Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery

BACKGROUND Esophageal cancer is one of the most common malignant tumors.The three-dimensional quality structure model is a quality assessment theory that includes three dimensions:Structure,process,and results.AIM To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery.METHODS In this prospective study,the control group received routine nursing,and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care.Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale(GSES)and Exercise of Self-Care Agency scale,respectively.IBM SPSS Statistics for Windows,version 17.0,was used for the data processing.RESULTS This study recruited 112 patients who were assigned to the control and experi-mental groups(n=56 per group).Before the intervention,there was no significant difference in GSES scores between the two groups(P>0.05).After the inter-vention,the GSES scores of both groups increased,with the experimental group showing higher values(P<0.05).At the time of discharge and three months after discharge,the scores for positive attitudes,self-stress reduction,and total score of health promotion in the experimental group were higher than those in the control group(P<0.05).CONCLUSION The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

颅脑损伤患者血清脑红蛋白与低氧诱导因子1α水平的变化及临床意义

目的观察颅脑损伤患者血清脑红蛋白(Ngb)和低氧诱导因子1α(HIF-1α)水平变化并探讨其意义。方法选取急性期非开放性颅脑损伤患者71例,入院24 h后根据格拉斯哥昏迷指数(GCS)评分评价病情为轻型36例、中型19例、重型16例;血肿体积<10 ml 39例、10~40 ml 16例、>40 ml 16例。患者入院后12 h(T_1)、24 h(T_2)、48 h(T_3)及72 h(T_4)采用ELISA检测血清Ngb和HIF-1α,随访记录患者预后,比较不同病情、血肿体积及预后的患者各时间血清Ngb、HIF-1α。结果随着时间延长,不同病情、血肿体积及预后的颅脑损伤患者血清Ngb、HIF-1α水平均先升高后降低。中型、重型颅脑损伤患者T_1~T_4时间血清Ngb、HIF-1α水平均高于轻型患者,且重型患者升高更明显(P<0.05)。血肿体积>40 ml、10~40 ml的颅脑损伤患者T_1~T_4时间血清Ngb、HIF-1α水平均高于血肿体积<10 ml,且血肿体积>40 ml升高更明显(P<0.05)。死亡的颅脑损伤患者T_1~T_4时间血清Ngb、HIF-1α水平均高于存活患者(P<0.05)。结论颅脑损伤患者血清Ngb、HIF-1α水平先升高后降低,其水平变化可能与患者的病情及预后有关。

清洗刷材质与刷洗速度对内镜导光软管内吸引管道清洗质量的影响

目的富士胃镜EG-450WR5与富士结肠镜EC-600WM导光软管内吸引管道的长度一致,选取1.70 m的导光软管内的吸引管道,分析不同刷洗速度与不同材质清洗刷对相同长度的胃镜和结肠镜导光软管内吸引管道清洗质量的影响,探讨内镜导光软管内吸引管道最佳的刷洗速度与清洗刷材质.方法选取该院内镜室2017年3月-2017年9月应用的160条内镜,胃镜EG-450WR5和结肠镜EC-600WM各80条,随机分为4组(A、B、C和D组),每组又分为两组(Ⅰ组,Ⅱ组),塑料材质海绵刷头清洗刷(Ⅰ组)和钢丝材质塑料刷头清洗刷(Ⅱ组),每组中均包括20条胃镜和20条肠镜.应用不同材质的清洗刷对4组(A、B、C和D组)采取速度分别为0.57、0.34、0.21和0.17 m/s,耗时分别用3、5、8和10 s,每条均进行100人次的清洗之后,对吸引管道进行菌落数监测,从而得出最佳的刷洗速度.对自购的8条导光软管内的吸引管道采用的速度分别为0.57、0.34、0.21和0.17 m/s,应用不同材质(塑料材质海绵刷头清洗刷;钢丝材质塑料刷头清洗刷)对吸引管道进行100次的清洗,之后用手术剪刀纵向抛开吸引管道用放大内镜进行观察,查看管道损害程度.结果 C组中钢丝材质塑料刷头速度在0.21 m/s清洗胃镜和结肠镜导光软管内的吸引管道时,细菌采样菌落数明显优于其他3组的清洗效果,差异有统计学意义(P<0.05).对自购的8条导管软管内的吸引管道以4个速度、两种材质的刷子模拟进行100人次刷洗,C组管道内壁损坏程度优于其他3组.结论采用钢丝材质塑料刷头的清洗刷、刷洗速度在0.21 m/s(清洗时间为8 s),对胃镜和结肠镜导光软管内吸引管道清洗质量最佳.

环状RNA参与调控糖尿病视网膜病变的研究进展

糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病在眼部的慢性微血管并发症之一,导致糖尿病患者视觉质量下降甚至失明事件发生率不断提高。然而目前为止,导致DR的病理改变机制十分复杂且未完全阐明,临床治疗多根据DR不同分期采取对症治疗,如视网膜激光光凝治疗、抗血管内皮因子治疗、玻璃体切割及剥膜手术等,仍缺乏安全有效的治疗方法,因此有必要寻找新的诊治靶标。随着分子生物学分析技术的发展,环状RNA(circular RNA,circRNA)成为目前重要的研究热点之一。据报道在多种因素的刺激下,基因的调节表达——circRNA通过调节视网膜微血管周细胞、视网膜微血管内皮细胞、视网膜色素上皮细胞等功能,参与到视网膜基底膜增厚、血管渗漏、细胞凋亡、炎症反应及新生血管增生等病理性过程来调控DR发生发展。故本文主要阐述环状RNA、竞争性内源性RNA以及微小RNA在DR病理改变分子机制、治疗前景中的研究进展,以期为临床及基础研究提供一定的参考。

MicroRNAs在糖尿病视网膜病变中的相关研究进展

MicroRNAs(miRNAs)是一种小分子非编码RNA,是转录后调节基因表达关键因子,参与调控细胞分化、增殖和新陈代谢等多种生物学过程。在糖尿病视网膜病变(DR)发生发展过程中miRNAs表达差异改变明显,国内外多项研究表明miRNAs调控基因的表达与DR生理病理机制关系密切。部分特异性表达的miRNAs可以通过调控视网膜中氧化应激与炎症反应水平等影响DR发生发展,因此通过增强或抑制这部分miRNAs可以延缓DR病情进展。单个或多个miRNAs的组合可以作为DR新型的转录组学生物标志物,也是未来治疗DR的潜在有效靶点。目前针对血液或体液中特定miRNAs的检测有助于DR的早期干预治疗和病情随访追踪。因此,本文主要对miRNAs及其参与调控DR的分子机制、治疗前景及生物标志物的相关研究进展作一综述。

Advanced Space-based Solar Observatory(ASO-S):an overview

The Advanced Space-based Solar Observatory(ASO-S)is a mission proposed for the 25 th solar maximum by the Chinese solar community.The scientific objectives are to study the relationships between the solar magnetic field,solar flares and coronal mass ejections(CMEs).Three payloads are deployed:the Full-disk vector Magneto Graph(FMG),the Lyman-αSolar Telescope(LST)and the Hard X-ray Imager(HXI).ASO-S will perform the first simultaneous observations of the photospheric vector magnetic field,non-thermal imaging of solar flares,and the initiation and early propagation of CMEs on a single platform.ASO-S is scheduled to be launched into a 720 km Sun-synchronous orbit in 2022.This paper presents an overview of the mission till the end of Phase-B and the beginning of Phase-C.

Application of modified sepiolite as reusable adsorbent for Pd(Ⅱ) sorption from acidic solutions

The adsorption characteristics and mechanisms of modified sepiolite as an adsorbent to recover Pd(Ⅱ) from acidic solutions were studied. The Pd(Ⅱ) adsorption properties were analyzed through isotherm, kinetic and thermodynamic models. In addition, SEM-EDS, TEM and XPS were applied to investigating the Pd(Ⅱ) adsorption mechanisms onto modified sepiolite. The equilibrium data were well fitted to Langmuir isotherm model with maximum Pd(Ⅱ) adsorption capacity of 322.58 mg/g at 30 ℃. The kinetic data could be satisfactorily simulated by the pseudosecond order model, indicating that the rate-controlling step was chemical adsorption. 99% of Pd(Ⅱ) could be recovered using 1 g/L modified sepiolite when initial concentration of Pd(Ⅱ) was 100 mg/L. The results of reusability studies indicated the modified sepiolite had an acceptable stability and reusability. This study indicated that the modified sepiolite might be an efficient and cost-effective material for Pd(Ⅱ) recovery.

Treatment of backwater in bauxite flotation plant and optimization by using Box-Behnken design

Flotation indexes gradually decrease with the increase of cycle time of the backwater in bauxite floatation,and discharge of backwater brings environmental risk.In this study,methods such as Fenton-oxidation,adsorption and coagulation were used in the treatment of backwater,the flotation indexes were checked after backwater treatments,and Box-Behnken design(BBD)was used in the optimization of the main operating parameters.The results reveal that flotation indexes are effectively improved after coagulation treatment by polyaluminum ferric chloride(PAFC).The optimum parameters predicted by BBD are pH 7.55,1.09 g/L PAFC dosage and temperature of 25℃.Under these optimum conditions,a maximum recovery of Al2O3 of 82.83%and a minimum A/S of 1.30 of tailings are gained,while the deviations are less than 3%from the predicted values.These findings encourage the application of BBD for the optimization of critical parameters in backwater treatment.

TGF-β在增殖性视网膜疾病中的研究进展

转化生长因子-β(TGF-β)是一类具有多重功效的生物因子,参与调控细胞增殖、凋亡、分化,调节机体的免疫功能、炎性反应等。TGF-β信号通路介导的肌成纤维细胞转化与细胞外基质(ECM)过量积累导致视网膜组织收缩和功能受损。各种细胞因子信号参与视网膜组织中的纤维化反应,但TGF-β是影响视网膜纤维化疾病发病最关键的因子。就眼睛而言,角膜混浊、黄斑下纤维化和增殖性视网膜疾病等病理性纤维性疾病导致全世界数以百万计的人视力受损和失明,这仍然是眼科临床需求未得到满足的主要领域之一。故本文主要阐述TGF-β在增殖性视网膜疾病中的发病机制及治疗前景的相关研究进展,以期能为增殖性视网膜疾病的防治提供更多的分子靶点,为新药的研究提供新思路。

Four new diterpenoids from Isodon eriocalyx var.laxiflora

Four new diterpenoids,laxiflorins S-V(1-4),bearing four different types,and one known compound,laxiflorin O(5),were isolated from Isodon eriocalyx var.laxiflora.Compound 1 was the first example of ent-kauranoids bearing a unique C_(24) carbon framework and compound 4 was the first example of 3,4-seco-ent-abietane diterpenoids from the Isodon genus.Their structures were determined by spectroscopic methods(UV,IR,MS,NMR).

Application of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU

Objective:To observe the application effect of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU.Methods:A total of 80 patients with acute heart failure merged with respiratory failure who were admitted in ICU from January, 2015 to January, 2016 were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were given routine treatments after admission. On this basis, the patients in the observation group were given non-invasive ventilator. The patients in the control group were given continuous low flow oxygen inhalation. PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before and after treatment between the two groups were compared. The serum NT-pro BNP and cTnI levels before treatment, 24 h and 48 h after treatment in the two groups were compared.Results:The comparison of PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before treatment between the two groups was not statistically significant. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the two groups were significantly elevated, while PaCO2 was significantly reduced when compared with before treatment. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group, while PaCO2 was significantly lower than that in the control group. The comparison of NT-pro BNP and cTnI levels before treatment between the two groups was not statistically significant. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the two groups were significantly elevated when compared with before treatment. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the observation group were significantly lower than those in the control group.Conclusions:Non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure can effectively improve the ventilation function, reduce NT-pro BNP and cTnI levels, and is of great significance in enhancing the rescued effect.

Effects of <i>Baicalin</i>and <i>Ligustrazine</i>on airway inflammation and remodeling and underlying mechanism in asthmatic rats

Aim: To explore the effects of Baicalin and Ligustrazine on airway inflammation and construction and underlying mechanisms through the expressions of GATA-3, IL-5, MMP-9 and TIMP-1 in asthmatic rats. Methods: 30 Wistar rats were randomly divided equally into five groups. Lung tissues were sliced. WBC and Eos in lung tissue were estimated by HE stain and the expressions of IL-5, GATA-3, MMP-9, TIMP-1 and collagen type IV in lung tissue were observed by immunohistochemistry. The airway wall and airway smooth muscle thicknesses were measured by computed image analysis system. Results: Compared with asthma group, EOS counts and the expression of IL-5 and GATA-3 in the lung tissue were significantly lower in normal controlled groups (P Baicalin or Ligustrazine, EOS decreased, and the thicknesses of airway wall and airway smooth muscle became thinner compared with asthma group. Meanwhile, the expression of collagen type IV, IL-5, GATA-3, MMP-9 and TIMP-1 significantly decreased (P < 0.05). Airway wall thickness and collagen type Ⅳ were associated with Eos, IL-5, TAGA-3, MMP-9, TIMP-1 and MMP-9/ TIMP-1. Conclusion: Two herbs could diminish infiltration of EOS with inhibiting the expressions of IL-5, and GATA-3, meanwhile, decrease the deposition of collagen type IV and the thickness of the airway smooth muscle through regulating MMP-9, TIMP-1 level and the balance between MMP-9 and TIMP-1, additionally, had synergetic effects.

IP10, KC and M-CSF Are Remarkably Increased in the Brains from the Various Strains of Experimental Mice Infected with Different Scrapie Agents

Activation of inflammatory cells and upregulations of a number of cytokines in the central nervous system(CNS)of patients with prion diseases are frequently observed.To evaluate the potential changes of some brain cytokines that were rarely addressed during prion infection,the levels of 17 different cytokines in the brain homogenates of mice infected with different scrapie mouse-adapted agents were firstly screened with Luminex assay.Significant upregulations of interferon gamma-induced protein 10(IP10),keratinocyte chemoattractant(KC)and macrophage colony stimulating factor(M-CSF)were frequently detected in the brain lysates of many strains of scrapie infected mice.The upregulations of those three cytokines in the brains of scrapie infected mice were further validated by the individual specific ELISA and immunohistochemical assay.Increased specific mRNAs of IP10,M-CSF and KC in the brains of scrapie infected mice were also detected by the individual specific qRT-PCRs and IP10-specific digital PCR.Dynamic analyses of the brain samples collected at different time points post infection revealed the time-dependent increases of those three cytokines,particularly IP10 during the incubation period of scrapie infection.In addition,we also found that the levels of IP10 in cerebral spinalfluid(CSF)of 45 sporadic Creutzfeldt–Jakob disease(sCJD)patients were slightly but significantly higher than those of the cases who were excluded the diagnosis of prion diseases.These data give us a better understanding of inflammatory reaction during prion infection and progression of prion disease.

6,7-seco-ent-Kaurane diterpenoids from Isodon sculponeatus and their bioactivity

One new 6,7-seco-ent-kaurane diterpenoid, sculponin T （1）, was isolated from the aerial parts of lsodon sculponeatus, along with four known analogs, sculponeatin J （2）, sculponeatin K （3）, sculponeatin C （4）, and sculponeatin Q （5）. Their structures were elucidated by extensive spectroscopic analysis and by comparison with data reported in the literature. Significant cytotoxic activity was observed for compound 2 against five human tumor cell lines with IC50 values ranging from 1.8 μmol/L to 3.3 μmol/L, and it also inhibited NO production in LPS-stimulated RAW264.7 cells, with IC50 value of 3.3 μmol/L.

A New Compound from Swertia cincta

Objective To study the chemical constituents from the whole plant of Swertia cincta.Methods The chemical constituents were purified by chromatographic methods such as silica gel column and Sephadex LH-20. The structures of these compounds were elucidated by MS, IR, and NMR analyses. Results Two compounds were isolated from S. cincta. Conclusion Compound 1 is a new compound named swercinctlactone A. Compound 2 is identified as（±）-gentiolactone and its configuration is confirmed by single crystal X-ray diffraction and optical specific rotation.