Injectable hydrogel made from antler mesenchyme matrix for regenerative wound healing via creating a fetal-like niche.

BACKGROUND: Scar formation and loss of cutaneous appendages are the greatest challenges in cutaneous wound healing. Previous studies have indicated that antler reserve mesenchyme (RM) cells and their conditioned medium improved regenerative wound healing with partial recovery of cutaneous appendages. AIM: To develop hydrogels from the antler RM matrix (HARM) and evaluate the effect on wound healing. METHODS: We prepared the hydrogels from the HARM via enzymatic solubilization with pepsin. Then we investigated the therapeutic effects of HARM on a full-thickness cutaneous wound healing rat model using both local injections surrounding the wound and topical wound application. RESULTS: The results showed that HARM accelerated wound healing rate and reduced scar formation. Also, HARM stimulated the regeneration of cutaneous appendages and blood vessels, and reduced collagen fiber aggregation. Further study showed that these functions might be achieved via creating a fetal-like niche at the wound site. The levels of fetal wound healing-related genes, including Collagen III and TGFß3 treated with HARM were all increased, while the expression levels of Collagen I, TGFß1, and Engrailed 1 were decreased in the healing. Moreover, the number of stem cells was increased in the fetal-like niche created by HARM, which may contribute to the regeneration of cutaneous appendages. CONCLUSION: Overall, we successfully developed an injectable hydrogel made from antler RM matrix for the regenerative repair of full-thickness cutaneous wounds. We uncovered the molecular mechanism of the hydrogels in promoting regenerative wound healing, and thus pave the way for HARM to be developed for the clinic use.

Development and Psychometric Evaluation of the Career Growth Scale for Nurses.

PURPOSE: The purpose of this study was to develop the career growth scale for nurses (CGSN) and evaluate its psychometric properties. METHODS: This study was conducted in four phases: (1) creating a pool of potential items through a qualitative design; (2) developing a preliminary scale using a modified two-round Delphi process; (3) refining the preliminary scale to finalize the scale using a cross-sectional survey; and (4) evaluating the psychometric properties of the final scale using another cross-sectional survey. A sample of 858 registered nurses from 12 general hospitals was recruited for this study. RESULTS: The final scale consisted of 17 items categorized into three factors: career goal progress, professional ability and attribute improvement, and career promotion and prestige increase. The three factors accounted for 75.4% of the observed variance in career growth. The overall Cronbach's α was .96, and the intraclass correlation coefficient was .92. The content validity index was .97. Confirmatory factor analysis showed acceptable model fitness. CONCLUSIONS: These results showed that the CGSN has good psychometric properties and can be used to evaluate specific career growth among nurses. This new instrument can further help nurse managers and clinical nurses themselves assess career growth and identify unsatisfactory aspects of growth, thereby designing tailored training programs and evaluating the effectiveness of such interventions.

Development of prediction model of low anterior resection syndrome for colorectal cancer patients after surgery based on machine-learning technique.

BACKGROUND: Low anterior resection syndrome (LARS) is a common postoperative complication in patients with colorectal cancer, which seriously affects their postoperative quality of life. At present, the aetiology of LARS is still unclear, but some risk factors have been studied. Accurate prediction and early management of medical intervention are keys to improving the quality of life of such high-risk patients. OBJECTIVES: Based on machine-learning methods, this study used the follow-up results of postoperative patients with colorectal cancer to develop prediction models for LARS and conducted a comparative analysis between the different models. METHODS: A total of 382 patients diagnosed with colorectal cancer and undergoing surgery at West China Hospital from April 2017 to December 2020 were retrospectively selected as the development cohort. Logistic regression, support vector machine, decision tree, random forest and artificial neural network algorithms were used to construct the prediction models of the obtained dataset. The models were internally validated using cross-validation. The area under the curve and Brier score measures were used to evaluate and compare the differentiation and calibration degrees of the models. The sensitivity, specificity, positive predictive value and negative predictive value of the different models were described for clinical use. RESULTS: A total of 342 patients were included, the incidence of LARS being 47.4% (162/342) during the six-month follow-up. After feature selection, the factors influencing the occurrence of LARS were found to be location, distance, diverting stoma, exsufflation and surgical type. The prediction models based on five machine-learning methods all showed acceptable performance. CONCLUSIONS: The five models developed based on the machine-learning methods showed good prediction performance. However, considering the simplicity of clinical use of the model results, the logistic regression model is most recommended. The clinical applicability of these models will also need to be evaluated with external cohort data.

The mediating role of psychological needs on the relationship between perceived organizational support and work engagement.

AIM: To examine the mediating effect of basic psychological needs on the relationship between perceived organizational support and work engagement among nurses. BACKGROUND: The satisfaction of basic psychological needs is crucial for breeding and sustaining individuals' intrinsic motivation. Little is known about the underlying motivational mechanisms that explain the relationship among perceived organizational support, basic psychological needs, and work engagement in a nursing context. METHODS: This was a cross-sectional online survey. A sample of 858 nurses from 12 hospitals was surveyed on their perceived organizational support, basic psychological needs, and work engagement. Structural equation models and bootstrapping methods were used to examine the hypotheses. STROBE reporting guidelines were utilized. RESULTS: Perceived organizational support was positively associated with basic psychological needs and work engagement. Basic psychological needs were positively associated with work engagement. Basic psychological needs mediated the relationship between perceived organizational and work engagement. CONCLUSION: Perceived organizational support may enhance work engagement by fulfilling the basic psychological needs of nurses. IMPLICATIONS FOR NURSING AND NURSING POLICY: Basic psychological needs deserve more attention in nursing organizations. Managers should seek optimal strategies to fulfill nurses' needs for autonomy, competence, and relatedness to stimulate their intrinsic motivation to enhance work engagement.

Nurses' perceptions of career growth: A qualitative descriptive study.

AIMS: To explore nurses' experiences and perceptions of career growth and its influencing factors, as career growth is more closely associated with individual attitudes and behaviours in the new career era. DESIGN: A qualitative descriptive design was used. METHODS: Thirty-one nurses from 10 secondary and 8 tertiary hospitals in Sichuan Province of China were purposively selected to participate in this study. The data were collected using individual semi-structured face-to-face interviews. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis. FINDINGS: The nurses' perceptions of career growth fully described the nurses' experience and occurred in five dimensions: career promotion, career goal progress, professional ability and quality improvement, professional identity development and increase in personal prestige. The factors influencing career growth were identified at the organizational, individual and social levels. Career growth in nursing was complex, changed over time and showed several specific characteristics compared with other careers. The nurse-specific symbol of career growth was professional identity development, which reflected career progression characteristics. CONCLUSIONS: Career growth is a multi-dimensional concept with varying influencing factors. The meaning of career growth for nurses is distinct from that for employees in other careers. IMPACT: Nursing managers should guide nurses to comprehensively assess their career growth from multiple perspectives, and professional identity development deserves more attention. Both organizations and individuals should take responsibility for career management to pursue career growth.

Gene Expression Profiling of Glioblastoma to Recognize Potential Biomarker Candidates.

Glioblastoma is an aggressive malignant tumor of the brain and spinal cord. Due to the blood-brain barrier, the accessibility of its treatments still remains significantly challenging. Unfortunately, the recurrence rates of glioblastoma upon surgery are very high too. Hence, understanding the molecular drivers of disease progression is valuable. In this study, we aimed to investigate the molecular drivers responsible for glioblastoma progression and identify valid biomarkers. Three microarray expression profiles GSE90604, GSE50601, and GSE134470 containing healthy and glioblastoma-affected samples revealed overlapping differentially expressed genes (DEGs). The interrelational pathway enrichment analysis elucidated the halt of cell cycle checkpoints and activation of signaling pathways and led to the identification of 6 predominant hub genes. Validation of hub genes in comparison with The Cancer Genome Atlas datasets identified the potential biomarkers of glioblastoma. The study evaluated two significantly upregulated genes, SPARC (secreted protein acidic and rich in cysteine) and VIM (vimentin) for glioblastoma. The genes CACNA1E (calcium voltage-gated channel subunit alpha1 e), SH3GL2 (SH3 domain-containing GRB2-like 2, endophilin A1), and DDN (dendrin) were identified as under-expressed genes as compared to the normal and pan-cancer tissues along with prominent putative prognostic biomarker potentials. The genes DDN and SH3GL2 were found to be upregulated in the proneural subtype, while CACNA1E in the mesenchymal subtype of glioblastoma exhibits good prognostic potential. The mutational analysis also revealed the benign, possibly, and probably damaging substitution mutations. The correlation between the DEG and survival in glioblastoma was evaluated using the Kaplan-Meier plots, and VIM had a greater life expectancy of 60.25 months. Overall, this study identified key candidate genes that might serve as predictive biomarkers for glioblastoma.

Protective effects of Radix Isatidis polysaccharide ameliorates obesity via promotion AMPK pathway in high-fat-diet-induced obese rats and 3T3-L1 adipocyte cells.

OBJECTIVES: The purpose of this paper is to ascertain the effect and mechanism of Radix Isatidis polysaccharide (RIP) on obesity. METHODS: High fat diet (HFD)-induced obese rats and the MDI-induced 3T3-L1 adipocyte cells were established to evaluate the ameliorated obesity effect and mechanism from RIP. KEY FINDINGS: Experiments in vivo show that oral administration of RIP has significant preventive effects on HFD-induced obesity and metabolic disorders in rats. With treatment of RIP (20, 40 and 80 mg/kg BW), the body weight, fat accumulation, adipocyte cell size, serum lipid levels and antioxidant enzyme activity were progressively improved. On the other hand, the treatment of 3T3-L1 cells with RIP (25, 50 and 100 mg/L) led to a decrease in lipid accumulation and glucose consumption. In addition, during adipogenesis in 3T3-L1 cells, RIP remarkably down-regulated mRNA levels of peroxisome proliferator-activated receptor-γ (PPARγ), CCAAT/enhancer binding protein-α (C/EBPα), sterol regulatory element-binding protein-1c (SREBP-1c), fatty acid synthase (FAS), acetyl-CoA carboxylase and glycerol-3-phosphate dehydrogenase. Furthermore, after RIP treatment, the protein expression of PPARγ, C/EBPα, FAS, HMG-CoA reductase and acetyl-CoA synthetase-1 (AceCS1) were significantly decreased and the expression of p-AMPK was increased. CONCLUSION: These results highlight the potential of RIP for obesity interventions and suggest that RIP inhibited adipocyte differentiation and lipid synthesis by activating adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) signalling pathway and down-regulating the expression of major adipogenic transcription factors, PPARγ, C/EBPα, etc.

Strategies and criteria targeting the reform and development for the teaching resource of nursing undergraduate: A multi-center cross-sectional study.

ABSTRACT: Teaching resource of nursing students play an important role in improving clinical performance, while there is a little know and dearth of the access and development criteria or guidance of teaching resources for nursing undergraduates.To develop the admission and development criteria of education resources for nursing undergraduates, and to explore and determine its composition and connotation.A cross-sectional survey has been used.A total of 22 Chinese nursing schools and affiliated teaching bases (hospitals and community health centers).A total of 20 nursing experts were consulted to develop the questionnaire of admission and development criteria of teaching resource for nursing undergraduates in China, and then 285 valid experts from 22 Chinese nursing schools and affiliated teaching bases (hospitals and community health centers) conducted the questionnaire survey to evaluate experts' consensus rate and view on the composition and connotation of the developed criteria.There were 6 domains and 43 items included in the admission and development criteria of teaching resource for nursing undergraduates, which domains included educational budget and allocation of resources, infrastructure, clinical teaching bases, books and information services, educational experts, and educational exchanges. The experts' consensus rate was more than 90.2%.The standard is helpful to guide the future admission and development of teaching resource for nursing undergraduates, and favor the education quality improvement of nursing undergraduates.

Effects of mindfulness-based intervention on glycemic control and psychological outcomes in people with diabetes: A systematic review and meta-analysis.

AIMS/INTRODUCTION: Psychological therapies have showed benefits for both glycemic control and psychological outcomes in people with diabetes. However, the effects of mindfulness-based intervention (MBI) on glycemic control and psychological outcomes are inconsistent across studies, and the evidence for MBI has not been summarized. We aimed to identify the effects of MBI on glycemic control and psychological outcomes in people with diabetes by carrying out a systematic review and meta-analysis. MATERIALS AND METHODS: Six databases (Pubmed, Embase, CINAHL, Cochrane, Web of science and PsycINFO) were searched from inception to October 2019. Randomized controlled trials of MBI for people with type 1 and type 2 diabetes were included. Two authors independently extracted relevant data and assessed the risk of bias, with a third reviewer as arbitrator. Subgroup analyses and sensitivity analyses were also carried out. RESULTS: Eight studies with 841 participants met the eligibility criteria. Meta-analysis showed that MBI can slightly improve glycosylated hemoglobin (HbA1c; -0.25%, 95% confidence interval [CI] -0.43 to -0.07) and diabetes-related distress (-5.81, 95% CI -10.10 to -1.52) contribute to a moderate effect size in reducing depression (standardized mean difference -0.56, 95% CI -0.82 to -0.30) and stress (standardized mean difference -0.53, CI -0.75 to -0.31). Subgroup analyses showed greater HbA1c reductions in subgroups with baseline HbA1c levels <8% and follow-up duration >6 months. Mixed effects were observed for anxiety. CONCLUSIONS: MBI appears to have benefits on HbA1c, depression, stress and diabetes-related distress in people with diabetes. More rigorous studies with longer follow-up duration are warranted to establish the full potential of MBI.

Asymmetry of Subthalamic Neuronal Firing Rate and Oscillatory Characteristics in Parkinson's Disease.

PURPOSE: The aim of this study was to compare the neuronal firing rate and oscillatory activity of the subthalamic nucleus (STN) between the more affected (MA) and the less affected (LA) hemispheres in Parkinson's disease (PD). PATIENTS AND METHODS: We recorded and analyzed the intra-operative microelectrode recordings (MER) from the STN of 24 PD subjects. Lateralized Unified Parkinson's Disease Rating Scale (UPDRS) III sub-scores (item 20-26) were calculated. The STN corresponding to the MA side was designated as the MA STN while the other side as the LA STN. Single unit characteristics including interspike intervals were identified and spectral analyses were assessed. Further, the mean spontaneous firing rate (MSFR) of neurons was calculated. The correlations between clinical symptoms and neuronal activity were analyzed. RESULTS: The firing rate in the MA and LA sides were 43.18 ± 0.74 Hz and 36.94 ± 1.32 Hz, respectively, with an increase of 16.9% in the MA group. The number of neurons that oscillated in the Tremor-Frequency Band (TFB), ß-Frequency Band (ßFB), and the non-oscillatory cells in the MA group were 43, 115, and 62 versus 78, 68, and 54 in the LA group, respectively. The proportions of the three types of neurons were different between both groups. The firing rate of the STN neurons and the UPDRS III sub-scores were positively correlated. Additionally, we observed a positive correlation between the percentage of ßFB oscillatory neurons and bradykinesia score. CONCLUSION: The firing rate of the STN in the MA hemisphere is higher than in the LA side, following disease progression and there seems to be an increase in firing rate. The ßFB oscillatory neurons are at a larger proportion in the MA group while there were larger percentage of TFB oscillatory cells in the LA group. The proportion of ßFB oscillatory neurons is selectively correlated with the severity of bradykinesia.

Effect of Radix isatidis polysaccharide on alleviating insulin resistance in type 2 diabetes mellitus cells and rats.

OBJECTIVES: The objective of this paper was to explore the effects of Radix isatidis polysaccharide (RIP) extracted from Radix isatis on alleviating insulin resistance. METHODS: The insulin resistance models of 3T3-L1 preadipocytes and type 2 diabetic rats were established to evaluate the insulin resistance activity of RIP. KEY FINDINGS: Radix isatidis polysaccharide within the concentration range of 25-100 µg/ml could reduce cell supernatant glucose and TNF-α levels (P < 0.01) and increase the expression of PI-3K P85, Glut4, IRS-1 and Akt protein in symptoms of IR 3T3-L1 preadipocytes. In the meantime, RIP contributed to relieve the weight loss of diabetic rats whose liver weight and liver index were decreased due to the effects of RIP. Experiments in rats also showed that RIP had capacity in reduced serum TC, TG, LDL-C, FFA, FBG, FINS, MDA, ALT, AST activities and increased serum HDL-C, SOD, ISI (P < 0.05 or 0.01). In addition, the oral glucose tolerance in rats was improved (P < 0.05) and liver damage was restored due to RIP. CONCLUSIONS: Radix isatidis polysaccharide significantly alleviates insulin resistance in 3T3-L1 preadipocytes and type 2 diabetic rats. These beneficial effects of RIP may associate with their roles in improving the glucose metabolism, lipid metabolism and oxidative stress.

Thalamus Stimulation for Myoclonus Dystonia Syndrome: Five Cases and Long-Term Follow-up.

BACKGROUND: Myoclonic dystonia syndrome (MDS) is a rare inherited movement disorder characterized by the coexistence of myoclonic jerks and dystonia. Deep brain stimulation (DBS) is a promising treatment for patients with MDS that targets the globus pallidus internus or ventral intermediate nucleus (Vim) of the thalamus. However, there are few studies regarding the long-term effects of Vim DBS in patients with MDS and even fewer in those without gene mutations. METHODS: Two positive and three negative SGCE mutation patients presenting with predominant myoclonus underwent Vim DBS. The Unified Myoclonus Rating Scale and the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) were assessed pre- and postoperation. RESULTS: Over an average follow-up period of 50 months, the myoclonus improvement rate was 92.7%. The average improvement in the BFMDRS motor score was 71.4% and the average improvement in the BFMDRS disabling score was 75.8%. CONCLUSIONS: This study suggests that Vim DBS can be a safe and effective treatment option for patients with MDS. Vim DBS alone may be preferable for patients with myoclonus-dominated MDS regardless of the identification of an SGCE mutation. Additional globus pallidus internus DBS may be used for progressive dystonia after Vim DBS.

Effects of transitional care on self-care, readmission rates, and quality of life in adult patients with systemic lupus erythematosus: a randomized controlled trial.

BACKGROUND: Lack of adequate self-care, frequent admissions, and poor quality of life are common and serious problems in adult patients with systemic lupus erythematosus (SLE). Some studies have revealed that transitional care is effective in improving self-care and quality of life as well as reducing rehospitalization rates. However, limited studies explored its effects in adult patients with SLE. Therefore, we performed a study to examine the effects of transitional care on self-care, readmission rates, and quality of life in adult patients with SLE. METHODS: This study was a single-center, single-blind, and parallel-group randomized controlled trial comparing transitional care with usual care in SLE patients from a university hospital in China. Evaluations were conducted at baseline before discharge and at 3 months after discharge by using hospital readmission rate, the Exercise of Self-Care Agency Scale, and the Medical Outcomes Study Short Form 36-item Health Survey for self-care and quality of life. Data were collected between June and December 2016. RESULTS: Compared with the usual care group, the transitional care group reported significantly greater improvement in self-care and quality of life. Additionally, the 30-day readmission rate for the patients in the transitional care group was significantly lower than in the usual care group, and this effect remained significant at 60 and 90 days after patient discharge. CONCLUSION: This study shows that transitional care improves self-care and quality of life in adult patients with SLE and reduces readmissions. However, further studies are needed. TRIAL REGISTRATION: China clinical trial registry, ChiCTR-IPR-16007708 . Registered January 5, 2016.

[Clinical experience and academic thoughts of Professor LIU Feng-bin on case series of gastroesophageal reflux disease based on data mining].

To analyze and summarize Professor LIU Feng-bin's clinical experience and academic thoughts on gastroesophageal reflux disease (GERD), the study group adopted the retrospective study for case series and expert interview, extracted the retrospective data, including the herbs, diseases, syndrome type, medical expense and quantity of herbs of GERD patients attended the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Statistical description and binary Logistic regression were used for the identification and modification of syndrome type and initial core herbs. After expert interviews were performed for the syndrome type and herbs, the final scheme were formed. A total of 112 GERD patients ages（48.97±13.13）y; male: 35 (31.3%), female: 77(68.7%) were enrolled. The numbers of patients with liver and stomach incoordination syndrome, heat stagnation of liver and stomach syndrome, syndrome of dual deficiency of Qi and Yin, syndrome of spleen deficiency and dampness-heat, spleen-stomach disharmony syndrome were 40, 26, 19, 17 and 10, respectively. The patients used totally 80 herbs, and 26 of them had significant differences among different syndrome groups. According to the logistic regression analysis on the 23 herbs used by 112 patients, the herbs scheme was modified for the second time. After the expert interviews and modification, the final consensus was reached. The main causes for GERD were dietary irregularities, moodiness, and weak constitution. The basic mechanism of GERD was spleen deficiency with Qi adverseness. The spleen-stomach disharmony syndrome was deleted by expert interviews. The 10 core herbs for GERD treatment were Taizishen(Pseudostellariae Radix), Fuling(Poria), Baizhu(Atractylodismacrocephalae Rhizoma), Gancao(Glycyrrhizae Radix Et Rhizoma), Zhebeimu(Fritillariae Thunbergii Bulbus), Haipiaoxiao(Sepiae Endoconcha), Zhiqiao(Aurantii Fructus), Chenxiang(Alosewood), Pugongying(Taraxaci Herba), Zhizitan(Cape Jasmine Fruit). The modification and psychological and diet interventions were also identified. This study summarized Professor LIU Feng-bin's clinical experience and academic thoughts of chronic atrophic gastritis based on data mining of case series and expert interviews. The quality of methodologies and report were both well. The results provide a foundation and ideas for further study on the complex intervention for GERD, and can be directly applied in clinical practice.

Creatine kinase (CK) and its association with aggressive behavior in patients with schizophrenia.

OBJECTIVE: To study the association between the serum creatine kinase (CK) level and aggressive behavior in patients with schizophrenia. METHOD: This retrospective study recruited 2780 Chinese patients with schizophrenia from January 2009 to December 2013 at the psychiatric inpatient units of West China Hospital. The diagnosis was made according to the DSM-IV criteria. The serum level of CK was checked. RESULTS: Aggressive behavior was positively correlated with the serum CK level (r=0.262, p=0.000). The OR value is 8.084 when comparing the high CK group and normal CK group prior to admission. The aggressive behavior rate in the 5 times group (serum level≥1130U/L) after admission (28.2%) is higher than the rate prior to admission (16.5%). CONCLUSION: The aggressive patients with schizophrenia displayed increased serum CK level. It may be useful to include a lab test of CK level in patients with schizophrenia and history of aggression. It would help the staff to take precautions to protect the patients and others.

Curcumin induces G2/M cell cycle arrest and apoptosis of head and neck squamous cell carcinoma in vitro and in vivo through ATM/Chk2/p53-dependent pathway.

Studies have demonstrated that curcumin (CUR) exerts its tumor suppressor function in a variety of human cancers including head and neck squamous cell carcinoma (HNSCC). However, the exact underlying molecular mechanisms remain obscure. Here, we aim to test whether CUR affects ATM/Chk2/p53 signaling pathway, leading to the induction of cell cycle arrest, inhibition of angiogenesis of HNSCC in vitro and in vivo. To this end, we conducted multiple methods such as MTT assay, Invasion assay, Flow cytometry, Western blotting, RT-PCR, and transfection to explore the functions and molecular insights of CUR in HNSCC. We observed that CUR significantly induced apoptosis and cell cycle arrest, inhibited angiogenesis in HNSCC. Mechanistically, we demonstrated that CUR markedly up-regulated ATM expression and subsequently down-regulated HIF-1α expression. Blockage of ATM production totally reversed CUR induced cell cycle arrest as well as anti-angiogenesis in HNSCC. Moreover, our results demonstrated that CUR exerts its antitumor activity through targeting ATM/Chk2/p53 signal pathway. In addition, the results of xenograft experiments in mice were highly consistent with in vitro studies. Collectively, our findings suggest that targeting ATM/Chk2/p53 signal pathway by CUR could be a promising therapeutic approach for HNSCC prevention and therapy.

Studies on anti-angiogenesis of ginsenoside structure modification HRG in vitro.

This study investigates the anti-angiogenic effect of 3ß, 12ß, 20(S)-trihydroxy dammarane-3-O-ß-d-glucopyranosyl(1-2)-ß-d-glucopyranoside(HRG), a new chemical compound obtained by structure modification on Ginseng saponins Rg3, associated with the regulation of matrix metalloproteinases(MMPs) and its upstream signal-regulated molecule of vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(b-FGF) in vitro, which plays an critical role in angiogenesis during the process of carcinoma. In our study, to investigate the anti-angiogenesis effect of HRG in HUVECs, we utilized cell proliferation assay, tube formation assay, wound-healing assay, Semi-quantitative reverse transcription PCR, and Western blot assay. Our results demonstrated that HRG plays a major role in the regulation of proliferation, migration and tube formation of HUVECs by suppressing the expression of VEGF and b-FGF in both transcriptional and post-transcriptional levels. In addition, the expression of MMP-2 and MMP-9, which were related to the ECM degradation, were down-regulated after administration of HRG as well. Overall, our results revealed that HRG strongly inhibited the process of angiogenesis and shows better effectiveness than Rg3.

[Effects of Nurse-Led Team Management on Type 2 Diabetes Patients in the Community].

BACKGROUND: Managing increasing numbers of diabetic patients is placing increasing pressure on healthcare providers, especially general practitioners, who usually serve in multiple roles. This situation has caused generally poor results in terms of diabetes management. However, community nurses in some countries have successfully and effectively controlled chronic diseases among their patients. Therefore, the effects of nurse-led management is worth further exploration in order to better understand and promote this mode of care. PURPOSE: To explore the effects of community-nurse-led team management on diabetes patients. METHODS: An experimental research design was adopted. Patients with type 2 diabetes were recruited from two community health centers (the first for the intervention group, the second for the control group) in Wuhou District, Chengdu City, China. The intervention group received nurse-led team management care for 2 years, while the control group received standard care. The evaluations were conducted before the intervention and at 6, 12, and 24 months into the intervention. Outcomes included glycosylated hemoglobin (HbA1c) level, body mass index, waist circumference, visual acuity, ankle brachial index, kidney function index, urinary protein level, and electrocardiogram. RESULTS: The 179 participants included 88 in the intervention group and 91 in the control group. After the intervention, HbA1c level, ankle brachial index, and waist circumference were all significantly better in the intervention group than in the control group (F = 28.894, p < .01; F = 4.065, p < .01; F = 5.540, p < .01). The other outcome variables remained statistically similar between both groups throughout the study period. CONCLUSIONS: Community nurse-led team management is an effective mode of care in terms of controlling blood glucose control and preventing diabetes-related complications.