Abstract:Objective To explore the clinical efficacy of low-dose nifedipine combined with vitamin D in treating gestational hypertension(GH),and to explore their influence on intrauterine growth restriction and hemorheology.Methods Eighty-five GH patients admitted from January 2023 to May 2024 were selected.They were grouped according to different treatments,including 43 cases in the control group and 42 cases in the combined group.Baseline data,hemorheology,coagulation function index,oxidative stress index,umbilical artery flow index,vascular elasticity index,endothelial index,thromboelastography(TEG)parameters,psychological resilience scores,adverse pregnancy outcomes,and clinical efficacy were compared between groups.Results Compared with pre-treatment values,malondialdehyde(MDA),k value,brachial-ankle pulse wave velocity(ba-PWV),resistance index(RI),whole blood low shear viscosity,pulsatility index(PI),Ep,D-dimer(D-D),whole blood high shear viscosity,Endothelin-1(ET-1),systolic/diastolic(S/D),fibrillation(FIB),plasma viscosity,lipid peroxidation(LPO)and soluble vascular cell adhesion molecule-1(sVCAM-1)after the treatment were significantly lower,and R value,resilience score,nitric oxide(NO),thrombin time(TT),optimistic score,α-angle,superoxide dismutase(SOD),prothrombin time(PT),strength score,MA and AC were significantly higher(P<0.05).Compared with the control group,patients in the study group had significantly lower K,whole blood high shear viscosity,ba-PWV,PI,D-D,MDA,ET-1,whole blood low shear viscosity,S/D,Ep,FIB,plasma viscosity,LPO,RI,sVCAM-1 and incidence of poor pregnancy outcome,but higher R,NO,resilience score,TT,α-angle,SOD,optimistic score,PT,MA,strength score,AC and overall clinical efficacy rate(P<0.05).Conclusion Low-dose nifedipine combined with vitamin D in treating GH can significantly reduce the level of hemorheology,reduce the incidence of fetal functional growth restriction,improve vascular endothelial function,oxidative stress,stable uterine arterial blood flow and elevate clinical efficacy.

Abstract:Objective To investigate the effectiveness of a peer support group in patients with replantation of severed fingers,focusing on its impact on functional recovery of finger,nursing satisfaction,and quality of life.Methods This retrospective case-control study enrolled 108 patients who underwent digital replantation at our hospital from May 2023 to June 2024.Participants were assigned to a control group(n=54,receiving routine care)or an experimental group(n=54,receiving routine care plus peer support group interventions).The intervention included peer education,personal health record,discharge guidance,WeChat platform support,and regular assessments.Outcomes were evaluated at 6-month post-intervention,including functional recovery of finger,nursing satisfaction scores,and quality of life(QoL)including physical,psychological,social functioning,and material well-being domains.Results The experimental group demonstrated significantly higher rates of excellent/good functional recovery of finger compared to the control group(90.74%vs 75.93%,P<0.05).Nursing satisfaction scores(98.14%vs.85.19%)and QoLscores across all dimensions were statistically superior in the experimental group(P<0.05).There was no significant difference in age,gender,education,personal monthly income,injury site,and the cause of injury between the two groups(P>0.05).Conclusion The peer support group effectively enhances functional recovery of finger nursing satisfaction,and quality of life in the patients underwent digital replantation,while improving self-management capabilities and rehabilitation confidence.This evidence-based approach warrants broader clinical implementation.

Abstract:Objective To explore the molecular mechanism of a novel NOD-like receptor family pyrin domain containing 3(NLRP3)inhibitor(MCC950)in inducing pyroptosis of pancreatic acinar cells(PACs)with an inflammatory response induced by lipopolysaccharide(LPS).Methods Mouse PACs were selected for primary culture in vitro,and monolayer cells in the third generation(P3)were selected for the study.PACs were treated with blank control,LPS,and LPS+low-dose or high-dose MCC950.Fluorescent probes were used to detect reactive oxygen species(ROS)levels.Enzyme-linked immunosorbent assay(ELISA)was performed to measure intracellular inflammatory factors(interleukin-1beta[IL-1β],interleukin-18[IL-18]),and oxidative stress factors(superoxide dismutase[SOD],malondialdehyde[MDA],and glutathione peroxidase[GSH-Px]).RT-PCR and Western blot were used to detect the mRNA and protein expressions of key members in the NLRP3 signaling pathway(NLRP3,apoptosis-associated speck-like protein containing a CARD[ASC],Caspase-1)and pyroptosis-associated markers(Caspase-4,Caspase-5,Caspase-11,gasdermin D[GSDMD],gasdermin E[GSDME]).Results Compared with the control group,LPS induction significantly increased intracellular ROS fluorescence intensity,MDA content,IL-1β and IL-18 levels,and mRNA and protein levels of NLRP3,ASC,Casepase-1,Caspase-4,Caspase-5,Caspase-11,GSDMD and GSDME,and decreased SOD and GSH-Px levels(P<0.05).Compared with LPS-induced PACs,LPS+MCC950 treatment significantly decreased intracellular ROS fluorescence intensity,MDA content,IL-1β and IL-18 levels,and mRNA and protein levels of NLRP3,ASC,Casepase-1,Caspase-4,Caspase-5,Caspase-11,GSDMD and GSDME,and increased SOD and GSH-Px levels(P<0.05).High-dose MCC950 treatment resulted in significantly lower intracellular ROS fluorescence intensity,MDA content,IL-1β and IL-18 levels,and mRNA and protein levels of NLRP3,ASC,Casepase-1,Caspase-4,Caspase-5,Caspase-11,GSDMD and GSDME than the low-dose MCC950 treatment,showing a dose-dependent manner(P<0.05).Conclusion MCC950 can inhibit LPS-induced inflammatory response,oxidative stress injury,and cell pyroptosis in PACs by inhibiting the activity of the NLRP3/GSDME signaling pathway,which deserves further research.

Abstract:Infection remains a common and difficult-to-treat disease in clinical practice.Although the pathogenesis of infection has been studied for many years,it is still not well understood.Staphylococcus aureus(SA)is one of the most prevalent pathogens responsible for various infections,with its resistance escalating due to the widespread use of antibiotics.Ferroptosis,an emerging programmed cell death mechanism,significantly influences the progression of infections,neurological conditions,and liver ailments.Recent evidence shows that nuclear factor E2-related factor 2(Nrf2)is not only of significance in preserving oxidative equilibrium within tissue cells,but also in regulating ferroptosis.Nrf2 governs the expressions of downstream genes,such as heme oxygenase 1(HO-1)and glutathione peroxidase 4(GPX4),thereby averting cellular ferroptosis and subsequently impacting inflammation dynamics.Through summarizing existing literatures,this review analyzed the prospectives of ferroptosis change after SA infection,potential regulation of Fe iron,ferroptosis involved in the pathogenesis of SA infection,and ferroptosis regulated by the Nrf2-HO-1/GPX4 axis.It provided theoretical references for illustrating the pathogenesis of SA infection,and treatment of SA Infection by targeting the Nrf2-HO-1/GPX4 axis.Moreover,this review offered new ideas and directions in the design and synthesis of antimicrobial drugs.

Abstract:Objective To investigate the clinical efficacy of age-appropriate psychosomatic nursing in children with idiopathic short stature(ISS)who are treated with recombinant human growth hormone(rh-GH),and the adverse effects.Methods A total of 96 children with ISS who were admitted to the Department of Pediatrics from February 2022 to February 2024 were selected as the study objects.They were randomly divided into two groups according to random number table method,with 48 cases per group.Children in the control group were treated with rh-GH alone,and those in the experimental group were treated with age-appropriate psychosomatic nursing plus rh-GH.The treatment time was 12 months.After the intervention,25 hydroxy-vitamin D3[25-(OH)D3],insulin-like growth factor 1(IGF-1),growth and development indicators,clinical efficacy and adverse events were compared.Results The total effective rate of the experimental group was significantly higher than that of the control group(P<0.05).The height and growth rate of the experimental group were significantly higher than those of the control group after intervention(P<0.05).Expression levels of 25-(OH)D3 and IGF-1 in the experimental group were significantly higher than those in the control group after intervention(P<0.05).Expression levels of baseline bone-specific alkaline phosphatase(BSAP)and osteocalcin(OC)in the experimental group were significantly higher than those in the control group after intervention(P<0.05).There was no significant difference in the total incidence of adverse events between groups(P>0.05).Conclusion The application of age-appropriate psychosomatic nursing in rh-GH treatment of ISS has good clinical efficacy,which can promote the growth and development of ISS children,improve the growth rate of the body,correct the abnormal expression levels of 25-(OH)D3 and IGF-1,improve bone metabolism,and have high safety.

Abstract:Objective To explore the application effect of gelatin sponge with"米"-character compression on moderate-to-severe bleeding at the puncture point for peripherally inserted central catheter(PICC).Methods A total of 60 patients with moderate-to-severe bleeding at the puncture point after PICC catheterization in and out of the hospital(for maintenance)from July 2024 to June 2026 were selected.They were randomly divided into the observation group and control group,with 30 cases in each group.In the control group,patients were treated with routine disinfection,followed by applying sterile gauze that was folded into small squares to cover the puncture point,and self-adhesive elastic bandage wrapping the arm for two cycles.In the observation group,patients were treated with routine disinfection,followed by applying two gelatin sponges on the puncture point,"米"-character compression in avoidance of the catheter using the sterile infusion patch,and self-adhesive elastic bandage wrapping for"八"-character compressed fixation.The degree of bleeding at the puncture point was observed in the two groups within 7 days(starting from the first dressing change of bleeding,dressing was changed according to the degree of bleeding until no bleeding at the puncture site).At the same time,the average maintenance times within one week,the incidence of vascular catheter-related local infection and patient satisfaction were counted.Results Compared with the control group,the improvement of moderate-to-severe bleeding in the observation group was significantly obvious within 7 days(P<0.05).The duration of oozing blood in the observation group was significantly shorter than that in the control group(P<0.05),and the average maintenance times within one week was significantly less than that in the control group(P<0.05).The incidence of catheter-related local infections in the observation group was significantly reduced compared to the control group(P<0.05).The total satisfaction was significantly higher in the observation group than the control group(96.67%vs 76.67%,P<0.05).Conclusion The application of gelatin sponge with"米"-character compression on has a significant effect on moderate-to-severe bleeding at the puncture point for PICC.It effectively reduces the degree of moderate-to-severe bleeding at the puncture point,shortens the duration of bleeding,reduces the average maintenance times within a week,lowers the incidence of vascular catheter-related local infection and promotes patient satisfaction.

Abstract:Objective To analyze the influence of the hope theory on the degree of psychological pain,and the efficacy and safety of chemotherapy in patients with lung cancer.Methods A total of 92 lung cancer patients treated from January 2021 to December 2023 were selected by convenient sampling method.They were all treated with chemotherapy,and grouped according to computer random number table method.Forty-six cases in the control group received routine intervention,and 46 cases in the observation group received interventions based on the hope theory.The degree of psychological pain,hope level,and efficacy and safety of chemotherapy were compared between groups.Results After interventions,Distress Thermometer(DT)results were significantly better in the observation group than the control group(P<0.05).The Herth Hope Index(HHI)was significantly higher in the observation group than the control group(P<0.05).The overall efficacy of chemotherapy was significantly higher in the observation group than the control group(78.26%vs 56.52%,P<0.05).The incidence of adverse events was significantly lower in the observation group than the control group(32.61%vs 54.35%,P<0.05).Conclusion For lung cancer patients treated with chemotherapy,interventions based on the hope theory can achieve satisfactory results,which can not only alleviate their psychological pain and improve the level of hope,but also promote the efficacy and safety of chemotherapy.

Abstract:Objective To establish a risk prediction model for intensive care unit(ICU)patients with multidrug-resistant organism infection(MDRO)based on decision tree,to provide references for clinical implementation of MDRO prevention and treatment strategies.Methods Using a retrospective analysis method,clinical data of a total of 210 nosocomial infection patients from January 2022 to January 2024 were collected.They were divided into MDRO group(61 cases)and non-MDRO group(149 cases)according to the onset of MDRO.Multivariate logistic regression analysis and decision tree method were implemented to establish prediction models for MDRO infection in ICU patients,and the predictive performance of two models was compared.Results Logistic regression analysis showed that age(OR=1.036,95%CI:1.002-1.072),length of hospital stay(OR=1.289,95%CI:1.072-1.550),hypoproteinemia(OR=2.604,95%CI:1.186-2.719),and antibacterial drugs>3 types(OR=3.250,95%CI:1.566-3.791)were independent risk factors for predicting MDRO in ICU(all P<0.05).Decision tree model demonstrated that the length of hospital stay was the most critical predictor of MDRO in ICU.The area under the curve(AUC)of the Logistic regression model for predicting MDRO was 0.719(95%CI:0.653-0.778),while that of the decision tree model was 0.813(95%CI:0.753-0.863).The prediction performance of the decision tree model was better than the Logistic regression model(Z=2.666,P=0.008).Conclusion The decision tree model of MDRO in ICU patients has high predictive performance and can be used as an effective tool for screening potential MDRO.

Abstract:Objective To explore the effect of upper limb rehabilitation exercise combined with mucopolysaccharide polysulfate cream for external use on the management of arteriovenous fistula in maintenance hemodialysis(MHD)patients.Methods From January 2021 to June 2022,40 MHD patients treated with routine care and external application of mucopolysaccharide polysulfate cream were selected as the control group.From July 2022 to January 2024,40 MHD patients in our hospital treated with upper limb rehabilitation exercises combined with external application of mucopolysaccharide polysulfate cream were included as the experimental group.The grip strength,arteriovenous fistula blood flow,head vein diameter on the non-fistula side,and incidence of arteriovenous fistula complications were compared between the two groups.Results After 4 months of intervention,patients in the experimental group showed significantly higher grip strength,arteriovenous fistula blood flow,and head vein diameter on the non-fistula side compared to the control group(P<0.05),while the incidence of arteriovenous fistula complications showed an opposite trend(P<0.05).Conclusion The combination of upper limb rehabilitation exercises and mucopolysaccharide polysulfate cream for external use is effective in maintaining arteriovenous fistula and reducing the incidence of complications in MHD patients.

Abstract:Objective To analyze the clinical efficacy of early comprehensive physical and mental rehabilitation management in patients undergoing total knee arthroplasty(TKA).Methods This study included 86 patients treated with TKA in the Department of Orthopaedics,from June 2022 to June 2023 as the research subjects.All research subjects were randomly divided into the observation group and control group according to the drawing method,with 43 cases per group.A routine TKA perioperative management plan was given to the control group,while an early comprehensive physical and mental rehabilitation management plan on the basis of routine intervention was applied to the observation group.Knee joint function,postoperative routine recovery,incidence of complications,quality of life,and intervention satisfaction were compared between two groups of patients under different management plans.Results HHS at 2 weeks and 2 months postoperatively in both groups significantly increased than preoperative values,which were significantly higher in the observation group than the control group(P<0.05).The length of stay,off-bed activity time,active straight leg lifting time and time required for knee flexion≥90° were significantly shorter in the observation group than the control group,while the 24-h sleep duration was significantly longer(P<0.05).The incidence of postoperative complications was significantly lower in the observation group than the control group(P<0.05).The 36-Item Short-Form(SF-36)score at 2 months postoperatively was significantly reduced in both groups than that at 1 day postoperatively,and the elevations were significantly pronounced in the observation group than the control group(P<0.05).Satisfaction score was significantly higher in the observation group than the control group(P<0.05).Conclusion Early physical and mental rehabilitation management programs in TKA patients can promote improvement in knee joint function,reduce complications,accelerate recovery,enhance quality of life,and increase intervention satisfaction.

Abstract:Objective To explore the impacts of individualized enteral nutrition therapy(ET)under the concept of enhanced recovery after surgery(ERAS)on the postoperative nutritional status and immune function of laryngeal cancer patients.Methods From July 2022 to August 2024,102 patients with laryngeal cancer were randomly assigned into the routine group(n=51,receiving routine care)and nutritional intervention group(n=51,receiving individualized ET intervention under the ERAS concept based on the routine group).The nutritional status(albumin[Alb],prealbumin[PA]),immune function(immunoglobulin[Ig]A,IgG,CD+3,CD+4),Piper Fatigue Scale(PFS)score,levels of inflammatory factors(C-reactive protein[CRP],interleukin-6[IL-6]),incidence of postoperative complications,and length of hospital stay were compared between the two groups.Results One week after surgery,the levels of Alb,PA,IgA,IgG,CD+3,and CD+4 in the nutritional intervention group were significantly higher than those on admission(P<0.05),while the levels of Alb,PA,IgA,IgG,CD+3,and CD+4 in the routine group were significantly lower than those on admission(P<0.05).Alb,PA,IgA,IgG,CD+3,and CD+4 levels in the nutritional intervention group were significantly higher than those in the routine group(P<0.05).One week after surgery,the PFS score of the nutritional intervention group was significantly lower than that on admission(P<0.05),while the PFS score of the routine group was significantly higher than that on admission(P<0.05),The PFS score of the nutritional intervention group was significantly lower than that of the conventional group(P<0.05).One week after surgery,the levels of CRP and IL-6 in both groups were significantly higher than those on admission(P<0.05),but the levels of both inflammatory factors in the nutritional intervention group were significantly lower than those in the routine group(P<0.05).The incidence of postoperative complications in the nutritional intervention group was significantly lower than the routine group(P<0.05),and the postoperative hospital stay was significantly shorter than that in the routine group(P<0.05).Conclusion Individualized ET under the ERAS concept can improve postoperative nutritional status and immune function and cancer-related fatigue in laryngeal cancer patients,accelerate inflammation resolution,reduce the incidence of complications,and shorten postoperative recovery time.

Abstract:Objective To study the effect of Orem self-care model intervention combined with Roy adaptation model on the quality of life in patients with diabetes mellitus.Methods A total of 136 patients with diabetes mellitus who visited the Affiliated Huai'an Hospital of Xuzhou Medical University from March 2023 to March 2024 were selected.They were randomly classified into the Roy adaptation group and the Orem combination group,with 68 patients per group.The Roy adaptation was applied to all patients,and those in the Orem combination group were additionally given the Orem self-care model intervention.Quality of life,sleep quality,blood glucose control,insulin consumption and satisfaction before and after the intervention were compared between the two groups.Results Compared with the Roy adaption group,the barthel index(BI)and satisfaction were significantly elevated,while the Pittsburgh Sleep Quality Index(PSQI),compliance time of glucose control,and insulin consumption were significantly reduced in the Orem combination group(P<0.05).Conclusion Orem self-care mode intervention combined with Roy adaptation mode can effectively improve the quality of life of diabetic patients,effectively control blood sugar,and improve satisfaction.

Abstract:Objective To evaluate the effect of warm heparin sodium saline hydrotherapy on wound scab formation in patients underwent finger replantation surgery.Methods A total of 80 patients with bleeding and scabbing after finger replantation surgery who were treated from November 2023 to June 2024 were selected as the research subjects.They were randomly divided into the study group and control group by drawing lots.All patients in the control group received routine nursing interventions,while those in the observation group additionally received warm heparin sodium saline hydrotherapy.The integrity of blood scab clearance,pain level during and after finger scab care,nursing hours,bleeding situation,incidence of vascular crisis and local infection,and comfort satisfaction were compared between the two groups.Results In the observation group,39 patients had complete blood scab cleaning,and 1 patient had residual blood scabs that were not completely cleaned.The completeness of blood scab cleaning in the observation group was 97.50%(39/40).In the control group,30 patients had complete blood scab cleaning,while 10 patients had residual blood scabs that were not completely cleaned.The completeness of blood scab cleaning in the control group was 75.00%(30/40),which was significantly higher in the observation group than the control group(P<0.05).The numerical rating scale(NRS)scores of the two groups of severed finger scabs after care decreased compared to the pre-treatment values before care.The NRS scores of the observation group after nursing care of severed finger scabs care were significantly lower than the control group(P<0.05).The nursing time after hydrotherapy in the observation group was(7.82±1.39)minutes,while the cotton ball wiping nursing time in the control group was(26.58±3.29)minutes.The nursing hours in the observation group were significantly shorter than the control group(P<0.05).The incidence of blood leakage,vascular crisis,and local infection in the observation group was 2.50%(1/40),2.50%(1/40),and(0/40),respectively.The incidence of blood leakage,vascular crisis,and local infection in the control group was(0/40),20.00%(8/40),and(0/40),respectively.The incidence of vascular crisis in the observation group was significantly lower than that the control group(P<0.05),while the incidence of blood leakage and local infection was comparable between the two groups(P>0.05).The comfort satisfaction was significantly higher in the observation group compared with the control group(97.50%vs 75.00%,P<0.05).Conclusion Warmed heparin sodium saline hydrotherapy can improve the integrity of blood scab cleaning in patients,shorten nursing hours,alleviate patient pain,reduce the incidence of vascular crisis,and enhancing patient comfort satisfaction.

Abstract:Objective To analyze the self-acceptance status and its impact on vocal function remodeling in patients with glottic carcinomas after surgery,thus expanding intervention approaches for vocal function remodeling in patients with glottic carcinomas after surgery.Methods Patients with glottic carcinomas treated with elective partial laryngectomy from December 2023 June 2024 were included as the study subjects.The score of the Self-Acceptance Questionnaire(SAQ)was investigated 3 days after surgery.Patients were instructed to conduct vocal function training.After 3 months of training,the recovery of vocal function was evaluated using the Voice Handicap Index(VHI)scale.The self-acceptance status of patients with glottic carcinomas after surgery and its impact on vocal function remodeling were analyzed.Results A total of 122 questionnaires were distributed in this study,and 116 valid questionnaires were recovered,with an effective recovery rate of 95.08%.The VHI and SAQ scores of 116 patients with glottic carcinomas after surgery were 26.85±3.30 points and 38.12±5.20 points,respectively.The VHI scores of patients with negative coping style,negative emotion and low self-efficacy were significantly higher than those of patients with positive coping style,no negative emotion and good self-efficacy,(P<0.05).Pearson correlation analysis showed that the self-acceptance status of patients with glottic carcinomas after surgery was significantly associated with the remodeling of vocal function(r=-0.669,P<0.001).Simple linear regression analysis showed that low self-acceptance score,negative coping style,negative emotion and low self-efficacy were factors influencing the remodeling of vocal function in patients with glottic carcinomas after surgery(P<0.05).Conclusion Patients with glottic carcinomas have a poor self-acceptance status after surgery.Low self-acceptance levels,negative coping styles,negative emotions,and low self-efficacy are important factors that affect vocal function remodeling in patients with glottic carcinomas after surgery.

Abstract:Objective To construct and apply a self-management intervention scheme for colon cancer patients with radiotherapy and chemotherapy based on the dual-management mode of narrative psychology.Methods A total of 126 patients with colon cancer treated with chemoradiotherapy from July 2021 to July 2024 were selected.They were randomly divided into the control group and intervention group,with 63 cases in each group.Patients in the control group were managed by routine nursing care,while those in the intervention group were given a self-management scheme based on the dual-management mode of narrative psychology.Patients'depression and anxiety were assessed by the Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA),respectively.Carcinoembryonic antigen(CEA)and sugar antigen chain 125(CA125)levels were measured.The Cancer Fatigue Scale(CFS)was used to assess cancer fatigue.The General Self-Efficacy Scale(GSES)and the Exercise of Self-Care Agency(ESCA)were used to assess self-management and self-care abilities,respectively.Sleep quality was evaluated by the Pittsburgh Sleep Quality Index(PSQI).The WHO Quality of Life-BREF(WHOQOL-BREF)scale was used to assess quality of life.Satisfaction of clinical intervention was compared.Results The scores of HAMD,HAMA,and CFS,and the levels of PSQI,CEA and CA125 all significantly decreased in the intervention group relative to the control group(P<0.05),while the scores ofGSS,ESCA,and QOL-BREF all significantly increased(P<0.05).Conclusion Building a self-management scheme with a dual-management mode of narrative psychology for colon cancer patients can improve the psychological state,self-management,self-care,sleep quality and quality of life,and reduce the degree of cancer fatigue,with a high overall satisfaction.

Abstract:Objective To analyze the application of cognitive behavioral interventions in maintenance hemodialysis patients and its influence on self-management ability and symptom distress.Methods A total of 120 cases of maintenance hemodialysis patients from January 2021 to January 2024 were selected by convenient sampling method and divided into groups based on computer random number table method.The nursing plan of 60 cases in the control group was routine nursing,while the cognitive behavior intervention was carried out in the study group of 60 cases.The disease cognition,self-management ability,symptom distress and quality of life of the two groups were compared.Results the scores of the Chinese version of the disease cognition questionnaire was(150.08±20.60)points in the study group,and(131.28±21.00)points in the control group,and the score in the study group was significantly higher(P<0.05).The self-management scale score of hemodialysis patients was(64.56±9.04)points in the study group,and(56.25±9.25)points in the control group,and the score was significantly higher in the study group(P<0.05).In the study group,the Dialysis Symptom Index(DSI)was significantly better than the control group(P<0.05).In the study group,the Kidney Disease Quality of Life-Short Form(KDQOL-SFTM)score was significantly higher than the control group(P<0.05).Conclusion The application of cognitive behavioral intervention in maintenance hemodialysis patients can obtain satisfactory results,which can not only enhance their disease cognition and self-management ability,but also reduce the degree of symptom distress of patients and promote the improvement of their quality of life.

Abstract:Objective To investigate the effect of Shenling Baizhu Powder on gut microbiota and various parameters of the body in patients with diarrhea after an enterostomy reversal.Methods A total of 78 patients treated with an enterostomy reversal from January 11,2022 to January 23,2023 were selected.Using the EXCEL table method,they were randomly divided into the experimental group and the control group,with 39 cases in each group.Patients in both groups were managed by conventional treatments like montmorillonite powder,fluid replacement,nutritional support,and electrolyte correction,those in the experimental group were additionally treated with modified Shenling Baizhu Powder based on clinical syndromes.In the third week of treatment,the changes in gut microbiota,inflammatory factors,D-lactate,diamine oxidase(DAO),intestinal function,nutritional status and other parameters were compared between the two groups.Results After 3 weeks of treatment,the abundances of gut microbiota in both groups significantly increased compared with preoperative values,which were significantly higher in the experimental group than the control group(P＜0.05).The probiotic ratio(B/E value)was significantly higher in the experimental group than the control group(P＜0.05).C-reactive protein(CRP),interleukin-2(IL-2),interleukin-6(IL-6),platelet count(PLT)and serum amyloid A(SAA)significantly decreased in both groups,which were significantly lower in the experimental group than the control group(P＜0.05).Declines of serum D-lactate and DAO in the experimental group were significantly higher than the control group(P＜0.05).After interventions for 1,2 and 3 weeks,the recovery of bowel function was significantly better in the experimental group than the control group(P＜0.05).The assessment of nutritional status showed a significantly higher nutritional index in the experimental group than the control group after 3 weeks of interventions(P＜0.05).Conclusion Shenling Baizhu Powder can significantly improve the gut microbiota and systemic condition of patients with diarrhea after an enterostomy reversal,and its treatment effect is good.

Abstract:Objective To evaluate the protective effect of different hydration intensities combined with diuretics therapy on the contrast-induced nephropathy in high-risk patients after emergency percutaneous coronary intervention(PCI).Methods Using convenient sampling method,a total of 132 patients with high-risk contrast-induced nephropathy after emergency PCI from January 2020 to May 2023 were selected.They were randomly divided into the strengthening hydration+diuretics therapy group,routine hydration+diuretics therapy group,strengthening hydration group,and routine hydration group using the random number table method,with 33 cases in each group.Patients in the routine hydration group were given hydration therapy at 6h before and 6h after PCI via continuous intravenous infusions of normal saline at 1mL/kg/h.Those in the strengthening hydration group were given hydration therapy at 12h before and 6h after PCI via continuous intravenous infusions of normal saline at 1mL/kg/h.Injection of 20mg furosemide was additionally given to patients in the diuretics therapy groups based on the corresponding hydration regimen.Serum creatinine(Scr)before,and 24,48 and 72h after PCI,and estimated glomerular filtration rate(eGFR)were compared among the four groups.The patients were followed up for 12 months after surgery,and the adverse events were recorded.Results At 48h after PCI,Scr was significantly lower in the strengthening hydration+diuretics therapy group than the routine hydration group(P＜0.05).At 72h after PCI,Scr in the strengthening hydration+diuretics therapy group was significantly lower than the routine hydration+diuretics therapy group,strengthening hydration group and routine hydration group(P＜0.05).The eGFR was significantly higher in the strengthening hydration+diuretics therapy group than the routine hydration+diuretics therapy group,strengthening hydration group and routine hydration group(P＜0.05).Patients were followed up for 12 months,and the risk of clinical adverse events in the strengthening hydration+diuretics therapy group,routine hydration+diuretics therapy group and routine hydration group was significantly lower than the strengthening hydration group(Log-rank 2=7.942,4.287,and 6.125,respectively;P＜0.05).Conclusion Strengthening hydration combined with diuretics therapy can effectively alleviate contrast-induced nephropathy in high-risk patients after emergency PCI,without increasing the risk of long-term adverse events.

Abstract:Objective To investigate whether kaempferol(KAE)can regulate cell pyroptosis and maintain T helper cells 1/2(Th1/Th2)balance in an atopic dermatitis(AD)model.Methods Sixty male rats in the specific pathogen free(SPF)level were randomly divided into the control group(Col group),model group(AD group),low-dose,medium-dose and high-dose KAE groups,and positive control group(Pre group),with 10 rats in each group.Mouse scratching behavior and skin inflammatory damage measurements were recorded.Flow cytometry was used to detect the ratio of Th1/Th2 cells in peripheral blood of mice.The enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of interleukin-4(IL-4),interferon-gamma(IFN-γ)and tumor necrosis factor-alpha(TNF-α)in peripheral blood of mice.The hematoxylin and eosin(H&E)staining was used to detect histopathological changes in skin lesions of mice.Western blotting was used to detect protein levels of NOD-like receptor family pyrin domain containing 3(NLRP3),Caspase-1,gasdermin D(GSDMD),IL-18,and IL-1β in skin lesion tissues of mice.Results Compared with the Col group,the scratching behavior,SCORAD(scoring atopic dermatitis)index,percentage of Th2 cells,IL-4 and TNF-α levels,and protein expressions of NLRP3,Caspase-1,GSDMD,IL-18,and IL-1 β in skin lesion tissues of mice in the AD group were significantly higher,and the percentage of peripheral blood Th1 cells,the ratio of Th1/Th2 cells,and the level of IFN-γ were significantly lower(P＜0.05).Compared with the AD group,the scratching behavior,SCORAD index,percentage of Th2 cells,IL-4 and TNF-α levels,and protein expressions of NLRP3,Caspase-1,GSDMD,IL-18,and IL-1 β in skin lesion tissues of mice in the low-dose,medium-dose and high-dose KAE groups and Pre group were significantly lower,and the percentage of peripheral blood Th1 cells,the ratio of Th1/Th2 cells,and the level of IFN-γ were significantly higher(P＜0.05).Conclusion KAE ameliorates skin inflammatory injury and maintains Th1/Th2 balance in atopic dermatitis mice by inhibiting NLRP3 inflammasome--mediated cellular pyroptosis.

Abstract:Objective To explore the effects of etomidate(Eto)on intestinal mucosal barrier function damage and the myosin light chain kinase/myosin light chain(MLCK/MLC)signaling pathway in burned rats.Methods A burn rat model was constructed and rats were randomly separated into a Model group,low-dose and high-dose etomidate groups(Eto-L,Eto-H groups),and high-dose Eto+MLCK/MLC signaling pathway activator group(Eto-H+iE-DAP group),with 12 rats in each group.Another 12 normal rats were regarded as the Control group.After administration,the disease activity index(DAI)and colon mucosal damage index(CMDI)were scored.The enzyme-linked immunosorbent assay(ELISA)was applied to detect relative levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-10(IL-10).The hematoxylin and eosin(H&E)staining was applied to observe and score pathological changes in colon tissue.Immunohistochemistry was applied to detect the expressions of intestinal mucosal barrier associated proteins zonula occludens-1(ZO-1)and Occludin.Western blot was applied to detect the protein expressions of MLCK and p-MLC/MLC.Results Compared with the Control group,rats in the Model group had disordered structure of the intestinal mucosal,disarrangement of mucosal epithelial cells,shedding of intestinal villi,inflammatory cell infiltration,mucosal congestion,edema,and ulcers.In comparison to the Control group,Model group had significantly higher DAI,CMDI,TNF-α and IL-6 levels,protein level of MLCK,and p-MLC/MLC,but lower IL-10 level and protein expressions of ZO-1 and Occludin(P＜0.05).Compared with the Model group,rats in the Eto-L and Eto-H groups had relatively neatly arranged intestinal mucosa,mucosal epithelial cells,complete and clear villous morphology,reduced inflammatory cell infiltration and ulcers.In comparison to the Model group,Eto-L and Eto-H groups had significantly lower DAI,CMDI,TNF-α and IL-6 levels,protein level of MLCK,and p-MLC/MLC,but higher IL-10 level and protein expressions of ZO-1 and Occludin(P＜0.05).Compared with the Eto-H group,rats in the Eto-H+iE-DAP group had more severe damage to the intestinal mucosal structure and mucosal epithelial cells,severe loss of intestinal villi,and worsened inflammatory cell infiltration and ulcers.In comparison to the Eto-H group,Eto-H+iE-DAP group had significantly higher DAI,CMDI,TNF-α and IL-6 levels,protein level of MLCK,and p-MLC/MLC,but lower IL-10 level and protein expressions of ZO-1 and Occludin(P＜0.05).Conclusion Etomidate can improve intestinal mucosal barrier function damage in burned rats by inhibiting the MLCK/MLC signaling pathway.