Objective To investigate the clinical significance and serum changes of asprosin(ASP)levels in patients with essential hypertension and early renal damage.Methods According to urinary albumin/creatinine ratio(UACR),160 patients with essential hypertension were divided into the simple hypertension group(78 cases)and the early renal damage group(82 cases).Another 60 healthy subjects were selected as the control group.The differences of serum ASP,interleukin-6(IL-6)and UACR levels were compared between groups.The correlation between ASP and blood pressure,IL-6 and UACR was analyzed.Logistic regression analysis was used to analyze the factors influencing early renal damage in essential hypertension.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for early renal injury.Results The serum levels of ASP,IL-6 and UACR were higher in the early renal damage group than those in the control group and the simple hypertension group(all P＜0.05).The serum levels of ASP and IL-6 showed an increasing trend with the increase of blood pressure.ASP was positively correlated with systolic blood pressure(SBP),diastolic blood pressure(DBP)and IL-6 levels in patients with essential hypertension(all P＜0.05).Serum ASP was positively correlated with SBP,UACR and IL-6 levels in essential hypertension patients(P＜0.05),and serum ASP was positively correlated with UACR and IL-6 levels in the early renal damage group(P＜0.05).Logistic regression analysis showed that higher levels of SBP,ASP and IL-6 were independent risk factors for early renal damage.ROC curve showed that ASP had the largest area under the curve(AUC)of 0.972(95%CI:0.950-0.993).The AUC of combined detection of ASP+IL-6+SBP was 0.986(95%CI:0.972-0.999).Conclusion The increased serum ASP level in patients with early renal damage in essential hypertension is a good predictor of early renal damage.The combined detection of ASP+IL-6+SBP is better than single detection.

Objective To evaluate the scientificity,transparency and applicability of Chinese guidelines and expert consensuses on nursing published in 2022,in order to improve the quality of guidelines and consensuses.Methods Databases including Medline,Embase,Web of Science,CBM,CNKI,WanFang database,Chinese Medical Journal,and related websites were electronically searched,as well as China Hong Kong,Macao and Taiwan medical journals,to collect Chinese guidelines and expert consensuses on nursing from January to December 2022.STAR tool was used to evaluate the quality of each guidelines and consensuses by 3 assessors independently.Total score,scoring rate of each domain and item were adopted to analyze the outcomes.Results A total of 3 guidelines and 33 expert consensuses were included.The total guidelines and expert consensuses STAR score(33.5±14.3).The quality of guidelines and consensuses was low.The quality of guidelines was moderate with average score of 55.1,and the quality of consensuses was low with average score of 31.5.The included guidelines and consensuses had a highest score rate(52.4％)in the domain of recommendation.Among 39 items of STAR tool,the top 4 items including listing participants and institutions,explaining additional instructions for implementation,describing consensus method,and listing references for recommendations had a high score rate of 100％,83.3％,77.8％,75.0％respectively.However,the items of registration,providing registration information,protocols being searched on public platforms and explaining the role of funding had a low score rate,urgent need for attention and upgrading.Conclusion The overall quality of the Chinese guidelines and expert consensuses on nursing published in 2022 was low.As a medical and nursing practice guidance document,the quality of guidelines and expert consensuses should be improved by encouraging registration,strengthening management of interest conflict,enhancing the rigor of guideline developing process,and expanding the dissemination.

Objective To explore mechanisms of family resilience in children with obstetrical brachial plexus palsy(OBPP)and provide a basis for developing interventions to family resilience.Methods Semi-structured interviews were conduc-ted with 10 primary caregivers,and data were analyzed through content analysis.Results Three themes were distilled,namely,great impact of the injurious event on the family,positive response of the family to the injurious event,and hidden pain that the injurious event brought to the family.Conclusion The overall resilience of families of OBPP children is in a high level.It is es-sential to address the adverse impact of the injurious event on the families,consolidate the positive results of the family's re-sponse to the injury,and promote the restoration and enhancement of the family's function.

Objective To observe the effects of Guanxinning tablet on atherosclerotic plaque,renal function,hemorheology,blood homocysteine(Hcy)and immunoinflammation in patients with blood stasis type chronic renal failure complicated by hemodialysis and carotid atherosclerosis.Methods According to the diagnosis,inclusion and exclusion criteria,67 patients with blood stasis type chronic renal failure complicated with carotid atherosclerosis and undergoing hemodialysis from Lishui Second People's Hospital and Lishui Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and randomly divided into control group(33 cases)and observation group(34 cases).The control group received routine treatment of chronic renal failure and hemodialysis.In the observation group,Guanxinning tablet was added to the basic treatment,and the levels of carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy and immunoinflammation were detected in both groups before and after treatment.Results There were no significant differences in general information,carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy level and immunoinflammation level between the two groups before treatment(P>0.05).After treatment,the observation group was superior to the control group in reducing carotid plaque,improving carotid intimedia thickening,improving renal function,reducing inflammatory index level and improving immune function(P<0.05),but there was no significant difference in reducing blood Hcy level compared with the control group(P>0.05).Conclusion Guanxinning tablet can improve the chronic inflammation in the body of patients with blood stasis type chronic renal failure combined with hemodialysis and carotid atherosclerosis,reduce blood viscosity,inhibit red blood cell aggregation,thereby improving carotid atherosclerosis,reducing carotid atherosclerotic plaque,improving renal function and improving immune function of patients,but does not reduce blood Hcy level.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

AIM: To investigate the role of ribonucleotide reductase M2 (RRM2) in 5-fluorouracil (5-FU) resistance of HCC cells and to develop potential strategies to enhance the sensitivity of HCC cells to 5-FU. METHODS: The expression of RRM2 was examined by Western blot in BEL/5-FU cells and BEL7402 cells. The expression of RRM2 was down-regulated through RNA interference (RNAi) technology and the activity of RRM2 was inhibited by the RRM2 inhibitor 3-AP. The cell proliferation ability was detected by CCK-8 assay and colony formation assay, and the apoptosis was analyzed by Confocal high-content system. RESULTS: The expression level of RRM2 was increased by 2.5-fold in BEL/5-FU cells compared with BEL7402 cells. Compared with control siRNA, the half maximum inhibitory concentration IC

Objective To OxplorO thO OffOct of N-tOrminal pro-brain natriurOtic pOptidO( NT-proBNP) combinOd with nOutrophil to lymphocytO ratio ( NLR) on short -tOrm prognosis in patiOnts with acutO ST sOgmOnt OlOvation myocardial infarction ( STEMI ) undOrgoing primary pOrcutanOous coronary intOrvOntion ( PCI ). Methods From January 2015 to DOcOmbOr 2016, 243 patiOnts with acutO STEMI who undOrwOnt primary PCI in Harrision IntOrnational POacO Hospital wOrO OnrollOd in thO study. ThO lOvOls of NT-proBNP and NLR wOrO mOasurOd at admission. ThO occurrOncO of major advOrsO cardiac and cOrObrovascular OvOnts(MACCE) was followOd up during 1 yOar aftOr PCI. ROcOivOr opOrating charactOristic( ROC) curvOs wOrO usOd to sOt cut-off valuOs of NT-proBNP and NLR for prOdicting MACCE. All patiOnts wOrO dividOd into 4 groups basOd on thO optimal cut-off point: low NT-proBNP/low NLR group, low NT - proBNP/high NLR group, high NT - proBNP/low NLR group, high NT-proBNP/high NLR group. Various indicators wOrO comparOd among thO four groups. Survival curvOs of thO 4 groups at 12 months wOrO constructOd by Kaplan -MOiOr analysis and comparOd using thO log -rank tOst. ThO prOdictivO valuO of NT-proBNP and NLR alonO or in combination for MACCE aftOr PCI was OvaluatOd by thO Cox proportional hazard modOl. Results ThOrO wOrO statistically significant diffOrOncOs in TC,LDL-C, blood glucosO, glycosylatOd hOmoglobin, FMC to Ballon timO, NT-proBNP, NRL among thO high NT-proBNP/high NLR group and thO othOr thrOO groups(F =40.684,65.429,398.62,41.330,217.218,331.5,393.02,all P <0.05). ROC analysis indicatOd thO optimal cut-off point of NT-proBNP, NLR for prOdicting MACCE wOrO 1 600 ng/L(thO arOa undOr thO ROC curvO 0.779,sOnsitivity 81.4% ,spOcificity 83.5% ) and 6.5(thO arOa undOr thO ROC curvO 0.742, sOnsitivity 78.6% ,spOcificity 80.8% ),rOspOctivOly.ThO patiOnts in thO high NT-proBNP(>1 600ng/L) and high NLR(>6.5) group had significantly highOr risk of cardiovascular dOath(23.5% ),hOart failurO(47.1% ),rOcurrOnt MI(17.6% ),and cOrObral strokO(11.7% ),but no significantly incrOasO in thO risk of non-plan rOpOat rOvascular-ization, stOnt thrombosis.ThO survival ratO in high NT -proBNP and high NLR group(76.5% ) was significantly lowOr than thO othOr thrOO groups(98.1% ,97.9% ,95.0% ,χ2 =20.626,P<0.05).MultivariatO analysis of COX proportional hazards modOl showOd that TC, LDL - C, blood glucosO, glycosylatOd hOmoglobin, thO onsOt timO, NT-proBNP, NRL could bO usOd as thO prognostic factors for cardiac and cOrObrovascular OvOnts. ThO prOdictivO powOr of NT-proBNP combinOd with NLR was highOr than OithOr NT-proBNP or NLR alonO.Conclusion IncrOasOd lOvOls of NT -proBNP and NLR at admission could prOdict cardiovascular dOath, hOart failurO, rOcurrOnt MI and cOrObral strokO in patiOnts with STEMI aftOr primary PCI. ThO prognostic capability of intOrgratOd application of NT-proBNP and NLR is bOttOr than OithOr NT-proBNP or NLR alonO.

Objective To investigate the efficacy and safety of different doses of Rosuvastatin calcium in treating elderly patients with coronary heart disease complicated with hyperlipidemia.Methods A total of 130 patients with coronary heart disease in combination with hyperlipidemia admitted into our hospital from January 2015 to December 2017 were enrolled.They were randomly divided into the control group(with Rosuvastatin calcium 10 mg per day,n=65)and the study group (with Rosuvastatin calcium 20 mg per day,n=65).Clinical efficacy,changes of blood lipid levels and adverse reactions after treatment were compared between the two groups.Results In the study group,25 cases had obvious effects,35 cases had effects and 5 cases had noeffect.In the control group,21 cases with obvious effects,31 cases with effects and 13 cases without effect were found.The total effective rates were 92.3％ in the study group and 80.0％ in control group(x2 =4.127,P =0.042).The blood levels of total cholesterol (TC),triglyceride(TG)and low-density lipoprotein cholesterol (LDL-C) in the study group were decreased in post-vs.pre-treatment,and were lower in treatment group than in control group(all P =0.000).Nausea and vomiting in 1 case,and muscle ache in 1 case were found in the control group.In the study group,2 cases of nausea and vomiting,2 cases of skin rash,1 case of muscle ache,and 2 cases of joint ache were found.The incidences of adverse reactions were 10.8％ and 3.1％ in the study and control group respectively,with no significant difference between the two groups (x2 =2.984,P =0.084).Conclusions The high-dose of Rosuvastatin calcium(20 mg daily)has significant clinical efficacy and improve the blood lipid levels in elderly patients with coronary heart disease complicated with hyperlipidemia,with no significant difference in incidence of adverse reactions between 10 mg daily versus 20 mg daily Rosuvastatin calcium.

Objective: To improve the accuracy of diagnosis and to reduce the misdiagnosis rate of nasopharyngeal carcinoma by analyzing the characteristics of such masses. Methods: Clinical data from 55 patients with suspicion of nasopharyngeal carcinoma diagnosed and treated between March 2016 and September 2017 were analyzed. All patients were followed up regularly. Results: With following-up of 12 to 25 months, 6 (10.9%) of 55 cases were identified as nasopharyngeal malignant tumors, including 4 cases of nasopharyngeal carcinoma and 2 cases of lymphoma, and 49 cases (89.1%) were diagnosed with nasopharyngeal benign masses, including 29 (59.2%) cases for nasopharyngeal lymphoid proliferation, 15 (30.6%) for adenoid hypertrophy, 2 (4.1%) for nasopharyngeal cyst, 1 (2.0%) for polyp, 1 for papilloma and 1 for nasopharyngeal pharyngeal cyst. Small nasopharyngeal malignant tumor and masses with benign hyperplasia showed the overlap of images on the enhanced MRI/CT and Fibro-nasopharyngoscopy, but all 6 patients with nasopharyngeal malignant tumors presented with moderately enhanced multiple enlarged lymph nodes. Conclusions Fibro-nasopharyngoscopy and enhanced MRI/CT have some value on evaluation of nasopharyngeal masses, but biopsy is a golden standard for diagnosis. Follow-up is necessary for the patients with negative biopsy and benign nasopharyngeal hyperplasia indicated by fibro-nasopharyngoscopy and enhanced MRI/CT.