ObjectiveTo explore the potential mechanism of Banxia Xiexin Decoction （半夏泻心汤， BXD） in the treatment of diabetic gastroparesis （DGP）. MethodsA total of 29 SD rats were randomly divided into four groups， blank group （5 rats） and model group， BXD group and metformin group （8 rats in each group）. Except for the blank group， rats were administered intraperitoneally with 1% streptozotocin （STZ） solution and were fed a high-sugar， high-fat diet to establish the DGP rat model. After successful modeling， the BXD group was treated with BXD at 6.68 g/（kg·d） by gavage， the metformin group was treated with metformin hydrochloride at 105 mg/（kg·d） by gavage， and the blank group and the model group were treated with normal saline at 6.68 ml/（kg·d） by gavage， for 8 weeks. After the last administration， fasting blood glucose （FBG）， glycated hemoglobin （HbA1c）， total cholesterol （TC）， triglycerides （TG） were measured and gastric emptying rate was calculated. ELISA was used to detect the levels of gastrointestinal hormones motilin （MTL） and gastrin （GAS）， as well as inflammatory factors including tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， interleukin-1β （IL-1β） and interleukin-10 （IL-10） in gastric tissue. Oil red O staining was performed to observe liver pathological morphology. Hematoxylin and eosin （HE） staining was used to observe gastric antrum tissue morphology. Immunofluorescence staining was used to detect liver X receptor α （LXRα） levels in the liver. Western Blot was used to detect the protein levels of LXRα in liver tissue， and of janus kinase 2 （JAK2）， phospho-janus kinase 2 （p-JAK2）， signal transducer and activator of transcription 3 （STAT3） and phospho-signal transducer and activator of transcription 3 （p-STAT3） in gastric antrum tissue. Quantitative real-time polymerase chain reaction （qPCR） was used to measure the mRNA expression of LXRα in liver tissue and JAK2， STAT3 in gastric antrum tissue. ResultsCompared with the blank group， the model group showed significant hepatic fatty degeneration， gastric antrum tissue structure destruction， and increases in FBG， HbA1c， TC， and TG levels； the average fluorescence intensity， protein level， and mRNA expression of LXRα in liver tissue were reduced； the gastric emptying rate and gastric tissue GAS and MTL levels decreased； inflammatory factors including TNF-α， IL-6， IL-1β in gastric tissue increased， IL-10 decreased； in gastric antrum tissue， the mRNA expression of p-JAK2/JAK2， p-STAT3/STAT3， and JAK2 and STAT3 increased （P＜0.01）. Compared with the model group， both the BXD group and the metformin group showed improved liver and gastric antrum tissue pathology； FBG， HbA1c， TC， and TG levels decreased， while LXRα fluorescence intensity， protein level， and mRNA expression in liver tissue significantly increased； the gastric emptying rate and the levels of GAS and MTL in gastric tissue were markedly higher； the levels of TNF-α， IL-6， and IL-1β decreased， whereas IL-10 levels increased， p-JAK2/JAK2， p-STAT3/STAT3， and the mRNA expression of JAK2 and STAT3 in gastric antrum tissue decreased （P＜0.05 or P＜0.01）. The BXD group showed higher level than the metformin group in FBG， HbA1c， and TG levels， lower level in gastric emptying rate and gastric tissue GAS content， and higher level in gastric tissue TNF-α， IL-6， IL-1β levels； there was also a decrease in IL-10 levels， and a reduction in LXRα fluorescence intensity and mRNA expression in liver tissue， as well as in p-JAK2/JAK2 levels in gastric antrum tissue （P＜0.05 or P＜0.01）. ConclusionBXD can reduce blood glucose and lipid levels in DGP model rats while improving gastric function and alleviating gastric tissue inflammation. Its mechanism may be related to the regulation of LXRα expression in liver tissue and the JAK2/STAT3 pathway in gastric antrum tissue.

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)followed by hepatic arterial infusion chemotherapy(HAIC)combined with TKI drugs and PD-1 inhibitors as the first-line treatment for advanced hepatocellular carcinoma(HCC).Methods We retrospectively analyzed the data of 70 patients with advanced HCC treated in the Department of Oncology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine between July,2020 and June,2023.23 of the patients received TACE combined with HAIC and TKI(TACE+HAIC+TKI group)and 47 received TACE combined with HAIC,PD-1 inhibitors and TKI(TACE+HAIC+PD-1+TKI group).The clinical characteristics,laboratory test results,efficacy,outcomes and adverse events of the patients were compared between the two groups.Results The TACE+HAIC+TKI and TACE+HAIC+PD-1+TKI groups had significantly different objective remission rates(ORR;60.87%vs 36.17%,P=0.031),comparable disease control rates(95.65%vs 93.62%,P=0.068),and different median progression-free survival(PFS)time(10.2 vs 11.8 months,P=0.003)and median overall survival(OS)time(15.7 vs 19.5 months,P=0.035).After propensity score matching(PSM),the median PFS and OS time of the two groups was 10.1 vs 14.5 months(P=0.024)and 14.2 vs 21.2 months(P=0.221),respectively.The 1-year PFS rates of the 2 groups were 24.0%vs 52.2%,and the 1-,2-and 3-year OS rates were 72.3%vs 93.1%,23.9%vs 63.8%,and 23.9%vs 36.5%,respectively.The incidence of proteinuria was significantly higher in TACE+HAIC+PD-1+TKI group than in TACE+HAIC+TKI group(21.28%vs 0,P=0.025),but the incidences of grade 3-4 treatment-related adverse events were all similar between the two groups.Conclusion The first-line treatment with TACE+HAIC+PD-1+TKI is safe and effective for advanced HCC and can significantly prolong the survival of the patients.

Objective:To explore the regulatory effects of Danzhi Jiangtang Capsules on glucose metabolism and mitochondrial oxidative stress levels in db/db mice.Methods:Totally 32 db/db mice were randomly divided into model group, positive control group, and Danzhi Jiangtang Capsule low-, medium- and high-dosage groups; at the same time, 8 same-sex C57BL/6 mice of the same week age were selected as the blank group. The metformin group was filled with metformin solution 0.1 g/kg, and the Danzhi Jiangtang Capsule low-, medium- and high-dosage groups were injected with 0.99, 0.49 and 0.25 g/kg Danzhi Jiangtang Capsule solution respectively. The model group and the blank group received the same volume of physiological saline solution for the gavage, 1 time/d, continuous 12 weeks. The weight and fasting blood sugar (FBG) changes in each group of mice were detected; the serum insulin (FINS) level was detected by ELISA method and the insulin resistance index (HOMA-IR) was calculated; kits were used to detect the pancreatic tissue SOD and MDA levels of each group of mice; HE staining was used to observe pathological morphology of pancreatic tissue. Transmission electron microscopy was used to observe the ultrastructure of pancreatic mitochondria; Western blot method was used to detect the expressions of p-AMPK and AMPK proteins in pancreatic tissue.Results:Compared with the model group, after 8 or 12 weeks of drug administration, the weight of mice in the Danzhi Jiangtang Capsule high-dosage group decreased ( P<0.05 or P<0.01), and the level of FBG decreased ( P<0.01); FINS and HOMA-IR in the Danzhi Jiangtang Capsule high- and medium-dosage groups decreased ( P<0.01), the SOD activity in Danzhi Jiangtang Capsule high- medium- and low-dosage groups increased, and the level of MDA decreased ( P<0.01); the expressions of p-AMPK and AMPK in Danzhi Jiangtang Capsule high-and medium-dosage groups increased ( P<0.01), the expression of AMPK in Danzhi Jiangtang Capsule low-dosage group increased ( P<0.01). Conclusion:Danzhi Jiangtang Capsule can improve SOD activity in pancreatic tissue of db/db mice, reduce MDA content, and activate the AMPK signaling pathway, suggesting that Danzhi Jiangtang Capsule can improve insulin resistance and restore glucose homeostasis by inhibiting oxidative stress levels and improving mitochondrial function.

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)followed by hepatic arterial infusion chemotherapy(HAIC)combined with TKI drugs and PD-1 inhibitors as the first-line treatment for advanced hepatocellular carcinoma(HCC).Methods We retrospectively analyzed the data of 70 patients with advanced HCC treated in the Department of Oncology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine between July,2020 and June,2023.23 of the patients received TACE combined with HAIC and TKI(TACE+HAIC+TKI group)and 47 received TACE combined with HAIC,PD-1 inhibitors and TKI(TACE+HAIC+PD-1+TKI group).The clinical characteristics,laboratory test results,efficacy,outcomes and adverse events of the patients were compared between the two groups.Results The TACE+HAIC+TKI and TACE+HAIC+PD-1+TKI groups had significantly different objective remission rates(ORR;60.87%vs 36.17%,P=0.031),comparable disease control rates(95.65%vs 93.62%,P=0.068),and different median progression-free survival(PFS)time(10.2 vs 11.8 months,P=0.003)and median overall survival(OS)time(15.7 vs 19.5 months,P=0.035).After propensity score matching(PSM),the median PFS and OS time of the two groups was 10.1 vs 14.5 months(P=0.024)and 14.2 vs 21.2 months(P=0.221),respectively.The 1-year PFS rates of the 2 groups were 24.0%vs 52.2%,and the 1-,2-and 3-year OS rates were 72.3%vs 93.1%,23.9%vs 63.8%,and 23.9%vs 36.5%,respectively.The incidence of proteinuria was significantly higher in TACE+HAIC+PD-1+TKI group than in TACE+HAIC+TKI group(21.28%vs 0,P=0.025),but the incidences of grade 3-4 treatment-related adverse events were all similar between the two groups.Conclusion The first-line treatment with TACE+HAIC+PD-1+TKI is safe and effective for advanced HCC and can significantly prolong the survival of the patients.

Objective:To explore the influencing factors of enteral nutrition feeding intolerance (FI) in patients with abdominal trauma and construct a risk prediction model.Methods:This was a retrospective study. General and clinical data such as Acute Physiology and Chronic Health Evaluation (APACHEⅡ), Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and Acute Gastrointestinal Injury (AGI) of patients with abdominal trauma and enteral nutrition admitted to Department of Emergency Surgery of the First Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were collected by means of medical record inquiry. Patients were divided into FI group and non-FI group according to whether FI occurred within three days after receiving enteral nutrition. Multivariate Logistic regression analysis was used to explore the influencing factors of FI in patients with abdominal injury and to construct the related risk prediction model. The diagnostic value of the prediction model was evaluated by the area under the receiver operating characteristic curve.Results:A total of 101 research objects were included, including 30 patients with enteral nutrition FI and 71 patients without enteral nutrition FI. The multivariate Logistic regression results analysis showed that injury severity score, acute gastrointestinal injury grading, and hypoalbuminemia were the influencing factors of enteral nutrition FI in patients with abdominal injury ( P<0.05). A risk prediction model for enteral nutrition FI in patients with abdominal injury was constructed based on the above factors. The area under the receiver operating characteristic curve (AUC) of the predictive model was 0.856, with a sensitivity of 0.833, a specificity of 0.732, a Jordan index of 0.565, and an optimal critical value of 0.265. Conclusions:The constructed risk prediction model for enteral nutrition FI in patients with abdominal injury has good predictive performance, which can provide a reference for medical staff to predict the risk of enteral nutrition FI in patients with abdominal injury.

Objective:To explore the knowledge, attitude and practice (KAP) status of ICU nurses on enteral nutrition treatment of severe acute pancreatitis and to analyze its influencing factors.Methods:A total of 520 ICU nurses from 7 ClassⅢ Grade A hospitals in Henan Province from February to April 2022 were selected as research objects by the convenient sampling method. General Data Questionnaire and Clinical Nurses' Knowledge, Attitude and Practice Questionnaire on Enteral Nutrition Treatment of Acute Pancreatitis were used to investigate.Results:A total of 520 questionnaires were sent out, and 504 were effectively collected, with an effective recovery rate of 96.92%. The total score of ICU nurses' knowledge, attitude and practice in enteral nutrition for severe acute pancreatitis was (113.68±12.48), including knowledge dimension (10.67±2.58), attitude dimension (61.60±6.38), and practice dimension (41.42±7.44). There were positive correlation among ICU nurses' scores of knowledge, attitude and practice on enteral nutrition in patients with severe acute pancreatitis ( P<0.01). The results of multiple linear regression analysis showed that professional title, length of service in ICU nursing, personnel relations, whether to participate in specialized training, and whether to care for patients with severe acute pancreatitis and enteral nutrition were the influencing factors of knowledge dimension ( P<0.05). Post, whether to participate in specialized training, and whether to care for patients with severe acute pancreatitis undergoing enteral nutrition were influencing factors of attitude dimension ( P<0.05). Gender, professional title, post, whether to participate in specialized training, and whether to care for patients with severe acute pancreatitis undergoing enteral nutrition were the influencing factors of behavioral dimensions ( P<0.05) . Conclusions:ICU nurses have a positive attitude towards enteral nutrition treatment for severe acute pancreatitis, and their knowledge attitude and practice level need to be improved. Nursing managers should establish and improve a training system, strengthen the knowledge and behavior of ICU nurses on enteral nutrition for patients with severe acute pancreatitis and improve their management level of enteral nutrition for patients with severe acute pancreatitis, thereby improving the quality of nursing.

OBJECTIVE: To investigate accuracy of the currently used strategies for intraocular pressure measurements for reflecting actual 24-hour intraocular pressure fluctuations. METHODS: From September, 2018 to January, 2019, the patients with a suspected diagnosis of primary open angle glaucoma at our hospital were prospectively enrolled to receive 24-hour intraocular pressure monitoring using a Goldmann tonometer. With the intraocular pressure measurements at 0:00, 2:00, 5:00, 7:00, 8:00, 10:00, 11:00, 14:00, 16:00, 18:00, 20:00, and 22:00 as the gold standard (strategy 1), we compared the measurements taken at 5:00, 7:00, 10:00, 14:00, 18:00, and 22:00 (strategy 2) and at 8:00, 11:00, 14:00, and 16:00 (strategy 3) for their accuracy in reflecting 24-h intraocular pressure fluctuations. RESULTS: A total of 41 patients (82 eyes) were enrolled in this study. The peak intraocular pressures measured using the 3 strategies were 21.09±4.15 mmHg, 20.54±4.10 mmHg, and 19.91±4.38 mmHg, respectively, showing significant differences among them ( CONCLUSIONS For suspected cases of glaucoma, intraocular pressure measurements at 4 and 6 time points of a day can not precisely reflect the actual range of intraocular pressure fluctuations, and may lead to a missed diagnosis of glaucoma.
Glaucoma/diagnosis* ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Prospective Studies ; Tonometry, Ocular

In order to train professionals in medical laboratory technology who are directly engaged in medical examination and medical laboratory work and who have strong practical ability and can adapt to the development of precision medicine, the reform of precise teaching for experiment is implemented. Through the precise stratification of experimental projects and knowledge points, the design of precise teaching activity and the construction of precise evaluation system for experiments, guided by precision medicine during the experimental process, the standardization and precision training of basic skills for students are strengthened in clinical laboratory test. The students can more well adapt to the needs of society for technical and innovative talent in the new period. The precise teaching for experiment will become one of the main characteristics of medical laboratory technology education in our school.

Objective:To explore the needs for discharge plans in patients with ischemic stroke and their family members, and provide a reference for formulating a scientific and standardized discharge plan.Methods:Totally 15 patients with hemiplegia after ischemic stroke admitted in our hospital between January and March 2019 and 15 family members received semi-structured in-depth interviews using phenomenological research methods in qualitative studies. Colaizzi analysis was used to encode, analyze, categorize and refine the data.Results:The needs for discharge plans in patients with hemiplegia after ischemic stroke were summarized into 5 themes, namely, disease knowledge, rehabilitation exercise, psychological support, financial support, and referral services; the needs for discharge plans in family members were summarized into 3 themes, namely, care knowledge/skills guidance, rehabilitation equipment guidance and respite care needs.Conclusions:Patients with hemiplegia after ischemic stroke and their family members have high needs for discharge plans. A personalized multidisciplinary collaborative discharge plan should be provided, and the role of communities in the follow-up rehabilitation treatment should be given full play to.

OBJECTIVE: To analyze the clinical features and genetic mutations in a patient with mucolipidosis type II α/β by using next generation sequencing. METHODS: Clinical data of the patient was collected. Genomic DNA of the patient and her parents was extracted by a standard method. The patient was subjected to targeted sequencing using an Ion Ampliseq panel, which included genes related to mucolipidosis and mucopolysaccharidosis. Suspected mutations were verified by Sanger sequencing. RESULTS: Compound heterozygous mutations, namely c.1284+1G>T and c.1090C>T (p.Arg364*), were detected in the patient, which were respectively inherited from her mother and father. No other disease-causing mutation was detected in the patient. GNPTAB c.1090C>T was known to be pathogenic, while GNPTAB c.1284+1G>T is a novel mutation. The same mutations were not detected among 50 healthy controls. CONCLUSION The compound heterozygous mutations c.1284+1G>T and c.1090C>T (p.Arg364*) of GNPTAB gene probably account for the mucolipidosis type II α/β in the patient. NGS has a great value for the molecular diagnosis and typing of mucolipidosis.
Female ; High-Throughput Nucleotide Sequencing ; Humans ; Mucolipidoses ; genetics ; Mutation ; Transferases (Other Substituted Phosphate Groups) ; genetics