Objective:To explore Lijin Zhenggu Therapy combined with heat supplementing needles on cartilage damage, immune balance, and liver X receptor NF-κB in knee osteoarthritis of New Zealand white rabbits.Methods:Totally　60 New Zealand white rabbits were divided into normal group, model group, Lijin Zhenggu Therapy group, heat supplementing needles group, and a combination group using random number table method, with 12 rabbits in each group. Except for the normal group, all other groups were established with knee osteoarthritis models. The Lijin Zhenggu Therapy group was treated with Lijin Zhenggu Therapy, the heat supplementing needles group was treated with heat supplementing needles, the combination group was treated with Lijin Zhenggu Therapy combined with heat supplementing needles. The pain threshold of each group of white rabbits was observed using a pain meter; HE staining was used to observe the morphology of cartilage damage in each group of white rabbits; ELISA was used to detect PGE 2, IL-1β and β-EP in the articular cartilage tissue of white rabbits in each group; PCR was used to detect the levels of LXRα and NF-κB mRNA. Western blot was used to detect toll like receptor 4 (TLR4), myeloid differentiation factor (MyD88), interferon regulatory factor-7 (IRF-7) in synovial tissue of rabbits in each group. Results:Compared with model group, the pain threshold of rabbits in heat supplementing needles group, Lijin Zhenggu Therapy group and combination group increased ( P<0.05); the levels of PGE 2 and IL-1β decreased ( P<0.05), while the level of β-EP increased ( P<0.05). LXRα mRNA level increased ( P<0.05), and NF-κB mRNA level decreased ( P<0.05); the expressions of TLR4, MyD88, IRF-7 and NF-κB P65 in synovial tissue decreased ( P<0.05). Conclusions:Lijin Zhenggu Therapy combined with heat supplementing needles can reduce the levels of PGE 2 and IL-1β, increase β-EP level, improve pain and cartilage tissue morphology. The mechanism may be related to the regulation of liver X receptor nuclear factor NF-κB pathway, reduction of inflammatory reactions and immunity maintaining.

Objective To search and evaluate the relevant evidence of blood purification and anticoagulant management of perioperative liver transplantation patients,and to summarize the best evidence,so as to provide evidence-based evidence for clinical blood purification and anticoagulant management practice.Methods Evidence-based questions were determined.Systematic search was conducted on relevant domestic and foreign databases and websites for clinical decisions,guidelines,evidence summaries,system evaluations,and expert consensuses related to blood purification anticoagulation management.The retrieval period is from the establishment to May 2,2023.Literature screening,quality evaluation and evidence summary were conducted by 2 researchers.Results A total of 17 articles were included,including 2 clinical decisions,3 guidelines,2 evidence summaries,4 systematic evaluations and 6 expert consensuses.24 pieces of best evidence were summarized from 6 dimensions,including coagulation function evaluation,anticoagulant strategy,mode selection,vascular access,standardized operation implementation points and personnel organization management.Conclusion The best evidence was summarized in the study on perioperative blood purification and anticoagulant management of liver transplantation,which can provide evidence-based basis for clinical medical staff to implement anticoagulant management.However,it is necessary to further carry out evidence-based practice of perioperative blood purification and anticoagulant management of liver transplantation to verify its anticoagulation effect and nursing safety in clinical practice.

Objective To gain insights into the supportive care needs of liver transplant recipients,in order to provide references for the formulation of effective and targeted intervention strategies.Methods Phenomenological research method was employed to conduct semi-structural in-depth interviews with 16 liver transplant recipients in the liver transplant center of a tertiary hospital in Shanghai from November 2021 to April 2022.Colaizzi 7-step analysis method and Nvivo software were used to analyze and extract the themes.Results 5 themes were extracted,including symptom management needs,longing for the perception and avoidance of recurrence risk,disease information management needs,emotional and psychological support and the return to social roles.Conclusion The physical distress and burden of liver transplantation recipients coexist.Although the initiative to seek medical treatment is high,the perception level of disease recurrence risk is not high.In order to meet the needs of liver transplant recipients and improve their quality of life,it is necessary to strengthen the health education of disease symptom management and related risk factors,pay attention to psychological counseling and strengthen social support,and provide targeted treatment care.

Objective:To construct a biospecimen bank of patient derived organoids (PDOs) from pancreatic cancer tissues and to explore the feasibility of PDOs drug sensitivity assay technology to guide chemotherapy drug selection for pancreatic cancer.Methods:Pancreatic cancer tissue specimens obtained after surgical resection and puncture biopsy from Mar 2020 to Dec 2022 at Drum Tower Hospital, Nanjing University School of Medicine were collected. Pancreatic cancer PDOs were cultured in vitro and histologically identified; PDOs were treated with gemcitabine, Nab-paclitaxel, fluorouracil, Oxaliplatin, and Irinotecan and cell viability was measured to analyze the correlation between PDOs drug sensitivity and the actual clinical treatment response.Results:The PDOs can reproduce the pathological features of corresponding tumor tissues; the sensitivity of different PDOs to the same chemotherapeutic drug is significantly different; The sensitivity of PDOs was highly consistent with the actual treatment effect of the corresponding patients 75.76% (25/33); organoid organ-based susceptibility testing had predictive value for the treatment response of patients (AUC=0.733, 95% CI: 0.546-0.919, P<0.05). Conclusion:A biobank of pancreatic cancer PDOs was successfully constructed, and the drug susceptibility test results were significantly correlated with the actual medication response of patients, suggesting that the drug susceptibility test technology based on PDOs has the potential to guide individualized chemotherapy for pancreatic cancer.

Objective:To construct the access standard of nursing service project according to the feasibility, operational risk and difficulty of "Internet+ nursing service" home-based nursing project operation, so as to provides references for establishing the management method of "Internet+ nursing service".Methods:From March to August 2021, nursing service projects in the existing "Internet+ nursing service" platform were collected, and relevant literature and policies were referred to build an "Internet+ nursing service" project pool, including 64 nursing service items. The convenient sampling method was adopted to select 19 hospital nursing managers, community nursing managers, clinical nursing and nursing education experts in the field of "Internet+ nursing service" in Beijing from November 2021 to January 2022. Delphi method was adopted to conduct expert letter inquiry, and to evaluate the feasibility of home operation, difficulty score, risk score and access suggestions of nursing service projects.Results:The results showed that 61 nursing service items had the feasibility of home nursing operation. The nursing operations of intravenous injection, intravenous infusion and indwelling needle infusion were not suitable for home operation. Among them, the operators of the five items such as transfusion port maintenance, wound dressing change, peritoneal dialysis, ostomy nursing and disease rehabilitation guidance should be competent only after they passed the training and assessment of specialized nurses and had the operation experience of the project due to the difficulty of operation or the medium and high level of risk. Hair care and warm water bath were of low difficulty and low risk to be operated at home and they could be completed by trained caregivers or nursing workers. Operators of 54 items such as oral care, perineal scrubbing, rapid blood glucose monitoring, etc., should have nurse practicing certificate, nurse or above title, and have more than 5 years of related work experience.Conclusions:The access standard of "Internet+ nursing service" project established in this study is highly scientific and reliable, which can provide useful reference for establishing the access management method of "Internet+ nursing service".

Objective:To investigate the role of ineffective esophageal motility (IEM) in non-erosive acid reflux related diseases, and the influence of the fourth edition Chicago classification (CC v4.0) on the diagnosis of IEM.Methods:From January 2018 to January 2020, 63 patients with acid reflux related symptoms who underwent gastroscopy and showed no abnormal changes in esophageal mucosa or structure, and underwent high resolution esophageal manometry (HRM) and 24-hour esophageal pH monitoring in the Department of Gastroenterology of Beijing Friendship Hospital were included in the case-control study. According to the HRM results, the third edition Chicago classification standard (CC v3.0) and CC v4.0 were used to divided patients into IEM group and normal dynamic group. The HRM results, 24-hour esophageal pH monitoring results and final diagnosis of the two groups under the two editions of Chicago classification standard were mainly compared and analyzed.Results:Among the 63 patients, there were 14 cases of non-erosive gastroesophageal reflux disease (NERD), 19 cases of reflux hypersensitivity (RH), and 30 cases of functional heartburn (FH). When using CC v3.0, there were 20 cases in the IEM group, including 9 cases of NERD, 5 cases of RH and 6 cases of FH, and 43 cases in the normal dynamic group, including 5 cases of NERD, 14 cases of RH and 24 cases of FH. When using CC v4.0, there were 16 cases in the IEM group, including 7 cases of NERD, 4 cases of RH and 5 cases of FH, and 47 cases in the normal dynamic group, including 7 cases of NERD, 15 cases of RH and 25 cases of FH. When using CC v3.0, compared with the normal dynamic group, the acid exposure time (AET) of the IEM group was significantly higher [3.45 (1.55, 6.40)% VS 1.20 (0.40, 2.30)%, Z=-2.940, P=0.003], the DeMeester score was also significantly higher [13.8 (5.8, 21.4) VS 5.3 (2.9, 10.0), Z=-2.851, P=0.004], the lower esophageal sphincter pressure (LESP) [10.15 (7.52, 13.65) mmHg (1 mmHg=0.133 kPa) VS 15.40 (11.20, 21.60) mmHg, Z=-3.241, P=0.001], 4-second integrated relaxation pressure (4sIRP) (3.79±0.57 mmHg VS 6.05±0.50 mmHg, t=2.727, P=0.008), and distal contraction integral (DCI) [334.65 (208.25, 438.92) mmHg·s·cm VS 1 258.70 (919.00, 1 750.10) mmHg·s·cm, Z=-6.305, P<0.001] were significantly lower than those of the normal dynamic group. When using CC v4.0, AET and Demeester scores in the IEM group were also significantly higher than those in the normal dynamic group (both P<0.05), and LESP, 4sIRP and DCI were also significantly lower than those in the normal dynamic group (all P<0.05). In addition, upper esophageal sphincter pressure was significantly lower than that in normal dynamic group [34.60 (21.50, 48.05) mmHg VS 49.67 (36.75, 61.10) mmHg, Z=-2.140, P=0.032]. Conclusion:IEM is associated with impaired anti-reflux barrier function and esophageal acid exposure in patients with non-erosive acid reflux related diseases. Compared with CC v3.0, CC v4.0 can reduce the heterogeneity of IEM patients to some extent.

ObjectiveTo observe the efficacy and safety of sertraline combined with low-dose olanzapine in the treatment of depression and anxiety comorbidity and its effect on sleep quality， so as to provide references for the related clinical treatment. MethodsA total of 121 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for depressive episode and generalized anxiety disorder in The Third People's Hospital of Tianshui and the Sanatorium for Mental Illness of Veterans in Tianshui from October 2019 to August 2020 were enrolled， and they were divided into two groups according to the random number table method. Study group （n=61） received sertraline combined with low-dose olanzapine， while control group （n=60） received sertraline only. Then the disease severity degree， sleep quality and adverse reactions were assessed using Hamilton Depression Scale - 17 item （HAMD-17）， Hamilton Anxiety Scale （HAMA）， Pittsburgh Sleep Quality Index （PSQI） and Treatment Emergent Symptom Scale （TESS） at the baseline， 1^st， 2^nd， 4^th， 6^th and 8^th weekend， respectively. ResultsPost-treatment HAMD-17， HAMA and PSQI scores in both groups were lower than those before treatment （P<0.05）. At each time point after treatment， HAMD-17， HAMA and PSQI scores of study group were lower than those of control group， with statistical significance （P<0.05）. ConclusionSertraline alone and its combination with low-dose olanzapine are both effective in the treatment of depression and anxiety comorbidity， while the combination therapy achieves better efficacy and higher safety in alleviating anxiety and insomnia symptoms.

Objective: To study the effects of hedysarum polybotys saccharides (HPS) and selenizated hedysarum polybotys saccharides (SE-HPS) on the oral squamous cancer cell line SCC25. Methods: Different concentrations (0, 10, 25, 50, 100, 200, 400 μg/ml) of HPS and SE-HPS were added to SCC25 cells in the logarithmic growth stage. Cell proliferation was detected by the CCK-8 method, apoptosis was detected by flow cytometry, and apoptosis-related indexes were observed by RT-qPCR and Western blotting. Results : The concentrations of HPS and SE-HPS inhibited the proliferation of SCC25 cells. The inhibitory effect of 50 μg/mL HPS and SE-HPS on the proliferation of SCC25 cells was the strongest and was time-dependent. The inhibition effect significantly increased within 48 h, and the effect was achieved after 48 h. At the plateau stage, SE-HPS inhibited the proliferation of SCC25 cells more strongly than HPS (P < 0.05). The results of flow cytometry showed that 50 μg/mL HPS and SE-HPS acted on SCC25 cells for 48 h, and the apoptotic rates were 25.8% and 30.8% respectively. Compared with the control group (0 μg/mL HPS and SE-HPS), the difference was statistically significant (P < 0.05). RT-qPCR and Western blotting showed that 50 μg/mL HPS and SE-HPS acted on SCC25 cells for 48 h, and the mRNA and protein expression levels of the apoptosis gene Fas/FasL were upregulated. The difference was statistically significant (P < 0.05). Conclusion Both HPS and SE-HPS can inhibit the proliferation of SCC25 oral cancer cells, but SE-HPS is superior to HPS and can induce apoptosis through the Fas/Fasl pathway.

Objective To investigate the continuous ambulatory peritoneal dialysis (CAPD) and daytime ambulatory peritoneal dialysis (DAPD) on sleep and quality of life. Methods In this is a multi-center cross-sectional survey, we used the Pittsburgh Sleep Index Scale (PSQI) and the Chinese version of peritoneal dialysis patient quality of life scale, the unified investigating time, the organized trained peritoneal dialysis nurses qualified to conduct research full-time. Survey content includes general information, sleep and quality of life, laboratory tests, dialysis adequacy and other indicators, and the results were pooled analysis. Results A total of 325 hospitalized peritoneal dialysis patients were included in the study, including 177 patients in CAPD, 148 patients in DAPD. The total scores of QOL, physical function, physical factors, psychological status, social function and life satisfaction were (72.61± 10.94), (19.44±3.65), (59.69±7.31), (32.65±5.65), (24.82±6.03), (15.42±5.47)and (74.06±13.59), (20.16± 2.95), (58.99 ± 5.86), (34.58 ± 6.17), (25.10 ± 5.01), (15.36 ± 4.28). The score of CAPD in the mental state dimension was significantly lower than that in DAPD patients (t=-3.715, P<0.01). Else, there was no significant difference between the two groups (P> 0.05). Conclusions Sleep and quality of life in peritoneal dialysis patients are lower than normal adults. Dialysis modes have an impact on sleep andquality of life of patients, health care workers should fully assess the physical and mental state of the patients in order to select the appropriate mode of dialysis.

Objective To explore the color preference in hospitalized patients with mental disorders and healthy adults. Methods Abstract color preference test was conducted in 1951 clinic patients with mental disor-ders and 1005 healthy adults by use of dual comparison method. Results The order of color preference for pa-tients with mental disorders was blue(4.72),green(4.67),red(4.52),yellow(4.46),orange(4.38),purple (3.92),gray (3.56),white (3.43) and black (2.96). There were significant differences between patients with mental disorders and healthy adults in preference to purple(Z = 2.934,P = 0.003),black(Z = 3.730,P =0.000),orange(Z =-2.113,P = 0.035),yellow(Z =-2.093,P = 0.036),white(Z =-2.499,P = 0.012) and gray(Z=-3.204,P=0.001). The preference to black(χ2=22.409,P<0.001)and gray(χ2=134.086, P < 0.001) differed significantly among schizophrenia , mood disorders and neurosis. Schizophrenia patients mostly preferred blue,mood disorders patients mostly preferred red,and neurotic patients mostly preferred green. Conclusions The color preference in hospitalized patients with mental disorders is different from that in normal adults. There are differences in color preference among patients with different types of mental disorders.