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AIM: To evaluate the efficacy of 0.01% hypochlorous acid as a conjunctival sac disinfectant before cataract phacoemulsification and its impact on the ocular surface.METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ2=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients. CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.
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ObjectiveTo establish a rat model of diabetic wound by feeding on a high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin (STZ) and surgical preparation of full-thickness skin defects, observe the effect of cinnamaldehyde on the wound healing of diabetes rats, and explore the therapeutic mechanism of cinnamaldehyde in improving wound healing of diabetes rats based on the PTEN-induced putative kinase (PINK1)/Parkin pathway-mediated mitochondrial autophagy. MethodForty-eight male SD rats were randomly divided into blank group (n=12) and diabetes group (n=36). The diabetes group was further randomly divided into model group, cinnamaldehyde group, and Beifuxin group, with 12 rats in each group. The blank group and the model group received routine disinfection with physiological saline after creating the wounds, while the cinnamaldehyde group received topical application of polyethylene glycol 400 (PEG 400) gel containing 4 μmol·L-1 cinnamaldehyde, and the Beifuxin group received topical application of Beifuxin gel. Dressings were changed once daily. The wound healing rate of each group was observed. On the 7th and 14th days after intervention, the wound tissues of the rats were collected. Hematoxylin and eosin (HE) staining was performed to observe the pathological changes in the local tissues. Immunohistochemistry (IHC) was used to detect the expression of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and collagen fibers. Immunofluorescence (IF) and Real-time polymerase chain reaction (Real-time PCR) were used to detect the protein, and mRNA expression of PINK1, Parkin, microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ). ResultAfter intraperitoneal injection of STZ, compared with the blank group, the random blood glucose values of rats in the diabetic group increased significantly (P<0.01), all higher than 16.7 mmol·L-1, and persistently hyperglycemic for some time after modeling. Compared with the blank group, the model group showed poor growth and healing of granulation tissue in the wounds, and the wound healing rate decreased (P<0.01). On the 7th day after intervention, the blank group had squamous epithelial coverage on the wounds. Compared with the blank group, the model group only had a small amount of scab at the wound edges, with a large number of infiltrating inflammatory cells in the wounds. The protein expression levels of IL-6 and TNF-α in the tissues increased (P<0.01), and the protein and mRNA levels of PINK1, Parkin, and LC3Ⅱ decreased (P<0.01). On the 14th day after the intervention, the granulation tissue in the wounds of the blank group was mature and well-healed. Compared with the blank group, the model group still had infiltrating inflammatory cells and red blood cell exudation. The protein expression levels of VEGF and collagen fibers in the tissues decreased (P<0.01), and the protein and mRNA expression levels of PINK1, Parkin, and LC3Ⅱ increased (P<0.01). Compared with the model group, the cinnamaldehyde group and the Beifuxin group showed better wound healing, with increased wound healing rates (P<0.01). On the 7th day after intervention, the protein expression levels of IL-6 and TNF-α in the tissues decreased (P<0.01), and the protein and mRNA expression levels of PINK1, Parkin, and LC3Ⅱ increased (P<0.01). On the 14th day after intervention, the protein expression levels of VEGF and collagen fibers in the tissues increased (P<0.01), and the protein and mRNA expression levels of PINK1, Parkin, and LC3Ⅱ decreased (P<0.01). ConclusionCinnamaldehyde can promote the wound healing of diabetes rats by increasing the wound healing rate, reducing the levels of inflammatory factors IL-6 and TNF-α, and increasing the levels of VEGF and collagen fibers. Its mechanism may be related to the regulation of the PINK1/Parkin signaling pathway, activation of mitochondrial autophagy, inhibition of inflammatory responses, and promotion of angiogenesis and collagen synthesis, thereby promoting the wound healing of diabetes rats.
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Objective:To report 3 cases of rare subtypes of hereditary epidermolysis bullosa.Methods:Clinical data were collected from the probands and their relatives, whole-exome sequencing was performed to screen disease-causing mutations in the probands, and Sanger sequencing or qPCR was conducted to verify the mutations in patients and their relatives.Results:Case 1 mainly presented with linear red scars on the back, and the proband, her mother with similar clinical manifestations and her asymptomatic daughter all carried a mutation c.4573G>A (p.Gly1525Arg) in the COL7A1 gene. Case 2 presented with generalized reticular pigmentation all over the body and occasional blisters restricted to the hand and foot, and carried a de novo mutation c.74C>T (p.Pro25Leu) in the KRT5 gene. Case 3 presented with pigmentation abnormalities mainly located at the sun-exposed sites and incomplete syndactyly of the left hand, and carried homozygous deletion mutations in exons 2-6 of the FERMT1 gene, which were inherited from her asymptomatic parents. Case 1 was diagnosed with dominant dystrophic epidermolysis bullosa pruriginosa, case 2 was diagnosed with epidermolysis bullosa simplex with mottled pigmentation, and case 3 was diagnosed with Kindler epidermolysis bullosa. Conclusion:The clinical manifestations of epidermolysis bullosa vary greatly, and gene detection is very important for confirmation of diagnosis of its rare types.
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Objective:To analyze the number of appeals volume and causes for complaints received by the government hotline against a hospital in Yangzhou during the pandemic of novel coronavirus pneumonia(hereinafter referred to as COVID-19), so as to provide reference for handling such hotline complaints during pandemics.Methods:Retrospective comparative analysis was made on the " 12345" government hotline work orders received from July 28, 2020 to August 28, 2020(routine prevention and control period) and July 28, 2021 to August 28, 2021(pandemic closure and control period). A descriptive analysis was made on the cause types of complaints and the distribution of departments in question, along with an analysis of the correlation between the cumulative number of cases of pandemic development and the number of complaints using Spearman rank correlation method.Results:The number of work orders for a hospital in Yangzhou during the pandemic control period(659 cases) was 7.7 times higher than that in the routine control period(76 cases). Management problems accounted for 96.7%(637 cases) in the level-1 type of the causes of complaints during the closure and control period of the pandemic, and workflow problems accounted for 90.9%(599 cases) in the level-2 type, which increased by 28.3 and 27.7 percentage points respectively compared with the routine prevention and control period; The highest proportion in the level-3 type of causes for complaints during the closure and control period of the pandemic was administrative management, accounting for 87.9%(579 cases). The departments being complained the most during the pandemic incubation period, outbreak period and recovery period of the pandemic were the fever clinic, oncology department and discharge center respectively. The cumulative number of cases of pandemic development was positively correlated with the number of complaints.Conclusions:During the COVID-19, the handling of the government hotline should be analyzed along with the causes of complaints, focusing on patients′ demands, providing timely feedback, developing collaborative management measures, and achieving accurate policy implementation.
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Objective:Rat osteoarthritis (OA) model with different experimental cycles was established, analysis of small molecule metabolites in urine were carried out, in order to study the OA biomarkers and/or biomarker clusters with disease and/or the severity of disease indicator function.Methods:Using random number table method, sixty male SPF sprague-dawley (SD) rats weighing 300 - 350 g were randomly divided into model group and control group according to their body weights with 30 rats in each group. The experimental cycles were 4, 8 and 12 weeks, respectively. Rat OA model was established by modified Hulth method. At the end of each experiment, knee joint tissue and urine samples were collected. The knee joint histopathological slides were used to observe modeling situation under light microscope. High performance liquid chromatography quadrupole ion trap tandem mass spectrometer [HPLC-(Q-TRAP)-MS/MS] was used to quantitatively detect the candidate substance in the urine of rats. SPSS 20.0 was used to process and analyze the measurement data. Wilcoxon rank-sum test was used for comparison between groups. Python 3.0 was used to plot the receiver operator characteristic (ROC) curve. P < 0.05 was considered to be statistically significant. Results:Histological observation showed that in model group, the joint space narrowed or disappeared, the cartilage became thinner, damaged or extensively exfoliated. The chondrocytes were degenerated, necrotic or absence. With the extension of the experimental cycles, the lesions worsened. Targeted metabolomics study found that 7 different metabolites were screened at 4 weeks, namely fumaric acid, succinic acid, oxaloacetic acid, malic acid, cis-aconite acid, α-ketoglutaric acid and sulfoalanine. Sulfoalanine was low expressed in model group and other 6 organic acids were high expressed ( P < 0.05). At 8 weeks, a total of 12 different metabolites were screened, including histidine, lysine, tyrosine, tryptophan, threonine, valine, leucine, aspartic acid, creatinine, α-ketoglutaric acid, oxaloacetic acid and malonyl carnitine, all of them were highly expressed in model group ( P < 0.05). At 12 weeks, a total of 4 different metabolites were screened, among which sulfoalanine, cysteine and sarcosine were low expressed in model group, and succinic acid was high expressed ( P < 0.05). Conclusions:Typical OA pathology changes and disease progress in the rats of model group are exhibited, the model is established successfully. The urinary small molecular metabolite profiles of OA rats with different disease progress are different, mainly organic acids and amino acids. The metabolites related to urinary tricarboxylic acid cycle and essential amino acids can be used as biomarker clusters of OA.
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Objective:To screen differential metabolites and metabolic pathways which are related to knee osteoarthritis in rats, and to provide clues for further study of biomarkers of osteoarthritis.Methods:Sixty SPF male SD rats were divided into model and control groups according to their body weight (300 - 350 g) by random number table method, with 30 rats in each group. The experimental periods were 4, 8 and 12 weeks, each period included 10 rats in each group. The left knee joints of rats in the model group were operated by the modified Hulth method. After 5 d, rats in the model group were driven to move for 30 min every day. All rats were fed ordinary solid fodder and drank tap water. At the end of the experimental period, the knee joints and blood samples of rats were collected. Hematoxylin-eosin (HE) staining was used to observe histopathological changes of knee joint, ultra-performance liquid chromatography quadrupole time-flight mass spectrometry (UPLC-Q-TOF-MS) was used to detect small molecule metabolites in serum, and multivariate statistical analysis and database comparison were used to screen the differential metabolites and related metabolic pathways associated with osteoarthritis.Results:In the model group, the articular cartilage of knee was thinned, the surface was roughness, defect or peeling, chondrocytes were degeneration, necrosis and deletion, and the lesions were aggravated with prolonged experimental period. A total of 11 serum differential metabolites related to osteoarthritis were screened out, including selenocysteine, 6-hydroxymelatonin, γ-glutamylcysteine, arachidonic acid, sphinganine, leukotriene A4, leukotriene B4, 11,12-epoxy-eicostrienoic acid (11,12-EpETrE), lysopc, ceramide and N-arachidonoyl glycine. Among them, 9 metabolites were screened out at 4 weeks, compared with the control group, 5 metabolites were increased and 4 metabolites were decreased in the model group; 8 metabolites were screened out at 8 weeks, compared with the control group, 2 metabolites were increased and 6 metabolites were decreased in the model group; 8 metabolites were screened out at 12 weeks, compared with the control group, 5 metabolites were increased and 3 metabolites were decreased in the model group. The most relevant metabolic pathways related to osteoarthritis were sphingolipid metabolic pathway and arachidonic acid metabolic pathway. Sphinganine and ceramide were belonged to sphingolipid metabolic pathway, whereas arachidonic acid, leukotriene A4 and leukotriene B4 were belonged to arachidonic acid metabolic pathway.Conclusions:The progression of osteoarthritis can affect the composition and level of serum metabolite profile. Eleven serum differential metabolites are involved in sphingolipid metabolic pathway and arachidonic acid metabolic pathway, which are related to the occurrence and development of osteoarthritis.
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Objective The objective is to probe into the effects of astragaloside Ⅳ (AS-Ⅳ) on activity and proliferative function of endothelial progenitor cells (EPCs),which lays a foundation for further study on the effects of AS-Ⅳ on vascular neovascularization mediated by endothelial progenitor cells.Methods The mononuclear cells were isolated by the density gradient centrifugation in umbilical cord blood of full-term healthy infants,and EPCs were obtained by subculture and cell identification when the cells presented spindle shapes.The obtained EPCs were randomly divided into the experimental group and the control group.In the experimental group,EPCs were cultured by AS-Ⅳ with different concentration gradients (25 mg/L,50 mg/L,100 mg/L,200 mg/L and 400 mg/L),while in the control group,they were treated with the same amount of phosphate buffer saline (PBS) solutions.The effects of AS-Ⅳ on the proliferation of endothelial progenitor cells was studied by cell counting kit-8 (CCK-8) cell proliferation experiment,and the activity rate of EPCs cells was measured at the optimum concentration of EPCs proliferation.Results EPCs were successfully obtained after confirming nuclear staining test of CD31 antibody and 4',6-diamidi-no-2-phenylindole (DAPI).Further study showed that AS-Ⅳ can promote the proliferation of EPCs,and its optimal concentration of EPCs proliferation is 100 mg/L.Compared with the normal control group,the activity rate of endothelial progenitor cells after intervention of AS-Ⅳ was 98.7%,higher than 98.12% in the control group,with significant difference (x2 =49.59,P <0.01).Conclusions AS-Ⅳ can enhance the activity of human EPCs and promote their proliferation in vitro.
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Cervical cancer (CC) is the fourth most commonly diagnosed female malignancy and a leading cause of cancer-related mortality worldwide, especially in developing countries. Despite the use of advanced screening and preventive vaccines, more than half of all CC cases are diagnosed at advanced stages, when therapeutic options are extremely limited and side effects are severe. Given these circumstances, new and effective treatments are needed. In recent years, exciting progress has been made in immunotherapies, including the rapid development of immune checkpoint inhibitors. Checkpoint blockades targeting the PD-1/PD-L1 axis have achieved effective clinical responses with acceptable toxicity by suppressing tumor progression and improving survival in several tumor types. In this review, we summarize recent advances in our understanding of the PD-1/PD-L1 signaling pathway, including the expression patterns of PD-1/PD-L1 and potential PD-1/PD-L1-related therapeutic strategies for CC.
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Objective To quantitatively analyze the dynamic changes of amino acid levels in serum of osteoarthritis rats,and to provide clues for further studies on biomarkers and metabolic mechanisms of osteoarthritis.Methods Sixty healthy male Sprague-Dawley (SD) rats were randomly divided into model group and control group according to their body weight by random number table method,the experimental period was 4,8 and 12 weeks,respectively,ten rats in each group.The left knee hind joints of rats in model group were operated by the modified Hulth method.After 5 days,rats of model group were driven to move for 30 minutes a day.Rats of two groups were fed ordinary solid fodder and drank tap water.At the end of the experimental period,the knee joints were collected for pathological observation.The amino acid content in serum was determined by high performance liquid chromatography-quadrupole ion trap tandem mass spectrometer (HPLC/Q-TRAP-MS/MS).The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the ability of differential amino acids to diagnose disease,AUC > 0.7-0.9 was certain accuracy,> 0.9 was high accuracy.Results Under the light microscope,in control group,the articular cartilage surface was smooth and continuous,and the chondrocytes had good overall morphological structure and distinct layers;in model group,the articular cartilage of rats thinned,the surface was roughness and defect,the chondrocytes degenerated,necrosis and disappeared,and the lesions were aggravated with the extension of observation period.Forty kinds of amino acids were detected.Compared with control group,at 4 weeks after surgery,the level of 24 kinds of amino acids in model group decreased and 14 kinds of amino acids were increased,among which the differences in taurine,glutamine,serine,glutamic acid,aspartic acid,γ-aminobutyric acid and hydroxyproline were statistically significant (P < 0.05);at 8 weeks after surgery,24 kinds of amino acids in model group were increased and 16 were decreased,among which the differences in histidine,serine,glutamic acid,homoarginine,lysine,isoleucine and glycine were statistically significant (P < 0.05);at 12 weeks after surgery,36 kinds of amino acids in model group were decreased,among which the differences in 21 kinds of amino acids were statistically significant (P < 0.05),all of their AUC were not less than 0.740,and the AUC of 14 amino acids were not less than 0.800,and the highest was kynurenine (0.980).Conclusions The model of knee osteoarthritis in rats is established successfully.With the increased time,the progress of osteoarthritis lesions increases,and the amino acid metabolism in osteoarthritis rats is out of order.
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Objective:To explore the application of pyrophosphorolysis-activated polymerization(PAP)to monitor plasma cfDNA in ad-vanced non-small cell lung cancer(NSCLC).Methods:A total of 85 patients diagnosed with advanced NSCLC between March 2016 and June 2017 were enrolled in the present study. EGFR mutations in cfDNA extracted from the plasma were detected using PAP and ARMS-PCR technology.The concordance analysis of EGFR mutations involved plasma vs.tumor tissue and PAP vs.ARMS-PCR.Further-more,38 EGFR-positive patients were selected to monitor EGFR mutations with PAP.Results:No statistical differences in EGFR muta-tions were observed between plasma and tumor tissue(P=0.092),as well as PAP and ARMS-PCR(P=0.210).The detection rate of EGFR mutations in cfDNA was higher in the progressor than in the non-progressor(62.5% vs.21.3%,P<0.001).Conclusions:PAP can be used for detecting and monitoring EGFR mutations in cfDNA to predict disease progression.
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Objective To explore the application of projection pursuit model in anti-assessment on peer reviewer of scientific research project,discussing the rational of this application.Methods Establishing the projection pursuit model of anti-assessment on peer reviewer,with the best projection direction as a weight,making an evaluation on the peer reviewer,and sequencing experts by projection value.Results The projection pursuit model is stable and scientific,the importance of index ranking as correlation coefficient> dispersion> hit rate> synthetic dispersion> self dispersion ratio.Conclusions The application of projection pursuit model in anti-assessment on peer reviewer of scientific research project,is reasonable and practicable.
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Peer review anti assessment includes the evaluation of expert and index system in two parts.The current status of anti-assessment study mainly focused on expert,much of the index system anti-assessment study reports.As can be seen from the status,the anti-assessment system not yet formed and the application is rare.In urgent need of further research to improve our peer-reviewed scientific research.
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<p><b>OBJECTIVE</b>To establish a gene identification method of Yersinia pestis and Yersinia pseudotuberculosis for plague surveillance.</p><p><b>METHODS</b>According to the specific genomic sequences of Y. pestis and Y. pseudotuberculosis, i.e. "pestis Island (PeI)" and "pseudotuberculosis Island (PsI)" and the published genomic sequences of 12 strains of Y. pestis and 4 strains of Y. pseudotuberculosis, the specific identification primers of these sequences were designed.</p><p><b>RESULTS</b>A total of 52 strains of Y. pestis and 57 strains of Y. pseudotuberculosis and other intestinal bacteria strains were tested with PCR. Of the 5 pairs of Y. pestis identification primers, PeI2 and PeI11 were specific for Y. pestis. Besides Y. pestis, the primers PeI1, PeI3 and PeI12 could detect part of 57 Y. pseudotuberculosis strains. Of the 5 pairs of Y. pseudotuberculosis identification primers, PsI1 could detect all the 52 strains of Y. pestis and 57 strains of Y. pseudotuberculosis. PsI7, PsI16, PsI18 and PsI19 were specific for Y. pseudotuberculosis.</p><p><b>CONCLUSION</b>The primers PsI1, PeI 2 and PeI11, PsI7, PsI16, PsI18 and PsI19 can be used in the rapid identification of Y. pestis and Y. pseudotuberculosis, which can be also used to explore the circulation of atypical Y. pestis in quiescent plague foci.</p>
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Humanos , Secuencia de Bases , China , Epidemiología , Cartilla de ADN , Genómica , Peste , Diagnóstico , Epidemiología , Reacción en Cadena de la Polimerasa , Vigilancia de la Población , Métodos , Yersinia pestis , Genética , Yersinia pseudotuberculosis , GenéticaRESUMEN
With a reflection on the grand quantitative analysis in previous historical investigations, microhistory came into being in Italy in the 1960s and the 70s. Microhistory is, in principle, the intensive historical investigation of a relatively well defined smaller object. Notwithstanding, it still has the ambition to draw a larger picture of the history. Microhistory is also characterized by its preference to the exceptional individuals or phenomena, its "narrative" style and the delicate way it deals with historical sources. Essentially, microhistory endeavors to bring the individual's role, the concrete life as well as the diversity and complexity of history to the historical writing. At first, microhistory did not have intersection with the medical history. Nevertheless, the history of medicine echoes microhistory in bringing the concrete and vivid life beings to history. Mainly due to this similarity, historical surveys on medicine from the perspective of microhistory are increasing and gradually develop into a remarkable trend in the international historical academy from the 1980s onwards. As the microhistory is rising and its influence is expanding, the microhistorical approach has been practiced to a certain extent in the historical writings on medicine in China. Concentrating on an individual person, a single event, a particular drug or a specific concept, there already have some studies conduct intensive historical investigation on a small scale. A small part of these researches, for example, those of Chang Che-Chia, Li Shang-jen and etc. could be regarded as perfect examples of microhistory. However, no relevant research is carried out explicitly under the heading of microhistory, instead, they are the offspring of the "new history". Besides, most of these researches could not be regarded as real microhistories, strictly speaking. They do not practice microhistory consciously and they have a long way to go to improve the delicacy of the analysis, to reinforce the narrative style and to grasp the social context of the individual or the event (the link between micro and macro levels). Nevertheless, these studies anyway indicate the invisible influence of microhistory and have paved a way for the future microhistorical investigations on medicine. We believe that microhistory is an undercurrent about to emerge in the field of Chinese medical history. It is the right time to advocate and promote the self-conscious microhistorical investigation, promptly and strongly, while updating the ideas and methods of it to make it a dominant trend rather than an undercurrent in the studies of Chinese medical history. Its rise would not only display the value and significance of microhistory in a better way, but also would help medical history to realize its core idea of history of life, therefore to propel our inquiry into Chinese medical history.
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China , Historiografía , Historia de la MedicinaRESUMEN
It is imperative to apply information technology in the area of management of clinical research so as to ensure the quality of clinical trials and to improve management efficiency.In this study,the based analysis method was the quality function deployment (QFD).This methodology is used to analysis the clinical trials management information system on a hospital directly under the Ministry of Health.It ensured user participation,lay a solid foundation for software engineers on system design.