Current situation and correlation analysis of professional identity and burnout among nurses in health management department / 中华健康管理学杂志

Objective:To understand the current situation of professional identity and burnout among nurses in health management department in Henan province, and analyze their correlation.Methods:This is a cross-sectional study. A general data questionnaire, the Nurse Professional Identity Scale and Nursing Burnout Scale were used to conduct an online questionnaire survey on 204 nurses from the health management departments of 6 tertiary A hospitals in Henan Province (Henan Provincial People′s Hospital, the First Affiliated Hospital of Henan University of Chinese Medicine, Henan Hospital of Traditional Chinese Medicine, Fuwai Central China Cardiovascular Hospital, Henan Chest Hospital and Zhengzhou branch of Henan Orthopedic Hospital) from March 1, 2023 to May 1, 2023. A total of 204 questionnaires were issued and 204 were recovered, with an effective rate of 100%. The correlation between professional identity and burnout was analyzed, and the general data was included into the regression equation as the control variables and the multiple linear regression analysis was carried out.Results:Among the 204 nurses in the health management department, 114 (55.9%) had a medium level and 25 (12.3%) had a low level of professional identity, 137 (67.1%) had job burnout. There was a significant negative correlation between professional identity and burnout ( r=-0.244, P<0.01). The results of multiple step-up regression showed that cognitive evaluation, frustration coping, social support, marital status, age and position were the main influencing factors of job burnout (all P<0.05). Conclusions:The professional identity and burnout of nurses in health management department are at a medium level. The higher the level of professional identity identity, the lower the burnout, and marriage, age and position were related to job burnout.

sDR5 attenuates DR5-Trail-mediated neuronal apoptosis and improves long-term neurological deficits following subarachnoid hemorrhage / 中华神经医学杂志

Objective:To investigate the role and molecular mechanism of death receptor 5 (DR5) in early brain injury (EBI) after subarachnoid hemorrhage (SAH), as well as the neuroprotective effect of soluble DR5 (sDR5) on SAH.Methods:Experiment 1: SD rats were randomly divided into sham-operated group ( n=6) and SAH group (SAH model was established by carotid artery puncture, n=30), and the SAH group was further subdivided into post-SAH (6 h) group, post-SAH (12 h) group, post-SAH (24 h) group, post-SAH (48 h) group and post-SAH (72 h) group ( n=6); Western blotting was used to detect the expressions of tumor necrosis factor (TNF)-α and DR5; immunofluorescent DR5 and neuronal nuclear antigen (NeuN) double staining was used to evaluate the DR5 expression in neurons. Experiment 2: SD rats were randomly divided into sham-operated group, SAH group, Trail group (injected Trail agonist dordaviprone), and Trail+sDR5 group (injected dordaviprone+sDR5, n=6); at the 24 th h of successfully constructed SAH model, the caspase family protein levels were detected by Western blotting, and Tunel staining and immunofluorescent DR5 and Caspase-3 double staining were performed. Experiment 3: SD rats were divided into sham-operated group, SAH group, Trail group and Trail+sDR5 group ( n=6); long-term motor functions, by modified Gracia score, forelimb placement experiment, rotarod test and misstep experiment, were evaluated 5, 7 and 12 d after successfully constructed SAH model; and long-term learning and memory functions were detected by water maze experiment 14, 16, 18, 20 and 21 d after successfully constructed SAH model. Results:(1) Result of Experiment 1: the expressions of TNF-α and DR5 in sham-operated group, post-SAH (6 h) group, post-SAH (12 h) group, post-SAH (24 h) group, post-SAH (48 h) group and post-SAH (72 h) group were statistically different ( F=837.992, P<0.001; F=503.942, P<0.001), and these expressions peaked 24 h after SAH; immunofluorescent DR5 and NeuN double staining showed that DR5 was located in neurons after SAH. (2) Result of Experiment 2: compared with the SAH group and Trail group, the Trail+sDR5 group had significantly decreased levels of activated caspase-8, tBid and activated caspase-3, significantly decreased numbers of Tunel positive cells and DR5 and activated caspase-3 co-marked positive cells ( P<0.05). (3) Result of Experiment 3: compared with the SAH group and Trail group, the Trail+sDR5 group had significantly increased Garcia scores, decreased failure rate in forelimb placement experiment, prolonged duration of stick rotation, and decreased foot fault rate ( P<0.05), suggesting that sDR5 could improve the long-term motor function deficit after SAH; water maze experiment showed that 21 d after SAH, compared with the SAH group and Trail group, Trail+sDR5 group had significantly increased proportion of escape time in the original platform quadrat in total escape time and increased proportion of movement path in the original platform quadrat in total movement path after platform removal ( P<0.05), suggesting that sDR5 could improve long-term learning and memory impairment after SAH. Conclusion:The sDR5 can inhibit DR5-Trail-mediated neuronal apoptosis and improve long-term neurological functional deficits after SAH.

Application of TARP luciferase reporter system in function identification of CAR-T cells / 细胞与分子免疫学杂志

Objective To investigate a convenient and quantitative solution to activation levels and functional characterization of CAR-T cells by inserting T cell activity-responsive promoter (TARP) nanoluciferase reporter gene system into a lentiviral plasmid containing the gene encoding the chimeric antigen receptor (CAR). Methods The recombinant plasmid was constructed by using whole gene synthesis and molecular cloning techniques. The lentivirus was packaged and was infected with human primary T lymphocytes. Flow cytometry was used to detected the positive rate of lentivirus-infected T cells. The functional characterization of CAR-T cells was identified by luciferase reporter gene system, Western blot, flow cytometry, and small animal live imaging techniques. Results The results of enzyme digestion identification and the plasmid sequencing showed that the recombinant plasmids were constructed, and flow cytometry displayed the normal preparation of CAR-T cells. This system could dynamically respond to the activation of CAR-T cells by luciferase reporter gene system. The functional assay in vitro confirmed that the system could reflect the exhaustion of CAR-T cells, and the small animal live imaging results demonstrated that the system can be used as a tracer of CAR-T cells in mice. Conclusion TARP nanoluciferase reporter gene system provides a more convenient, sensitive and quantitative method for evaluating CAR-T cells activation level, exhaustion phenotype and tracing.

Collaboration between tertiary hospital and community health service center in comprehensive management of chronic liver diseases in the community / 中华全科医师杂志

Chronic liver diseases, including chronic hepatitis, autoimmune liver disease, alcoholic liver disease, cirrhosis, fatty liver disease, drug-induced liver injury and so on, are common and important disorders in China. A hospital-community-patient-family integration management model for chronic liver diseases has been implemented since 2018 in Shuangshuinian Community Health Service Center collaborated with Sichuan Provincial People′s Hospital. Patients were taken care by general practitioners in the community health center under the guidance of hospital specialists, and with the active participation of patients and their family. This article introduces this integrated management model and the preliminary accomplishment to provide a reference for the management of patients with chronic liver diseases in the community.

Application of flipped classroom teaching mode under the perspective of POA theory in orthopedic nursing teaching management / 中华医学教育探索杂志

Objective:To explore the application of flipped classroom teaching mode under the perspective of production oriented approach (POA) theory in orthopedic nursing teaching management.Methods:This study randomly enrolled 60 orthopedic clinical nursing interns from August 2018 to August 2019. They were randomly divided into control group (traditional teaching) and observation group (flipped classroom teaching under the perspective of POA theory), with 30 cases in each group. The out-department assessment results, error statistics of practice assessment, qualification rate of out-department assessment and the evaluation on teachers were compared between the two groups. SPSS 19.0 was used for chi-square test and t test. Results:When the interns leaving the department, the total scores of theoretical knowledge, nursing practice and assessment were higher than those before department admission, which were higher in observation group than in control group ( P<0.05). The scores of learning new knowledge, summarizing ability and clinical thinking ability in observation group were higher than those in control group ( P<0.05). The error rates such as unskilled physical examination and poor concept of aseptic debridement in observation group were lower than those in control group ( P<0.05). The satisfaction of interns with teachers' theoretical teaching ability, practical skill level and teaching attitude in observation group was higher than that in control group ( P<0.05). Conclusion:Flipped classroom teaching under the perspective of POA theory is beneficial to improve out-department assessment results and learning ability of orthopedics students, reduce physical examination and debridement errors in practice assessment, and improve higher satisfaction with teachers.

Effect of the location and size of region of interest on the measurement of liver fat content by QCT / 中华健康管理学杂志

Objective:To explore the effect of the location and size of region of interest (ROI) on the measurement of liver fat by means of quantitative computed tomography (QCT).Methods:A total of 98 subjects who were examined with QCT for bone mineral density examination from December 25, 2019 to January 17, 2020 were recruited continuously from the Department of Health Management of Henan Provincial People′s Hospital. The liver fat content was measured by QCT workstation. The ROI was located respectively in the left lobe, the right anterior lobe and the right posterior lobe of the liver, and it was measured independently by the A measurer and B measurer. The central position of the ROI was fixed and the diameter was increased, and it was measured by the A measurer. In this study, Friedman test was used to compare the differences of measurement results in different positions or sizes of ROI, and intra-class correlation coefficients (ICC) was used to evaluate the repeatability of inter-measurers.Results:There was a significant difference for liver fat content under different positions of ROI (χ2=62.306, P<0.001), but no difference under different seizes of ROI (χ2=1.088, P=0.581). The ICC values of the inter-measurers repeatability analysis of the A measurer and B measurer in the left lobe, right anterior lobe and right posterior lobe of the liver were 0.847, 0.917 and 0.874, all more than 0.75, and the reproducibility was good. Conclusions:When QCT technique is applied to the measurement of liver fat content, the location conditions of ROI may affect results, so it is necessary to select multiple ROI in the whole liver for measurement. The inter-measurers repeatability of QCT in different parts of the liver is good.

Meta-analysis of comparison for efficacies between surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced hypopharyngeal cancer / 中华耳鼻咽喉头颈外科杂志

Objective@#Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT).@*Methods@#We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software.@*Results@#A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01).@*Conclusions@#SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.

Correlation between acoustic radiation force impulse imaging and reserve function of liver / 中华超声影像学杂志

Objective:To investigate the correlation between acoustic radiation force impulse imaging(ARFI) and reserve function of liver and the feasibility of liver reserve function assessment by ARFI.Methods:According to the inclusion criteria, 74 patients were screened and 71 patients were finally enrolled from Henan Province People′s Hospital during June 2017 and June 2019. The portal vein diameter (D PV), spleen length (L SP) were measured by two-dimensional ultrasound. The liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were measured by ARFI. Serological markers were checked, and the indocyanine green (ICG)15-minute retention rate (ICG R15) was measured by excretion test. The patients were divided into ICG R15<10% group and ICG R15≥10% group, the difference of the measurements between two groups were calculated, the correlations of the measurements and ICG R15 were analyzed. LSWV diagnostic performance for liver reserve function was evaluated by the ROC curve. Results:There were significant differences in LSWV, D PV, SSWV, L SP, aspartate transaminase(AST), alkaline phosphatase(ALP), y-glutamyl transpeptidase(γ-GGT) and albumin (ALB) between ICG R15<10% group and ICG≥10% group( P<0.05), but no significant differences in other measurements( P>0.05). The correlations between ICG R15 and LSWV( r=0.673, P<0.001), D PV( r=0.355, P<0.05), SSWV( r=0.384, P<0.05), L SP( r=0.403, P<0.001), ALP( r s=0.245, P<0.05) and ALB( r s=-0.390, P<0.05) were statistically significant. The ROC curve showed high diagnostic performance for liver reserve function assessment by LSWV. The area under the ROC curve was 0.903 (95% CI=0.810-0.961, P<0.01), and the cut-off value was 2.15 m/s (sensitivity 84.6%, specificity 86.7%). Conclusions:The LSWV can evaluate the reserve function and it is a useful supplement to the ICG excretion experiment.

Reproducibility of liver fat content measured using quantitative computed tomography / 中华健康管理学杂志

Objective:To provide support for the clinical application of quantitative computed tomography (QCT) in the measurement of liver fat content, this study evaluated the intra-observer and inter-observer reproducibility of liver fat content measured by QCT in a population receiving physical examinations.Methods:From April to July 2019, 291 people were consecutively selected who underwent QCT examination in the health management department of Henan Provincial People′s Hospital. There were 214 males (73.5%) and 77 females (26.5%), aged 48.7±11.0. We measured liver fat content by QCT workstation. Three observers (A, B, C) measured their liver fat content independently, then observer A performed re-testing two weeks later. The mean value of the two measurements from observer A was taken as the final result. Measurement data were described by mean±SD. Intra-observer and inter-observer reproducibility were assessed using intra-class correlation coefficients ( ICC). Results:The first measurement result for observer A was 10.46±5.55 and the second measurement for observer A was 10.66±5.59, resulting in a final value of 10.56±5.51. The measurement results of observers B and C were 10.70±5.45 and 10.86±5.77, respectively. The ICC value of liver fat content values measured by the three observers was 0.960 (95% CI: 0.951-0.967, P<0.001) and the ICC value of liver fat content values for the two measurements of observer A was 0.953 (95% CI: 0.941-0.962, P<0.001). The ICC values were>0.75, so reproducibility of results was good. Conclusions:If the measurement method is consistent, the results for liver fat content measured by a conventional CT scanner and QCT workstation will have good reproducibility between and within observers, and will also have certain clinical application prospects.

Estimating the burden of influenza-associated hospitalization for cases of severe acute respiratory infection, Beijing, 2015 / 中华预防医学杂志

Objective@#To estimate the influenza infection rate among severe acute respiratory infection(SARI) cases and the hospitalization rates of SARI attributable to influenza, based on two sentinel hospital surveillance databases in Beijing, 2015.@*Methods@#Surveillance was conducted at two sentinel hospitals in Beijing in 2015. A total of 1 842 patients who admitted to the sentinel hospitals and met the definition of SARI were enrolled in the study. The respiratory tract specimens of SARI cases were collected, and sent to laboratories within 48 hours for influenza RNA detection. The catchment area of sentinel hospitals was defined by reviewing the home address of inpatients; A total of 1 491 patients were sampled and tested for influenza. The population size of catchment areas was obtained from demographic year book. We investigated the number of pneumonia patients admitted to the sentinel hospitals and other hospitals in catchment areas in 2015, and calculated the proportions of pneumonia patients that were admitted to sentinel hospitals in catchment areas. The catchment population size was calculated using the number of total population of catchment areas multiply by the proportions of pneumonia patients that were admitted at sentinel hospitals.@*Results@#Among 1 491 patients, 13.7% (205 cases) was test positive for influenza viruses, 2 (0.9%) cases positive for influenza A (H1N1), 91 (44.6%) cases influenza A (H3N2), 1 (0.5%) case influenza B/Victoria, 111 (54.0%) cases influenza B/Yamagata. Influenza was associated with an estimated 30 (95%CI:9-51) SARI hospitalizations per 100 000 during 2015. The hospitalization rate was 243 (95%CI: 232-255), 86 (95%CI: 59-112),1(95%CI: 0-5), 8 (95%CI: 0-23) and 92 (95%CI: 16-168) SARI hospitalizations per 100 000 population for<5 years children, 5-14 years children, 15-24 years adult, 25-59 years adult and ≥60 years population, respectively. The hospitalization rate of SARI attributed to influenza A and B was 14 (95%CI:4-17) and 16 (95%CI:0-23) per 100 000 population, respectively.@*Conclusion@#The influenza positive rate among SARI cases was relatively high. The hospitalization burden of SARI attributed to influenza was the greatest in children under 5 year-old.

Pathogenesis and prenatal diagnosis of hereditary Glanzmann thrombasthenia / 临床儿科杂志

Objective To explore the gene sequencing and prenatal diagnosis of Glanzmann thrombasthenia (GT). Methods The blood samples were drawn from one case of phenotype GT pediatric patient, patient’s parents, and one normal control. The amniotic lfuid and cord blood from the fetus of patient’s mother were collected. When the fetus was born 2 days, the blood was drawn. The coagulation routine test and platelet aggregation test were performed. The expression of platelet membrane glycoprotein (GP) IIb and GPIIIa were tested by lfow cytometry. Microsatellite technology is used to determine whether fetal cord blood is contaminated with maternal cells. The expressed region and the junctional zone between exon and introns of GPIIb and GPIIIa were ampliifed by PCR technology from blood sample of patient, patient’s parents, and fetus’s cord and 2 days after birth. The PCR products were then subjected to DNA sequencing. Results Adenosine diphosphate (ADP) cannot induce the platelet aggregation in the patient. The max rate of the platelet aggregation in the fetus’s cord blood was half of the normal. However, the max aggregation rate induced by ADP in the blood sample of parents and fetus 2 days after birth were equal to normal. The mean lfuorescence intensity (MnX) of platelet membrane GPIIb and GPIIIa in the patient were 10%and nearly zero of the normal control, respectively, while those in the parents, the fetus’s cord blood and 2 days after birth were more than 90%and 30%to 50%of the normal control. The cast-off cells in amniotic lfuid and the DNA in cord blood analysis by microsatellite technology conifrmed that the amniotic lfuid and cord blood not contaminated by maternal cells. Gene analysis showed the heterozygosis mutation in exon6 A3829→C and exon9 G42186→A of the patient’s GPIIIa led to the amino acid heterozygosis mutation in GPIIIaHis281→Tyr and Cys400→Pro. These two mutations came from the father and the mother separately. However, there was only one heterozygosis mutation in exon9 G42186→A in the cast-off cells in amniotic lfuid, the fetus’s cord and blood 2 days after birth. Conclusion This GT patient have double heterozygosis mutation. The fetus has heterozygosis mutation conifrmed after birth.

Evaluation for Clinical Application of Salvianolate Injection in the Second Hospital of Hebei Medical University / 中国中医药信息杂志

Objective To investigate the use of salvianolate injection for inpatients in our hospital; To primarily evaluate its rationality and security in clinic.Methods Medical records using the salvianolate injection from December 2013 to March 2014 were surveyed statistically and analyzed in respect of patient gender and age, department, disease diagnosis, usage and dosage, solvent types, treatment course, medicine combination, occurence of ADR, etc.Results Totally 600 cases of inpatients receiving salvianolate injection were collected, about 69.33% consistent with the indication, 67.00% with a correct single dosage, and 52.50% with a correct treatment course. In the clinical application of salvianolate injection, a high rate of unreasonable usage was found in indication, single dosage, treatment course and medicine combination.ConclusionBecause the problems still existed in the use of salvianolate injection, it should be used strictly according to the medicine instructions and General Principles for Clinical Application of Traditional Chinese Medicine Injection to ensure clinical medication safety.

Correlation of serum omentin-1 level and insulin resistance in rats / 中国病理生理杂志

[ ABSTRACT] AIM:To establish the insulin resistance rat model for evaluating the correlation of omentin-1 level and insulin resistance.METHODS: SPF male Wistar rats ( n =30 ) were randomly divided into normal control group (NC, n=15) and high-fat diet group (HF, n=15).The rats in NC group were fed with basic diet.The insulin resistant model was established by feeding the rats with high-fat diet in HF group.After 10 weeks, 5 rats in each group were as-sessed by the technique of hyperinsulinaemic-euglycaemic clamp.After the insulin resistant model was successfully estab-lished, the body weight and fasting blood glucose were detected.The concentration of fasting serum omentin-1 was analyzed by ELISA.Fasting serum insulin was measured by radioimmunoassay.RESULTS: No difference of fasting blood glucose between the 2 groups was observed.The level of fasting serum insulin in HF group was significantly higher than that in NC group ( P <0.05 ) .The level of serum omentin-1 in HF group were significantly decreased compared with NC group (P<0.01).Pearson’s correlation analysis showed that negative correlations between serum omentin-1 and fasting serum insulin (r=-0.654,P<0.01), serum omentin-1 and free fatty acid (r=-0.446, P<0.05) was found.CONCLU-SION:In rats, serum omentin-1 level began to decrease at insulin resistance stage.As serum omentin-1 level decreased, the basal insulin level increased, indicating that decreased serum omentin-1 level may be an early factor of IR, diabetes and cardiovascular diseases.

The establishment of a novel method of nano-immunomagnetic separation and Real-time PCR for detecting Vibrio cholerae from seafood / 中华预防医学杂志

<p><b>OBJECTIVE</b>A novel method of Nano-Immunomagnetic Separation (Nano-IMS) plus Real-time PCR was established for detecting Vibrio cholerae.</p><p><b>METHODS</b>The Nano-Immunomagnetic Beads were created by using the monoclonal antibody of Vibrio cholerae, which was named Nano-IMB-Vc. Nano-IMB-Vc has specific adsorption of Vibrio cholerae, combined with Real-time PCR technology, a method for rapid detection of Vibrio cholerae was established. The capture specificity of Nano-IMB-Vc was tested by using 15 bacteria strains. The specificity of Real-time PCR method was tested by using 102 targets and 101 non-targets bacteria strains. The sensitivity of Nano-IMS plus Real-time PCR were tested in pure culture and in artificial samples and compared with NMKL No.156.</p><p><b>RESULTS</b>The capture ratio of Nano-IMB-Vc was reached 70.2% at the level of 10(3) CFU/ml. In pure culture, the sensitivity of Nano-IMS plus Real-time PCR was reached at 5.4×10(2) CFU/ml. The specific of Real-time PCR method was tested by using 102 targets and 101 non-targets bacteria. The results showed that 102 strains of Vibrio cholerae test results were all positive, and the rest of the 101 strains of non-target bacteria test results were negative. No cross-reaction was founded. Add 1 CFU vibrio cholerae per 25 g sample, it could be detect with Nano-IMS plus Real-time PCR method after 8 hours enrichment.</p><p><b>CONCLUSIONS</b>The Nano-IMS plus Real-time PCR method of Vibrio cholerae established in this study has good specificity and sensitivity, which could be applied to the rapid detection of Vibrio cholerae.</p>

Clinical studies of 162 patients with von Willebrand disease / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyse the epidemiological feature, clinical characters and therapeutic regimens for von Willebrand disease(VWD).</p><p><b>METHODS</b>The clinical data and laboratory tests results of 162 VWD patients in our center were analyzed.</p><p><b>RESULTS</b>There were 76 males and 86 female among these patients with the mean age of 7.2(2.0-41.0) and 20.7(5.0-48.0) years, respectively. 86 patients (53.1%) were identified to be type 1 VWD, 34 patients (21.0%) type 3 VWD and 42 patients (25.9%) type 2 VWD. Among type 2 VWD patients, 33 patients were type 2A, 4 patients type 2M, 5 patients type 2B. Eighty-seven patients (53.7%) had a definite family history of bleeding tendency. The most common and specific bleeding symptoms were easy bruising (61.7%), epistaxis (53.7%), prolonged bleeding after surgery or minor injury (53.1%). Menorrhagia (66.3%) was common in female patients. The analysis of Vicenza bleeding scores in all patients showed that only 56(34.6%) patients had abnormal bleeding scores. FVIII/VWF concentrates and cryoprecipitate were applied to 45 patients (27.8% ), Desmopressin (DDAVP) to 8 patients. Eight female patients need oral contraceptives jointly to control menorrhagia. Hysterectomy had to be performed in 2 female patients with VWD.</p><p><b>CONCLUSION</b>VWD was a common congenital bleeding disorder with heterogeneous characters, it was necessary to screen, identify, classify accurately this disease in order to supply to effectively individualized treatment.</p>

Continuous venovenous hemofiltration after cardiac valve replacement / 中国组织工程研究

BACKGROUND:Abnormal immunological function is possibly observed after cardiac valve replacement. However, effect of continuous venovenous hemofiltration on immunological function after cardiac valve replacement is rarely reported. OBJECTIVE:To observe the effect of continuous venovenous hemofiltration on the cellular immune function in patients with multiple organ dysfunction syndrome after cardiac valve replacement. METHODS:Thirty-one patients with multiple organ dysfunction syndrome after cardiac valve replacement in Xijing Hospital, the Fourth Military Medical University of Chinese PLA, from August 2008 to July 2009, were included in this study. They were treated with continuous venovenous hemofiltration using AV600 hemofilter and were divided into two groups:survival group (17 survivors) and death group (14 deaths). In addition, 16 healthy blood donors served as the control group. RESULTS AND CONCLUSION:The duration of acute renal failure before continuous venovenous hemofiltration of survival group was significantly lower than that of death group (P<0.05). Before continuous venovenous hemofiltration, the CD4+/CD8+ratio and Th1/Th2 ratio of survival group and death group were lower than that of control group (P<0.05), and lymphocyte apoptosis rate and Fas/FasL antigen expression were higher than that of control group (P<0.05). This evidence suggested the presence of immunosuppression state and Th1/Th2 disbalance. During continuous venovenous hemofiltration, the CD4+/CD8+ratio and Th1/Th2 ratio of survival group were gradual y increased (P<0.05), while lymphocyte apoptosis rate and Fas/FasL antigen expression were gradual y decreased (P<0.05) at 24 hours. The above changes were observed in both survival group and death group, but emerged latter in death group. Continuous venovenous hemofiltration can improve cellular immune function, maintain the balance of T lymphocyte subsets and Th1/Th2, down-regulate Fas/FasL expression on the surface of lymphocyte membrane, and decrease lymphocyte apoptosis rate in patients with multiple organ dysfunction syndrome after cardiac valve replacement. Early continuous venovenous hemofiltration can improve patients’ prognosis.

Effect of curcumin on expression of resistin mRNA in rats with insulin resistance / 中华内分泌代谢杂志

By feeding rats with high-fat diet insulin resistant models were induced.Some of the models were treated with intragastric administration of curcumin,then the effects were evaluated by hyperinsulinaemic-euglycaemic clamp technique.Curcumin reduced the level of serum resistin and the expression of resistin mRNA in adipose tissue,and thus ameliorated insulin resistance in rats.

Effects of metformin on chemerin expression in visceral adipose tissue of insulin-resistant rats / 中华内分泌代谢杂志

After 4 weeks old male Sprague-Dawley rats were fed with normal diet and high-fat diet for 10 weeks,the rats were treated with metformin (200 mg/kg) for 6 weeks. Insulin sensitivity was determined by hyperinsulinemic-euglycemic clamp technique.Realtime PCR and western blot were used to measure mRNA and protein levels of chemerin in perirenal adipose tissue of rats.The results showed that the expressions of chemerin mRNA and protein were higher in high-fat diet-induced insulin resistant rats compared with rats fed with normal diet ( both P＜0.05 ),and these incremental findings were diminished by metformin treatment ( both P＜0.01 ).The levels of chemerin mRNA and protein were correlated well with the epididymis fat mass index.

Hydroxychloroquine inhibits ultraviolet-induced expression of interleukin-10 and interferon-7 from CD4+T cells in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To explore the role of hydroxychloroquine (HCQ) in ultraviolet B (UVB)- induced expression of interleukin (IL)-10 and interferon (IFN)-γ from CD4+T cells in patients with systemic lupus erythematosus (SLE). Methods Thirty patients with SLE and 10 healthy controls were enrolled in the study. CD4+ T cells were isolated using magnetic beads from SLE patients and healthy controls. HCQ was added in culture media before and after irradiation with UVB 311 nm narrow band ultraviolet B (NB-UVB). The levels of IL-10 and IFN-γ in the supernatant were detected with enzyme-linked immunosorbent (ELISA). Comparisons between groups were performed by t-test. Results The level of IL-10 was higher in SLE patients [(27±4) pg/ml] than that in healthy controls [(18±3) pg/ml, P=0.011]. After exposure of CD4+T cells to UVB in 45 or 100 mJ/cm2 dosages, the level of IL-10 was increased significantly in patients with active disease (P=0.022, P=0.048). After exposure of CD4+T cells to UVB in 100 mJ/cm2 dosages, the levels of IL-10 was higher in patients with active disease [(77±42) pg/ml] than patients with stable disease [(24± 4) pg/ml, P=0.029]. When CD4+ T cell were cultured with HCQ, IL-10 and IFN-γ levels in patients with active disease [(2.6±4.0), (17.5±2.3) pg/ml] were decreased significantly (P=0.018, P=0.017). HCQ reversed UVB-induced IL-10 expression in active SLE patients after exposure of CD4+T cells to UVB in 45 or 100 mJ/cm2 dosages (P=0.037, P=0.04). HCQ also reversed UVB-induced IFN-7 expression in active SLE patients and stable SLE patients after exposure to CD4+T cells with UVB in 100 mJ/cm2 dosages (P=0.013, P= 0.049). Conclusion UVB can aggravate the imbalance of Th1 and Th2 cytokines. HCQ inhibits UVB-induced IL-10 and IFN-7 expression of CD4+T cells in patients with SLE, especially in patients with active disease.

Hydroxychloroquine reverses ultraviolet ray-induced genomic DNA hypomethylation in CD4+ T cells from patients with systemic lupus erythematosus / 中华皮肤科杂志

Objective To explore the effect of hydroxychloroquine on ultraviolet ray-induced genomic DNA hypomethylation in CD4+ T cells from patients with systemic lupus erythematosus (SLE). Methods Thirty patients with SLE and 10 normal human controls were enrolled in the study. CD4+ T cells were isolated from these subjects by using magnetic beads, and cultured. Hydroxychloroquine of 50 mg/L was added to the culture medium of CD4+ T cells before or after the exposure to narrow band ultraviolet B (NB-UVB) 311 nm.After additional culture, the levels of genomic DNA methylation in CD4+ T cells were determined with the Imprint Methylated DNA Quantification kit. Results The levels of DNA methylation was lower in SLE patients than in the normal controls [(3.922 ±2.215)% vs. (10.210 ± 5.573)%, t= 3.450, P = 0.026]. After exposure to UVB at 45 and 100 mJ/cm2, the DNA methylation level in patients with active SLE decreased from (7.235 ±3.846)% to (1.784 ± 1.033)% and (1.932 ± 1.844)% respectively (t= 3.000, 4.118, both P< 0.05). Decreased DNA methylation level was observed in CD4+ T cells from patients with active SLE compared with those from patients with stable SLE and normal human controls [(1.932 ± 1.844)% vs. (7.235 ± 3.846)% and (5.472 ±5.573)%, t = 2.648, 3.000, both P< 0.05] after irradiation with UVB of 100 mj/cm2. A significant increase in the methylation level was observed in active SLE patient-derived CD4+ T cells treated with hydroxychloroquine following the irradiation with UVB of 45 (4.698% ± 1.948%) and 100 mJ/cm2(8.698% ± 3.151%) compared with those only treated with UVB irradiation (t = 4.827, 3.184, both P< 0.05), as well as in those treated with hydroxychloroquine before and after the irradiation with UVB of 45 mJ/cm2 compared with those receiving irradiation alone [(5.404 ± 2.308)% vs. (1.784 ± 1.033)%, t = 4.827, P< 0.01]. Conclusion Hydroxychloroquine can reverse the UVB-induced genomic DNA hypomethylation in CD4+ T cells from patients with SLE,especially in those from patients with active SLE.