IMB-Guided Rehabilitation Nursing in Patients with Diabetic Nephropathy Undergoing Maintenance Hemodialysis.

Objective: This study aims to analyze the application effect of IMB (Information-Motivation-Behavioral skills) model rehabilitation nursing, which focuses on enhancing patient knowledge, motivation, and skills for disease management in patients with diabetes and end-stage renal disease receiving maintenance hemodialysis and its impact on the patient's nutritional status. Methods: Eighty-four patients with diabetes and end-stage renal disease undergoing maintenance hemodialysis were selected as study subjects at our hospital. All patients met the inclusion criteria and were divided into two groups based on the nursing interventions received. The control group (n=42) received routine rehabilitation nursing intervention, while the observation group (n=42) received IMB-guided rehabilitation nursing intervention. The effects of nursing intervention, psychological conditions, nutritional status, and quality of life were evaluated using standardized measurement tools. Psychological conditions were assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Nutritional status was evaluated through measurements of albumin (ALB), body composition analysis (BBC), hemoglobin (Hb), triceps skinfold thickness (TSF), arm circumference (A.C.), and arm muscle circumference (AMC). Quality of life was assessed using the SF-36 Health Survey. Comparative analysis was conducted to examine the differences between the two groups in terms of the aforementioned outcomes. Results: The results of the study revealed compelling data showcasing the effectiveness of the nursing intervention. Notably, after the nursing intervention, ALB (albumin) levels in the observation group increased by 12%, indicating a significant improvement in nutritional status. This increase signifies enhanced protein synthesis and improved overall metabolic functioning among the patients. Additionally, the SF-36 scores, reflecting the quality of life, demonstrated a substantial improvement of 15 points in the observation group following the nursing intervention. This improvement indicates a significant enhancement in various aspects of health-related quality of life, such as physical functioning, mental health, social functioning, and overall well-being. Furthermore, the total nursing effective rate in the observation group was an impressive 97.62%, surpassing the 80.95% rate in the control group. This statistically significant difference (P < .05) emphasizes the superior outcomes achieved through the nursing intervention in the observation group. Moreover, when comparing psychological conditions, the SAS scores in the observation group after the nursing intervention were significantly lower than those in the control group by 8 points (P < .05). Similarly, the SDS scores in the observation group showed a significant decrease of 10 points compared to the control group (P < .05). These findings indicate a substantial reduction in anxiety and depression levels among patients in the observation group. Conclusion: The findings of this study have significant implications for patient care and highlight potential areas for future research. The results suggest that integrating IMB-guided approaches into hemodialysis care protocols could significantly enhance patient well-being. The notable improvements in nutritional status, as indicated by the increase in ALB levels, and the substantial enhancement in quality of life, as reflected by the improvement in SF-36 scores, underscore the effectiveness of the nursing intervention. These findings have important implications for clinical practice, emphasizing the need for broader implementation of IMB-guided approaches in diverse clinical settings. By incorporating these interventions into routine hemodialysis care, healthcare providers can potentially improve patient outcomes and enhance their overall quality of life. Furthermore, these results also highlight potential areas for future research. Additional studies could explore the long-term effects of the nursing intervention on patient health outcomes, sustainability of the improvements observed, and the cost-effectiveness of implementing IMB-guided approaches in hemodialysis settings. Moreover, investigating the feasibility and efficacy of these interventions in different patient populations could further expand our understanding and inform tailored approaches for specific subgroups.

New technology for preparing energetic materials by nanofiltration membrane (NF): rapid and efficient preparation of high-purity ammonium dinitramide (ADN).

The development of environment-friendly and non-toxic green energetic materials and their safe, environmentally friendly, and economical production is very important to the national economy and national security. As an innovative, efficient, and environmentally friendly energetic material, the preferred preparation method of ammonium dinitramide (ADN) is the nitro-sulfur mixed acid method, which has the advantages of high yield, simple method, and easy access to raw materials. However, the large number of inorganic salt ions introduced by this method limits the large-scale production of ADN. Nanofiltration (NF) has been widely used in various industrial processes as a separation method with high separation efficiency and simple operation. In this study, NF was used for the desalination and purification of ADN synthesized by the mixed acid method. The effects of NF types, operation process (pressure, temperature, and feed solution concentration) on desalination efficiency, and membrane flux during purification were examined. The results showed that 600D NF could achieve the efficient desalination and purification of ADN. It was verified that the highest desalination and purification efficiency was achieved at 2 MPa pressure, 25 °C, and 1 time dilution of the feed solution, and the membrane flux of the desalination and purification process was stable. Under the optimized process conditions, the removal rate of inorganic salts and other impurities reached 99% (which can be recycled), the purity of ADN reached 99.8%, and the recovery rate reached 99%. This process has the potential for the large-scale production of ADN and provides a new process for the safe, efficient, and cheap preparation of energetic materials.

[Effect of curcumin on hippocampal IRS-1 and p-IRS-1 expressions in APP/PS1 double transgenic mice].

OBJECTIVE: To observe the effect of curcumin on the expressions of insulin receptor substrate-1 (IRS-1) and phosphated insulin receptor substrate-1 (p-IRS-1I) in APP/PS1 double transgenic mice of the AD model. METHOD: Three-month-old APP/ PSI double transgenic mice were randomly divided into the model group, the positive rosiglitazone control group and curcumin high (400 mg . kg-1 . d-1), medium (200 mg . kg-1 . d-1) and low (100 mg . kg-1 . d-1) dose groups. The normal group was composed of non-transgenic mice under the same background. After they were orally administered for three months, they were detected with immunohistochemistry, Western blot and RT-PCR. RESULT: According to IRS-1 and p-IRS-1 immumohistochemical staining, the expression of IRS-1 positive cells in hippocampus CA1 area in model mice was significantly higher than that of the normal control group (P<0. 01). Compared with the model group, the number of IRS-1 positive cells in hippocampus CA1 area decreased (P <0. 05 or P <0. 01) and the number of p-IRS-1 positive cells in hippocampus CA1 area increased in all of curcumin intervention groups. Western blot results were consistent with IRS-1 and p-IRS-1 protein expressions and immunohistochemistry results. RT-PCR test showed opposite IRS-1 mRNA expression results with immunohistochemistry and Western blot results. CONCLUSION: Curcumin can recover increased IRS-1 and decreased p-IRS-1 in hippocampus of APP/PS1 double transgenic mice, increase IRS-1 mRNA expression, and improve the insulin-signaling transduction in APP/PS1 double transgenic mice. This suggests that curcumin can regulate the insulin-signaling transduction mechanism and show an anti-AD effect.

[Effects of curcumin on expression of PI3K and p-pI3K in hippocampus of AD mice].

OBJECTIVE: To observe the effect of curcumin on the expression of PI3K (phosphatidylinositol-3-kinase, PI3K) and p-P3 K (phosphated phosphatidylinositol-3-kinase, p-PI3K) in the hippocampus of Alzheimer's disease (AD) model (APP/PS1 double transgenic) mice. METHOD: A total of 60 three-month-old APP/PS1 double transgenic mice were randomly divided into model group, rosiglitazone group(10 mg . kg-1 . d-1) and curcumin large(400 mg . kg-1 . d-1), medium(200 mg- kg-1 . d-1) and small(100 mg . kg-1 . d-1) dose group. Twelve C57BL/6J mice in the same age and genetic background as APP/PS1 double transgenic mice were used as normal control group. All the 6 groups of mice were intragastrically administered for 3 months. After 3 months, the expression of PI3K and p-PI3K were detected by immunohistochemistry and Western blot. RESULT: The expression of PI3K and p-PI3K positive cells in hippocampus CA1 region significantly decreased in model group compared with normal control group (P < 0. 05) , while compared with model group, PI3K and p-PI3K positive cells of all the curcumin intervention groups increased to varying degrees in hippocampus CA1 region,especially the middle dose group(P <0. 01). Besides,Western blot results of the curcumin high dose group were also increased obviously (P <0. 05). CONCLUSION: Curcumin can recover the decreased PI3K and p-PI3K and improve the insulin-signaling transmission in the hippocampus of APP/PS1 double transgenic mice. The mechanism of curcumin maybe by regulating the insulin signal transduction to treat AD.

[Dynamic effect of curcumin on urine concentration of neuronal thread protein in AD mice].

OBJECTIVE: Through the dynamic detection of the concentration change of the urine Alzheimer-associated neuronal thread protein (AD7C-NTP) in the curcumin treated Alzheimer's disease (AD) model (APP/PS1 double transgenic) mice, the therapeutic effect of curcumin in AD was determined. METHOD: Thirty three-month-old APP /PS1 double transgenic mice were randomly divided into 5 groups, 6 in each group, the model group, rosiglitazone group(10 mg . kg-1 . d-1) , high(400 mg . kg -1 . d-1) , medium(200 mg . kg-1. d-1) and low(100 mg . kg-1 . d-1) dose curcumin groups. Six C57BL/6J mice in the same age and genetic background were used as normal control group. All the 6 groups of mice were intragastrically administered for 6 months. Urine samples were collected on 4 month, 5 month and 6 month after intragastric administration, respectively. The changes of urinary AD7C-NTP concentration were detected by enzyme-linked immunosorbent assay (ELISA). RESULT: The concentration of AD7C-NTP of each group was compared at the same time point, the concentration of model group is higher than normal control group (P <0.05) ; the concentration of other groups is lower than model group. The concentration of high curcumin dose group with 4 months treatment, has no statistical difference compared with model group. The AD7C-NTP concentration of each group was elevated with the age growth, and all concentrations of the treatment groups were lower than the model group at the same period. With the treatment of 4, 5 and 6 months, the concentration of the normal control group has significant difference with the treatment groups(P <0. 01). There have no statistical difference between all the groups with the treatment of 6 months compared with 5 months. CONCLUSION: With the progression of the disease in AD mice, there are fluctuations in urinary AD7C-NTP concentration, the compound curcumin from traditional Chinese medicine can delay the progression of AD.

[Effect of curcumin on expression of AKT and p-AKT in hippocampus CA1 area of App/PS1 double transgenic mice].

OBJECTIVE: To observe the effect of curcumin on the expressions of AKT (serine-threonine kinase, AKT, also known as PKB) and p-AKT (phosphated serine-threonine kinase, p-AKT) in APP/PS1 double transgenic mice of the AD model. METHOD: Three-month-old APP/PS1 double transgenic mice were randomly divided into the model group, the rosiglitazone (10 mg kg-1 . d-1) group, and high (400 mg . kg-1 d-1), medium (200 mg . kg-1 d-1) and low (100 mg kg-1 d-1) dosecurcumin groups. Non-transgenic mice of the same age and background were selected as the control group ( n = 12). After all of the six groups were intragastrically administered for consecutively three months, the protein expressions of AKT and p-AKT in hippocampus CA1 area were detected by immunohistochemistry and Western blot. RESULT: The results of immunohistochemistry showed that the expression of AKT and p-AKT positive cells in hippocampus CA1 area significantly decreased in the model group (P <0. 05 and P < 0. 01). Compared with the model group, AKT and p-AKT positive cells of hippocampus CA1 area increased obviously in the rosiglitazone group and high and medium dose curcumin group (P <0.05 or P <0.01) ,especially the medium dose group (P <0.01). The results of Western blot were consistent with that of immunohistochemistry. CONCLUSION: Curcumin can recover the decreased AKT and p-AKT cells in hippocampus CAl area of APP/PS1 double transgenic mice of the AD model, suggesting that curcumin may regulate AKT and its phosphorylation process, as well as PI3K/AKT insulin signal transduction pathway, and show the anti-AD effect.

[Peri-operative characteristics of cerebral oxygen metabolism in patients with encephalopathy after orthotopic liver transplantation].

OBJECTIVE: To investigate the feature of cerebral oxygen metabolism during peri-operative stage of orthotopic liver transplantation (OLT), in order to identify the difference between the patients with or without complicating encephalopathy after OLT, and the relationship between the cerebral oxygen metabolism and encephalopathy after OLT. METHODS: Thirty patients undergoing OLT were studied. The patients were divided into two groups according to occurrence or not of encephalopathy after OLT: encephalopathy group and non-encephalopathy group. Blood samples were taken from radial artery and jugular vein simultaneously for blood gas analysis before operation, 25 minutes after onset of anhepatic phase, 30 minutes after graft reperfusion , 3 hours after graft reperfusion , and 24 hours after graft reperfusion. Cerebral arterial oxygen content (CaO(2)), oxygen content of jugular vein blood (CjvO(2)), cerebral arterial-venous oxygen content difference (Ca-jvO(2)), cerebral oxygen extraction ratio (CERO(2)) and cerebral blood flow/cerebral metabolic rate of oxygen ratio (CBF/CMRO(2)) were calculated, and the levels of blood glucose and lactic acid were recorded. RESULTS: There were 11 patients (36.7%) complicated by encephalopathy after OLT. The quantity of red blood cell infusion, blood loss and the dosage of noradrenalin in encephalopathy group were significantly larger compared with non-encephalopathy group. The overall tendency of change in cerebral oxygen metabolism index was about the same for both groups, while CaO(2) and Ca-jvO(2) at 25 minutes after onset of anhepatic phase, 30 minutes after graft reperfusion and 3 hours after graft reperfusion , and CERO(2) at 30 minutes after graft reperfusion and 3 hours after graft reperfusion were significantly decreased compared with those before operation [CaO(2) (ml/L) in encephalopathy group: 132.4 ± 23.5 , 125.9 ± 17.6, 133.4 ± 11.1 vs. 148.5 ± 28.8, in non-encephalopathy group: 135.7 ± 22.4, 130.5 ± 20.0, 139.9 ± 21.2 vs. 148.9 ± 28.2; Ca-jvO(2) (ml/L) in encephalopathy group: 42.9 ± 13.2, 31.4 ± 12.3 , 32.3 ± 6.5 vs. 52.9 ± 23.5, in non-encephalopathy group: 33.0 ± 14.1, 26.6 ± 9.1, 30.6 ± 10.3 vs. 50.2 ± 23.2; CERO(2) in encephalopathy group: (24.9 ± 9.7)%, (24.4 ± 5.5)% vs. (35.4 ± 11.5)%, in non-encephalopathy group: (20.6 ± 7.3)%, (21.9 ± 7.0)% vs. (33.4 ± 13.1)%, all P < 0.05], and they returned to the levels before operation at 24 hours after graft reperfusion. Jugular venous oxygen saturation (SjvO(2)) and CBF/CMRO(2) ratio were significantly increased at 30 minutes after graft reperfusion and 3 hours after graft reperfusion compared with the levels before operation [SjvO(2) in encephalopathy group: 0.838 ± 0.105, 0.835 ± 0.065 vs. 0.709 ± 0.125, in non-encephalopathy group: 0.854 ± 0.074, 0.824 ± 0.074 vs. 0.713 ± 0.138; CBF/CMRO(2) ratio in encephalopathy group: 37.8 ± 16.6, 31.9 ± 6.8 vs. 20.9 ± 6.7 , in non-encephalopathy group: 37.8 ± 14.1, 35.7 ± 13.7 vs. 24.3 ± 14.0, all P <0.05], and they returned to the levels before operation at 24 hours after graft reperfusion. The overall tendency of change in blood glucose and lactic acid was about the same in both groups, while the levels of blood glucose increased significantly from anhepatic phase to 24 hours after graft reperfusion compared with the levels before operation , and the levels of lactic acid increased significantly from anhepatic phase to 3 hours after graft reperfusion compared with the levels before operation and returned to the levels before operation at 24 hours after graft reperfusion. CONCLUSION: There are significant changes in the features of cerebral oxygen metabolism during OLT, but there is no difference between encephalopathy group and non-encephalopathy group. The occurrence of encephalopathy can be attributed to many factors, so the prevention and treatment should be comprehensive considered.

[Changes in plasma S-100 beta and neuron-specific enolase in peri-operative period of orthotopic liver transplantation and its relationship with encephalopathy after operation].

OBJECTIVE: To observe the changes in plasma S-100 beta and neuron-specific enolase (NSE) and to study their relationship with encephalopathy after orthotopic liver transplantation (OLT). METHODS: Thirty patients without neurological disease undergoing OLT were studied. Plasma S-100 beta and NSE were examined at three time points: after induction of anesthesia (T1), at the end of operation (T2) and 24 hours after reperfusion of the transplant (T3). The difference of plasma S-100 beta and NSE between encephalopathy group and non-encephalopathy group was analyzed. RESULTS: Eleven patients were complicated with encephalopathy after OLT. In 30 patients, S-100 beta at T2 [(3.715+/-1.523) microg/L] was higher than that at T1 [(1.478+/-0.809) microg/L, P<0.01]; S-100 beta at T3 [(1.765+/-0.894) microg/L] decreased to normal level (T1). NSE at T2 [(26.684+/-7.973) microg/L] was higher than that at T1 [(14.012+/-4.612) microg/L, P<0.01]. At T3, the level of plasma NSE [(18.105+/-7.345) microg/L] was decreased, but higher than that at T1. Plasma S-100 beta and NSE in encephalopathy group (11 cases) and non-encephalopathy group (19 cases) showed the same tendency of change as all of the patients. Plasma S-100 beta at T3 in encephalopathy group [(2.007+/-0.854)microg/L] was higher than that in non-encephalopathy group [(1.468+/-0.903) microg/L, P<0.05], and it was correlated with the presence of encephalopathy (r=0.385, P=0.039), but not at T1 and T2. Plasma NSE at three time points showed no relationship to the presence of encephalopathy. CONCLUSION: The increase in plasma S-100 beta and NSE during OLT indicates the occurrence of damage to the brain. But plasma S-100 beta and NSE cannot predict encephalopathy after OLT.

[Study of modified Biejiajian pill on pathological immune hepatic fibrosis model induced by albumin in rats].

OBJECTIVE: To quantitatively analyze the effect of modified Biejiajian Pill (BJJP) on the pathological change and degree of albumin induced immune hepatic fibrosis in rats. METHODS: Rats were immunized by multiple subcutaneous injections of human serum albumin (8 g/L) , and were medicated in groups respectively after antibody producing, BJJP high-dose (13 g/kg) group, medium-dose (6.5 g/kg) group, low-dose (3.25 g/kg) group, the model group, colchicines (1.0 mg/kg) group, and Ganpikang (22.23 mg/kg) group. Then, caudal vein injection of albumin was given 40 min after medication to induce liver fibrosis. Animals were sacrificed finally to observe the pathological change, and the distribution and content of collagen and plastin were determined quantitatively with HE and Masson stain. RESULTS: BJJP high-, medium-, and low-dose groups could obviously improve the pathological change of the hepatic fibrosis rats (decreasing rate of the total score was 62.50%, 40.75%, and 8.33%, respectively), and the content of collagen reduced markedly (P<0.05, P<0.01). CONCLUSION: BJJP can effectively prevent and reduce the pathological change of albumin induced immune hepatic fibrosis in rats.

[An experiment study of protection and treatment of Kudan granule on rats of pulmonary fibrosis induced by pinyangmycin].

OBJECTIVE: To explore the protection and treatment effects of Kudan granule on rats of pulmonary fibrosis induced by pinyangmycin. METHOD: In asepsis condition, rat was anaesthetized by 3.5% chloral hydrate, inserted the needle above the bifurcation of trachea and injecting 5 mg x kg(-1) pinyangmycin normal saline solution. RESULT: For model-group rats, after injecting pinyangmycin at 7, 14, 28, 56 days, there were mass inflammation cell infiltration at pulmonary alveoli and interstitial, the pulmonary alveolar wall and interstitial thickened obviously, and the pulmonary interval broadened distinctly. The structure of collagen fiber was destroyed, and the pulmonary alveoli disappeared. By Masson dyeing, there were hunk collagen fiber and the consolidation of lung had come into being. Compared with the model group, the rats of Kudan granule big-dose group, at 7, 14, 28, 56 days after injecting pinyangmycin, there were still much inflammation cell infiltration at pulmonary alveoli and interstitial, pulmonary interstitial edema and spotty necrosis, thickened alveolar wall, broadened pulmonary interval, and much collagen fiber in pulmonary interstitial, but there was not bunk the consolidation of lung. The curative effect of Kudan granule small-dose group was not better than that of Kudan granule big-dose group, because there were still bunk collagen fiber and the consolidation of lung in pulmonary interstitial. Although the destroyed area was more than 50%, it was better than that of the model-group. CONCLUSION: The big-dose Kudan granule show the better function of protection and treatment for pulmonary fibrosis of rats induced by pinyangmycin.