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Travelers are known to convey infectious diseases across international borders. After its experience with SARS, Taiwan established a comprehensive mechanism at its border to prevent the entry of infectious diseases. However, people with chronic infectious diseases, carriers with no symptoms, and those likely to be infected are not easy to identify during border screenings. Therefore, Taiwan must implement internal disease-containment measures in addition to stopping infectious disease at its borders. With increasing numbers of patients coming to Taiwan for medical examinations, medical aesthetic treatments, and medical treatments and care, the risk of acute, chronic, and contagious diseases originating from non-residents must be considered and addressed. This article was developed to discuss the role and importance of nurses in preventing transnational infectious diseases from the perspective of international medical care. In addition to showing rich nursing experience, sensitivity, and conducting the management and communication of international cases, it is also necessary to make good use of information tools for remote screening care. Taking the period of the COVID-19 outbreak as an example, several procedures have been conducted. First, online detailed history of infectious diseases and nursing evaluations are conducted before admission. Second, preparation and movement notifications are given before admission. Third, online health education and follow-up care as well as cross-unit communication and coordination are implemented. International medical nurses directly affect the quality and effectiveness of international medical treatment. As Taiwan builds up its brand as an international medical caring destination, nursing professionals should help further this trend and announce to the world: Taiwan can help! Nursing can help!

Objective: To explore the role of NF-E2-related factor 2(Nrf2) and its related factors in the progression of nonalcoholi steatohepatitis (NASH) by investigating the alterations of lipid metabolism and liver histopathology as well as the changes of mRNA and protein expression levels of Nrf2 and its related factors in rats during NASH progression., Methods: Male SD rats were randomly divided into normal group and model group, which were administrated with high fat diet to establish nonalcoholic steatohepatitis model. The rats from both groups were randomly killed at the end of 4, 12 weeks respectively. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were detected in the serum and liver tissue; Changes in fat deposition in liver tissue were determined by oil red O staining. HE staining were used to observe the pathological changes of liver tissue and to calculate nonalcoholic fatty liver disease (NAFLD) activity score (hepatic steatosis, inflammation and ballooning degeneration of liver cells). The expression of Nrf2 in liver was detected by immunohistochemical staining. The mRNA and protein levels of Nrf2 and related factors in liver were determined by Realtime PCR and Western blot, respectively., Results: After 4 weeks of high fat diet, the levels of ALT, AST, TC in rat serum and TC, TG, LDL-C in liver were significantly increased compared with that of the normal group (P < 0.01, P < 0.05). After 4 weeks of high fat diet, the levels of ALT, AST, TC, TG in serum and TC, TG, LDL- C in liver increased further (P < 0.01, P < 0.05). Until the 12th week, the content of HDL-C in liver was significantly lower than that of the normal group (P < 0.05). At the end of the 4th or the 12th week, lipid droplets in the model rat liver cells were heavily dyed red and hepatic steatosis increased severely, with ballooning degeneration of liver cells. With the extension of high fat diet feeding time, fat deposition in the liver tissue, hepatic steatosis, NAFLD score, Nrl2 expression were significantly increased (P < 0.01). Expression levels of mRNA and protein of Nrf2, heme oxyenase 1(HO1), NADPH quinone oxidoreductase 1(NQO1), γ-glutamylcysteine synthethase (γ-GCS), glutathione S-transferase (GST) in the model rats increased or decreased at the end of the 4th or the 12th week differentially, (P < 0.01, P < 0.05) with the more significant changes at the end of the 4th week than the 12th week., Conclusion: Nrf2 and its related factors may be involved in the occurrence and development of nonalcoholic fatty liver disease, which may play an important role in the process of NASH formation.

Identifying and clarifying how stream fish assemblage patterns vary spatially and temporally are basic measures for the conservation and management of fish species. Based on data collected from 24 wadeable reaches within the Qiupu Headwaters National Wetland Park between May and October 2012, we examined the spatial and temporal patterns of the assemblage structures and diversities, collecting a total of 29 fish species belonging to four orders and ten families. The results of our survey showed influences of local habitat and tributary spatial position variables on fish assemblages. Fish diversity showed significant variations across stream-orders and seasons, which were higher in the second-order streams than in first-order streams and higher in October than in May. Habitat factors such as substrate coarseness and heterogeneity, water temperature and water depth, as well as tributary position factor-link, showed significant effects on fish diversity. Fish assemblages fitted the nested pattern that upstream assemblages presented as a nested subset of downstream assemblages. Fish assemblage structures did not vary significantly across seasons but did across stream-orders; fish assemblages between first- and second-order streams showed significant differences despite some overlap. These spatial differences mainly resulted from spatial variations of the relative abundance of Cobitis rarus, Ctenogobius sp., Zacco platypus, Phoxinus oxycephalus, Rhodeus ocellatus and Vanmanenia stenosoma, among which P. oxycephalus had higher abundance in first-order than in second-order streams but the other five species were more abundant in second-order streams. Fish assemblage structures were significantly related to substrate heterogeneity, water depth, stream order, link and C-link.

Objective: To study and discuss the effect and mechanism of Hirsutella sinensis mycelium (HSM) on idiopathic pulmonary fibrosis in rats., Method: Forty Wistar rats were divided into five groups: the normal control group, the model control group, the high-dose group (1.0 g x kg(-1) HSM), the low-dose group (0.5 g x kg(-1) HSM), and the positive control group (10 mg x kg(-1) hydrocortisone). In addition to rats in the normal control group, the pulmonary fibrosis model was established by injecting 5 mg x kg(-1) bleomycin into rat tracheas for consecutively 28 days, in order to observe their lung function, lung tissue hydroxyproline, cytokines and pathology., Result: After rats were administered with HSM, 0.5 g x kg(-1) and 1.0 g x kg(-1) HSM could significantly decrease lung index and hydroxyproline content (P<0.01), while notably improving pulmonary function, alveolus inflammation and fibrosis degree (P<0.05, P<0.01); 1.0 g x kg(-1) HSM could decrease significantly protein expressions of TNF-alpha, IL-1beta and TGF-beta1 in lung tissues, while increasing significantly protein expressions of IFN-gamma (P<0.05)., Conclusion: HSM have better effect in treating idiopathic pulmonary fibrosis in rats. Its treatment effect and mechanism are related to the regulation of TNF-alpha, IL-1beta and TGF-beta1 and IFN-gamma imbalance.

Objective: To investigate the effect of milk and milk products on morphological structure and epidermal growth factor (EGF) of non-steroidal anti-inflammatory drugs (NSAIDs) induced small intestinal damage in animals., Methods: Eighty male SD rats were randomly divided into 5 groups: control group, diclofenac group, diclofenac with 10% low fat milk group, diclofenac with 10% colostrum group and diclofenac with yoghurt group. The animals with milk or colostrum or yoghurt were fed for 5 days before the administration of diclofenac with 15 mg/kg by gavage, once. Then they were observed the scores of anatomical lesion and the scores of tissue damage of mucous membrane and the height of villous at the 24(th) and 48(th) hour after making the models. Observation of the change of ultrastructural organization of mucous membrane was carried out with transmission and scanning electron microscope and immunohistochemistry of EGF., Results: The scores of anatomical lesion and tissue damage of mucous membrane of the colostrum group were lower than those of the diclofenac group (P < 0.05). The heights of the pile on small intestine of the 24(th) and 48(th)hour of the colostrum group were (145.7 ± 16.5) µm and (139.2 ± 19.0) µm, respectively. They were higher than those of the diclofenac group [(119.2 ± 19.2) µm and (105.4 ± 18.4) µm, P < 0.05]. However there was no difference of the scores and the height among diclofenac group, milk group and yoghurt group. TEM and SEM of tissues showed that the cytoplasmic membrane and other cellular components of villous epithelial cells were well preserved in colostrum group, and the microvilli in the milk group and yoghurt group were ablated more obviously. The positive area of EGF of small intestine [(6170.5 ± 1483.9) µm(2)] were higher 48 h after administration of diclofenac compared with the diclofenac group (P < 0.05). The expression of EGF in milk and yoghurt group were no significant statistical difference with the diclofenac group., Conclusion: Bovine colostrum may have a beneficial effect in prevention of NSAIDs induced small intestinal injuries and preserve mechanical barrier of small intestinal mucosa which is probably relative to EGF.

Objective: To investigate the effect of valsartan and fluvastatin on the expression of connective tissue growth factor in early diabetic cardiomyopathy., Methods: Forty male SD rats were randomly divided into five groups: normal control group, diabetic model (DM) group, DM + valsartan group (30 mg x kg(-1) x d(-1)), DM + fluvastatin group (4 mg x kg(-1) x d(-1) ) and DM + valsartan + fluvastatin group (valsartan 30 mg x kg(-1) x d(-1) + fluvastatin 4 mg x kg(-1) x d(-1)). After 12 weeks, miniature cardiac catheter was inserted into the left ventricle to conduct hemodynamic examination. Then myocardial tissue was collected and collagen content was detected with Van-Gieson staining. The levels of connective tissue growth factor (CTGF) mRNA expression in myocardium were determined using RT-PCR and Western blot was used to detect the protein expression of transforming growth factor (TGF) beta, CTGF, collagen I and III., Results: By the end of the experiment, left ventricular diastolic function was significantly decreased in the DM group in comparison with the control group (P < 0.05). As compared with the normal control group, myocardial collagen content was significantly increased 1.1 fold (P < 0.05), and the heart weight/body weight ratio was increased 37% in the DM group, but it was significantly reduced in the valsartan group and the fluvastatin group in comparison with the DM group (both P < 0.05). The mRNA expression of CTGF was significantly higher in the DM group than in the control group, but it was significantly lower in the valsartan group and fluvastatin group than that in the DM group (both P < 0.05). The values of protein expression of CTGF, TGFbeta, collagen I and III were all significantly higher in the DM group than those in the control group (all P < 0.05). The protein expression of CTGF, TGFbeta, collagen I and III in the valsartan group and fluvastatin group was all significantly lower than that in the DM group (P < 0.05). It was shown that treatment with valsartan or fluvastatin was effective for myocardial fibrosis in diabetic SD rats and valsartan combined with fluvastatin would be still better., Conclusion: Valsartan and fluvastatin can reduce myocardial fibrosis, resulting in prevention of left ventricular remodeling and improvement of cardiac function in an experimental model of diabetic cardiomyopathy. The process was related to the inhibition of the overexpression of CTGF and TGFbeta and reduction in cardiac extracellular matrix collagen content. It is also shown that a better result may be obtained with the coadministration of the two drugs than using one alone.

Objective: To approach the effect on mechanical barricade of the mucous membrane of small intestine caused by non-steroidal anti-inflammatory drugs (NSAIDs)., Methods: Thirty-two male SD rats were randomly divided into control group and model group. The rats of the model group were given 7.5 mg/kg diclofenac by gavage, bid; the rats of the control group were given the same dose of saline. Then they were further randomly divided into two subgroups (n=8) at the first day and the fifth day after making the models to observe the scores of anatomical lesion on stomach and small intestine and the scores of tissue damage of mucous membrane and to quantitatively analyze the height of villi, as well as the thickness and the section area of mucous membrane with Carl Zeiss Imaging Systems. Observation of the change of ultrastructural organization of mucous membrane was carried out with transmission electron microscope., Results: The mucous membrane of stomach of the model groups was slightly edematous. There was no difference between the scores of the model groups and control groups. It was seen that the mucous membrane of small intestine of the first day model group presented with erythema, amaurosis and ulcer. The ulcer was distributed along mesentery. The mucous membrane of small intestine of the fifth day model group showed bleeding, perforation and sinus tract formation, and the scores of anatomical lesion was higher than that of the control group (P < 0.05). The scores of the lesions of the first and fifth day model groups were 3.5 and 5.0. The difference had statistical significance when compared with those of the control groups (the scores were 0) (P < 0.05). Cell degeneration and cellular necrosis of epithelial mucosa of small intestine was also seen in the first day model group. The top of villi was ablated. The height of the pile on jejunum was (126.9 +/- 32.0) microm and that on ileum was (118.6 +/- 22.9) microm. They were lower than those of the control group (P < 0.05). However there was no difference of the thickness and section area between them, but the thickness and section area showed a tendency of decrease. It was also seen that there were apomorphosis and sphacelism of epithelial cells in the fifth day model group. Some villi were ablated and laminae propria exposed. The height of villi on jejunum [(73.4 +/- 25.4) microm] and that on ileum [(109.3 +/- 17.6) microm] decreased significantly. The thickness of mucous membrane [(123.8 +/- 51.6) microm and (165.7 +/- 37.4) microm] decreased and the section area [(2.48 +/- 1.01) mm2 and (3.27 +/- 0.76) mm2] became smaller (P < 0.05 vs. control group). The mucous membrane of the villi on small intestine was continuous but arranged disorderly. Cytochondriome swelled, endocytoplasmic reticulin expanded with different degrees, intercellular junction widened partly. The microvilli in the fifth day model group were ablated more obviously and intercellular junctions were broken and destroyed gravely., Conclusions: Diclofenac can cause damage to the function of mucous membrane barricade of small intestine. It could also lead to shortening of the villi, thinning of the mucous membrane, ablation of the microvilli, and widening of the tight intercellular junction as the characteristic morphological change.