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1.
Acta Pharmaceutica Sinica ; (12): 98-108, 2022.
Article in Chinese | WPRIM | ID: wpr-913172

ABSTRACT

Tumor microenvironment (TME) is composed of abnormal tumor vasculature, extracellular matrix components, endothelial cells, pericytes, tumor associated fibroblasts, smooth muscle cells and immune cells, which is characterized by hypoxia, acidosis and high interstitial fluid pressure. Hypoxia and acidosis within the TME trigger an adjustment of the extracellular matrix (ECM), a response from neighbor stromal cells (e.g., fibroblasts) and immune cells (lymphocytes and macrophages), inducing tumor growth, angiogenesis, and ultimately, resulting in metastasis. What's more, the components of TME including abnormal tumor vasculature, rich composition of the ECM, and abundant stroma cells impair tumoral distribution and penetration of the drugs. At the same time, this stromal microenvironment plays a vital role in creating an immunosuppressive environment.Over the past years, more and more researches focus on targeting and remolding TME to improve therapeutic effects against tumors. Herein, we reviewed current strategies developed to target and remodel TME, including modulating tumor hypoxia, tumor vasculature, tumor associated fibroblasts, extracellular matrix components, tumor associated macrophage phenotypes and dendritic cells. Also, potential problems and future directions are pointed out in this review.

2.
Chinese Journal of Endemiology ; (12): 652-655, 2021.
Article in Chinese | WPRIM | ID: wpr-909071

ABSTRACT

Objective:To understand the surveillance status of iodine deficiency disorders (IDD) among children aged 8 - 10 years and pregnant women in Yantai City, Shandong Province.Methods:In 2019, Yantai City was divided into four areas: east, west, south and north according to administrative regions. In each area, 125 children aged 8 - 10 years (age balanced, half males and half females) and 75 pregnant women were selected as the survey subjects. The household edible salt samples and morning urine samples of the survey subjects were collected, and the contents of salt iodine and urinary iodine were detected by direct titration and arsenic-cerium catalytic spectrophotometry, respectively. At the same time, a color Doppler ultrasound diagnostic apparatus was used to examine the thyroid volume of children and the goiter rate was calculated.Results:A total of 800 salt samples were tested, and the median salt iodine was 20.9 mg/kg. Among them, 779 were iodized salts, the coverage rate of iodized salt was 97.38% (779/800); 756 were qualified iodized salts, the qualified rate of iodized salt was 97.05% (756/779), and the consumption rate of qualified iodized salt was 94.50% (756/800). A total of 491 urine samples from children aged 8 - 10 years were tested, the median urinary iodine was 169.23 μg/L, which was an appropriate level of iodine. The medians urinary iodine of children aged 8, 9, and 10 years ( n = 150, 209, 132) were 168.28, 164.39, and 171.23 μg/L, respectively, and the difference was not significant ( H = 1.123, P > 0.05). A total of 491 children's thyroid glands were examined, of which 11 were enlarged, with a goiter rate of 2.24%. The goiter rates of children aged 8, 9, and 10 years were 2.00% (3/150), 2.39% (5/209), 2.27% (3/132), respectively, and the difference was not significant (χ 2 = 0.112, P > 0.05). A total of 300 urine samples from pregnant women were tested, and the median urinary iodine was 208.98 μg/L, which was an appropriate level of iodine. Conclusions:In 2019, children aged 8 - 10 years and pregnant women in Yantai City are at an appropriate level of iodine. The consumption rate of qualified iodized salt ( > 90%) and the goiter rate of children ( < 5%) meet the national standards for eliminating IDD.

3.
Journal of Clinical Hepatology ; (12): 2595-2599, 2021.
Article in Chinese | WPRIM | ID: wpr-904999

ABSTRACT

Objective To investigate the use of hepatoprotective drugs in China in recent years, and to put forward related suggestions. Methods The outpatient prescription data of hepatoprotective drugs were collected from 85 hospitals in 6 cities of China from 2015 to 2019, and a real-world data analysis was performed to analyze the payment method, issuing department, drug category, and use of hepatoprotective drugs. Results A total of 1 113 575 prescriptions were extracted, involving 38 hepatoprotective drugs such as compound glycyrrhizin, polyene phosphatidylcholine, and bicyclol. Hepatoprotective drugs were mainly in tertiary hospitals, and the highest number of prescriptions containing hepatoprotective drugs were observed in department of infectious diseases, department of gastroenterology, and department of tuberculosis. Anti-inflammatory hepatoprotective drugs accounted for the highest proportion of all prescriptions, mainly compound glycyrrhizin, polyene phosphatidylcholine, and bicyclol. Of all prescriptions, 253 429 (22.76%) had the combination of multiple hepatoprotective drugs, with the highest number of 6 drugs, among which polyene phosphatidylcholine combined with bicyclol accounted for the highest proportion. Conclusion There are large quantities of hepatoprotective drugs used by outpatients in China. At present, the hepatoprotective drugs are clinically applied rationally, but there are still some problems to be solved, such as the combination of drugs.

4.
Article in Chinese | WPRIM | ID: wpr-904327

ABSTRACT

@#Remdesivir-loaded liposomes for inhalation were prepared and the in vitro properties were evaluated. Firstly, preparation methods of remdesivir-loaded liposomes were screened, and single-factor experiments were conducted to optimize the prescription and preparation process. Then the physical property, deposition ratio and aerodynamic particle size distribution of remdesivir-loaded liposomes suspension for inhalation were comprehensively evaluated. As a result, the optimal liposomes were prepared by the thin-film dispersion method with pH 6.5 phosphate-buffered saline as the hydration medium. In the prescription, the ratio of drug to DPPC was 1∶20; the cholesterol accounted for 10% of total lipids; and 20% DSPE-mPEG 2000 was added as stabilizer.4% trehalose was added as lyoprotectant when lyophilizing to obtain ideal appearance, good stability and a small particle size change after reconstitution. Remdesivir-loaded liposomes were spherical with smooth surface and uniform particle size distribution under transmission electron microscope. In vitro release tests showed no significant change for release curves of remdesivir-loaded liposomes suspension before and after nebulization. Deposition experiments indicated that the fine particles fraction of liposomes was 51.4%, and the mass median aerodynamic diameter was less than 5 μm measured by next generation impactor. To sum up, remdesivir-loaded liposomes for inhalation with high encapsulation efficiency and stability can achieve a suitable particle size distribution to effectively deposit in the lung after nebulization, which provides a new approach for the treatment of COVID-19.

5.
Article in English | WPRIM | ID: wpr-896985

ABSTRACT

Purpose@#Oxidized cellulose is available in many forms, but manufactured using either a regenerated or non-regenerated process. In this study, we evaluated the effects of 2 different hemostatic agents for the treatment of local bleeding in patients undergoing hepatic resection. @*Methods@#This was a monocentric, parallel-group, randomized, and controlled clinical trial to compare oxidized regenerated cellulose gauze (ORCG) with oxidized non-regenerated cellulose gauze (ONRCG) in patients undergoing hepatectomy. The primary endpoint was the time to hemostasis at the target bleeding site. The secondary endpoints were the postoperative drainage volume on the first 2 days after surgery and the hospital stay. @*Results@#There was no significant difference between the ORCG and ONRCG groups in time to hemostasis from column analysis (238.8 ± 121.6 seconds vs. 193.7 ± 85.3 seconds, P = 0.068), and there were no differences in the rates of hemostatic success between the 2 groups at 120 seconds (18.4% vs. 24.3%; odds ratio [OR], 0.703; 95% confidence interval [CI], 0.231–2.136) and 300 seconds (71.1% vs. 89.2%; OR, 0.298; 95% CI, 0.085–1.041). However, the ONRCG group was superior to the ORCG group in hemostasis according to the survival analysis (log-rank test, P = 0.044). Moreover, there were also no significant differences between the 2 groups in postoperative drainage volume on the first 2 days (P = 0.436, P = 0.381) and hospital stay (P = 0.537, P = 0.200). @*Conclusion@#ONRCG was not inferior to ORCG as a hemostatic agent in patients undergoing liver resection.

6.
Chinese Medical Journal ; (24): 2430-2437, 2021.
Article in English | WPRIM | ID: wpr-921177

ABSTRACT

BACKGROUND@#Circulating tumor DNA (ctDNA) is a promising biomarker for non-invasive epidermal growth factor receptor mutations (EGFRm) detection in lung cancer patients, but existing methods have limitations in sensitivity and availability. In this study, we used the ΔCt value (mutant cycle threshold [Ct] value-internal control Ct value) generated during the polymerase chain reaction (PCR) assay to convert super-amplification-refractory mutation system (superARMS) from a qualitative method to a semi-quantitative method named reformed-superARMS (R-superARMS), and evaluated its performance in detecting EGFRm in plasma ctDNA in patients with advanced lung adenocarcinoma.@*METHODS@#A total of 41 pairs of tissues and plasma samples were obtained from lung adenocarcinoma patients who had known EGFRm in tumor tissue and were previously untreated. EGFRm in ctDNA was identified by using superARMS. Through making use of ΔCt value generated during the detection process of superARMS, we indirectly transform this qualitative detection method into a semi-quantitative PCR detection method, named R-superARMS. Both qualitative and quantitative analyses of the data were performed. Kaplan-Meier analysis was performed to estimate the progression-free survival (PFS) and overall survival (OS). Fisher exact test was used for categorical variables.@*RESULTS@#The concordance rate of EGFRm in tumor tissues and matched plasma samples was 68.3% (28/41). At baseline, EGFRm-positive patients were divided into two groups according to the cut-off ΔCt value of EGFRm set at 8.11. A significant difference in the median OS (mOS) between the two groups was observed (EGFRm ΔCt ≤8.11 vs. >8.11: not reached vs. 11.0 months; log-rank P = 0.024). Patients were divided into mutation clearance (MC) group and mutation incomplete clearance (MIC) group according to whether the ΔCt value of EGFRm test turned negative after 1 month of treatment. We found that there was also a significant difference in mOS (not reached vs. 10.4 months; log-rank P = 0.021) between MC group and MIC group. Although there was no significant difference in PFS between the two groups, the two curves were separated and the PFS of MC group tended to be higher than the MIC group (not reached vs. 27.5 months; log-rank P = 0.088). Furthermore, EGFRm-positive patients were divided into two groups according to the cut-off of the changes in ΔCt value of EGFRm after 1 month of treatment, which was set at 4.89. A significant difference in the mOS between the two groups was observed (change value of ΔCt >4.89 vs. ≤4.89: not reached vs. 11.0 months; log-rank P = 0.014).@*CONCLUSIONS@#Detecting EGFRm in ctDNA using R-superARMS can identify patients who are more likely sensitive to targeted therapy, reflect the molecular load of patients, and predict the therapeutic efficacy and clinical outcomes of patients.


Subject(s)
Adenocarcinoma of Lung/genetics , Circulating Tumor DNA/genetics , ErbB Receptors/genetics , Humans , Lung Neoplasms/genetics , Mutation/genetics , Protein Kinase Inhibitors
7.
Article in Chinese | WPRIM | ID: wpr-912801

ABSTRACT

Objective:To translate the health literate healthcare organization 10 item questionnaire(HLHO-10) into Chinese and examine its reliability and validity.Methods:The Chinese version of HLHO-10 questionnaire(HLHO-10-C) was developed by following the Brislin translation model of translation, back translation, cultural adaptation and questionnaire epistemological survey.Five experts and 1 071 medical staff from 24 healthcare organizations in Zhejiang province were selected to conduct the validity and reliability test of the HLHO-10-C.Results:The content validity indices at the item level and total questionnaire level of HLHO-10-C were from 0.8 to 1.0 and 0.96 respectively, and the results of the exploratory factor analysis showed good structural validity.Conclusions:HLHO-10-C proves adequate reliability and validity to serve as a tool for healthcare organizations in evaluating and becoming HLHO. It can also help the implementation of the Healthy China Initiative(2019—2030), which is a performance assessment mechanism for health education and promotion of healthcare providers and health care organizations.

8.
Article in Chinese | WPRIM | ID: wpr-912800

ABSTRACT

Health literacy serves as the foundation of health for all. Hence the authors introduced the connotation and extension of health literate health care organization(HLHO) and related concepts. On such basis, the paper presented the construction method of HLHO from the perspective of health policy, healthcare organizations and inter-institutional cooperation, in order to improve the health literacy of the Chinese people and implement the Healthy China initiative(2019—2030).

9.
Article in Chinese | WPRIM | ID: wpr-912072

ABSTRACT

Objective:To optimize the BALB/c mouse rhinitis model sensitized by Artemisia annua pollen allergen, and explore the humoral and cellular immune indicators that can be used for the evaluation of allergic reactions. Methods:Using BALB/c mice as experimental animals, using Artemisia annua pollen allergen extract as sensitizing protein, through different content of the main allergen Art a1 and different sensitization times, different immunization programs were set to immunize mice subcutaneously, One week and five weeks after the last immunization, Artemisia annua pollen allergen extract containing 50 μg/ml and 500 μg/ml Art a1 was used for nasal stimulation, once a day, for 1 week each time.Observe the allergic reaction of mice, detect the pathological changes of nasal tissues, determine the levels and dynamic changes of antigen-specific IgE, IgG1, IgG2a and other antibodies in the serum of each group of mice. and detect the changes in the number of antigen-specific IL-4, IL-5, IL-2, IFN-γ and other lymphocytes in the spleen of mice. Results:Sensitized mice showed obvious scratching and sneezing reactions after being stimulated by antigen; obvious allergic inflammation appeared in nasal tissue; The increase in serum level of Artemisia annua pollen-specific IgE antibody was significantly correlated with the challenge antigen; The antigen-specific IL-4 lymphocytes in the spleen of the sensitized mice were significantly increased, but the IFN-γ-specific lymphocytes did not change significantly. Conclusions:The successful establishment of a mouse model of Artemisia annua pollen allergen allergy is the first domestic use of ELISPOT technology to detect an increase in the number of antigen-specific IL-4 lymphocytes in Artemisia annua allergy mice, laying a foundation for the subsequent evaluation of the efficacy of preparations for desensitization treatment basis.

10.
Article in Chinese | WPRIM | ID: wpr-912048

ABSTRACT

Objective:To explore how an enriched environment promotes synaptic remodeling in the hippocampus after cerebral ischemia.Methods:Among 60 clean, adult, male C57BL/6 mice, 16 were randomly selected into a sham operation group, while the remaining 44 underwent permanent left middle cerebral artery embolization. The 32 mice with successful modeling were randomly divided into a normal environment group and an enriched environment group, each of 16. The enriched environment group lived in an enriched environment for 28 days, while the other two groups were raised in normal conditions. The number of synapses in the CA3 area of the hippocampus was then measured using transmission electron microscopy, and the expression of Wnt7a, Dvl1, β-catenin, synaptophysin (SYN) and PSD-95 in the hippocampus were measured using western blotting.Results:Compared with the normal environment group, the average protein expression levels of Wnt7a, Dvl1, β-catenin, SYN and PSD-95 were all significantly higher in the enriched environment group. The number of synapses in the CA3 region of the enriched environment group was also significantly higher than in the normal environment group.Conclusion:An enriched environment can activate the Wnt7a-β-catenin-Dvl1 signaling pathway in the hippocampus after cerebral ischemia to promote synaptic remodeling, at least in mice.

11.
Article in Chinese | WPRIM | ID: wpr-911982

ABSTRACT

We here report the diagnosis and treatment of tricho-hepato-enteric syndrome in a female neonate. The 11-day-old patient, born at a gestational age of 38 weeks and with a birth weight of 1 700 g, was admitted to the Affiliated Hospital of Jining Medical University in January 2019 due to "skin stained yellow for 6 d". She presented with yellow, thin, and sparse hair that was easy to fall off, intractable diarrhea, repeated fever, and slow weight gain, further complicated by congenital heart disease. After 25-days of treatment, the child's infection was under control, but still had diarrhea. The baby girl was discharge later on request of her parents, but readmitted at the age of 3 months due to pulmonary infection. Delayed development, malnutrition, prominent forehead, wide eye distance, low nasal bridge, hepatomegaly, and intractable diarrhea were also observed. Whole exome sequencing identified a homozygous mutation of c.2344delC(p.His782fs) in SKIV2L gene in the baby, and both her parents were heterozygous carriers of the mutation at this site. She was diagnosed with SKIV2L gene mutation-induced tricho-hepato-enteric syndrome. The patient suffered from sustained diarrhea and recurrent infection and died of infection at 4 months of age after her parents' decision to withdraw treatment.

12.
Chinese Journal of Neurology ; (12): 1249-1255, 2021.
Article in Chinese | WPRIM | ID: wpr-911862

ABSTRACT

Objective:To discuss the clinical and electrophysiological characteristics of familial cortical myoclonic tremor with epilepsy (FCMTE) with fixation-off sensitivity (FOS).Methods:The clinical and electrophysiological characteristics of four patients diagnosed as FCMTE with FOS in the Electroencephalography (EEG) Monitoring Center of Xijing Hospital from May 2016 to December 2017 were studied and followed up.Results:The four patients were all female. The age was ranged from 29 to 67 years. The course was from six to 30 years, and the follow-up time was at least two years. The tremors and jerks occurred to the four patients frequently when the eyes were closed, which prevented their falling a sleep, and three of them had generalized tonic-clonic seizure occasionally. The FOS was monitored in the all four patients, and the photosensitivity occured to the three of them.Conclusions:The fixation-off sensitive trail during EEG monitoring is helpful to find the FCMTE with FOS. It is necessary to determine the potential clinical significance of FOS and photosensitivity coexisting in patients with FCMTE.

13.
Chinese Journal of Microsurgery ; (6): 157-160, 2021.
Article in Chinese | WPRIM | ID: wpr-885773

ABSTRACT

Objective:To evaluate the clinical effect of fibula flap in the repair of large segment of composite tissue defect in upper limb.Methods:From April, 2015 to June, 2019, 7 patients with large composite tissue defects in upper limbs were treated. All of them with various skin, vessel, nerve, tendon and other tissue defects. Repairing was well planned before surgery according to the type, location and size of defect. While in repairing of the bone and skin defect, fibula flap was taken from the shank and to repair the defects of nerve, tendon and vessels in upper limb. Regular followed-ups were made after surgery.Results:The 7 fibula flaps all survived. Postoperative follow-up ranged between 8 to 36 (averaged of 15) months. All the reconstructed limbs were in satisfactory appearance and function recovery. All the patients were able to manage their daily activities and live independently. The shape and function of donor sites were good. According to the Enneking system, the outcomes were graded as excellent in 4 cases and good in 3, with the average score was 25.9 points.Conclusion:Free grafting of vascularised fibula flap is especially feasible to be used in the repair of large bone tissue defect of upper limb. It repairs the defects of skin, vessel, nerve and tendon with the flap from a single donor site.

14.
Article in Chinese | WPRIM | ID: wpr-883777

ABSTRACT

Objective:To investigate the effect of levosimendan on myocardial injury in patients with sepsis.Methods:Eighty-two patients with sepsis complicated by myocardial injury who received treatment in Yinzhou Second Hospital from June 2015 to September 2017 were included in this study. They were randomly assigned to receive either dobutamine treatment (control group, n = 41) or levosimendan treatment (study group, n = 41) based on conventional basic treatment. Before and after treatment, serum levels of heart-type fatty acid-binding protein (H-FABP), cardiac troponin I (cTnI), N-terminal pro brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LEVF), Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score, intensive care unit (ICU) stay, and 28-day mortality were compared between the control and study groups. Results:Before treatment, there were no significant differences in serum levels of H-FABP, cTnI, and NT-proBNP as well as LVEF and APACHE II score between the control and study groups (all P > 0.05). At 6 hours after treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the control and study groups [(26.22 ± 7.22) μg/L vs. (39.93 ± 9.85) μg/L, (25.97 ± 6.93) μg/L vs. (34.86 ± 8.55) μg/L, (0.004 ± 0.002) μg/L vs. (1.580 ± 0.360) μg/L, (0.003 ± 0.003) μg/L vs. (0.760 ± 0.210) μg/L, (1 561.73 ± 633.70) ng/L vs. (2 570.06 ± 747.95) ng/L, (1 602.28 ± 681.45) ng/L vs. (2 225.53 ± 585.14) ng/L] were significantly increased compared with before treatment ( t = 7.188, 5.172, 28.031, 23.079, 6.586, 4.443, all P < 0.05). After treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the study group were significantly lower than those in the control group ( t = 2.489, 12.598, 2.323, all P < 0.05). In each group, serum level of H-FABP at 72 hours after treatment was significantly lower than that at 6 hours after treatment [(39.93 ± 9.85) μg/L vs. (6.28 ± 1.07) μg/L, (34.86 ± 8.55) μg/L vs. (5.82 ± 1.88) μg/L], serum levels of cTnI and NT-proBNP at 72 hours after treatment were significantly increased compared with those at 6 hours after treatment [(1.58 ± 0.36) μg/L vs. (2.72 ± 0.55) μg/L, (0.76 ± 0.21) μg/L vs. (1.78 ± 0.49) μg/L, (2 570.06 ± 747.95 ) ng/L vs. (3 623.27 ± 1 105.28) ng/L, (2 225.53 ± 585.14) ng/L vs. (3 128.08 ± 1 098.07) ng/L, t = 11.105, 12.251, 5.053, 4.645, all P < 0.05). At 72 hours after treatment, serum levels of cTnI and NT-proBNP levels in the control group were significantly higher than those in the study group ( t = 8.171, 2.035, both P < 0.05). At 72 hours after treatment, there was no significant difference in serum H-FABP level between the control and study groups ( P > 0.05). At 72 hours after treatment, APACHE II score in each group was significantly decreased and LVEF in each group was significantly increased compared with before treatment ( t = 7.718, 11.380, 9.049, 9.501, all P < 0.05). The change in APACHE II score at 72 hours after treatment relative to before treatment in the study group was more obvious than that in the control group ( t = 2.583, P < 0.05). At 72 hours after treatment, there were no significant differences in LVEF, ICU stay and 28-day mortality between the control and study groups (all P > 0.05). Conclusion:Levosimendan can reduce the serum levels of H-FABP, cTnI and NT-proBNP as well as APACHE II score in patients with sepsis, increase serum level of LVEF, and alleviate myocardial injury.

15.
Article in Chinese | WPRIM | ID: wpr-883121

ABSTRACT

Objective:To design and develop an unplanned extubation clinical decision support system, aiming to provide a reference for nurses' clinical decision-making.Methods:Through literature review and expert consultation, the knowledge base of the clinical decision support system for unplanned extubation was constructed, and the system function and interface were designed.Results:The authoritative coefficients of the two rounds of expert consultation were 0.853 and 0.867, respectively, and the Kendall ′s W were 0.458 and 0.492, respectively. The final built knowledge base included catheter evaluation module, unplanned extubation evaluation module, and knowledge reasoning rule module. At present, the knowledge base had sorted out 48 first-level items, 9 second-level items, 72 third-level items in the catheter evaluation module, and 5 first-level items, 12 second-level items, and 73 third-level items in the unplanned extubation evaluation module. Entry, 40 knowledge reasoning rules. Conclusions:The clinical decision-making system for unplanned extubation has changed the implementation of unplanned extubation risk early warning, optimized the management process, and realized the interaction of the hospital system. It can conduct dynamic unplanned extubation risk assessment based on individualization and assist nurses Make clinical decisions and promote the safety of nursing management.

16.
Article in Chinese | WPRIM | ID: wpr-883071

ABSTRACT

Objective:To examine the status of career decision-making and its influencing factors among nursing postgraduate students.Methods:From October 2018 to December 2019, 249 nursing postgraduate students from universities were selected by convenience sampling method and were investigated using general information questionnaire, Career Decision-making Difficulties Questionnaire, Professional Identity Scale and Proactive Personality Scale.Results:The score of postgraduate nursing students' career decision-making difficulties was (58.10±8.98). Correlation analysis showed that the score of the career decision-making difficulties was positively correlated with professional identity and proactive personality of nursing postgraduate students ( r=0.187, 0.581, P<0.01). Multiple linear regression analysis showed that gender, whether they had received career counseling and proactive personality scores were influencing factors of career decision-making difficulties which explained 38.0% of the total variation. Conclusions:The career decision-making difficulties of nursing postgraduate students is at a medium level. Educators can reduce the career decision-making difficulties of nursing postgraduate students by conducting career counseling, improving professional identity or enhancing career initiative.

17.
Article in Chinese | WPRIM | ID: wpr-882963

ABSTRACT

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

18.
China Occupational Medicine ; (6): 107-114, 2021.
Article in Chinese | WPRIM | ID: wpr-881981

ABSTRACT

Complex noise with impulse or impact property is common in workplace, and its damage on the auditory system is greater than that of steady-state noise. At present, the noise exposure measurement and evaluation indicators widely used in the world mainly include the equivalent continuous sound level and the cumulative noise exposure, both are based on the equal energy hypothesis(EEH). EEH only considered the damage of noise energy on the auditory system, but ignored the effect of temporal characteristics of noise, and underestimated the degree of hearing loss associated with complex noise. This paper first introduced the limitations of current noise exposure assessment standards at home and abroad, then introduced the definition of temporal kurtosis and the calculation method of its related energy indexes(such as cumulative noise exposure and equivalent continuous A-weighted sound pressure level), and further summarized the effectiveness of temporal kurtosis as an auxiliary parameter of noise energy in assessing the risk of hearing loss caused by complex noise, providing a rationale to supplement the existing noise assessment standards.

19.
Article in English | WPRIM | ID: wpr-881079

ABSTRACT

Two new type B polycyclic polyprenylated acylphloroglucinols (PPAPs) (1 and 2) and a known biogenetic precursor hyperbeanol Q (3) were isolated from the root extract of Hypericum beanii, a medicinal plant widespread in southwest China. Their chemical structures were elucidated by 1D/2D NMR and HRESIMS data analysis, and absolute configurations were determined through detailed electric circular dichroism (ECD) analysis including ECD exciton chirality, Mo

20.
Article in English | WPRIM | ID: wpr-881069

ABSTRACT

Polyphyllin I (PPI) purified from Polyphyllarhizomes displays puissant cytotoxicity in many kinds of cancers. Several researches investigated its anti-cancer activity. But novel mechanisms are still worth investigation. This study aimed to explore PPI-induced endoplasmic reticulum (ER) stress as well as the underlying mechanism in non-small cell lung cancer (NSCLC). Cell viability or colony-forming was detected by MTT or crystal violet respectively. Cell cycle, apoptosis, reactive oxygen species (ROS) and mitochondrial membrane potential were assessed by flow cytometry. Gene and protein levels were evaluated by qRT-PCR and immunoblotting respectively. Protein interaction was determined by immunoprecipitation or immunofluorescence assay. Gene overexpression or silencing was carried out by transient transfection with plasmids or small interfering RNAs. The Cancer Genome Atlas (TCGA) database was used for Gene Set Enrichment Analysis (GSEA), survival analysis, gene expression statistics or pathway enrichment assay. PPI inhibited the propagation of NSCLC cells, increased non-viable apoptotic cells, arrested cell cycle at G2/M phase, induced ROS levels but failed to decrease mitochondrial membrane potential. High levels of GRP78 indicates poor prognosis in NSCLC patients. PPI selectively suppressed unfolded protein response (UPR)-induced GRP78 expression, subsequently protected CHOP from GRP78-mediated ubiquitination and degradation. We demonstrated that the natural product PPI, obtained from traditional herbal medicine, deserves for further study as a valuable candidate for lead compound in the chemotherapy of NSCLC.

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