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Long-term exposure to ultraviolet (UV) radiation induces skin photoaging, which manifests as oxidative stress, inflammation, and collagen degradation. Multiple approaches (topical or systemic retinoids, antioxidants, alpha-hydroxy acids, laser, surgery) are used in the treatment of photoaged skin, and the use of topical retinoids is currently a primary clinical treatment. Previous studies revealed that retinoic acid promotes keratinocyte proliferation and reduces melanin deposition and matrix metalloproteinase (MMP) secretion; it also causes potential allergic and inflammatory damage to the skin. This study aimed to investigate the therapeutic effects and mechanisms of trifarotene, a functional retinoic acid analog, on UV-irradiated photoaging ICR and BALB/c nude mice and UVB photodamaged human epidermal keratinocyte (HaCaT) cells by examining indicators such as collagen, oxidoreductase, and inflammatory factor presence through histochemical staining, Western blot, and ELISA. Results suggested that trifarotene significantly reduced UV-induced photoaging in mouse skin tissue, potentially by reducing oxidative stress damage and inflammatory factor release, and inhibiting melanin deposition and collagen degradation by downregulating MMP expression. Concentrations of malondialdehyde, tyrosinase, interleukin-6, interleukin- 12, and tumor necrosis factor-alpha in photoaged skin decreased, while SOD content in photodamaged HaCaT cells significantly increased. Trifarotene (3.3 μmol L–1) inhibited phosphorylated JNK and c-Jun expression both independently and collaboratively with the JNK activator anisomycin, demonstrating that trifarotene mitigates UV-induced collagen degradation and apoptosis through inhibition of the JNK/c-Jun/MMPs signaling pathway.

PurposeTo explore the inter-regional health index at the city level to contribute to the reduction of health inequalities.MethodsEmployed the health determinant model to select indicators for the urban health index of Shenzhen City. Utilized principal component analysis, the weights of these indicators are determined to construct the said health index. Subsequently, the global Moran’s index and local Moran’s index are utilized to investigate the geographical spatial distribution of the urban health index across various administrative districts within Shenzhen.ResultsThe level of urban health index in Shenzhen exhibits spatial clustering and demonstrates a positive spatial correlation (2017, Moran’s I = 0.237; 2019, Moran’s I = 0.226; 2021, Moran’s I = 0.217). However, it is noted that this clustering displays a relatively low probability (90% confidence interval). Over the period from 2017 to 2019, this spatial clustering gradually diminishes, suggesting a narrowing of health inequality within economically developed urban areas.ConclusionOur study reveals the urban health index in a relatively high-income (Shenzhen) in a developing country. Certain spatially correlated areas in Shenzhen present opportunities for the government to address health disparities through regional connectivity.

In order to meet the demand for accurate identification of distant targets by improving the resolution of multi-scale imaging systems, from primary lenses focus, a design scheme of a multi-scale long-focal imaging system based on the Tessar primary lenses is proposed in this paper. Two constraints that need to be added to the primary lenses for meeting the linear arrangement of secondary lenses are analyzed. In response to the problem of the imaging quali-ty degradation of the system as the off-axis angle of the secondary lenses array increases, synergy optimization is applied to the secondary lenses in adjacent areas. Additionally, free-form surface types are used to correct aberrations in the off-axis position optimization of the secondary lenses. The MTF curves of different field-of-view areas are consistent, showing that the system achieves ideal imaging quality across the full field of view. The spatial resolution of the multi-scale imaging system designed using the Tessar primary lenses structure is 14 μrad. Compared to multi-scale systems based on concentric spherical lenses, it is significantly higher.

This article summarizes the nursing experience of a patient with nausea and vomiting after paclitaxel liposome chemotherapy treated by acupoint injection therapy combined with intravenous administration of antiemetic drugs. Comprehensive nursing interventions on hospitalization environment, dietary and emotion of the patient were carried out. Based on the Traditional Chinese Medicine meridian theory, Zusanli acupoint injection of metoclopramide combined with intravenous drips of ondansetron was administrated to relieve the nausea and vomiting symptoms and improve the gastrointestinal function of the patient during chemotherapy. (本文总结穴位注射疗法联合静脉滴注止吐药治疗1例紫杉醇脂质体化疗后患者恶心呕吐的护理经验。基于中医经络学说理论, 在环境护理、饮食护理、情志护理等常规基础上, 采用足三里穴位注射甲氧氯普胺联合静脉滴注昂丹司琼镇吐止呕, 快速缓解患者恶心呕吐症状, 改善患者胃肠功能。)

Photovoltaic power generation and photothermal power generation are two forms of solar power generation. The development cost of photovoltaic is relatively lower than photothermal, but a certain proportion of energy storage and distributed synchronous condensers are needed to ensure the safe and stable operation of the system. As a result the cost of photovoltaic power generation rises. Photothermal comes with heat storage and output friendliness, so currently there is still a great dispute about the technical route of photovoltaic and photothermal. This paper takes Haixi area of Qinghai province as an example. Firstly, based on the characteristics of solar irradiation resources and output in the same time and space, the power guarantee capabilities of photovoltaic+energy storage and photothermal is compared. Then this paper compares photovoltaic+energy storage+condenser with photothermal from the perspective of power grid security and stability support ability. Finally, this paper compares the economics of solar thermal and photovoltaic based on the forecast of their cost declining trend. Photothermal has both thermal storage and conventional generator functions, providing short circuit capacity, reactive power compensation and moment of inertia support for the system. The results show the economy of photothermal is basically equivalent to, or even better than photovoltaic+energy storage+condenser after the cost reduction in the case of technical equivalence.

For the traditional low voltage ride through control under asymmetrical faults, due to the limited control degrees of freedom, the grid-connected inverter control suffers from the problem of not being able to simultaneously realize the output current negative-sequence component suppression and the DC side voltage double-frequency fluctuation suppression. In this regard, a multiple-objective decoupling control strategy is proposed for low voltage ride through of two-stage grid-connected photovoltaic system under asymmetrical faults. The strategy sets the control objective of the inverter as the negative-sequence component suppression of the output current and gives a reference value calculation method for the inner current loop considering the inverter output current limit and reactive power output demand. The super-capacitor is connected to both ends of the DC bus capacitor through the bidirectional Buck-Boost converter to maintain its voltage stability, and the DC side voltage double-frequency fluctuation is transferred to the super-capacitor side. The simulation results show that under the proposed control strategy, the unbalance between three phases of the inverter is reduced and the output current distortion is improved. The double frequency fluctuation of the DC side voltage is reduced significantly compared with the traditional control method.

At present,the research on UAV air combat mainly considers the fully autonomous decision-making maneuver algorithm of UAV,and the research on the air combat maneuver decision-making under the limited supervision decision of UAV is rare,let alone the research on manned aerial vehicle and unmanned aerial vehicle (MAVUAV) cooperative combat. In order to realize the autonomous maneuver of UAV in the process of cooperative air combat,a maneuver decision model for MAV-UAV cooperative air combat is designed on the basis of path planning technology. First,the dynamic grid environment is introduced to adaptively adjust the grid scale and resolution,so as to make up for the defect that,the larger the static grid environment planning space is,the lower the planning efficiency will be. Then,by taking the path planned using A star algorithm as the reference path,the ACO-A star hybrid path planning algorithm is proposed to improve the optimization efficiency of ACO algorithm.Finally,based on the mean clustering algorithm,a maneuver decision algorithm for MAV-UAV cooperative air combat is designed. The air combat simulation result shows that the proposed model has better decision correctness and can effectively improve the air combat victory rate.

Abstract Aim To understand the real experience of family members of patients in neurosurgical intensive care unit (NICU) during intra‐hospital transport (IHT), explore their inner needs and provide effective intervention measures for the construction of standardized IHT plan. Design A descriptive qualitative study. Methods For the purposes of this study, 10 family members of IHT patients were included using a purposive sampling method. Semi‐structured in‐depth interviews were used to collect the data, Nvivo 11 software was used to organize the data, and Colaizzi's 7‐step descriptive phenomenology method was used to analyse the data. Results A total of three themes and nine subthemes were extracted, namely: Experience of emotional changes at different stages (uncertainty before transfer, complex internal activity during transit, ambivalence after transfer); Perception of problems in IHT (poor doctor–patient communication, weak awareness of risk assessment, deficiencies in the transfer procedure); Consciousness of the real needs (emotional respect and closeness, stay informed of the progression of the disease, greater social support). Conclusion Family members of patients in the NICU have complex internal experiences and multiple support needs during IHT, reflecting the need for further standardization of the transport process. In the future, we should improve the mode of safe IHT involving doctors, nurses and family members of patients, ensure the safety of patient transport, meet the social support needs of family members and improve the experience of IHT and the medical satisfaction of family members.

The gut microbiota and microbial metabolites influence the enteric nervous system and the central nervous system via the microbial–gut–brain axis. Increasing body of evidence suggests that disturbances in the metabolism of peripheral branched-chain amino acids (BCAAs) can contribute to the development of neurodegenerative diseases through neuroinflammatory signaling. Preliminary research has shown that longitudinal changes in serum amino acid levels in mouse models of Parkinson’s disease (PD) are negatively correlated with disease progression. Therefore, the aim of the present study was to determine the changes in serum levels of short-chain fatty acids (SCFAs) in a mouse model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD after dietary BCAA supplementation. In our research, gas chromatography–mass spectrometry was used to detect serum SCFA concentrations. The data were then analyzed with principal component analysis and orthogonal partial least squares discriminant analysis. Finally, the correlations of serum SCFA levels with gut and motor function in MPTP-induced PD mice were explored. Propionic acid, acetic acid, butyric acid, and isobutyric acid concentrations were elevated in MPTP + H-BCAA mice compared with MPTP mice. Propionic acid concentration was increased the most, while the isovaleric acid concentration was decreased. Propionic acid concentration was positively correlated with fecal weight and water content and negatively correlated with the pole-climbing duration. In conclusion, these results not only suggest that propionic acid may be a potential biomarker for PD, but also indicate the possibility that PD may be treated by altering circulating levels of SCFA.

The mechanism of extracellular matrix metalloproteinase inducer (EMMPRIN) in the regulation of liver fibrosis has not been clarified. This study aims to investigate the role of EMMPRIN S-nitrosylation (SNO) in the regulation of hepatic stellate cell (HSC) migration and matrix metalloproteinase (MMP) activities in liver fibrosis. The results from the tissue microarrays and rat/mouse liver tissues suggest that EMMPRIN mRNA and protein levels in the fibrotic livers are lower than those in the corresponding normal control livers, but higher SNO level of EMMPRIN in fibrotic liver area was shown by immunohistochemistry, immunofluorescence staining, and biotin-switch assay conversely in vivo. Primary EMMPRIN comes from hepatocytes and liver sinus epithelial cells (LSECs) rather than quiescent HSCs. To mimic the uptake of extrinsic EMMPRIN, supernatants from mouse primary hepatocytes/293 cells transfected with EMMPRIN wild-type plasmids (WT) and EMMPRIN SNO site (cysteine 87) mutation plasmids (MUT) were collected and added to JS-1/LX2 cell medium. The MUT EMMPRIN diminishes SNO successfully, enhances the activities of MMP2 and MMP9, and subsequently increases HSC migration. In conclusion, SNO of EMMPRIN influences HSC migration and MMP activities in liver fibrosis. This finding may shed light on the possible regulatory mechanism of MMPs in ECM accumulation in liver fibrosis.

In the high-power IGBT module commutation circuit, under the combined impact of stray inductance and di/dt, the IGBT is under significant voltage and current stresses during the processes of switching on and off, which increases system losses and electromagnetic interference, lowers system reliability, and seriously affects the safe and stable operation of the system. Due to the lack of accurate and universal IGBT models, traditional analytic methods require continuous experimental tests and analyses to optimize design for different commutation circuits and schemes. They are not only costly and time-consuming, but also inefficient. Based on the analysis of the influence of stray inductance in commutation circuit on the switching characteristics of IGBT, this paper uses the Voltammetry method to extract the stray inductance. According to the IGBT data manual, parametric modeling of IGBT is achieved through data import and curve fitting methods, and the simulation comparison of the established parametric model verifies the effectiveness of the stray inductance extraction method and the accuracy of the established parametric model. The comparison between the prototype test and simulation test shows that the voltages of the two are basically consistent, and the error between the experimental and simulated values of the voltage spike of the lower device is just 4V, which indicates good consistency. The findings are of great help to the simulation analysis of complex circuits, and data prediction and method guidance in future experiments, and valuable for the fault reproduction, failure analysis and design optimization of high-power IGBT modules.

This article summarizes the experience of Traditional Chinese Medicine(TCM) nursing appropriate techniques for a diabetic patient with back carbuncle treated with vacuum sealing drainage (VSD) technology. Efforts have been made to enhance the continuous vacuum sealing drainage. Based on the TCM theory, nursing appropriate techniques such as auricular acupoint pressing, intradermal needling, TCM oral care, TCM five-tone therapy were carried out for management of blood pressure and diabetes mellitus, reduce the incidence the infection and improve the wound healing. (本文总结1例负压封闭引流技术(VSD)联合中医适宜护理操作技术治疗糖尿病合并背部外痈患者的护理经验。术前做好充分准备, 术后做好VSD持续引流的观察与护理。基于中医基础理论, 采用耳穴刺激、皮内针刺激、中药漱口液清洁口腔、中医五音疗法等中医护理适宜技术, 有效控制高血压、糖尿病等基础疾病, 降低感染风险, 促进创面的愈合。)

ObjectiveTo observe the effect and the patient acceptance of oral lactulose in bowel preparation before colonoscopy diagnosis and treatment. MethodsA total of 560 patients, who were scheduled to undergo colonoscopy for diagnosis and treatment in Anorectal Center of Nanjing Hospital of TCM from May 2021 to May 2022 were selected as research subjects and were randomly divided into observation group(n=289) and control group(n=271). Lactulose plus drinking water （1 500mL） and compound polyethylene glycol electrolyte plus drinking water （4000mL） were taken orally, respectively in observation group and control group. The basic information, intestinal cleanliness, acceptance of medication, foam formation, pathological changes and adverse reactions were observed and compared between two groups. ResultsThere were no significant differences in Boston score, bubble size and detection rate of colorectal polyps between two groups （P＞0.05）. In observation group, the patient acceptance for preparation medication doses was higher than that in control group(P＜0.05), the incidence of nausea and vomiting was significantly lower than that in control group(P＜0.05), and the incidence of dry mouth and fatigue was higher than that in control group （28.37%vs3.69%, χ2=7.862, P＜0.05； 10.73%vs3.32%, χ2=3.275, P＜0.05）. There was no significant differences in terms of abdominal distension, abdominal pain, dizziness and headache between two groups （P＞0.05）. ConclusionLactulose oral solution is safe, reliable and effective, with few adverse reactions and good patient acceptance in intestinal preparation before colonoscopy diagnosis and treatment.

Driven by the carbon peaking and carbon neutrality goals, the power system is transforming to the new structure which is dominated by renewable energy and is facing a new supply-demand balance situation. Pumped storage, as the most mature energy storage technology at present, can provide flexible resources with different time scales to ensure the safety of the power system and promote the consumption of renewable energy. However, the operation strategy and cost sharing mechanism of the pumped storage station (PSS) are not clear, which hinders its further development under the new situation. In this context, the technical characteristics and functions of PSS are sorted out first. Then, the investment cost model is established from the perspective of the whole life cycle. After that, the evolution path of pricing mechanism and cost sharing mode are described in view of the different stages of electricity market development, providing a feasible scheme for the marketization of PSS. Finally, the future development of PSS is summarized and prospected.

The rapid development of information technology and mobile Internet technology has brought about innovations in the field of education. The application of financial statement automation analysis methods in the teaching of accounting majors in higher vocational colleges and universities is conducive to improving the quality of the training of accounting talents in higher vocational colleges and universities so as to accelerate the construction of the modern accounting industry college. This study proposes the application of relevant deep learning techniques in the process of automated analysis of financial statements in terms of recognition and analysis, such as text detection based on CTPN and text recognition technology based on CRNN-Attention, which makes the processing of financial statements more automated and intelligent. It is also proposed to utilize the K-means algorithm to perform cluster analysis on the model output to extract the financial status of the company. To evaluate the model’s performance, several financial statement images of 12 companies are sampled for example analysis. The experimental data shows that the model has a high percentage of image skew correction, e.g., the ratio of image skew correction for the income statement and cash flow statement is 100%. The recognition speed of the model is also faster, with the consumption time of the profit and loss statement recognition task being around 0.3 seconds in 20 tests. In the financial statement analysis session, each of the three clusters of companies under the K-means algorithm clustering has its characteristics, with the first cluster of companies having a stronger quality of earnings, the third cluster of companies having outstanding profitability, and the second cluster of companies having average indicator data.

Objective To observe the therapeutic effect of acupoint application therapy combined with moxibustion on postoperative constipation in patients with thoracolumbar compression fracture. Methods Totally 100 patients with constipation after surgery for thoracolumbar compression fracture were randomly divided into two groups. The control group (n=50) was given routine guidance and nursing measures, and the experimental group (n=50) was given Traditional Chinese Medicine acupoint application combined with moxibustion treatment based on routine care. The clinical efficacy and anxiety status by Visual Analogue Scale (VAS) of the two groups were compared. Results The overall effective rate in the experimental group was higher than that in the control group (90. 00% vs. 82. 00%, P＜0. 05 ). The SAS score decreased in both two groups after intervention, and SAS score in the experimental group was lower than that in the control group (P＜0. 05 ). Conclusion Acupoint application combined with moxibustion is effective to relieve the postoperative abdominal distension, constipation and other symptoms after surgical treatment for thoracolumbar compression fracture. It is safe, effective, convenient and worthy of clinical application. (目的 探讨艾灸联合穴位贴敷治疗胸腰椎压缩性骨折患者术后便秘的效果。方法 选取2021年6月—2022年6月收治的100例胸腰椎段压缩性骨折术后便秘患者, 随机分为观察组和对照组, 各50例。对照组给予常规护理措施, 观察组在对照组基础上给予艾灸联合穴位贴敷干预。评价两组临床疗效, 采用焦虑自评量表(SAS)评估患者焦虑程度。结果 观察组总有效率90. 00%(45/50), 高于对照组的82. 00%(41/50), 差异有统计学意义(P＜0. 05)。干预后, 两组SAS评分均降低, 且观察组评分低于对照组, 差异有统计学意义(P＜0. 05)。结论 艾灸联合穴位贴敷能有效改善胸腰椎压缩性骨折患者术后便秘症状, 且操作安全、简单。)

To coordinate the conflict between the high-altitude task and long-term energy efficiency of high-altitude long endurance solar UAV, it is one of the core issues of UAV control. A strategy combining the energy management with the route tracking is presented. Firstly, based on the three-dimensional particle motion model, energy storage battery model and solar energy acquisition model for the solar UAV, according to the aerodynamic parameters of the solar UAV and the typical horizontal flight, climb, descent and other motion processes of the solar UAV, the energy management strategy of the solar UAV is designed, and the allocation mechanism and optimal flight parameters of the energy acquisition, storage and consumption of the solar UAV in different flight stages are determined. The surplus solar energy is stored by using the gravitational potential energy, and then the energy management based on height adjustment is carried out to realize the longitudinal tracking control of the solar UAV under different lighting and energy conditions. Then based on the task requirements of the lateral movement of the solar UAV, a track tracking control method based on the feedback linearization method is established by decoupling the particle dynamics equation of the solar UAV, and the track tracking control of the solar UAV in the lateral direction is realized. Finally, a simulation throughout 24 hours is implemented and illustrated the effectiveness of the energy management strategy and route tracking control law.

In-situ chemical oxidation (ISCO) refers to the use of appropriate conveyance technology to transport oxidants into soil or aquifer, where the contaminants are converted to low- or non-toxic substances by chemical oxidation. ISCO has been widely used for the remediation of organic contaminants in soil and groundwater due to its high efficiency and cost effectiveness.Oxidant demand is an important parameter in the application of ISCO. Once injected into the contaminated soil or aquifer, the oxidant reacts not only with the target contaminants, but also with natural organic matter (NOM) and reductive minerals (RM) such as Fe2+, Mn2+, S- and S2- in the medium. In addition, the oxidant may decompose naturally due to its own properties. If the amount of oxidant used is insufficient, the remediation of the contaminated site may not meet the project objectives and residual contaminants or reaction intermediates may be formed, resulting in a rebound of the contaminant concentration at the site. If too much oxidant is used, it would not only increase the cost of remediation, but also seriously damage the physical and chemical properties of soil, reducing the diversity of microbial communities. Therefore, accurate measurement of oxidant requirements is important to achieve good remediation performance.In previous studies, the specific meaning of terms related to oxidant demand is not consistent and they are often mixed in different studies, which would lead to ambiguity.In this review the composition and definition of oxidant demand is clarified and unified. The total oxidant demand (TOD) in ISCO is composed of pollutant oxidant demand (POD, the amount of oxidant consumed by oxidative degradation of pollutants), natural oxidant demand (NOD, the amount of oxidant consumed by natural organic matter and reducing minerals in soil or aquifer media), and decomposed oxidant (DEO, the amount of oxidant naturally decomposed due to its nature and the influence of environmental conditions).The methods for determining oxidant demand can be divided into two categories: experimental method and stoichiometric model method. The basic principle of the experimental method is to mix the treated medium sample with the oxidant in a system for a period of time, and then calculate the oxidant consumption before and after reaction to obtain the oxidant demand per unit of medium. Specifically, the experimental method can be divided into batch test, column test, push-pull test and reaction kinetics model according to the scale and dimension of the experiment. Among them, the batch test has been relatively widely used due to its excellent characteristics of simplicity and efficiency. The column test is more capable of reflecting the actual consumption of oxidant in the field medium, taking into account the transport process and interaction of oxidant in porous media. Although the push-pull test is carried out at the field scale, which can effectively overcome the error caused by the difference between laboratory conditions and field conditions, it is relatively complex to operate. Finally, the reaction kinetics model can be used to analyze the oxidant consumption in the reaction process based on experiments. This method can characterize the oxidant consumption on a longer time scale, which is of great importance for potassium permanganate or sodium persulfate oxidants with longer reaction times.The determination of oxidant demand by experimental method is affected by factors such as the initial concentration of oxidant, reaction time, solid-to-liquid ratio and mixing conditions of the reaction. To facilitate comparison of data and costing of the project, it is necessary to incorporate experimental conditions into the expression of oxidant demand. For example, the difference of the oxidant demand obtained at different times for the same sample can be as much as 37%. Therefore, the time required for the pollutant concentration to be reduced to the target limit by oxidation should be used as the oxidant demand determination time.Stoichiometric model method is the determination of the theoretical oxidant demand value by the establishment of the stoichiometric relationship model between the oxidant demand and the components in the medium. The stoichiometric model method was originally designed to explore the relationship between the total organic carbon in the medium and the oxidant demand. It was then developed to consider the oxidant demand of natural organic matter, other mineral ions and organic pollutants as a whole. Calculation results of the stoichiometric modelling method depend on the accuracy of the model and the precise determination of the content of relevant components in the medium.Both experimental method and stoichiometric model method mostly take potassium permanganate oxidant as the research object, but there is a lack of research on the demand of Fenton reagent, ozone and sodium persulfate. In particular, the DEO of more decomposable oxidants such as Fenton reagent and ozone may reach more than 50% of TOD. The existing methods still face difficulties in accurately measuring DEO, which deserves special attention. As a component of TOD that is easily overlooked, the importance of DEO needs to be further clarified and more accurate measurement methods need to be explored. In the actual project, the number of injection wells, well spacing, oxidant injection rate and other design parameters will have an important impact on the total oxidant demand, which still needs to be further investigated. The remediation of contaminated sites by ISCO is a complex project and a more scientific workflow or guideline is necessary for engineers to determine oxidant demand.

Objective To investigate the effect of abdominal massage on relieving constipation in elderly patients with diabetes, and summarize comprehensive nursing measures during the treatment. Methods Totally 80 elderly diabetic patients with constipation were randomly divided into the control group and observation group, with 40 cases in each group. All patients were given glucose-lowering Therapy and routine care, and Traditional Chinese Medicine abdominal massage was carried in the observation group. The constipation index, Patient Assessment of Constipation Quality of Life scale(PAC-QoL) and patient satisfaction were measured and compared between two groups. Results The constipation index score decreased in both two group after intervention, and constipation index score in the observation group was lower than that in the control group (P＜0. 01). The PAC-QoL score decreased in both two group after intervention, and PAC-QoL score in the observation group was lower than that in the control group (P＜0. 01). The satisfaction rate in the observation group was higher than that in the control group(P＜0. 05). Conclusion Based on the comprehensive nursing interventions, the abdominal massage is effective to relieve constipation symptoms and improve the quality of life in elderly patients with diabetes. (目的 探讨中医腹部推拿治疗糖尿病便秘的效果, 总结治疗期间综合护理干预措施。方法 选择2021年6月—2022年6月医院收治的糖尿病便秘患者80例, 随机分为对照组和观察组, 各40例。两组均接受常规降糖治疗, 对照组治疗期间接受常规护理, 观察组在对照组基础增加中医腹部推拿治疗。 采用便秘指数评价患者症状改善情况, 采用便秘患者生活质量问卷(PAC-QoL)评价患者生活质量, 采用自制量表评价患者满意度。结果 干预后, 两组便秘指数评分较干预前下降, 且观察组便秘指数评分低于对照组, 差异有统计学意义(P＜0. 01)。干预后, 两组PAC-QoL量表分较干预前下降, 且观察组PAC-QoL量表评分低于对照组, 差异有统计学意义(P＜0. 01)。观察组满意度高于对照组, 差异有统计学意义(P＜0. 05)。结论 在综合护理干预的基础上, 中医腹部推拿够迅速改善糖尿病便秘患者的便秘症状, 改善生活质量, 提升护理满意度。)

As a form of new emerging pollutant, antibiotics have been detected in soil, surface water, groundwater, sediment and other different environmental media. As a major country in the production and usage of antibiotics, China's production and usage are increasing year by year. However, most antibiotics used for humans or animals cannot be fully absorbed and metabolized and will enter the environment in the form of prototypes or metabolites through waste and wastewater accumulating in soil and leaching into groundwater. Antibiotics entering the environment may affect microbial ecology, produce resistance genes, and even threaten human health. Compared with surface water, polluted groundwater is hidden, lagging and difficult to recover. The pollution of antibiotics in groundwater, as the main source of drinking water, has attracted much attention.So far, the research on antibiotics in China is still mainly on surface water and soil, and there are few observations on antibiotics in groundwater. In order to systematically grasp the current pollution situation of antibiotics in groundwater in China, relevant literature on antibiotics in groundwater from 2012 to 2021 is reviewed in this paper. Twenty-eight antibiotics detected more than 100 times in environmental media in China were selected as target antibiotics, and the detected concentrations were summarized and analyzed. It was found that the concentrations of 28 antibiotics commonly detected in groundwater varied by more than 4 orders of magnitude, from 0.1ng/L to more than 1000ng/L. The most frequently detected antibiotics were norfloxacin, ofloxacin, sulfamethoxazole, sulfadiazine, enrofloxacin, and erythromycin. Through comparative analysis of the detection of antibiotics in various places, it can be seen that the concentration of antibiotics in groundwater is controlled by the properties of antibiotics, the location of pollution sources, hydrogeological structure and the amount of usage and emissions. From the perspective of spatial distribution, sulfonamide antibiotics are the most detected in northeast China, quinolones are the most detected in North and East China, quinolones and tetracyclines are the most detected in southwest China, and the research on antibiotics in groundwater in northwest China is relatively low. So far, restrained by the detection limits and detection types of the analysis methods, a comprehensive investigation and evaluation of antibiotics in groundwater is not possible.Due to the wide variety of antibiotics, their different structures lead to different physical andchemical properties. They exist in trace concentrations in the complex environment media, which also affects the accuracy of their qualitative and quantitative analysis. Therefore, the establishment of a sensitive and specific multi-component simultaneous analysis method has been a key issue for antibiotics research. The analysis methods of antibiotics are summarized, which are divided into qualitative analysis methods and quantitative analysis methods. The principle, advantages, disadvantages and application range of several antibiotic analytical methods are presented. These methods include microbial inhibition method (MIT), thin layer chromatography (TLC), gas chromatogram-mass spectrometry (GC-MS), high-performance liquid chromatogram-nuclear magnetic resonance (HPLC-NMR) and liquid chromatogram-mass spectrometry (LC-MS). Liquid chromatogram-mass spectrometry (LC-MS) is the most commonly used method for antibiotic analysis because of its high sensitivity, low detection limit and simultaneous determination of multiple antibiotics. With the rapid development of antibiotic analysis methods, some antibiotics in groundwater can be accurately quantified by using HPLC-MS/MS and other technologies. However, the number of antibiotics that can be analyzed and identified at one time is still limited. The research group of authors has established the qualitative spectrum library of common drugs by UPLC-MS/MS. In the future, the types of antibiotics that can be qualitatively identified in the spectrum library can be expanded by adding the mass spectrum information of antibiotics. Under specific conditions, the spectrum library can be used to carry out semi-qualitative identification of antibiotics in groundwater. At present, the commonly used quantitative detection methods include enzyme-linked immunoassay, capillary electrophoresis, and liquid chromatography-mass spectrometry. Compared with the other two methods, liquid chromatography-mass spectrometry has the advantages of high sensitivity, good selectivity and accurate quantitative ability. It is commonly used for the detection of trace antibiotics in reported water samples.Antibiotics exist in the environment at trace levels and the matrix of environmental samples is complex, so the pretreatment process, including antibiotic separation, purification and concentration, often becomes the key step of determination. For example, the samples to be tested should be adjusted to an appropriate pH to enhance the enrichment of target antibiotics on HLB columns, and Na2EDTA should be added to inhibit its complexation with calcium and magnesium and other metal ions in groundwater. The accuracy of antibiotic determination will be improved, and the detection limit will be lowered for water samples by solid phase extraction and the subsequent concentration process. In addition to the detection limit and recovery rate of antibiotics affected by the analytical instrument, the presence states of antibiotics in water samples will also affect the accuracy and precision.Antibiotics may exist in the ionized state, complex state, adsorption state and other forms in groundwater. At different pH values, antibiotics may exist in neutral, cationic, anionic, orzwitterionic forms. When it coexists with metal ions, complexation reaction will occur under certain conditions to form antibiotic-metal complex which will reduce the peak area to a certain extent or cause tailing phenomenon on the reverse analytical column. The formation of the complex may also change the environmental behavior (migration, transformation, toxicity, etc.) and ecological effects of antibiotics. In addition, the analysis of antibiotics in different adsorption states can be used to evaluate the differences in microbial killing effects of different adsorption forms, especially the differences in ARG production and spreading. This will be helpful for accurately evaluating the potential effects on the environment or human beings and effectively controlling the risks of antibiotics in environmental media. Therefore, the existing form analysis of antibiotics is of great significance for the further accurate determination of antibiotics and the evaluation of environmental effects.Up to now, limited by the detection limits and detected types of antibiotics in analytical methods, there has not been a comprehensive national-scale investigation and evaluation of antibiotics in groundwater in China. Only by clarifying the concentration level and spatial distribution of antibiotic pollution in China's groundwater can it help to understand the contents of relevant laws and regulations on new emerging pollutants and support the establishment of a regulatory framework for natural resources and the environment. In conclusion, optimizing qualitative and quantitative detection methods, analyzing different existing forms of antibiotics, comprehensively investigating antibiotics in groundwater, and scientifically evaluating the relationship between antibiotic forms and ecotoxicological effects are the main contents of antibiotics research in groundwater in the future.

The increase in the level of neutrophils following subclinical Cushing’s disease is an uncommon clinical phenomenon that is characterized by insignificant biochemical or clinical evidence of hypercortisolism. In this study, we reported a 37-year-old female patient who presented with palpitations and fatigue, and showed increased neutrophils that were unaffected by anti-infection therapy. The patient was suspected of having a urinary tract infection because of occasionally with urinary frequency, urgency, increased procalcitonin, leukocytosis, and an increased proportion of neutrophils. The ineffectiveness of anti-infection therapy ruled out the possibility of urinary tract infection. Further examination of the bone marrow excluded the possibility of blood disease. However, the levels of blood cortisol and adrenocorticotropic hormone (ACTH) increased, and a magnetic resonance imaging examination revealed lesions in the sphenoidal sinus and sella area of the sphenoidal bone, which confirmed the relationship between increased glucocorticoids and increased neutrophils. This was further confirmed by follow-up surgery and pathological examination, which revealed silent corticotropin adenomas, which are characterized by the lack of biochemical or clinical evidence of hypercortisolism with positive immunostaining for ACTH.

Foxtail millet are representative of the origins of dry farming in the north of China, having been domesticated and cultivated around 8 000 years ago, with setaria italica cultivation gradually dominating food production around 5 000 years ago and reaching its peak in the prehistoric period around 2 000 years ago. During the Xia, Shang and Zhou Dynasties, a period of transition from primitive setaria italica production techniques to traditional agricultural techniques, the emergence of oxen and iron farming tools and intensive cultivation techniques led to a breakthrough in setaria italica cultivation during the Spring, Autumn and Warring States period. Foxtail millet cultivation areas expanded during the Qin and Han Dynasties, and traditional setaria italica cultivation flourished during the Wei, Jin and North and South Dynasties. During the Sui and Tang dynasties, rice and wheat gradually rose in prominence, gradually replacing the traditional status of setaria italica, but in the traditional Yellow River basin, foxtail millet still occupied a staple food position. During the Yuan and Song dynasties, wheat continued to spread to the south and grain production gradually overtook cereals. During the Ming and Qing dynasties, the area planted with high-yielding crops such as maize and sweet potatoes expanded rapidly to meet the food needs of the rapidly growing population, but foxtail millet remained an important grain crop in the north. After the founding of the People's Republic of China, China's foxtail millet acreage continued to decline, going through three phases: the period as a staple food, the transition period from staple to miscellaneous cereals, and the miscellaneous cereal period, mainly due to slower yield increases, cumbersome cultivation, reduced consumer demand and a lack of policy. In the new era, the nutritional, ecological and cultural attributes of foxtail millet will bring new opportunities for the development of the foxtail millet industry. In the future, China's foxtail millet planting area will rise steadily, the demand for high-quality edible, nutritional and health care, special processing and other special varieties will become a trend, the type of processed products will be more abundant, and the foxtail millet industry will gradually develop in the direction of functionalization, branding, quality and high-end.

BACKGROUND Currently, the environmental detection of antibiotics is receiving extensive attention, but there is still a lack of methods that can simultaneously analyze seven categories of antibiotics in surface water and groundwater. OBJECTIVES To establish a method that can detect thirty-seven antibiotics (15 sulfonamides, 2 tetracyclines, 3 macrolides, 8 quinolones, 2 chloramphenicols, 2 β-lactams and 5 other kinds) simultaneously. METHODS Solid phase extraction coupled with ultra-performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-MS/MS) was used to quantify the concentration of antibiotics. RESULTS The method had good sensitivity and enrichment effect for the surface water and groundwater, the recoveries ranged from 60% to 130%, the detection limits ranged from 0.6 to 10.6ng/L. The method was applied to the determination of antibiotics in surface water of the Yongding and Chaobai Rivers, and groundwater of the Chaobai River in Beijing. Sulfonamides, quinolones and macrolides were the main antibiotics in the surface water of the Yongding River, and the detection rates were 88.9%, 55.6% and 33.3%, respectively. The highest concentration of floxacin was 111.9ng/L. Sulfonamides, quinolones and chloramphenicols were the main antibiotics in the surface water of the Chaobai River with detection rates of 100%. The highest concentration of tilmicosin was 71.6ng/L. Sulfonamides, quinolones and β-lactams antibiotics were the main antibiotics in the groundwater of the Chaobai River Basin, and the detection rates of were 66.7%, 55.6% and 22.2%, respectively. The highest concentration of sulfadiazine was 69.3ng/L. In both surface water and groundwater, the detection rate and concentration near the sewage treatment plant were significantly higher than those at other points. CONCLUSIONS The method established in this study is simple, rapid and accurate, which can be used for the simultaneous determination of 37 antibiotics in seven categories in surface water and groundwater. It provides antibiotic analysis method support for surface water and groundwater investigation, and provides a scientific basis for rational utilization of water resources and management of new pollutants in water.

BACKGROUND Antibiotic pollution carried by reclaimed water infiltration is one of the sources of groundwater pollution, which has become a problem that cannot be ignored in the safety of urban groundwater resources. The effects of antibiotics on microbial communities and their functions in complex and fragile groundwater environments deserve attention. OBJECTIVES To explore the differences of groundwater environmental factors in different seasons and the distribution characteristics of antibiotic pollution, and to explore the influence mechanism of antibiotics on a microbial community. METHODS Based on the high-throughput sequencing method of 16S rRNA gene, the microbial community structure in urban groundwater in the infiltration area of reclaimed water in March and September was studied. Combined with field investigation and indoor analysis, the ion (K+, Na+, Ca2+, Mg2+, NH4+, F-, Cl-, SO42-, NO3-, NO2-, HCO3-, CO32-) concentration in the sample was measured, and the main antibiotic (ciprofloxacin, norfloxacin, ofloxacin, moxifloxacin, sulfapyridine, sulfacetamide) concentration was measured by ultra-high performance liquid chromatography-tandem mass spectrometry. RESULTS (1) In the study area, the concentration of antibiotics in groundwater in March was higher than that in September, mainly sulfacetamide and ciprofloxacin. In addition to seasonal factors, human activities may be another factor affecting the distribution of antibiotics. (2) The microbial community was mainly composed of Proteobacteria (81.04%), Bacteroidota (7.60%), and Firmicutes (4.21%). 3-nitrogen (NH4+, NO3-, NO2-) and antibiotics were important factors affecting the microbial community structure in the study area. Different antibiotics had different effects on the microbial community. Among them, sulfapyridine, norfloxacin, ofloxacin and moxifloxacin had the greatest impact on microorganisms, while ciprofloxacin and sulfacetamide had less impact. (3) Co-occurrence network analysis found that the two dominant functional groups had a high degree of connection with antibiotics, namely, antibiotics had a potential impact on the main microbial functional groups and their functions in the study area. CONCLUSIONS The study provides support for understanding the impact mechanism of antibiotics on a groundwater microbial community and the ecological risk.

In order to prevent the large deformation of the surrounding rock of the mine and improve the stability of the unstable rock mass, the parameters of the cement anchoring agent material were optimized based on the orthogonal design method and the rock mass mechanical test; the amount of fly ash, water glass, the amount of ettringite, the amount of naphthalene sulfonate, the water-cement ratio, and the sand-cement ratio are the raw materials. Three physical and mechanical properties of uniaxial compressive strength, gripping force, and adhesive force were obtained through testing. The results were analyzed by range and variance to obtain the order and degree of influence. The results show that the greatest effect on the gripping force is the amount of fly ash, and the water-cement ratio, sand-cement ratio, and water glass content also have significant effects on the gripping force; the influence of the amount of bauxite and water-cement ratio on the adhesion force is second. Multivariate linear regression analysis was performed using the data obtained from the experiments, and the empirical equations for the mechanical indexes of the specimens and the ratio of the anchoring agent materials were obtained. It can be used to improve the safety of the surrounding rock anchoring system.

Total knee arthroplasty is an effective surgery in the treatment of end-stage arthritis. However, Postoperative pain adversely affects recovery and patients’ quality of life. There has been a wide use of Traditional Chinese Medicine (TCM) nursing technology in pain control after total knee arthroplasty, and common nursing interventions includes Chinese herbal medicine external application, auricular point pressing therapy, Tuina, moxibustion, and so on. Given the inadequacies in standardization of operation and evaluation system, it is required to enhance the evidence-based nursing practice and form an effective operation and evaluation system, aiming to promote the clinical practice of TCM nursing technology. (全膝关节置换术(TKA)是治疗终末期关节炎的有效方法, 但术后伤口疼痛不利于患者早期康复, 严重影响患者生活质量。中医护理技术在TKA术后疼痛中应用广泛, 且效果良好, 常见技术包括中药外用、耳穴压丸、推拿、艾灸等, 但操作频次、评价体系等尚未形成规范化、标准化, 在今后要加强循证护理实践, 形成有效的评价指标及完善的操作流程, 以推进中医护理技术的临床应用。)

In order to study the softening characteristics of gravel-geogrid interface during and after cyclic shearing, a series of displacement controlled monotonic direct shear tests, cyclic direct shear tests with 2 000 cycles and post cyclic direct shear tests were carried out on the gravel-geogrid interface using dynamic direct shear apparatus. The shear strength characteristics, volume change behavior, shear stiffness and damping ratio of the gravel-geogrid interface under four groups of normal stresses of 20, 40, 60 and 80 kPa were studied. The direct shear characteristics of the gravel-geogrid interface before and after cyclic shear were compared and analyzed. The results show that: in the cyclic direct shear test, the average peak shear stress of gravel-geogrid interface first increases and then decreases, and finally tends to be stable with the increase of number of cycles, and the interface shows shear softening characteristics; the vertical displacement increment of gravel-geogrid interface decreases gradually with the increase of number of cycles; the shear stiffness first increases and then decreases with the increase of number of cycles, and finally tends to be stable; the damping ratio first decreases and then increases with the increase of number of cycles, and finally tends to be stable; under the same normal stress, the peak shear stress increases and the residual shear stress decreases in the cyclic direct shear test compared with the monotonic direct shear test; the cyclic shear makes the interface cohesion increase significantly and the internal friction angle decrease.

Nicotine withdrawal symptoms, mainly anxiety, cause high level of relapse rate after quitting smoking. Vitamin D supplementation has shown its potential for the prevention and treatment of anxiety disorders; however, neurobiological studies about the effect of vitamin D on nicotine withdrawal-induced anxiety are limited. To investigate the effect and molecular mechanism of vitamin D3 supplement by dietary on anxiety-like behavior during nicotine withdrawal, male C57/BL6 mice were divided into four groups: vehicle, nicotine only, vitamin D3 only, and nicotine plus vitamin D3. Mice were administrated with nicotine in drinking water (200 µg/mL), and vitamin D3 in feed for 6 weeks. During nicotine withdrawal, vitamin D3-treated mice showed significantly less anxiety-like behavior by an open-field test and marble buried test that performed an increase in the duration of the central zone and a decrease buried marble, respectively. Moreover, vitamin D3 supplementation attenuated the hippocampal NR2A expression on both protein and mRNA levels in nicotine and vitamin D3-treated mice. Our data showed that dietary supplementation with vitamin D3 ameliorated nicotine withdrawal-induced anxiety, which may be related to downregulation of NR2A expression in hippocampus. Vitamin D3 may provide a new dietary intervention with the easy access for smoking cessation.

BACKGROUND Carbofuran and 3-hydroxycarbofuran are typical pesticides with the relationship of parent and metabolite. Due to high water solubility and toxicity, carbofuran and 3-hydroxycarbofuran can be transported through surface water or groundwater for long distances, causing harm to human health and environmental safety. In the past, carbofuran and 3-hydroxycarbofuran in samples were usually extracted by liquid or solid phase extraction. However, these methods are cumbersome to operate and time-consuming, which is not conducive to the detection of multiple sets of samples in indoor simulation experiments. OBJECTIVES In order to realize the rapid quantification of carbofuran and 3-hydroxycarbofuran in groundwater. METHODS A small volume liquid-liquid extraction pretreatment method was established for extraction, combined with gas chromatography-mass spectrometry to detect factors affecting the extraction efficiency of carbofuran and 3-hydroxycarbofuran. To improve the extraction efficiency of carbofuran and 3-hydroxycarbofuran, [JP] factors such as the type of extraction solvent, pH and dosage of NaCl were optimized. RESULTS Results showed that the extraction efficiency of carbofuran and 3-hydroxycarbofuran was highest when 1mL methylene chloride was selected as the extraction agent under pH=5, and 40g/L NaCl was added in the water samples. The extraction recoveries for carbofuran and 3-hydroxycarbofuran were 75.1%-98.6% and 55.0%-66.3%, respectively. The performance evaluation results showed that the instrument precision and method precision meet test requirements (n=5, relative standard deviation < 10%). The detection limits of carbofuran and 3-hydroxycarbofuran in water were 15.3μg/L and 10.2μg/L, respectively. CONCLUSIONS This method is simple and fast with less solvent. Compared with the traditional liquid-liquid extraction method, this method takes about 1/8 time of the former, and consumes about two orders of magnitude less solvent than the former, which can meet the needs of indoor simulation experiments.

Objective To construct a novel 100 000 hexagonal microchamber chip (NHMC) digital PCR (dPCR) platform for absolute quantification analysis of gene mutations in lung cancer based on epidermal growth factor receptor (EGFR) G719S mutation as an object. Methods First, a PCR detection system for EGFR G719S mutation was constructed and optimized. And then 8 concentration gradients of EGFR G719S standard plasmids and 4 interfering substances were detected by the NHMC-dPCR platform, and the sensitivity, specificity and anti-interference ability of the platform were evaluated. Finally, 6 tissue samples of lung cancer with EGFR G719X mutation were detected by NHMC-dPCR, droplet digital PCR (ddPCR) and DNA sequencing, and the reliability of NHMC-dPCR in clinical sample testing was verified. Results The minimum detection concentration of EGFR G719S detected by NHMC-dPCR is 3.01 copies/μL. The linear equation between the detected value and the expected value is Y=0.725X-0.581, and the correlation coefficient is R2=0.984. Four interfering substances were tested by this platform and no positive holes were found. The results of the G719S mutant plasmids and the mixture of 4 interferences were 23 194.4 copies and 22 095.7 copies, respectively. The qualitative results of 6 clinical samples tested by NHMC-dPCR, ddPCR and DNA sequencing had a coincidence rate of 100%. Among them, the quantitative results of 2 cases by NHMC-dPCR were 1 822.4 copies and 451.7 copies, and their corresponding quantitative results by ddPCR were 1 581.8 copies and 218.3 copies, respectively. Conclusion The nucleic acid absolute quantification technology established in this study, namely NHMC-dPCR, has the advantages of low cost, simple operation, fast speed, and strong anti-interference ability, and can be used for absolute quantification analysis of gene mutations in lung cancer.

BACKGROUND With the advancement of agricultural intensification and urbanization, pesticide residues in a large numbers of water environments in the world have exceeded the prescribed limit. The issue of pesticide pollution in the water environment has received extensive attention from all sectors of society. As the largest pesticide producer and user country in the world, the amount of pesticide residues in the water environment in China is much higher than other developed countries. Available studies have detected 19 pesticides in seven typical river basins in China (the Yangtze River, Taihu Lake, Yellow River, Songhua River, Heilongjiang, Grand Canal and Dongjiang), with an average concentration ranging from 0.02 to 332.75ng/L. Pesticides and their transformation products pose potential threats to the ecological environment and human health. Research on pesticide residues in the water environment is an indispensable part of water quality assessment. However, targeted screening is difficult to detect unknown pesticides and their transformation products. Therefore, the non-targeted screening of pesticide residues and their transformation products in the environment needs to be improved. OBJECTIVES To understand the pesticide pollution analysis techniques for environmental water samples. METHODS According to the analysis process of non-targeted screening of pesticide components, the targeted and non-targeted screening methods for pesticide residues in water quality samples in the past 5 years were reviewed, and the regulations and standards for pesticide residue limits and non-targeted screening of pesticides in water quality were summarized. The research progress of pesticide residue analysis methods in water environment in recent years was summarized. RESULTS The characteristics of liquid-liquid extraction (LLE), solid-phase extraction (SPE), solid-phase microextraction (SPME) and other pre-treatment methods were reviewed. Among them, solid-phase extraction was the main pre-treatment method for non-targeted pesticide screening and had good applications prospects. The development trend of analytical instruments from chromatography to chromatography mass spectrometry was discussed, and the production of a variety of high-resolution mass spectrometry provided multi-level analysis requirements for non-targeted pesticide screening. Finally, the guidelines, mass spectrometry database and various identification methods related to pesticide screening confirmation in recent years were summarized, and the development trend of pesticide pollution analysis technology in the water environment was prospected. CONCLUSIONS High resolution mass spectrometry technology poses a challenge to the sample pretreatment and purification process. The combination of multiple technologies in the water sample pretreatment process is the future development trend. Research on non-targeted pesticide screening based on high-resolution mass spectrometry is widely studied in the field of food testing although it has low priority in the environmental field. Relevant organizations at home and abroad have not yet issued relevant standards for screening and confirmation of unknown substances. Currently, the confirmation of unknown screening requires manual data analysis, which cannot be fully automated.