ObjectiveTo explore the potential mechanism of different processed products of Baiyaojian and its compound Xiangmei pills in rats with ulcerative colitis（UC） by comparing the pharmacodynamic and metabolomic differences. MethodEighty SD rats were acclimatized and kept for 3 d， and randomly divided into 8 groups［blank group， model group， mesalazine group（0.4 g·kg^-1）， Baiyaojian group（1.89 g·kg^-1）， stir-fried Baiyaojian group（1.89 g·kg^-1）， carbonized Baiyaojian group（1.89 g·kg^-1）， and Xiangmei pills low and high dose groups（1.89， 5.67 g·kg^-1）］， with 10 rats in each group. Rats in the blank group were administered physiological saline by gavage， and rats in the remaining 7 groups were orally administered 5% dextran sodium sulfate（DSS） solution daily for 8 consecutive days to induce UC model. After successful modeling， each dosing group was given the corresponding dose of drug solution by gavage， and the blank and model groups were given equal amounts of saline by gavage， and the drug was administered continuously for 8 d. Then serum levels of tumor necrosis factor-α（TNF-α）， interleukin（IL）-6， IL-10 and IL-1β were measured by enzyme-linked immunosorbent assay（ELISA）， hematoxylin-eosin（HE） staining was used to observe the histopathological changes of colon tissue， the proportion of T helper 17 cells（Th17） and regulatory T cells（Treg） in the peripheral blood of rats in each group was detected by flow cytometry. The endogenous metabolites in serum of rats were detected by ultra performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS）， and the differential metabolites were characterized by combining principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）， and were analyzed according to the variable importance in the projection（VIP） value>1.0 and P<0.05， and potential metabolic pathways were analyzed according to Human Metabolome Database（HMDB）. ResultCompared with the blank group， the colon tissue of the model group was congested and the mucosa was ulcerated， the colon length was significantly reduced（P<0.01） and the quality was significantly increased（P<0.05）， the proportion of Th17/Treg in the peripheral blood and the serum levels of TNF-α， IL-6 and IL-1β were significantly increased， while the IL-10 expression wassignificantly reduced（P<0.05， P<0.01）. Compared with the model group， the colon tissue of UC rats in each treatment group was improved with scattered ulcers， reduced inflammatory cell infiltration， significantly increased colon length， and significantly decreased mass（P<0.05）， the proportion of Th17/Treg in the peripheral blood decreased， the expression of TNF-α，IL-6 and IL-1β was significantly reduced（P<0.05， P<0.01）， while the IL-10 expression was significantly increased（P<0.01）. The therapeutic effect of different administration groups on UC was in the order of high dose group of Xiangmei pills>low dose group of Xiangmei pills>carbonized Baiyaojian group>stir-fried Baiyaojian group>Baiyaojian group. And a total of 26 differential metabolites were screened in the metabolomics results. Compared with the blank group， 14 differential metabolites were up-regulated and 5 metabolites were down-regulated in the model group， and 14， 9， 14， 12 and 17 metabolites could be recalled in the Baiyaojian group， stir-fried Baiyaojian group， carbonized Baiyaojian group， Xiangmei pills low and high dose groups. The main metabolic pathways involved were citrate cycle pathway， pantothenic acid and coenzyme A biosynthesis pathway， aromatic hydrocarbon receptor（AhR） signaling pathway， glycolysis/gluconeogenesis pathway. ConclusionThe therapeutic effect of Baiyaojian on UC is significantly improved after charcoal stir-frying， and the efficacy is more prominent when combined with Angelicae Dahuricae Radix and Mume Fructus Carbonisata， which can provide a basis for the development of Baiyaojian compound preparations.

Objective:To construct a peacetime and wartime integrated training indicator system for nursing staff in Armed Police Force hospitals, so as to provide scientific basis for reform of nursing staff training in the Armed Police Force.Methods:Using a mixed research design, from October 2021 to May 2022, based on the literature review and semi-structured interviews, the first draft of peacetime and wartime integrated training indicator system for nursing staff in Armed Police Forces hospitals was formed. The Delphi method was used to consult 15 experts for 2 rounds to determine the final version of the system.Results:The recovery rate of 2 rounds of expert inquiries was 100%, and the authority coefficients of the experts were 0.82 and 0.79. The Kendall′s rank-order correlation coefficients of 2 rounds of expert inquiries were 0.49, 0.51 for level-1 items, 0.27,0.31 for level-2 items ( all P<0.05). The final established peacetime and wartime integrated training indicator system for nursing staff in Armed Police Force hospitals included 5 level-1 items with 36 level-2 items, which were organizational management, teacher resources, training content, training forms and training assessment. The weights of all 5 level-1 items were from 0.135 to 0.221. Conclusions:The peacetime and wartime integrated training indicator system for nursing staff in Armed Police Force hospitals is scientific and reliable, which provides a reference for nurse training in Armed Police Force hospitals.

Objective To explore the effect of Dexmedetomidine (Dex) on acute brain edema in mice in condition with targeted temperature management (TTM) following traumatic brain injury (TBI).Methods A total of 180 male C57BL/6J mice were divided into control group,sham operation group,TBI group,TBI + Dex group,TBI + TTM group,and TBI + Dex + TTM group according to the random number table (n =30 per group).The sham operation group only opened the bone window but did not hit it,and the control group did not open the bone window.The TBI + Dex,TBI + TIM,and TBI + Dex + TTM groups were intraperitoneally injected with Dex (60 μg/kg once every 2 h for 3 times) and/or hypothermia after TBI.The brain tissue injury volume,EB extravasation and brain water content of each group were determined by toluidine blue,Evans blue staining and dry-wet weight method at 24 hours after injury.Real-time quantitative PCR and Western blot were used to detect the expression of Claudin-5 in the injured brain tissue.At 24,48,and 72 hours after injury,the neurological deficiency degree was assessed using the modified neurological severity scores (mNSS).Results Compared with the sham operation group,TBI mice showed significant increase in brain tissue injury volume [(0.49 ± 0.04)mm3 vs.(1 1.57 ± 1.01)mm3],blood-brain barrier permeability [(16.4 ± 0.8) μg/g vs.(54.3 ± 1.7) μg/g],brain tissue water content [(76.7 ± 0.9) ％ vs.(83.1 ± 0.8) ％],and mNSS score [(1.6 ± 0.7) points vs.(13.4 ± 0.7) points] at 24 hour after TBI (all P ＜ 0.01).However,Dex or TTM treatment reduced brain tissue injury volume [(7.20±0.18)mm3 and (5.94 ±0.18)mm3],blood-brain barrier permeability [(32.7 ± 1.2) μg/g and (27.6 ± 1.0) μg,/g],brain tissue water content [(78.5 ± 0.4) ％ and (78.2 ± 0.6) ％],and neurological function [mNSS:(7.3 ± 1.1) points and (5.8 ± 1.3) points] (all P＜0.01).Moreover,Dex + TTM group showed better neuroprotection [reduced brain tissue injury volume:(3.92 ± 0.05) mm3,reduced BBB permeability:(21.6 ± 0.7) μg/g,reduced brain water content:(77.7 ±0.3)％,and reduced mNSS:(4.3 ± 1.2) points] compared with Dex or TTM alone (all P ＜ 0.01).Additionally,the mRNA expression of Claudin-5 (0.23 ± 0.01) decreased significantly at 24 hours after TBI compared with sham group (0.93 ± 0.04,P ＜ 0.01),but Dex or TTM could increase the expression of Claudin-5 (0.47 ± 0.01,and 0.54 ± 0.09) compared with TBI group (P ＜0.01),especially that of TBI + Dex + TTM group (0.64 ± 0.02,P ＜ 0.01).Furthermore,the protein expression of Claudin-5 was in accordance with the result of its mRNA expression.Conclusion Dex in condition with targeted temperature management can up-regulate Claudin-5 expression in early TBI,protect the integrity of blood-brain barrier,attenuate acute brain edema and neurological damage,and improve neurological function recovery.

Objective To explore the effect of scenario simulation training to nurses in improving the rescue ability at ICU. Methods A total of 84 nurses were enrolled and divided into12 groups, who received 6 scenarios training developed by researchers. The score of theoretical knowledge, time of practice completion and 7 operating practices were compared before and after training. Results The theoretical knowledge score of the nursing staff before the exercise was 72.21 ± 3.14, and the score was 91.77 ± 4.55 after the exercise, and the difference before and after the exercise was statistically significant (t=2.77, P<0.05). After practice, nursing staff in cardiopulmonary resuscitation (CPR), intestinal spillover, limb fracture, pelvic fractures, burns, bleeding, glass into the seven skills score 96.23 ±4.80, respectively 96.92±4.12, 96.59±3.97, 93.79±3.45, 97.71±4.18, 95.58±4.16, 91.67±3.31, were higher than drills before 85.43± 4.55, 65.44± 4.21, 74.05± 3.25, 66.35± 2.95, 85.31± 4.05, 81.41± 3.11, 69.59± 3.96.There was a significant difference in 7 operational skills between before and after operation (t=4.010-9.780, P<0.01) . After practice,six scenario completion time was (265.45 ± 41.37), (274.90 ± 43.15), (296.52 ± 42.09), (285.44 ± 47.15), (296.42 ± 43.51), (303.50 ± 36.92) s respectively, than drills before (366.29 ± 41.12), (363.54 ± 32.94), (367.78 ± 33.75), (371.29 ± 40.16), (370.57 ± 34.69), (372.98 ± 35.32) s. There was a significant difference in time of finishing 6 scenarios between before and after operation exercises (t =2.190-6.210, P< 0.05). Conclusions Scenario simulation model training can improve the theoretical knowledge, time of practice completion andpractices ability of ICU nursing.

Objective To observe the effectiveness of lactobacillus acidophilus combined with electroacupuncture on gastrointestinal function in patients with traumatic brain injury. Methods A total of 167 patients with traumatic brain injury treated in our hospital from June 2013 to December 2016 were randomly divided into combining treatment group (n=84) and lactobacillus acidophilus group (n=83). The lactobacillus acidophilus group was given routine treatment and lactobacillus acidophilus. The combining group was given the routine treatment, electroacupuncture treatment and lactobacillus acidophilus. Data of gastronintestinal function, infection, pH of gastric juice, serum two amine oxidase (DAO) and D-lacticacid level were compared between two groups. Results Compared with lactobacillus acidophilus group, the incidence rates of reflux (χ2=7.948), vomit (χ2=7.514), diarrhea (χ2=4.521), abdominal distension (χ2=5.968), pulmonary infection (χ2=4.521) and enterogenic infection (χ2=4.531) were significantly decreased in the combining treatment group (P<0.05). After 20-day treatment, pH value of gastric juice (t=8.125) was significantly increased, the serum DAO value (t=6.383) and D-lacticacid level (t=6.745) were decreased, in combining treatment group than those of lactobacillus acidophilus group (P<0.05). Conclusion Lactobacillus acidophilus combined with electroacupuncture can improve the gastrointestinal function, stimulate gastric acid secretion and decrease serum levels of DAO and D-lacticacid.

Objective To explore the clinical efficacy of enteral nutrition combined with traditional Chinese medicine (TCM) acupuncture and moxibustion for treatment of craniocerebral trauma complicated by gastric paralysis.Methods A prospective study was conducted.One hundred and sixty-seven patients with craniocerebral trauma complicated by gastric paralysis admitted to the Department of Neurological Critical Care Medicine in Affiliated Hospital of the Logistics University Chinese People's Armed Police Force from January 2013 to October 2015 were divided into single group (83 cases) and combined group (84 cases) according to the random number table method.The basic treatment program was the same in the two groups.On the basis of gastrointestinal decompression,a nasojejunal tube was indwelled in the digestive canal of the patients in single group,and the nutrient food could be given by dripping slowly and continuously through the tube into the body,while in the combined group,they were additionally treated by acupuncture and moxibustion at auricular point,zusanli and neiguan acupoints,1 time a day,each time 30 minutes.Both groups were treated consecutively for 30 days,and then the clinical efficacies were evaluated.Before and after treatment in both groups,the changes of total serum protein (TP),pre-albumin (PA),hemoglobin (Hb) were observed;the incidences of reflux,vomiting,abdominal distension,diarrhea,pulmonary infection and intestine derived infection were also evaluated.Results After treatment the levels of TP,PA,Hb were significantly higher in combined group than those in the single group [TP (g/L):36.97 ± 2.17 vs.33.14± 2.13,PA (mg/L):215.19 ± 7.91 vs.203.15 ± 6.12,Hb (g/L):126.73 ± 11.17 vs.117.61 ± 11.24,all P ＜ 0.01].The numbers of patients with reflux,vomiting,abdominal distension,diarrhea were significantly lower in combined group than those in the single group,respectively (the number of patients had reflux being 15 cases vs.31 cases,vomiting 13 cases vs.28 cases,abdominal distension 17 cases vs.29 cases,diarrhea 17 cases vs.31 cases) and pulmonary infection (17 cases vs.29 cases),intestine derived infection (4 cases vs.12 cases),all the above comparisons showing statistically (all P ＜0.05).Conclusions Enteral nutrition combined with acupuncture and moxibustion treatment can effectively enhance the patients' nutritional status,reduce gastrointestinal dysfunction and the incidence of complications,thus the prognosis of patients with craniocerebral trauma complicated by gastric paralysis is obviously improved.

Objective To retrieve and analyze the available evidence on prevention of needlestick injuries among healthcare workers and summarize the best available evidence.Methods We searched the BMJ best practice,Uptodata,Cochrane Library(2014),Joanna Briggs Institute Library,Registered Nurses' Association of Ontario,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,and complementally searched the PubMed,EM-base,CNKI and Centers for Disease Control to collect literatures including guideline,evidence summary,best practice information sheet,recommended practice and systematic review.Results Nine references were selected including a clinical decision support system,3 evidence summaries,2 recommended practices and 3 systematic review.Finally,7 items of best evidence were summarized,including:wearing double gloves,never recapping needles,using blunt-tip suture,using a neutral zone for passing sharp device,adopting the safety features of sharps,using sharp disposal containers,and continuous education for needlestick injuries.Conclusion Healthcare workers should regulate their behaviors of using sharp instruments during clinical practice and guarantee personal safety by consulting high level evidence.

Objective To investigate the therapeutic effect of enteral nutrition in patients with severe traumatic brain injury (sTBI) by nasogastric tube and nasointestinal tube.Methods A retrospective case control study was made on 64 patients with sTBI hospitalized from October 2013 to December 2015.The patients were assigned to nasogastric tube group (n=32) and nasointestinal tube group (n=32) according to the random number table, and the same nutrient solution was given to all patients.Eighteen male and 14 female patients aged (37.8±8.7)years were identified in nasogastric tube group, and the Glasgow coma score (GCS) was (4.7±1.3)points.Twenty males and 14 females aged (39.7±6.5)years were identified in nasointestinal tube group, and the GCS was (4.1±1.2)points.Triceps skinfold thickness, body mass index, hemoglobin, level of serum albumin and level of prealbumin were measured and compared between groups before and after operation.Incidence of complications was recorded as well.Results All the above-mentioned indexes of the two groups did not differ significantly before the therapy (P>0.05), but showed significant differences 7 and 15 days after therapy (P<0.05).Incidence of complications in nasointestinal tube group (17 lung infection, nine gastrointestinal bleeding, 11 electrolyte imbalance) was lower than that in nasogastric tube group (seven lung infection, two gastrointestinal bleeding, one reflux esophagitis, four electrolyte imbalance) (P<0.05).Conclusion Nasointestinal tube enteral nutrition is better than nasogastric tube enteral nutrition in improving nutritional status and reducing complications in patients with sTBI.

Purpose To evaluate the diagnosis value of real-time ultrasound elastography for differential diagnosis between benign and malignant parotid tumors.Materials and Methods A literature retrieval in PubMed,Embase,High Wire Press,Ovid and CNKI as of May 31,2016 in the English and Chinese languages was conducted.Articles and reviews related to discrimination between benign and malignant parotid gland nodules by means of ultrasound elastography scoring were selected.Pooled sensitivity and specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio as well as summary receiver operating characteristic (ROC) curves were analyzed to evaluate the diagnostic accuracy of ultrasound elasticity scoring.Results A final selection of 7 articles involving 486 nodules in 449 patients was included.Pooled sensitivity and specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio of benign and malignant parotid tumors were 0.781 (95％ CI 0.702-0.847),0.797 (95％ CI 0.750-0.838),3.753 (95％ CI 2.293-6.124),0.285 (95％ CI 0.147-0.555) and 13.941 (95％ CI 4.571-42.519) respectively according to ultrasound elasticity scoring.Area under summary receiver operating characteristic curves was 0.8638 (index Q*=0.7944).Conclusion Real-time ultrasonic elastography has certain diagnostic value in differentiating benign parotid tumors and malignant ones.It can be used as a complement to conventional sonography for improving the diagnostic accuracy of parotid lesions.

This article reviewed the measures taken by the hospital against a catastrophic fire hazard and exploration in its response and work organization of nursing care of the wounded.Proposed in this paper are development of such five systems as the pre-plan,exercises,personnel,quality control and incentives,which are expected to improve the nursing capacity of the hospital in emergency rescue,for sustainable development of nursing emergency rescue work.