Involvement of NF-κB/PI3K/AKT signaling pathway in the protective effect of prunetin against a diethylnitrosamine induced hepatocellular carcinogenesis in rats.

Prunetin (PRU) is an O-methylated flavonoid that is present in various natural plants and a primary significant compound found in isoflavone. Liver cancer creates major carcinogenic death despite recently advanced therapies. Hepatocellular carcinoma (HCC) treatment and prognosis are better in people with secure liver function. In the present study, we evaluated the action of PRU on diethylnitrosamine (DEN) alone HCC in a rat model through inflammation-mediated cell proliferative phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway analysis. Male Wistar rats were divided into four groups of six rats each. Group I, normal rats; Group II, DEN alone; Group III, DEN + PRU, and Group IV, PRU-alone. All groups of rats carried out hepatic cancer development by hypothesis antioxidant, biochemical, cell proliferative, apoptosis, cytokines protein, and gene expression status profiles. In tumor incidence DEN + PRU, 100% delayed the tumor growth disappearance of the lesion,  and reversal of normal liver architecture was observed. Liver marker enzymes levels decreased when antioxidant levels (superoxidase dismutase, catalase, glutathione peroxidase, and glutathione reductase) were in Group III. Proinflammatory markers nuclear factor-κB, interleukin (IL)-6, IL-1ß, and tumor necrosis factor α, were elevated in the rat's serum in Group III. Cell proliferative markers proliferating cell nuclear antigen and Cyclin-D1 protein expressions were downregulated; in contrast, Bcl-2, Bax, caspase-3, and caspase-9 gene expressions were upregulated and then it followed that protein expression of PI3K/AKT was downregulated in PRU-treated groups. PRU assisted reversal of liver damage, antioxidant enzyme restoration cytokine balance, protein, and gene expression to control levels. Taken together, PRU improves functions of the liver, and as such prevents HCC. PRU can be used together with chemopreventives for HCC.

Epidemic patterns of the different influenza virus types and subtypes/lineages for 10 years in Chongqing, China, 2010-2019.

To optimize seasonal influenza control and prevention programs in regions with potentially complicated seasonal patterns. Descriptive epidemiology was used to analyze the etiology of influenza, and chi-square tests were used to compare the epidemic patterns among different influenza virus types and subtypes/lineages. From January 2010 to December 2019, a total of 63,626 ILI cases were reported in Chongqing and 14,136 (22.22%) were laboratory-confirmed influenza cases. The proportions of specimens positive for influenza A and influenza B were 13.32% (8,478/63,626) and 8.86% (5,639/63,626), respectively. The proportion of positive specimens for influenza A reached the highest in winter (23.33%), while the proportion of positive specimens for influenza B reached the highest in spring (11.88%). Children aged 5-14 years old had the highest proportion of positive specimens for influenza. The influenza virus types/subtypes positive was significantly different by seasons and age groups (P<.001), but not by gender (p = .436). The vaccine strains were matched to the circulating influenza virus strains in all other years except for 2018 (vaccine strain was B/Colorado/06/2017; circulating strain was B/Yamagata). The study showed significant variations in epidemic patterns, including seasonal epidemic period and age distributions, among different influenza types, subtypes/lineages in Chongqing. Influenza vaccines matched to the circulating influenza virus strain in nine of the ten years. To prevent and mitigate the influenza outbreaks in this area, high risk population, especially children aged 5-14 years, are encouraged to get vaccinated against influenza before the epidemic seasons.

Effect of standardized nursing cooperation on intravenous thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke.

OBJECTIVE: This study explored the impact of standardized nursing cooperation on intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in acute ischemic stroke (AIS). METHODS: From June 2019 to June 2020, a total of 235 AIS patients that received rt-PA intravenous thrombolysis were enrolled as the research subjects. Among them, there were 101 patients who were admitted between June 2019 and December 2019 and were placed into control-group and received traditional routine nursing collaboration procedures; and the remaining 134 subjects admitted between January 2020 to June 2020 were classified into the observation-group and received standardized care collaboration procedures. The time spent (from admission to CT examination, from completion of CT to medication and from admission to medication), the thrombolysis within 1 h, 1-2 h, 2-3 h and 3-4.5 h, the degree of damage of neurological function before and after nursing intervention, the occurrence of complications and satisfaction with nursing care were compared between the two groups. RESULTS: The time spent in each procedure of thrombolytic therapy in the observation group was remarkably less than that in control group (P<0.05). The distribution of thrombolysis in the observation group was superior to that in control group (P<0.05). NIHSS score of subjects in observation group after intervention was obviously lower than that in the control group, with statistically significant difference [(3.34±0.87) points, (4.82±0.93) points, t=12.5318, P=0.0000]. The incidence of complications in the observation group was 5.97%, and that in the control group was 24.75%, with a statistically significant difference (X2 =16.8317, P=0.0000). The nursing satisfaction of the observation group was 91.04%, which was significantly higher than 73.27% in the control group, and the difference was statistically significant (X2 =13.1496, P=0.0003). CONCLUSION: The standardized nursing cooperation for AIS patients with rt-PA intravenous thrombolysis is beneficial for effectively reducing the treatment delay and the incidence of complications, and improving the neurological function and satisfaction of nursing care, and as such it which is worthy of clinical promotion.

[Prevention of hospital-acquired pneumonia with Yupingfeng Powder in patients with acute cerebral vascular diseases: a randomized controlled trial].

BACKGROUND: An increase in the incidence rate of hospital-acquired pneumonia (HAP) has a direct influence on prognosis and survival of patients with acute cerebral vascular diseases (ACVD), and how to prevent HAP is a growing concern to clinicians. OBJECTIVE: To study the efficacy of Yupingfeng Powder, a compound traditional Chinese herbal medicine, in preventing HAP in patients with ACVD. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: Sixty ACVD patients with lung qi deficiency syndrome without concurrent infections were randomly divided into prevention group (28 cases) and control group (32 cases). The 60 cases were all from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Tough measures were taken to prevent cross-infection based on treatment of the primary diseases, well nutrition and support therapy. Yupingfeng Powder was used in the prevention group to prevent HAP. The patients were treated for 10 days. MAIN OUTCOME MEASURES: The clinical symptoms, physical signs, body temperature, and chest X-ray were observed. The changes of blood immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM) and interleukin-6 (IL-6) were detected before and after treatment. RESULTS: The total response rate in the prevention group was higher than that in the control group (P<0.05), and the total response rates were 78.57% (22/28) and 31.25% (10/32) respectively. The incidence rate of HAP in the prevention group was lower than that in the control group. There were no significant differences in white blood cell count, neutrophilic granulocyte count, and the levels of IgA, IgG, IgM and IL-6 between the two groups before treatment. The white blood cell count and neutrophilic granulocyte count in the control group increased after treatment, and there was a significant difference between the two groups (P<0.05). There was no significant difference in IgA level in the two groups after treatment, and the IgM levels in the two groups were higher than those before treatment (P<0.05), however there was no significant difference in IgM level between the two groups. In the prevention group, there were significant differences in values of IgG and IL-6 between before and after treatment (P<0.01), and after treatment there were differences in values of IgG and IL-6 between the two groups (P<0.05). CONCLUSION: Yupingfeng Powder has a good clinical effect in prevention of HAP in patients with ACVD, and it can improve the immunological function and relieve the lung qi deficiency symptoms. So the prevention effect of Yupingfeng Powder on HAP is worth being further investigated.

Portal-to-right portal vein bypass for extrahepatic portal vein obstruction.

OBJECTIVE: Rex shunt (mesenteric-to-left portal vein bypass) is considered a more physiologically rational treatment for EHPVO than other portosystemic systemic shunts in children. However, about 13.6% of children with EHPVO do not have usable left portal veins and up to 28.1%. Rex operations in children are not successful. Hence, a Rex shunt in these children was impossible. This study reports a novel approach by portal-to-right portal vein bypass for treatment of children with failed Rex shunts. MATERIAL AND METHODS: Eight children (age 6.1years, range 3.5-8.9years) who underwent Rex shunts developed recurrent gastrointestinal bleeding and hypersplenism 13months (11-30months) postoperatively. After ultrasound confirmation of blocked shunt, they underwent exploration. Three patients were found to have right portal vein agenesis. Five patients (62.5%) were found to have the patent right portal vein, with the diameter of 3-6mm. Four patients underwent bypass between the main portal vein in the hepatoduodenal ligament and the right portal vein by interposing an inferior mesenteric vein autograft, whereas the remaining patient underwent a bypass using ileal mesenteric vein autograft. RESULTS: The operations took 2.3h (1.9-3.5h). The estimated blood loss was 50ml (30-80ml), with no complication. The portal venous pressure dropped from 34.6cmH2O (28-45 cmH2O) before the bypass to 19.6cmH2O (14-24cmH2O) after the bypass. The 5 patients were followed up for 10.2months (4-17months) and the post-operative ultrasound and CT angiography confirmed the patency of all the grafts and disappearance of the portal venous cavernova in all five patients. CONCLUSION: The portal-to-right portal vein bypass technique is feasible and safe for treatment of children with EHPVO who have had failed Rex shunts. Our preliminary result indicates that this technique extends the success of Rex shunt from left portal vein to right portal vein and open a new indication of physiological shunt for some of the children who not only have had failed Rex shunts or but also are not suitable for the Rex shunts. TYPE OF STUDY: Treatment study. LEVEL OF EVIDENCE: Level IV.

A Novel Surgical Technique for treatment of Morel-Lavallée Lesion: Endoscopic debridement combined with percutaneous cutaneo-fascial suture.

Morel-Lavallée lesions are rare, closed degloving soft tissue injuries in which the skin and subcutaneous tissues are traumatic separated from the underlying fascia. There is lack of consensus regarding optimal management of these lesions. After failure of conservative management, operative intervention is imperative. The purpose of this manuscript is to describe a minimally invasive endoscopic method for treatment of Morel-Lavallée Lesions, which achieves the goal of an open surgical debridement.

Health behaviors of mandated and voluntary students in a motivational intervention program.

UNLABELLED: College students engage in many unhealthy behaviors, one of these, heavy alcohol use, is a major global public health problem. OBJECTIVE: This longitudinal study examined whether students' mandated/voluntary status in a program to reduce college drinking was associated with overall health, ethnicity, gender, and personality traits. Both mandated and voluntary groups participated in the Motivational Intervention (MI) program to prevent high risk drinking. METHODS: Freshmen (710 voluntary, 190 mandated, n = 900) between the ages of 18 and 21, received the MI at baseline and again at 2 weeks, with boosters at 3, 6 and 12 months. Participants completed three measures: the Daily Drinking Questionnaire (DDQ); the Substance Use Risk Profile Scale (SURPS), and the Health Promoting Lifestyle Profile II (HPLPII). Mandated and voluntary participants were compared at baseline and following the intervention using two sample t-tests for continuous variables (overall health, personality traits, drinking measures), and chi-square for categorical variables (gender, ethnicity). Linear mixed models were used to identify associations between HPLP II scores and mandated/voluntary status, time, ethnicity gender and SURPS scale scores. RESULTS: In both groups, alcohol consumption dropped significantly by 12 months. Overall health-promoting behaviors, physical activity, stress management, and interpersonal relations improved in both groups between baseline and 12 months. Associations were found between alcohol consumption, personality traits, gender, and lifestyle health-promoting behaviors. In particular, impulsivity and hopelessness were associated with poor health behaviors. CONCLUSIONS: Intervention programs to reduce drinking by college students need to address developmental dynamics of freshmen students, including gender, psychosocial factors, personality, and lifestyle health-promoting behaviors.

A community-based comprehensive intervention program for 7200 patients with type 2 diabetes mellitus in Chongqing (China).

This study assessed the feasibility of community-based comprehensive intervention on Type 2 diabetes mellitus (T2DM) on a large population in China. An intervention study was conducted on 7200 T2DM patients within one year and consisted of six lectures on health issues, and four times face-to-face lifestyle counseling delivered by general health practitioners, at local primary health centers (PHCs). A "knowledge, attitude and practice" (KAP) survey and fasting plasma glucose (FPG) measurement were conducted at baseline and after the intervention, respectively. A total of 6586 T2DM patients completed the intervention. After one year intervention, patients' KAP level improved significantly (p < 0.001) and the average FPG has decreased from 8.53 mmol/L (standard deviation: 2.84) to 7.11 mmol/L (standard deviation: 1.34) (p < 0.001). Patients in rural areas and with lower education level showed higher FPG and poorer KAP level both before and after the intervention. In conclusion, community-based comprehensive intervention for T2DM is feasible on a large population. Improving and repeating the comprehensive strategy is greatly recommended in order to sustain the impact, especially in rural areas and for patients with lower education levels.

[Effect of comprehensive control in demonstration plot of clonorchiasis in Yangshan County, 2006-2009].

OBJECTIVE: To evaluate the effect of comprehensive control of clonorchiasis in demonstration plot in Yangshan County so as to popularize it. METHODS: Five areas in the east, south, west, north and center of Yangshan County were randomly sampled as the investigation spots, where the comprehensive control measures centered on health education and infectious source control were carried out. The baseline data were collected and the control effect was evaluated in the final term in 2009. RESULTS: The infection rate of Clonorchis sinensis decreased from 14.01% in 2006 to 6.87% in 2009, with the reduction rate of 50.96% (Chi2 = 36.37, P < 0.01), and the decline rates in the 5 investigation areas were 33.15%, 37.86%, 55.74%, 45.91% and 71.38%, respectively. CONCLUSIONS: The effect of comprehensive control measures in demonstration plot of in Yangshan County is significant, and it has achieved the goal of the national demonstration county of parasitic disease control, which requests for 40% decline in the infection rate.

[Observation on the therapeutic effect of neck clustered needling on insomnia].

OBJECTIVE: To compare therapeutic effects of neck clustered needling and medication on insomnia so as to search for a better method for treatment of insomnia. METHODS: Seventy-six insomnia patients were randomly allocated to an acupuncture group and a medication group, 38 cases in each group. The acupuncture group was treated by neck clustered needling, twice each week, 10 sessions constituting one course, and the medication group by oral administration of Alprazolam, before sleeping each day, 5 weeks constituting one course. The Pittsburgh Sleep Quality Index (PSQI) score was used for assessment of therapeutic effects, and the therapeutic effect and changes of PSQI scores before and after treatment were observed in the both groups. RESULTS: The total effective rate was 92.1% in the acupuncture group and 89.5% in the medication group with no statistically significant difference (P > 0.05). The cured rate of 34.2% and the cured and markedly effective rate of 84.3% in the acupuncture group were significantly higher than 7.900 and 36.9% in the medication group (both P < 0.01). Comparisons of the differences before and after treatment in scores of various factors between the two groups showed that the acupuncture group was better than the medication group in sleep quality, hypnotic use, activity of daily living and the improvement of the total score (P < 0.05 or P < 0.01), but the medication group was better than the acupuncture group in improvement of falling-asleep time (P < 0.05). CONCLUSION: The therapeutic effect of the neck clustered needling on insomnia is better than that of the medicine.