An efficient approach toward production of near-zigzag single-chirality carbon nanotubes.

Synthesizing single-walled carbon nanotubes (SWCNTs) with a narrow chirality distribution is essential for obtaining pure chirality materials through postgrowth sorting techniques. Using carbon monoxide chemical vapor deposition, we devise a ruthenium (Ru) catalyst supported by silica for the bulk production of SWCNTs containing only a few (n, m) species. The result is attributed to the limited carbon dissociation on the supported Ru clusters, favoring the growth of only small-diameter SWCNTs at comparable growth rates. The resulting materials expedite high-purity single chirality separation using gel chromatography, leading to unprecedented yields of 3.5% for (9, 1) and 5.2% for (9, 2) nanotubes, which surpass those separated from HiPco SWCNTs by two orders of magnitude. This work sheds light on the large-quantity synthesis of SWCNTs with enriched species beyond near-armchair ones for their high-yield separation.

Kinetic Modulation of Carbon Nanotube Growth in Direct Spinning for High-Strength Carbon Nanotube Fibers.

With impressive individual properties, carbon nanotubes (CNTs) show great potential in constructing high-performance fibers. However, the tensile strength of as-prepared carbon nanotube fibers (CNTFs) by floating catalyst chemical vapor deposition (FCCVD) is plagued by the weak intertube interaction between the essential CNTs. Here, we developed a chlorine (Cl)/water (H2O)-assisted length furtherance FCCVD (CALF-FCCVD) method to modulate the intertube interaction of CNTs and enhance the mechanical strength of macroscopic fibers. The CNTs acquired by the CALF-FCCVD method show an improvement of 731% in length compared to that by the conventional iron-based FCCVD system. Moreover, CNTFs prepared by CALF-FCCVD spinning exhibit a high tensile strength of 5.27 ± 0.27 GPa (4.62 ± 0.24 N/tex) and reach up to 5.61 GPa (4.92 N/tex), which outperforms most previously reported results. Experimental measurements and density functional theory calculations show that Cl and H2O play a crucial role in the furtherance of CNT growth. Cl released from the decomposition of methylene dichloride greatly accelerates the growth of the CNTs; H2O can remove amorphous carbon on the floating catalysts to extend their lifetime, which further modulates the growth kinetics and improves the purity of the as-prepared fibers. Our design of the CALF-FCCVD platform offers a powerful way to tune CNT growth kinetics in direct spinning toward high-strength CNTFs.

Design of dual peptide-conjugated hydrogels for proliferation and differentiation of human pluripotent stem cells.

Completely synthetic cell cultivation materials for human pluripotent stem cells (hPSCs) are important for the future clinical use of hPSC-derived cells. Currently, cell culture materials conjugated with extracellular matrix (ECM)-derived peptides are being prepared using only one specific integrin-targeting peptide. We designed dual peptide-conjugated hydrogels, for which each peptide was selected from different ECM sites: the laminin ß4 chain and fibronectin or vitronectin, which can target α6ß1 and α2ß1 or αVß5. hPSCs cultured on dual peptide-conjugated hydrogels, especially on hydrogels conjugated with peptides obtained from the laminin ß4 chain and vitronectin with a low peptide concentration of 200 µg/mL, showed high proliferation ability over the long term and differentiated into cells originating from 3 germ layers in vivo as well as a specific lineage of cardiac cells. The design of grafting peptides was also important, for which a joint segment and positive amino acids were added into the designed peptide. Because of the designed peptides on the hydrogels, only 200 µg/mL peptide solution was sufficient for grafting on the hydrogels, and the hydrogels supported hPSC cultures long-term; in contrast, in previous studies, greater than 1000 µg/mL peptide solution was needed for the grafting of peptides on cell culture materials.

Monocyte distribution width as an early predictor of short-term outcome in adult patients with sepsis.

OBJECTIVES: Monocyte distribution width (MDW) is a quantitative measurement of monocyte anisocytosis and has been proposed as an efficient marker for early sepsis detection. This study aimed to assess the prognostic potential of MDW in septic patients. METHODS: In this study, a total of 252 adult septic patients were enrolled. Demographic, clinical, and laboratory finding including MDW and traditional inflammatory biomarkers detected at three time points (day 1, day 3 and day 6) after admission were collected and compared between 28-day survivors and non-survivors. Receiver operating characteristic (ROC) curves, Kaplan-Meier survival curve and Cox regression analyses were performed to assess and compare their predictive values. Group-based trajectory modeling was applied to identify MDW trajectory endotypes. Basic characteristics and 28-day outcomes were compared between the trajectories. RESULTS: ROC curve analysis showed that MDW levels measured on day 3 after admission (D3-MDW) had moderate prognostic value and was independently associated with 28-day mortality in patients with sepsis. A D3-MDW value of 26.20 allowed discrimination between survivors and non-survivors with a sensitivity of 77.8 % and a specificity of 67.6 %. However, the prognostic accuracy of D3-MDW was diminished in immune-compromised patients and patients who already received antibiotics before admission. Group-based trajectory modeling indicated that excessively elevated and delayed decreased MDW levels during the first week after admission inversely correlated with prognosis. CONCLUSIONS: MDW values detected on day 3 after admission and its kinetic change might be potential markers for predicting short-term outcome in adult septic patients.

Effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical ICU patients / 中国药房

OBJECTIVE To investigate the effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical intensive care unit （ICU） patients. METHODS Forty cases of mechanically ventilated non-surgical patients in the ICU of our hospital from February 1st， 2023 to July 31st， 2023 were selected and randomly divided into control group and esketamine （S-K） group using grouping method with opaque envelopes， with 20 cases in each group. Control group was given sufentanil， and S-K group was infused with Esketamine hydrochloride injection at a constant rate of 0.2 mg/（kg·h）+ sufentanil. The treatment period length， analgesic compliance rate， sedation level， analgesic and sedative consumption， and gastric motility indexes were compared between the two groups. RESULTS There was no statistically significant difference in the treatment period length， analgesic compliance rate， sedation level， or the consumption of propofol and midazolam between the two groups （P＞0.05）. The consumption of sufentanil in the S-K group was significantly less than control group （P＜ 0.05）. Compared with 1 h after randomization， the antral contraction frequency， antral contraction amplitude and antral motility index of patients in the S-K group were significantly higher at 72 h after randomization and were significantly higher than control group （P＜0.05）. CONCLUSIONS Esketamine may reduce opioid consumption and improve gastric motility in mechanically ventilated non-surgical ICU patients while ensuring a level of analgesic sedation.

Trilogy of drug repurposing for developing cancer and chemotherapy-induced heart failure co-therapy agent

Chemotherapy-induced complications, particularly lethal cardiovascular diseases, pose significant challenges for cancer survivors. The intertwined adverse effects, brought by cancer and its complication, further complicate anticancer therapy and lead to diminished clinical outcomes. Simple supplementation of cardioprotective agents falls short in addressing these challenges. Developing bi-functional co-therapy agents provided another potential solution to consolidate the chemotherapy and reduce cardiac events simultaneously. Drug repurposing was naturally endowed with co-therapeutic potential of two indications, implying a unique chance in the development of bi-functional agents. Herein, we further proposed a novel "trilogy of drug repurposing" strategy that comprises function-based, target-focused, and scaffold-driven repurposing approaches, aiming to systematically elucidate the advantages of repurposed drugs in rationally developing bi-functional agent. Through function-based repurposing, a cardioprotective agent, carvedilol (CAR), was identified as a potential neddylation inhibitor to suppress lung cancer growth. Employing target-focused SAR studies and scaffold-driven drug design, we synthesized 44 CAR derivatives to achieve a balance between anticancer and cardioprotection. Remarkably, optimal derivative 43 displayed promising bi-functional effects, especially in various self-established heart failure mice models with and without tumor-bearing. Collectively, the present study validated the practicability of the "trilogy of drug repurposing" strategy in the development of bi-functional co-therapy agents.

Prussian blue analogues derived magnetic FeCo@GC material as high-performance metallic peroxymonosulfate activators to degrade tetrabromobisphenol A over a wide pH range.

Metal-organic frame (MOF) materials can effectively degrade organic pollutants, whereas the MOF is rapidly hydrolysed in water and has poor stability and low reusability. However, in the current advanced oxidation process (AOP) system, the removal effect of pollutants under alkaline condition is not ideal. In this study, a magnetic composite material derived from MOF was synthesised and used as a new catalyst for rapid degradation of tetrabromobisphenol A (TBBPA). Compared to precarbonisation, FeCo@GC formed a conductive graphite carbon skeleton, retained the complete rhombododecahedron structure, had a larger specific surface area and provided more active sites for peroxymonosulfate (PMS) activation. The target pollutant TBBPA (20 mg/L) was completely degraded within 30 min, and the mineralisation rate reached 40.98% in the FeCo@GC (150 mg/L) and PMS (1 mM) systems, owing to the synergistic interaction between Fe, Co and graphite carbon. The reactive oxygen species (ROS) involved in the reaction were determined to be SO4•-, ·OH, 1O2 and O2•- by electron paramagnetic resonance and free radical scavenging experiments, and the 1O2 played a dominant role. Based on the results of LC-MS analysis results, the main degradation pathways of TBBPA involve three mechanisms: the debromination reaction, hydroxylation and cleavage of the benzene ring. In addition, compared with previous AOP systems, FeCo@GC/PMS overcomes the disadvantage of poor degradation effect of TBPPA under alkaline conditions, has a wide range pH (3-11) application and has the best effect on TBBPA degradation under alkaline conditions. FeCo@GC has an excellent cycle performance, with a removal rate of re-calcined material of 88.52% after five cycles. Therefore, FeCo@GC can be used as a promising and efficient catalyst for removing environmental organic pollutants.

Contacting individual graphene nanoribbons using carbon nanotube electrodes.

Graphene nanoribbons synthesized using bottom-up approaches can be structured with atomic precision, allowing their physical properties to be precisely controlled. For applications in quantum technology, the manipulation of single charges, spins or photons is required. However, achieving this at the level of single graphene nanoribbons is experimentally challenging due to the difficulty of contacting individual nanoribbons, particularly on-surface synthesized ones. Here we report the contacting and electrical characterization of on-surface synthesized graphene nanoribbons in a multigate device architecture using single-walled carbon nanotubes as the electrodes. The approach relies on the self-aligned nature of both nanotubes, which have diameters as small as 1 nm, and the nanoribbon growth on their respective growth substrates. The resulting nanoribbon-nanotube devices exhibit quantum transport phenomena-including Coulomb blockade, excited states of vibrational origin and Franck-Condon blockade-that indicate the contacting of individual graphene nanoribbons.

Carbon Nanotube-Directed 7 GPa Heterocyclic Aramid Fiber and Its Application in Artificial Muscles.

Poly(p-phenylene-benzimidazole-terephthalamide) (PBIA) fibers with excellent mechanical properties are widely used in fields that require impact-resistant materials such as ballistic protection and aerospace. The introduction of heterocycles in polymer chains increases their flexibility and makes it easier to optimize the fiber structure. However, the inadequate orientation of polymer chains is one of the main reasons for the large difference between the measured and theoretical mechanical properties of PBIA fibers. Herein, carbon nanotubes (CNTs) are selected as an orientation seed. Their structural features allow CNTs to orient during the spinning process, which can induce an orderly arrangement of polymers and improve the orientation of the fiber microstructure. To ensure the complete 1D topology of long CNTs (≈10 µm), PBIA is used as an efficient dispersant to overcome dispersion challenges. The p-CNT/PBIA fibers (10 µm single-walled carbon nanotube 0.025 wt%) exhibit an increase of 22% in tensile strength and 23% in elongation, with a maximum tensile strength of 7.01 ± 0.31 GPa and a reinforcement efficiency of 893.6. The artificial muscle fabricated using CNT/PBIA fibers exhibits a 34.8% contraction and a 25% lifting of a 2 kg dumbbell, providing a promising paradigm for high-performance organic fibers as high-load smart actuators.

AQP8 promotes glioma proliferation and growth, possibly through the ROS/PTEN/AKT signaling pathway.

BACKGROUND: The aquaporin (AQP) family of proteins has been implicated in the proliferation and growth of gliomas. Expression of AQP8 is higher in human glioma tissues than in normal brain tissues and is positively correlated with the pathological grade of glioma, suggesting that this protein is also involved in the proliferation and growth of glioma. However, the mechanism by which AQP8 promotes the proliferation and growth of glioma remains unclear. This study aimed to investigate the mechanism and role of abnormal AQP8 expression in glioma development. METHODS: The dCas9-SAM and CRISPR/Cas9 techniques were used to construct viruses with overexpressed and knocked down AQP8, respectively, and infect A172 and U251 cell lines. The effects of AQP8 on the proliferation and growth of glioma and its mechanism via the intracellular reactive oxygen species (ROS) level were observed using cell clone, transwell, flow cytometry, Hoechst, western blotting, immunofluorescence, and real-time quantitative polymerase chain reaction assays. A nude mouse tumor model was also established. RESULTS: Overexpression of AQP8 resulted in an increased number of cell clones and cell proliferation, enhanced cell invasion and migration, decreased apoptosis and phosphatase and tensin homolog (PTEN) expression, and increased phosphorylated serine/threonine protein kinase (p-AKT) expression and ROS level, whereas the AQP8 knockdown groups showed opposite results. In the animal experiments, the AQP8 overexpression group had higher tumor volume and weight, whereas the AQP8 knockdown group had lower tumor volume and weight compared with those parameters measured in the control group. CONCLUSIONS: Our results preliminary suggest that AQP8 overexpression alters the ROS/PTEN/AKT signaling pathway, promoting the proliferation, migration, and invasion of gliomas. Therefore, AQP8 may be a potential therapeutic target in gliomas.

Optical Fibers Embedded with As-Grown Carbon Nanotubes for Ultrahigh Nonlinear Optical Responses.

Photonic crystal fiber (PCF) embedded with functional materials has demonstrated diverse applications ranging from ultrafast lasers, optical communication to chemical sensors. Many efforts have been made to fabricating carbon nanotube (CNT) based optical fibers by ex situ transfer method; however, often suffer poor uniformity and coverage. Here, the direct growth of CNTs on the inner walls of PCFs by the chemical vapor deposition (CVD) method is reported. A two-step growth method is developed to control the narrow diameter distribution of CNTs to ensure desirable nanotube optical transitions. In the as-fabricated CNT- embedded fiber, third-harmonic generation (THG) has been enhanced by ≈15 times compared with flat CNT film on fused silica. A dual-wavelength all-fiber mode-locked ultrafast laser (≈1561 and ≈1064 nm) is further demonstrated by integrating the 1.36±0.15 nm-diameter CNTs into two kinds of photonic bandgap hollow core PCF (named HC-1550 and HC-1060) as saturable absorbers, using their S11 (≈0.7 eV) and S22 (≈1.2 eV) interband transition respectively. The fiber laser shows stable output of ≈10 mW, ≈800 fs pulse width, and ≈71 MHz repetition rate at 1561 nm wavelength. These results can enable the large-scale applications of CNTs in PCF-based optical devices.

Effects of microbial diversity loss on the stability of CO2 production and N2O emission in agricultural soils.

The relationship between biodiversity and ecosystem stability is a hot topic in ecology. However, current studies focus mainly on aboveground system with plants, little attention has been paid to belowground system with soils. In this study, we constructed three soil suspensions with varying microbial diversity (100, 10-2, 10-6) by the dilution method and inoculated separately into agricultural Mollisols and Oxisols to examine the stability (indicated by resistance and resilience) of soil CO2 production and N2O emission to copper pollution and heat stress. Results showed that the stability of CO2 production in Mollisols was not influenced by microbial diversity loss, while the resistance and resilience of N2O emission in Mollisols were significantly decreased at the 10-6 diversity. In the Oxisols, the resistance and resilience of N2O emission to copper pollution and heat stress started to decrease even at the 10-2 diversity, and the stability of CO2 production decreased at the 10-6 diversity. These results suggested that both soil types and the identity of soil functions influenced the relationship between microbial diversity and the stability of function. It was concluded that soils with ample nutrients and resistant microbial communities tend to have higher functional stability, and that the fundamental soil functions (e.g., CO2 production) are more resistant and resilient than the specific soil functions (e.g., N2O emission) in response to environmental stress.

Retrospective analysis of 217 fatal intoxication autopsy cases from 2009 to 2021: temporal trends in fatal intoxication at Tongji center for medicolegal expertise, Hubei, China.

This retrospective analysis of fatal intoxication case autopsies was performed at Tongji Center for Medicolegal Expertise in Hubei (TCMEH) from 2009 to 2021 to obtain up-to-date information on intoxication cases. The objective was to describe important data about evolving patterns in intoxication occurrences, enhance public safety policies, and assist forensic examiners and police in more efficient handling of such cases. Analyses based on sex, age, topical exposure routes, toxic agents, and mode of death were performed using 217 records of intoxication cases collected from TCMEH as a sample, and the results were compared with reports previously published (from 1999 to 2008) from this institution. Deaths from intoxications occurred at a higher rate in males than in females and were most common among individuals aged 30-39 years. The most frequent method of exposure was oral ingestion. The causative agents of deadly intoxications have changed when compared to the data from the previous 10 years. For instance, deaths from amphetamine overdoses are becoming more prevalent gradually, whereas deaths due to carbon monoxide and rodenticide intoxication have declined dramatically. In 72 cases, pesticides continued to be the most frequent intoxication cause. A total of 60.4% of the deaths were accidental exposure. Men died from accidents at a higher rate than women, although women were more likely to commit suicide. Particular focus is needed on the use of succinylcholine, cyanide, and paraquat in homicides.

(n, m) Distribution of Single-Walled Carbon Nanotubes Grown from a Non-Magnetic Palladium Catalyst.

Non-magnetic metal nanoparticles have been previously applied for the growth of single-walled carbon nanotubes (SWNTs). However, the activation mechanisms of non-magnetic metal catalysts and chirality distribution of synthesized SWNTs remain unclear. In this work, the activation mechanisms of non-magnetic metal palladium (Pd) particles supported by the magnesia carrier and thermodynamic stabilities of nucleated SWNTs with different (n, m) are evaluated by theoretical simulations. The electronic metal-support interaction between Pd and magnesia upshifts the d-band center of Pd, which promotes the chemisorption and dissociation of carbon precursor molecules on the Pd surface, making the activation of magnesia-supported non-magnetic Pd catalysts for SWNT growth possible. To verify the theoretical results, a porous magnesia supported Pd catalyst is developed for the bulk synthesis of SWNTs by chemical vapor deposition. The chirality distribution of Pd-grown SWNTs is understood by operating both Pd-SWNT interfacial formation energy and SWNT growth kinetics. This work not only helps to gain new insights into the activation of catalysts for growing SWNTs, but also extends the use of non-magnetic metal catalysts for bulk synthesis of SWNTs.

Fabrication of foxtail millet prolamin/caseinate/chitosan hydrochloride composite nanoparticles using antisolvent and pH-driven methods for curcumin delivery.

Co-assembled foxtail millet (FP)-sodium casein (NaCas) nanocomplex and NaCas coated FP nanoparticles (NPs) were produced by using pH-cycle and anti-solvent methods, respectively. Subsequently, the effects of chitosan hydrochloride (CHC) coating on the particle size, surface charge and physicochemical stability of the two different FP/NaCas nanoparticles (NPs) were evaluated. With the addition of CHC, the particle size of NaCas coated FP NPs and co-assembled FP-NaCas nanocomplex significantly increased from 128.3 nm and 69.5 nm to 183.5 nm and 113.8 nm, respectively. The stability of the two kinds of CHC coated FP-based NPs to different pH values and varying ionic strengths was different due to their different NP structures. Using different fabrication formulations, co-assembled FP-NaCas NPs entrapped curcumin in relatively hydrophilic microenvironment and showed higher curcumin retention rate in comparison with NaCas coated FP NPs in terms of long-term storage stability. The results revealed that the produced CHC coated FP/NaCas nanocomplexes could be very beneficial in entrapping and delivering bioactive substances.

Construction on the integrated management information platform of urban medical alliances and county medical communities in Hainan province / 中华医院管理杂志

In order to achieve the goal of integration, homogeneity, a net and a center of medical groups in Hainan province, Hainan province built an integrated management information platform of urban medical alliances and county medical communities based on projects such as the provincial three medical linkage information platform in February 2022. The overall architecture of the medical alliance and medical community platform was divided into system integration layer, data center layer, service layer and application layer. The service layer included four major systems: unified operation management platform, business center, performance evaluation management platform and comprehensive supervision subsystem, which was the core hub connecting the data center layer and application layer, and also was the unified operation and closed-loop management platform of the medical alliance and medical community. As of November 2022, the platform had covered 31 medical alliances or medical communities in 19 cities and counties of Hainan province, achieving information exchange, personnel interaction, resource sharing, business collaboration, and data integration among member units, narrowing the gap between urban and rural medical and health services, which had preliminarily achieved homogeneous management of the medical alliances and medical communities throughout the province, for a reference for the integrated management of medical alliances and medical communities within the regional scope of China.

Relationship between preoperative estimated glomerular filtration rate and postoperative delirium / 中华麻醉学杂志

Objective:To evaluate the relationship between preoperative estimated glomerular filtration rate (eGFR) and postoperative delirium (POD) in the patients.Methods:Six hundred and twenty-five patients, aged ≥60 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅱ, scheduled for elective total knee and hip arthroplasty under combined spinal-epidural anesthesia, were included. Peripheral blood samples were collected before surgery, and serum creatinine levels were measured by the sarcosine oxidase method, and eGFR was calculated using the MDRD equation. After successful spinal-epidural puncture, cerebrospinal fluid 2 ml was collected for determination of β-amyloid 42 (Aβ42), total tau protein (T-tau) and phosphorylated tau protein (P-tau) by enzyme-linked immunosorbent assay. The patients were divided into POD group and non-POD group (NPOD group) according to the occurrence of POD. The logistic regression analysis was used to identify the risk factors for POD, and the mediating effect of CSF biomarkers was analyzed. The receiver operating characteristic (ROC) curve was drawn to evaluate the accuracy of eGFR and biomarkers in predicting POD.Results:A total of 514 patients were finally enrolled in this study, and the incidence of POD was 16.7%. The logistic regression analysis showed that decreased eGFR and increased levels of P-tau and T-tau in CSF were risk factors for POD, while increased CSF Aβ42 level, Aβ42/P-tau ratio and Aβ42/T-tau ratio were protective factors for POD after adjusting for multiple confounding variables ( P<0.05). Analysis of mediating effet: The direct effect of eGFR on POD was -0.0 005 267, the total effect was 0.0 046 446, T-tau had a partly mediating role and the mediating effect accounted for 11.3% of the total effect. The area under the ROC curve of eGFR and CSF biomarker in predicting POD was 0.812( P<0.001). Conclusions:Preoperative decrease in eGFR is a risk factor for POD, and T-tau in CSF serves as a key mediator in the relationship between eGFR and POD.

Inhibitory effect of specnuezhenide on high glucose-induced human retinal microvascular endothelial cell injury and its mechanism / 中华实验眼科杂志

Objective:To investigate the effect of specnuezhenide on high glucose-induced human retinal microvascular endothelial cells (hRMECs) injury and its mechanism.Methods:The hRMECs were divided into a normal control group cultured in a culture medium containing 5.5 mmol/L glucose, a hypertonic group cultured in a culture medium containing 5.5 mmol/L glucose + 24.5 mmol/L mannitol, a high glucose group cultured in a culture medium containing 30 mmol/L glucose, as well as high glucose+ low-, medium-, and high-dose specnuezhenide groups cultured in culture media containing 30 mmol/L glucose + 25, 50, 100 μmol/L specnuezhenide for 24 hours, respectively.In addition, hRMECs were divided into a high glucose+ small interfering RNA-negative control (si-NC) group cultured in a culture medium containing 30 mmol/L glucose, a high glucose+ si-forkhead box O4 (FOXO4) group cultured in a culture medium containing 30 mmol/L glucose, a high glucose+ specnuezhenide+ pcDNA group cultured in a culture medium containing 100 μmol/L specnuezhenide + 30 mmol/L glucose, and a high glucose+ specnuezhenide+ pcDNA-FOXO4 group cultured in a culture medium containing 100 μmol/L specnuezhenide+ 30 mmol/L glucose for 24 hours after transfection by corresponding reagents.Cell apoptosis was detected by flow cytometry.The malondialdehyde (MDA) concentration and superoxide dismutase (SOD) activity in cells were detected by the thiobarbituric acid method and xanthine oxidase method, respectively.The concentrations of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in the cell culture supernatant were detected by enzyme linked immunosorbent assay.The relative expression level of FOXO4 protein in cells was determined by Western blot.Results:The apoptosis rates of normal control group, hypertonic group, high glucose group, high glucose+ low-, medium- and high-dose specnuezhenide groups were (7.32±0.72)%, (7.44±0.70)%, (23.96±1.32)%, (19.84±1.09)%, (14.13±0.85)% and (9.84±0.70)%, respectively.There were significant differences in cell apoptosis rate, MDA concentration, SOD activity, the concentration of IL-1β, the concentration of TNF-α, and the relative expression level of FOXO4 protein among the six groups ( F=498.545, 1 186.693, 516.629, 654.247, 638.238, 472.655; all at P<0.001). Compared with high glucose group, the apoptosis rate, MDA concentration, IL-1β and TNF-α concentration, FOXO4 protein expression level were significantly decreased in high glucose+ low-, medium- and high-dose specnuezhenide groups, and SOD activity was significantly increased in a dose-dependent manner.Compared with high glucose+ si-NC group, the expression level of FOXO4 protein, cell apoptosis rate, MDA concentration, IL-1β and TNF-α mass concentrations were decreased in high glucose + si-FOXO4 group, while the SOD activity was increased.Compared with high glucose+ specnuezhenide+ pcDNA group, the apoptosis rate, MDA concentration, IL-1β and TNF-α concentrations, FOXO4 protein expression level of hRMECs in high glucose+ specnuezhenide+ pcDNA-FOXO4 group were significantly increased, and SOD activity was significantly decreased (all at P<0.05). Conclusions:Specnuezhenide can protect hRMECs from high glucose-induced apoptosis, oxidative stress and inflammatory response by down-regulating FOXO4.

Study on the influencing factors of emergency care nurses′ perceived self-competence in palliative care based on dominance analysis / 中国实用护理杂志

Objective:To explore the relative importance of palliative care knowledge, attitude towards palliative care and healthy work environment of emergency care nurses in predicting perceived self-competence in palliative care based on dominance analysis, and to provide empirical evidence for formulating the optimal training course to improve perceived self-competence in palliative care.Methods:Totally 415 emergency care nurses from 22 tertiary hospitals in Hubei province were conducted a cross-sectional survey to complete the general information questionnaire, the Palliative Care Nursing Self-Competence Scale, the Hospice Knowledge Quiz for Nurses, the Frommelt Attitudes Toward Care of the Dying Scale Form B, and the American Association of Critical Care Nurses Healthy Work Environment Assessment Tool from January to March 2021 using convenient sampling method. Dominance analysis was used for statistical analysis.Results:The total score of perceived self-competence in palliative care of 415 emergency care nurses was (225.48 ± 60.61) points, the total score of palliative care knowledge was (12.44 ± 3.83) points, the total score of palliative care attitude was (97.35 ± 9.07) points and the total score of healthy work environment was (72.00 ± 11.99) points. Perceived self-competence in palliative care was positively associated with palliative care knowledge ( r=0.181, P < 0.01), attitude towards palliative care ( r=0.232, P<0.01) and healthy work environment ( r=0.393, P<0.01). Dominance analysis revealed that the healthy work environment, palliative care attitude and palliative care knowledge accounted for 74.15%, 14.97% and 10.88% of the variance of perceived self-competence in palliative care, respectively. Conclusions:The largest degree of prediction for emergency care nurses′ perceived self-competence in palliative care is healthy work environment, attitude next and the third is knowledge. It suggests that promoting a healthy work environment is an important way to improve nurses′ perceived self-competence in palliative care, and improving knowledge level and cultivating positive attitudes also will be better.

Study on the medication law and mechanism of treatment of lumbar disc herniation by national Traditional Chinese Medicine master Liu Bailing based on data mining and network pharmacology / 国际中医中药杂志

Objective:To explore the core prescriptions and mechanism of national TCM master Liu Bailing in the treatment of lumbar disc herniation (LDH) based on data mining and network pharmacology methods; To provide the clinical reference for the treatment of LDH.Methods:The cases of LDH treated by Professor Liu in Affiliated Hospital of Changchun University of Chinese Medicine, from January 1, 2011 to December 31, 2019 were collected and analyzed. Hierarchical clustering and association rules were used to analyze the medication rules and core prescriptions. TCMSP, GeneCards, ETCM, SymMap, DAVID, etc. were used to analyze the network pharmacology of the core compounds in treating LDH and symptoms, and reveal the mechanism.Results:A total of 1 334 prescriptions were included, involving 201 kinds of Chinese materia medica, among which the medicinal property was mainly warm, the flavor was mainly sweet and the meridians were mainly liver meridian and kidney meridian; the core medicines for the treatment of LDH included Aconiti Lateralis Radix Praeparata, Spatholobi Caulis, Cinnamomi Cortex, Corydalis Rhizoma, Eucommiae Cortex, Paederia Foetida and Amomi Fructus, reflecting that Professor Liu Bailing often treats LDH from the perspective of kidney deficiency, and commonly uses the treatment methods of dispelling wind, relieving pain, warming yang and benefiting the kidney. The core prescriptions mainly participated in three pathways of cancer, immunity and cell metabolism, including PI3K-Akt signaling pathway, TNF signaling pathway and FoxO signaling pathway. Conclusion:Professor Liu Bailing's treatment of LDH focuses on overall dialectical treatment, which mainly dispels wind, relieves pain, warms yang and benefits the kidney and the mechanism of the core prescriptions may lie in diminishing the inflammatory response. The core prescriptions may treat LDH by regulating the immune response and cellular physiological functions.