cells were spindle-shaped, adherently grew and had good proliferation ability, which were positive for CD44, CD90, CD105 and CD73, but not for CD45. Under standard inductions, the cultured cells were induced to differentiate into osteoblasts, adipocytes and chondrocytes. Therefore, these cells were confirmed as mesenchymal stem cells. Mesenchymal stem cells were successfully isolated from the joint drainage fluid of eight patients and had no difference in cell morphology, proliferation and phenotypes. To conclude, the joint drainage fluid is an ideal source of mesenchymal stem cells with the guaranteed quality and quantity.

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) guiding normal saline (NS) injection through endoscopic nasobiliary drainage duct(ENBD) on evaluation for residual stones in common bile duct.Methods Fifty-five patients with bile duct stones were treated by endoscopic retrograde cholangio-pancreatography (ERCP) and duodenoscopic sphincterotomy incision surgery (EST) and ENBD.All patients received normal ultrasonography and CEUS guiding NS injection ultrasonography after EST.The length and width of common bile duct and the detection rate of residual stones before and after NS injection were compared.Results In the 55 patients,1 patient failed in injection of contrast agent into the ENBD.In the other 54 patients,the difference of the length and width of common blie duct before and after NS injection were statistically significant [(2.94±1.76)cm vs (6.09±1.46)cm,(0.58±0.30)cm vs (1.11±0.98)cm](all P<0.001).The full display rate of the common bile duct before and after NS injection were 13.0%(7/54) and 90.7%(49/54),respectively.Before injection,none of common bile duct stones was suspected.After injection,5 cases of common bile duct stones were suspected.Three cases were confirmed by ERCP,1 case was confirmed by operation and 1 case was false positive.Conclusions CEUS of the common bile duct through ENBD performs its patency and course.On this basis the injection of NS increases the display rates of common bile duct,thus improving the detection rate of residual stones.

BACKGROUND:Matrix protein is an essential component of the vascular wal , provides a necessary frame for the integrity of the vessel wal and physiological function of vascular wal cel s, and regulates cel s and smooth muscle. OBJECTIVE:To construct rat model of early aneurysm, and to evaluate differences in the expression of matrix structural proteins during cerebral aneurysm formation. METHODS:Twenty-eight healthy male Sprague-Dawley rats were randomized into control group (n=8) and model group (n=20). Aneurysm model was established by ligation of the left common carotid artery and right renal artery-induced hypertension in the model group. In the control group, only the left carotid artery bifurcation and bilateral carotid were exposed in rats. Rats in the model group were sacrificed at 15 and 30 days after model establishment. Right anterior cerebral artery in rats and olfactory artery bifurcation received immunohistochemical staining. The expressions of fibronectin,α-smooth muscle actin and col agen III were analyzed. RESULTS AND CONCLUSION:Compared with the control group, no significant difference in fibronectin expression was detected in right anterior cerebral artery and olfactory artery bifurcation in rats of the model group at 30 days after model establishment (P>0.05). However,α-smooth muscle actin and col agen III expressions were significantly reduced (P<0.05). These data confirmed that expression of structural proteins had differences and dynamic changes during early aneurysm formation in rats. Degradation of matrix structural protein in cerebral artery may be one of the key mechanism of aneurysm formation.