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目的研究微小RNA microRNA-99b-5p（miR-99b-5p）对心肌细胞肥大表型的调节作用及机制。方法实时荧光定量PCR（RT-qPCR）检测人心肌组织（包括健康对照者、心力衰竭患者心肌组织）以及横向主动脉缩窄（TAC） 手术小鼠心肌中miR-99b-5p的表达水平。血管紧张素Ⅱ（AngⅡ）处理原代乳小鼠心肌细胞（NMVCs）后，利用鬼笔环肽染色呈现心肌细胞大小，RT-qPCR检测miR-99b-5p表达水平。利用RT-qPCR及蛋白质免疫印迹法检测转染miR-99b-5p mimic对NMVCs中肥大相关基因及成纤维细胞生长因子21（Fgf21）表达的影响。双萤光素酶报告实验验证miR-99b-5p与Fgf21基因3'端非翻译区（3’UTR）的结合作用。利用腺病毒介导在NMVCs中过表达Fgf21及超氧化物歧化酶2（Sod2），并利用小干扰RNA（siRNA）敲低NMVCs中Fgf21和Sod2表达，研究Fgf21/Sod2轴是否介导miR-99b-5p对心肌细胞肥大表型的调节作用。结果MiR-99b-5p在心衰患者心肌组织、TAC术后的小鼠心肌组织及在AngⅡ处理的心肌细胞中均表达上调（ P＜0.01）。MiR-99b-5p可促进NMVCs中与肥大相关基因的表达（ P＜0.01）。双萤光素酶报告基因实验证实miR-99b-5p与Fgf21基因的3’UTR存在结合作用，并且miR-99b-5p可抑制Fgf21及其下游基因Sod2表达（ P＜0.05）。在NMVCs中过表达Fgf21或Sod2均可有效逆转miR-99b-5p的促心肌细胞肥大作用（ P＜0.05）。结论MiR-99b-5p在肥厚心肌中表达增加，并通过Fgf21/Sod2轴发挥促进心肌细胞肥大的作用。

目的探究环形RNA circ_0036176对心肌纤维化表型的调控作用。方法通过RT-qPCR检测人心肌组织（包括18例器官捐赠健康志愿者和28例心力衰竭患者）中circ_0036176及其宿主基因MYO9A的表达水平。利用血管紧张素Ⅱ（Ang-Ⅱ）处理人心房肌成纤维细胞（HAFs），RT-qPCR检测circ_0036176和MYO9A的表达水平。放线菌素D和RNase R处理，鉴定circ_0036176的典型环状结构。使用circ_0036176腺病毒在HAFs中实现充分过表达，mRNA及蛋白水平检测纤维化相关基团的表达差异。利用双萤光素酶报告基因实验和RNA反义纯化技术（RAP）筛选可与circ_0036176有效结合的miRNA。利用C57BL/6乳小鼠心肌成纤维细胞（mCFs）研究miR-218-5p是否介导circ_0036176对心肌纤维化表型的调节作用。结果Circ_0036176在心衰心肌中表达增加（ P＜0.001），但在Ang-Ⅱ诱导的HAFs纤维化细胞模型中，宿主基因及该circRNA的表达一致下调 （ P＜0.01）。放线菌素D和RNase R实验证实circ_0036176具有典型的环形RNA稳定性。在HAFs中充分过表达circ_0036176后，纤维化相关基因表达均有所下降 （ P＜0.05）。双萤光素酶报告基因实验与RAP实验证实miR-218-5p与circ_0036176间存在结合作用。mCFs中转染miR-218-5p促进了纤维化相关基团的表达，并可有效抵抗circ_0036176的纤维化抑制作用。结论Circ_0036176在心衰病人的心肌组织中表达上调，并可通过吸附 miR-218-5p的方式来抑制心肌纤维化。

目的研究长链非编码RNA（lncRNA）RP11-879F14.2调控心肌成纤维细胞纤维化表型的作用及机制。方法对心衰患者及健康对照者心肌组织进行Masson染色检测心肌胶原水平。lncRNA表达谱芯片检测心衰患者及健康对照者心肌中lncRNAs的表达变化，实时定量荧光PCR（RT-qPCR）验证RP11-879F14.2在心衰患者心肌中的表达。利用重组RP11-879F14.2腺病毒（rAd-RP11-879F14.2）感染人心房肌成纤维细胞（HAFs），检测纤维化相关基因Col1a1，Col3a1和Acta2表达。RT-qPCR检测HAFs的核/质组分中RP11-879F14.2的水平。基于生物信息学预测和双荧光素酶报告基因实验鉴定RP11-879F14.2与多聚嘧啶区结合蛋白（PTBP1）的结合作用。检测敲低HAFs中PTBP1表达对RP11-879F14.2调控心肌纤维化相关基因表达的影响。结果Masson染色结果显示，心衰病人心肌组织发生明显纤维化。RT-qPCR结果证实RP11-879F14.2在心衰患者心肌组织中表达增加（P

This paper summarized the treatment and nursing measures for a patient with limb pain caused by arteriosclerosis obliterans. Based on the nursing risk assessment and routine nursing, the intradermal needling and digital acupoint pressure therapy were adopted to relieve the limb pain caused by arteriosclerosis obliterans, improve the patient’s quality of life and rehabilitation. (本文回顾1例闭塞性动脉硬化症患者肢体疼痛的治疗和护理体会。在完善护理评估的和常规护理的基础上, 运用中医特色护理技术皮内针联合手指点穴治疗, 能够减轻患者肢体疼痛, 提高生活质量, 促进康复。)

This paper summarized the nursing of integrated Traditional Chinese and western medicine for a patient with ankylosing spondylitis(AS) complicated with ecthyma. Based on the Traditional Chinese Medicine syndrome differentiation, TCM-characterized nursing technology such as Chinese Medicine collapse stains, moxibustion, acupoint massage, auricular acupoint sticking and pressing, dietary guidance were used jointly. Implementation of integrative nursing is potentially effective to relieve the pain and improve the ulcer healing. (本文总结1例强直性脊柱炎并发臁疮患者的中西医结合护理措施。在常规护理的基础上辨证施护, 合理应用中药塌渍、艾灸、穴位按摩、耳穴贴压、膳食指导等中医特色护理技术, 能有效缓解患者疼痛, 促进溃疡的早期愈合。)

Objective To investigate the effects of integrated Traditional Chinese and Western medicine nursing on treatment outcome, quality of life and prognosis of high-risk patients with diabetic foot, and provide evidence for more reasonable nursing intervention program. Methods From January 2021to January 2022, 200 patients with type 2 diabetes mellitus were screened; 40 high-risk patients with diabetic foot were eligible and randomly divided in to observation group and control group, with 20 cases in each group. The control group received routine care during the treatment, and those in the observation group received integrated traditional Chinese and Western medicine intervention based on routine care. The treatment outcome, patient quality of life and prognosis of disease were compared between two groups. Results The overall effective rate in the observation group was higher than that in the control group (P＜0. 05). According to the outcome of General Quality of Life Inventory-74(GQOL-74) assessment, the improvement rate in the observation group was 85. 00%(17/20), showing no significant difference compared with 65. 00%(13/20) in the control group (P＞0. 05). The incidences of foot infections and foot ulcers in the observation group were lower than those in the control group (P＜0. 05). Three cases of amputation were reported in the control group. Conclusion The integrated Traditional Chinese and Western medicine nursing showed positive effect on treatment outcome, patient quality of life and prognosis of disease, and the effect of integrative nursing intervention was superior to routine nursing. (目的 观察中西医结合护理干预高危糖尿病足患者的效果, 及对患者生活质量及预后的影响, 为高危糖尿病足患者采取更好的护理策略、制定更为合理的护理干预方案提供依据。方法 从医院2021年1月—2022年1月收治的200例2型糖尿病患者中筛查出40例高危糖尿病足患者, 随机分为现察组与对照组, 各20例。对照组采取常规护理干预, 观察组在常规护理基础上, 给予中西医结合护理干预。评价两组干预效果, 以及对患者生活质量以及足部状况影响。结果 观察组干预效果优于对照组, 差异有统计学意义(P＜0. 05); 观察组生活质量评定问卷(GQOL-74)评分改善率85. 00%(17/20), 高于对照组的65. 00%(13/20), 但差异无统计学意义(P＞0. 05); 观察组足部感染和足部溃疡发生率低于对照组, 差异有统计学意义(P＜0. 05), 观察组无1例患者截肢, 对照组3例患者截肢。结论 中西医结合护理干预能进一步提高高危糖尿病足患者的治疗效果, 改善患者生活质量及预后, 干预效果要优于常规护理干预。)

Objective To observe the effect of moxibustion on pain relief in patients with lower extremity arteriosclerosis obliterans (ASO)of cold coagulation and blood stasis type. Methods Totally 60 patients with lower extremity ASO of cold coagulation and blood stasis type were randomly divided into the control group and the observation group, with 30 cases in each group. Patients in both groups received routine care during the hospitalization, and those in the observation group were given moxibustion by Traditional Chinese Medicine (TCM) syndrome differentiation. The Visual Analogue Scale (VAS)was used to assess the degree of pain. Results The VAS score of the two groups decreased after nursing intervention, and VAS score in the observation group was lower than that in the control group (P＜0. 01). Conclusion The moxibustion by TCM syndrome differentiation is effective to relieve the pain of patients with lower extremity ASO of cold coagulation and blood stasis type. (目的 观察艾灸缓解下肢动脉硬化性闭塞症寒凝血瘀型患者疼痛的效果。方法 60例下肢动脉硬化性闭塞症寒凝血瘀型患者随机分为对照组和观察组, 各30例。对照组给予常规护理, 观察组在常规护理基础上增加中医护理干预, 根据中医辨证分型实施艾灸。采用视觉模拟评分(VAS)评估治疗前后患者疼痛程度。结果 干预后两组VAS评分均较干预前下降, 且观察组VAS评分低于对照组, 差异有统计学意义(P＜0. 01)。结论 基于中医辨证分型实施艾灸, 能进一步缓解下肢动脉硬化性闭塞症寒凝血瘀型患者疼痛。)