Study on the antipyretic mechanism of large pushing Tianheshui for young rabbits with endotoxin-induced fever / 针灸推拿医学（英文版）

Objective:To observe the effect of large pushing Tianheshui manipulation intervention on the body temperature of young rabbits with endotoxin-induced fever and discuss its antipyretic mechanism.Methods:Thirty-two young rabbits meeting the standards were selected from 40 ordinary young male New Zealand rabbits after being adapted for 7 d,and randomly divided into a normal group,a model group,a large pushing Tianheshui group,and an ibuprofen group according to the random number table method,with 8 rabbits in each group.Rabbits in the model group,the large pushing Tianheshui group,and the ibuprofen group were subjected to preparing the endotoxin-induced fever model by intravenous lipopolysaccharide from the marginal ear vein.Rabbits in the large pushing Tianheshui group received Tuina(Chinese therapeutic massage)manipulation intervention 1.5 h and 2.5 h after modeling,respectively.Rabbits in the ibuprofen group were intragastrically given ibuprofen suspension 1.5 h after modeling.The dynamic changes in body temperature were observed for the young rabbits after fever modeling.Enzyme-linked immunosorbent assay was used to determine the content changes in positive mediators of hypothalamic body temperature,including prostaglandin(PG)E2 and cyclic adenosine monophosphate(cAMP),as well as negative mediators of hypothalamic body temperature,including arginine vasopressin(AVP)and α-melanocyte stimulating hormone(α-MSH).Results:The body temperature of the young rabbits in the model group was significantly higher than that in the normal group at 0.5-4.0 h,5.0 h,and 5.5 h after modeling(P＜0.01),showing two obvious fever peaks in the model group at 1.5 h and 3.0 h after modeling,respectively,with the highest peak at 1.5 h.Compared with the model group,body temperatures of the large pushing Tianheshui group and the ibuprofen group decreased significantly after 0.5 h of intervention(P＜0.05).Compared with the normal group,the contents of PGE2 and cAMP were significantly increased(P＜0.05),and the contents of AVP and α-MSH were significantly decreased(P＜0.01)in the hypothalamus of the model group.Compared with the model group,the contents of PGE2 and cAMP were significantly decreased(P＜0.01),and the levels of AVP and α-MSH were significantly increased(P＜0.01)in the hypothalamus in the large pushing Tianheshui group and the ibuprofen group.There were no significant differences in the PGE2,cAMP,AVP,and α-MSH contents in the hypothalamus between the ibuprofen group and the large pushing Tianheshui group(P＞0.05).Conclusion:Large pushing Tianheshui manipulation has a significant antipyretic effect on endotoxin-induced fever in young rabbits.The mechanism may be related to inhibiting the positive regulators(PGE2 and cAMP)and promoting the negative regulators(AVP and α-MSH)of hypothalamic control of body temperature.

Application of bedside ultrasound in the evaluation of volume responsiveness in patients with septic shock / 中国医师杂志

Objective:To evaluate the value of bedside ultrasound in evaluating volume responsiveness of patients with septic shock.Methods:A total of 102 patients with septic shock admitted to ICU of the First Affiliated Hospital of Hebei North University from April 2018 to February 2021 were selected. Patients were divided into response group and non-response group according to the value of stroke volume increase (ΔSV) after volume loading test (VE), and the hemodynamic parameters before and after VE were compared between the two groups. Pearson correlation was used to analyze the relationship between ΔSV and hemodynamic indexes. Receiver operating characteristic (ROC) curve was drawn to analyze the sensitivity and specificity of each hemodynamic index in evaluating volumetric reactivity in patients with septic shock.Results:Of the 102 patients, 54 responded and 48 did not. Before VE, the distensibility index of inferior vena cava (ΔIVC 1), espiratory variability index of inferior vena cava (ΔIVC 2), respiratory variability of aortic peak velocity (ΔVpeak AO), brachial artery maximum velocity variability (ΔVpeak BA) and respiratory rate of peak flow velocity of femoral artery (ΔVpeak CFA) in response group were higher than those in non-response group (all P<0.05), but there was no statistical significance in heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) between 2 groups (all P>0.05). After VE, the HR, ΔIVC 1, ΔIVC 2, ΔVpeak AO, ΔVpeak BA and ΔVpeak CFA in response group were significantly decreased, while MAP and CVP were significantly increased (all P<0.05). The CVP was significantly decreased in the non-response group ( P<0.05), while other indexes were not significantly changed. Before VE, the ΔIVC 1, ΔIVC 2, ΔVpeak AO, ΔVpeak BA and ΔVpeak CFA were positively correlated with ΔSV ( r=0.589, 0.647, 0.697, 0.621, 0.766; all P<0.05). There was no correlation between CVP and ΔSV ( r=-0.345, P>0.05). Before VE, the area under the curve of ΔIVC 1, ΔIVC 2, ΔVpeak AO, ΔVpeak BA and ΔVpeak CFA were all >0.7, indicating high sensitivity and specificity. Conclusions:Bedside ultrasound monitoring ΔIVC, ΔVpeak AO, ΔVpeak BA and ΔVpeak CFA can better evaluate the volume response of patients with septic shock, and can provide a reference basis for clinical fluid resuscitation treatment.

Content determination of 3 alkaloids in different origins of Tibetan Corydalis pallida by UPLC-MS/MS / 中国药房

OBJECTIVE To establish and apply a method for simultaneous determination of the contents of dicentrine， protopine and coptisine in Tibetan Corydalis pallida of different origins， and to provide reference for origin determination and quality control of the kind of medicinal materials. METHODS Ultra performance liquid chromatography-tandem quadrupole mass spectrometry method was used. The determination was performed on Agilent EC-C18 column （100 mm×2.1 mm， 2.7 μm） with mobile phase consisted of acetonitrile-0.1% formic acid by gradient elution. The flow rate was 0.2 mL/min， and the column temperature was set at 35 ℃ . MS detection was carried out by electrospray ionization in positive modes， multiple reaction monitoring mode was used for quantitative analysis. RESULTS The injection mass concentrations of dicentrine， protopine， coptisine ranged from 5.88 to 117.60， 53.70 to 1 074.00， and 4.85 to 97.00 ng/mL， respectively， showing a good linear relationship with their respective peak areas （r＝0.998 2， 0.991 9， and 0.999 6， respectively）. The limits of quantitation were 2.35， 1.07 and 1.46 ng/mL； the limits of detection were 1.17， 0.54， 0.49 ng/mL， respectively. RSDs of precision， stability （24 h） and repeatability tests were all lower than 2.0％. The average recovery rates were 97.41%， 98.89% and 105.44%（ all RSDs＜5.0％， n＝6）. CONCLUSIONS The established method has good selectivity and high accuracy， and is suitable for the rapid analysis of dicentrine， protopine and coptisine in Corydalis. The total contents of three alkaloids in different original medicinal materials are from high to low in order of C. chrysosphaera， C. mucronifera， C. pygmaea， C. hendersonii and C. conspersa. The alkaloid contents in C. chrysosphaera and C. mucronifera are relatively similar， but no dicentrine has been detected in C. conspersa and C. hendersonii.

Analysis of ARX gene variant in a child with X-linked lissencephaly with abnormal genitalia / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and genetic basis for a child with X-linked lissencephaly with abnormal genitalia (XLAG).@*METHODS@#A child with XLAG who had presented at the Third Affiliated Hospital of Zhengzhou University in May 2021 was selected as the study subject. Peripheral blood samples of the child and his parents were collected and subjected to high-throughput sequencing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the result was analyzed by using bioinformatic software.@*RESULTS@#The child was found to have harbored a hemizygous c.945_948del variant in exon 2 of the ARX gene, which as a frameshifting variant has resulted in a truncated protein. His mother was found to be heterozygous for the variant, whilst his father was of wild type. The variant was unreported previously.@*CONCLUSION@#The hemizygous c.945_948del variant of the ARX gene probably underlay the XLAG in this patient. Above finding has provided a basis for the diagnosis and genetic counseling for this family.

Normalization and parallel comparison of the detection results of antibodies against SARS-CoV-2 / 中华微生物学和免疫学杂志

Objective:To improve the consistency of test results through reducing inter-laboratory variation in SARS-CoV-2 antibody detection with WHO SARS-CoV-2 antibody candidate international standard (IS, sample G) and antibody reference panel (samples E, F, H, I, J).Methods:Ten WHO samples (A-J) including the candidate IS and reference panel were evaluated using different methods, such as microneutralization tests based on live SARS-CoV-2, pseudovirus neutralization assay and commercial ELISA kits. The test results were compared using statistical analysis.Results:Using IS (sample G) as a reference, the relative concentrations of other samples could be determined with less variation. ELISA and pseudovirus neutralization assay had consistent results with those obtained with the microneutralization test based on SARS-COV-2 strain HB02. Weakly positive samples could be detected only by a certain kit.Conclusions:The availability of an IS for antibodies would facilitate the standardization of SARS-CoV-2 antibody detection methods. The reference panel fitted all the assays based on the SARS-CoV-2 prototype Wuhan strain. Pseudovirus neutralization assay and ELISA could be used as alternatives to live SARS-CoV-2-based neutralization test to some extent.

Evaluation of the performance of two commercial SARS-CoV-2 neutralizing antibody test kits / 中华微生物学和免疫学杂志

Objective:To evaluate the performance of two commercial EIA kits for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibodies.Methods:Two commercial SARS-CoV-2 neutralizing antibody ELISA test kits (A and B) were used to detect serum panel consists of the following sera: 44 collected before vaccination, 120 collected one month after vaccination and 64 collected six months after recovery from convalescent patients of COVID-19. In the meantime, the above samples were also taken for live virus micro-neutralization test (micro-NT) indicated as the 50% neutralization antibody titer (NT 50). The consistency of qualitative and quantitative results between the two commercial kits and live virus neutralization test was analyzed. Results:Taking the micro-NT results as the standard, the positive coincidence rates of A and B kits were 97.40% and 100.00%, respectively; the negative coincidence rates were 97.30% and 95.95%, respectively; the Youden indices were 0.95 and 0.96, respectively. Furthermore, quantitative analysis indicated that the correlation coefficients between A and B kits and micro-NT results were 0.24 ( P<0.05) and 0.52 ( P<0.000 1) for samples collected after vaccination, respectively; while the correlation coefficients were 0.81 ( P<0.000 1) and 0.89 ( P<0.000 1) for convalescent serum samples, respectively. Conclusions:The results obtained by the two commercial neutralizing antibody detection kits were in good agreement with the qualitative results of micro-NT. The neutralizing antibody titers in convalescent serum samples detected by the two kits showed a stronger correlation with the micro-NT results.

The prognostic relationship between CD56 expression and newly diagnosed multiple myeloma / 中华内科杂志

Objective:To evaluate the prognostic value of CD56 expression in newly diagnosed MM (NDMM).Methods:A total of 332 NDMM patients were enrolled in Beijing Chaoyang Hospital, Capital Medical University from January 1, 2011 to January 1, 2021, with a median age of 60 years and a male to female ratio of 1.2∶1. CD56 expression on myeloma cells was detected by flow cytometry before induction therapy. Overall survival (OS) and progression-free survival (PFS) data were collected. In order to reduce the confounding factors, the propensity score matching technique was used to match CD56 positive versus negative patients at a ratio of 1∶1.Results:Among 332 patients, CD56 positivity rate was 65.1% (216/332). Patients with CD56 expression had significantly longer median OS (58.4 vs. 43.1 months, P=0.024) and PFS (28.7 vs. 24.1 months, P=0.013) than those with negative CD56. Univariate Cox proportional hazards regression analyses showed that CD56 expression was positively correlated with OS ( HR=0.644, 95 %CI 0.438-0.947, P=0.025) and a favorable prognostic factor for PFS ( HR=0.646, 95 %CI 0.457-0.913, P=0.013). The favorable effect of CD56 expression on PFS was confirmed in multivariate analysis ( HR=0.705, 95 %CI 0.497-0.998, P=0.049), but OS was not affected ( P>0.05).In the propensity score matching analysis, 194 patients with 97 in each group were identified. CD56 positivity consistently predicted longer PFS (34.2 vs.25.1 months, P=0.047), but not OS (63.4 vs.43.1 months, P=0.056). Conclusion:These results demonstrate that CD56 expression is a favorable prognostic factor for PFS of newly diagnosed MM patients.

Clinical characteristics and genetic analysis of familial hypocalciuric hypercalcemia type 1 / 中华内分泌代谢杂志

A case of familial hypocalciuric hypercalcemia type 1 (FHH1) was reported detailing the course of diagnosis and treatment. The main clinical manifestations of the patient were recurrent pancreatitis with moderate hypercalcemia and low urinary calcium. The C→T heterozygous missense mutation at nucleotide 2 393 with conversion of codon Pro798 to Leu (p.P155L) in CaSR gene was identified. Serum calcium and parathyroid hormone levels of the patient were decreased significantly after treatment with cinacalcet.

Effects of comprehensive rehabilitation nursing based on guided education and training on rehabilitation treatment in school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection / 中国实用护理杂志

Objective:To evaluate the effects of comprehensive rehabilitation nursing based on guided education and training on rehabilitation treatment in school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection.Methods:Fifty movement disorders school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection in Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University from January 2017 to December 2019 were enrolled in this study. The child patients were divided into the control group and the observation group according to the order of admission, with 25 cases in each group, and the control group was from January 2017 to June 2018 while the observation group was from July 2018 to December 2019. In the control group, routine nursing after epileptogenic focus resection and functional exercise were conducted. The observation group was treated with comprehensive rehabilitation nursing based on guided education and training. On the third day after operation, the day of discharge respectively, the motor function and activity of daily living of the two groups were evaluated. The satisfaction of children′s parents on nursing was compared between the two groups.Results:The scores of motor function on the third day after operation and the day of discharge were (57.0 ± 6.8), (73.0 ± 5.4) points respectively in the observation group, and those in the control group were (55.0 ± 5.6), (65.6 ± 5.9) points. There were significant differences intra group comparison ( t=-9.26, -6.48, both P<0.05). The activity of daily living scores on the third day after operation and the day of discharge were (45.2 ± 5.9), (74.2 ± 8.3) points respectively in the observation group, and those in the control group were (44.0 ± 5.8), (60.2 ± 7.6) points. There were significant differences intra group comparison ( t=-14.33, -8.51, both P<0.05). There were significant differences between the scores of motor function and the ability of daily living scores on the day of discharge in the observation group and the control group ( t values were -4.65, -6.25, both P<0.05). The satisfaction of children′s parents on nursing in the observation group and the control group were 96.0% (24/25), 72.0% (18/25) respectively. There was significant difference between the two groups ( χ 2=8.78, P<0.05). Conclusions:Rehabilitation nursing based on guided education and training can improve motor function and ability of daily living in movement disorders school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection, promote the functional recovery of children after surgery and increase the satisfaction of children′s parents on nursing.

The 20-year follow-up of five victims externally exposed in " 4.26" 60Co radiation accident in Henan province / 中华放射医学与防护杂志

Objective:To investigate the late effects induced by external ionizing radiation through long-term follow-up of the victims exposed to 60Co radiation source at " 4.26" accident in Henan in 1999, and to provide valuable experience in the radiological medicine. Methods:Medical observations of the clinical symptoms, signs, eye lens examination and previous medical history of the five exposed victims were performed and recorded. The changes of the laboratory routine examinations, immune function, thyroid function, reproductive hormone levels, tumor markers, radiation genetic indicators as well as ultrasound examination of thyroid, cardiac, reproductive system, electrocardiogram, chest CT were systematically reviewed.Results:The typical radiation-induced cataract was found in " Mei" 2-3 years after 60Co accidental irradiation. 13 years after irradiation, the cataract surgery and intraocular lens implantation in left eye were performed followed by the same operation in right eye in November 2019. Different degrees phacoscotasmus under the posterior capsule or equatorial part of the eyes were also found in the rest of victims. ECG result of " Mei" indicated myocardial ischemia 7 years after accident. " Tian" confirmed diagnosis coronary heart disease 12 years after irradiation, and the surgery about coronary angiography heart stent implantation was taken at 20 years after irradiation. Five victims showed increased serum total cholesterol and/or triglycerides, and 4 victims showed bilateral or unilateral common carotid atherosclerotic plaque formation. Higher levels of thyroid stimulating hormone (TSH) were observed in " Mei" at 11 years after the irradiation. The thyroglobulin antibody (TGA)and thyroid microsomal antibody (TMA) were obviously increased in " Yi" , accompanied by thyroid uneven found by ultrasound. The thyroid nodules in " Mei" and " Min" were observed at 15 years after irradiation. The diagnosis of diffuse large B cell lymphoma(DLBL) in " Tian" was confirmed at 13 years after irradiation. Slightly higher of Neuron-specific enolase(NSE) were found in " Tian" , " Min" and " Yi" . A small nodule was detected from chest CT of " Tian" . Most of the chromosome aberrations observed in peripheral blood lymphocytes from the victims were stable chromosomal aberration such as translocation (t) with a few dicentric chromosome (dic) and acentric fragment (ace) in " Wang" and " Tian" . Conclusions:Ionizing radiation can cause variable degrees of deterministic effects in lens, thyroid gland and cardiovascular circulatory system and stochastic effects such as neoplasm. The genetic damages will last long in the patients.

Correlation study on the distribution of TCM constitution and syndrome type and gastroscopic performance in patients with hiatal hernia / 中国基层医药

Objective:To investigate the correlation between the distribution of traditional Chinese Medicine (TCM) constitution and the syndrome of TCM and the performance under gastroscope in patients with hiatal hernia(HH).Methods:A total of 300 HH patients diagnosed in the Department of Gastroenterology, the Second Affiliated Hospital of Shandong University of TCM from January 2016 to December 2018 were enrolled in this study.The clinical information was collected to complete TCM constitution, TCM syndrome type and gastroscopic performance classification.Results:The composition ratio of TCM constitution in 300 patients with HH was not exactly the same(χ 2=88.140, P<0.05). From high to low, the order was: Qi stagnation(58 cases), Qi deficiency(56 cases), damp heat(51 cases), phlegm dampness(45 cases), Yang deficiency(27 cases), Yin deficiency(21 cases), peace(17 cases), blood quality(17 cases), special quality(8 cases). There was a significant attribute association between TCM syndrome type and TCM constitution classification(χ 2=129.753, P<0.05), among which: the syndrome of liver and stomach stagnation heat corresponded to damp heat and Yin deficiency; the syndrome of spleen and stomach dampness heat corresponded to phlegm dampness syndrome; the syndrome of spleen and stomach deficiency cold corresponded to Yang deficiency and Qi deficiency; the syndrome of Qi stagnation and phlegm corresponded to blood sputum and Qi stagnation; Qi deficiency and blood stasis syndrome corresponded to Qi deficiency.There was significant attribute association between gastroscopic performance and TCM constitution(χ 2=123.189, P<0.05), among which: no esophagitis corresponded to Yang deficiency, Qi deficiency, peace and phlegm dampness; the grade A reflux esophagitis corresponded to the dampness heat and the Qi stagnation; the grade B corresponded to the dampness heat and the Qi stagnation, the grade C had no obvious correspondence, the grade D corresponded to the Yin deficiency. Conclusion:The TCM constitution of HH patients is mainly characterized by Qi stagnation, Qi deficiency, damp heat and phlegm dampness, and there is a significant correlation between constitution classification and TCM syndromes type and gastroscopic performance.

Effect on the treatment of patients with occupational coal worker′s pneumoconiosis using multistep breathing training combined with acupoint plastering / 中国职业医学

OBJECTIVE: To observe the clinical effect of multistep breathing training combined with acupoint plastering on the treatment of patients with occupational coal worker's pneumoconiosis(CWP). METHODS: Eighty cases of male occupational CWP patients were selected as the research subject using convenient sampling method. They were divided into control group(40 cases) and treatment group(40 cases) according to random number table method. The control group was given conventional treatment, while the treatment group received multistep respiratory training combined with acupoint plastering for 12 weeks based on conventional symptomatic treatment. Before and after treatment, clinical curative effect, pulmonary function, immune function, the total score of Chronic Obstructive Pulmonary Disease Assessment Test(CAT) Questionnaire and 6 minutes walk distance(6 MWDS) in two groups were observed. RESULTS: Before treatment, there was no statistical difference on forced vital capacity(FVC), ratio of forced expiratory volume in one second(FEV_1)/FVC, lymphocyte cluster of differentiation(CD) 4~+/CD8~+ ratio, percentage of natural killer cells(NK), total CAT scores and 6 MWD(P>0.05). After treatment, the FVC, FEV_1/FVC ratio and lymphocyte CD4~+/CD8~+ ratio increased [median: 78.3% vs 80.7%, 68.7% vs 72.5%, 1.16 vs 2.00, P<0.01], 6 MWD was increased [(430.6±45.9) vs(494.8±58.7) m, P<0.01], and CAT total score was decreased [(18.1±5.6) vs(15.5±5.3) points, P<0.01] in the treatment group compared with the control group. There was no significant difference in NK cell percentage between the two groups(P>0.05). CONCLUSION: Multistep respiratory training combined with acupoint plastering can alleviate the clinical symptoms such as cough, and shortness of breath of patients with CWP, improve their lung function, regulate the function of immunity, as well as improve sports endurance.

Influence of social support and self-efficacy on job burnout in sanitation workers / 中国职业医学

OBJECTIVE: To assess the influence of social support and self-efficacy on job burnout in sanitation workers. METHODS: A convenient sampling method was used to select 405 sanitation workers as study objects. The Maslach Burnout Inventory General Survey, Perceived Social Support Scale and General Self-Efficacy Scale were used to investigate the three dimensions of emotional exhaustion,cynicism and reduced personal accomplishment in job burnout, as well as the social support and self-efficacy. RESULTS: The cynicism was positively correlated with self-efficacy [partial correlation coefficient(r)=0.17, P<0.01]. Reduced personal accomplishment was negatively correlated with self-efficacy and social support respectively(r were-0.32 and-0.20, P<0.01). Hierarchical regression analysis indicated that the demographic variables can explain 30.4%, 29.9%, 22.0% of the three dimensions of sanitation workers′ emotional exhaustion, cynicism and reduced personal accomplishment respectively(P<0.01). After controlling for the demographic variables, self-efficacy could positively predict cynicism(P<0.01), the social support and self-efficacy could negatively predict reduced personal accomplishment(P<0.01). CONCLUSION: The institutional factor is the main reason affecting job burnout of sanitation workers. Cynicism is positively correlated with self-efficacy. Improving social support and self-efficacy can help alleviate the reduced personal accomplishment.

Analysis of intervention effect of improved nursing measures in deep brain stimulation for patients with dystonia in MRI localization / 中国实用护理杂志

Objective To explore the intervention effect of improved nursing measures in the treatment of patients with dystonia with deep brain stimulation in MRI localization. Methods Twenty patients with dystonia treated with deep brain stimulation from January 2013 to December 2015 were selected as the control group. Twenty patients with dystonia treated by deep brain stimulation surgery with improved nursing from January 2016 to December 2018 were in the experimental group. The primary success rate of MRI localization, examination time related indexes and incidence of adverse reactions after intravenous anesthesia were observed in the 2 groups. Results The primary success rate of MRI localization in the experimental group (95.00%,19/20) was higher than that in the control group (55.00%, 11/20), and the difference was statistically significant (χ2=8.533, P<0.01).The total examination time of the experimental group (33.60±8.27) min was significantly shorter than that of the control group (44.30±13.43) min, and the difference was statistically significant (t=-3.663, P<0.05).The incidence of total adverse reactions to MRI localization after intravenous anesthesia was lower in the experimental group (5%, 1/20) than in the control group (30%, 6/20), and the difference was statistically significant (χ2=4.329, P<0.05). Conclusions Improved nursing measures can effectively improve the success rate of MRI stereotactic brain target location in patients with dystonia, providing a guarantee for accurate calculation of surgical targets, enabling the operation to achieve the best results, early detection of changes in vital signs during examination, and the close cooperation of the medical team is the guarantee for the smooth completion of MRI examination.

Study of endoplasmic reticulum stress role in hepatic failure induced by severe hepatitis B / 中华肝脏病杂志

Objective@#To investigate the endoplasmic reticulum stress (ERS) role in the course of liver failure induced by severe hepatitis B virus (HBV) infection and its related mechanism.@*Methods@#Liver tissue samples and clinical data [chronic hepatitis B patients (12 cases, chronic hepatitis B group), hepatic failure induced by severe hepatitis B virus (12 cases, severe hepatitis B virus liver failure group), and normal subjects (8 cases, control group)] were collected from the Beijing You'an Hospital affiliated to Capital Medical University between 2009 to 2011. Statistical analysis was performed on the clinical indicators of each group. The structure of endoplasmic reticulum in liver tissue was observed by transmission electron microscopy. Western blot and qRT-PCR were used to detect the expression of endoplasmic reticulum stress and apoptosis-related factors, including glucose-regulated protein (Grp), and C/EBP homologous protein (CHOP). Frozen sections of liver tissues were prepared for immunofluorescence test. All data were expressed as mean ± standard deviation. LSD-t test was used to compare the results between groups. A p value < 0.05 was considered as statistically significant.@*Results@#Transmission electron microscopy showed that the morphological structure of the endoplasmic reticulum was damaged in both groups (chronic hepatitis B and liver failure induced by severe hepatitis B virus), and liver failure induced by severe hepatitis B virus group was more critical. Western blot and qRT-PCR showed that Grp78, Grp94 and Caspase-4 were highly expressed in normal group and chronic hepatitis B group, and the relative protein expressions were 1.20 ± 0.13 and 0.78 ± 0.11, 0.90 ± 0.06 and 0.11 ± 0.01, 0.15 ± 0.02 and 0.22 ± 0.04, respectively. The expression of protein was weakened in liver failure induced by severe hepatitis B virus group (relative protein expression was 0.01 ± 0, 0.01 ± 0, and 0.11 ± 0.02, respectively).There was a statistically significant difference between the two groups (P < 0.05). The expression of CHOP was consistent with the results of immunofluorescence, and increased with the stressing of injury.@*Conclusion@#During the course of severe hepatitis B infection, dysregulated endoplasmic reticulum stress activated mild stress in chronic hepatitis B group, while severe stress in hepatic failure induced by severe hepatitis B virus group. Therefore, endoplasmic reticulum stress plays an important and complex role in the pathogenesis of hepatic failure induced by severe hepatitis B virus.

Analysis of intervention effect of improved nursing measures in deep brain stimulation for patients with dystonia in MRI localization / 中国实用护理杂志

Objective@#To explore the intervention effect of improved nursing measures in the treatment of patients with dystonia with deep brain stimulation in MRI localization.@*Methods@#Twenty patients with dystonia treated with deep brain stimulation from January 2013 to December 2015 were selected as the control group. Twenty patients with dystonia treated by deep brain stimulation surgery with improved nursing from January 2016 to December 2018 were in the experimental group. The primary success rate of MRI localization, examination time related indexes and incidence of adverse reactions after intravenous anesthesia were observed in the 2 groups.@*Results@#The primary success rate of MRI localization in the experimental group (95.00%,19/20) was higher than that in the control group (55.00%,11/20), and the difference was statistically significant (χ2=8.533, P<0.01).The total examination time of the experimental group (33.60±8.27) min was significantly shorter than that of the control group (44.30±13.43) min, and the difference was statistically significant (t=-3.663, P<0.05).The incidence of total adverse reactions to MRI localization after intravenous anesthesia was lower in the experimental group (5%, 1/20) than in the control group (30%, 6/20), and the difference was statistically significant (χ2 =4.329, P < 0.05).@*Conclusions@#Improved nursing measures can effectively improve the success rate of MRI stereotactic brain target location in patients with dystonia, providing a guarantee for accurate calculation of surgical targets, enabling the operation to achieve the best results, early detection of changes in vital signs during examination, and the close cooperation of the medical team is the guarantee for the smooth completion of MRI examination.

Effect of diabetes on the risk of stroke recurrence within one year after onset of ischemic stroke / 国际脑血管病杂志

Objective@#To investigate the effect of diabetes on the risk of stroke recurrence within 1 year after onset of ischemic stroke.@*Methods@#Patients with ischemic stroke admitted to the Department of Neurology, the Second Hospital of Hebei Medical University from October 2016 to August 2017 were enrolled prospectively. Their baseline clinical data were collected and they were followed up for one year. The risk factors for ischemic stroke in recurrence group and non-recurrence group were compared. Cox proportional hazard regression model was used to determine the independent risk factors for ischemic stroke recurrence. Kaplan-Meier survival analysis was used to explore the impact of risk factors on the risk of stroke recurrence.@*Results@#A total of 1 436 patients with ischemic stroke were included. During the follow-up of 1 year, a total of 183 patients had recurrence (12.74%). There were significant differences in the proportion of patients with diabetes, atrial fibrillation, hyperhomocysteinemia, oral antiplatelet drugs, and statins after discharge, and baseline fasting blood glucose level between the recurrence and the non-recurrence group (all P<0.05). Multivariate Cox proportional hazards analysis showed that diabetes mellitus (hazard ratio [HR] 1.574, 95% confidence interval [CI] 1.161-2.134; P=0.003) was an independent risk factor for stroke recurrence. Taking statins (HR 0.686, 95% CI 0.481-0.979; P=0.038) and antiplatelet agents (HR 0.678, 95% CI 0.467-0.983; P=0.041) after discharge were the independent protective factors for ischemic stroke recurrence. Kaplan-Meier survival analysis showed that the recurrence rate of ischemic stroke in patients with diabetes was significantly higher than that in those without diabetes (log-rank test, P=0.003). The recurrence rate of stroke in patients taking statins and antiplatelet drugs was significantly lower than that in patients who did not take the corresponding drugs (log-rank test, all P<0.001).@*Conclusions@#Diabetes is an independent risk factor for ischemic stroke recurrence, and taking statins and antiplatelet drugs are the independent protective factors for ischemic stroke recurrence.

Establishment and evaluation of receptor binding domain (RBD)-based ELISA for Middle East re-spiratory syndrome coronavirus (MERS-CoV) antibody detection / 中华微生物学和免疫学杂志

Objective To establish an indirect enzyme-linked immunosorbent assay (ELISA)and to compare the efficiency of receptor binding domain (RBD) proteins in different forms for Middle East re-spiratory syndrome coronavirus (MERS-CoV) antibody detection. Methods The monomeric and trimeric forms of MERS-CoV RBD were expressed in Bac-insect cells, 293T cells and ExpiCHO-STM expression sys-tem and then purified. The purified RBD proteins were identified with native gel electrophoresis and Western blot. Then, an equal amount of each RBD protein was used as coating antigen to establish an ELISA for de-tecting MERS-CoV IgG titer. For comparison, the newly developed ELISA and the commercial MERS-CoV IgG antibody detection kit (Euroimmune with S1 as the coating antigen) were used to measure the MERS-CoV antibody reference panel supplied by World Health Organization (WHO). Results The purified mon-omeric and trimeric MERS-CoV RBD were successfully prepared using 293T cells and ExpiCHO-STM system. RBD antigens of different forms and from different systems could recognize MERS-CoV specific antibody without having any cross reaction with the sera from healthy adults. The in-house RBD-based ELISA had good detection consistency with the Euroimmune commercial kit. The positive samples showed higher and more concentrated values based on the RBD trimer than the monomer. Conclusions Novel indirect ELISA methods based on the monomeric and trimeric forms of RBD protein were established. The trimetric form-based ELISA achieved higher detection efficiency than the one using the monomer antigen, suggesting that it could be uses as a competent alternative to the commercial kit.

Clinical biological characteristics of metastatic carcinoma of the thyroid: a report of 30 cases / 中华普通外科杂志

Objectives To study the clinical characteristics,diagnosis,treatment and prognosis of cancer metastases to the thyroid gland.Methods At Tianjin Medical University Cancer Hospital,from 1980 to 2016 30 patients were identified with a metastatic malignant tumor of the thyroid gland.Results Primary tumor sites were in the esophagus (26.7％),lung (16.7％),and kidney (13.3％).The median age at discovery of thyroid metastasis was 56 years old.The time lapse ranged from 0 to 108 months.There were 18 patients with metachronous metastasis with median survival of 36 months,12 patients were with synchronous metastasis,and the median survival was 8 months (P ＜ 0.01).20 patients were treated with thyroid surgery,and of which 15 patients were given post-op radiotherapy and chemotherapy.Patients who underwent thyroid resection had a median survival of 15 months,while that was 8 months in those without thyoid surgery (P ＜ 0.01).Conclusions Metastases to the thyroid gland is a rare clinical phenomenon,the prognosis of patients is mainly related to the biological behavior of primary tumors,but surgical resection and combined treatment can increase the survival rate.

Effects of Ligustri lucidi Fructus Extract on the Differentiation of Osteoclasts and the Proliferation of Osteoblasts / 中国药房

OBJECTIVE： To investigate the effects of Ligustri lucidi Fructus extract on the differentiation of osteoclasts and the proliferation of osteoblasts. METHODS： Rabbit primary bone marrow cells were induced with 1a，25-Dihydroxyvitamin D3 to obtain osteoclasts. After treated with low-dose， medium-dose and high-dose of L. lucidi Fructus ethanol and water extract （both 2， 20， 200 mg/L）， TRACP activity determined method was used to detect the activity of TRACP in cell lysis solution and the number of TRACP positive cells. The number of celluar bone resorption lacunae and the percentage of bone lacunae area were detected by toluidine blue staining. Osteoblasts were obtained by L-ascorbic acid， β-sodium glycerophosphate and dexamethasone-induced subcloning 14 of cranial parietal anterior osteocytes in mice. MTT assay and APK activity assay were used to detect relative proliferation rate of cells and the activity of APK. RESULTS： After treated with different doses of L. lucidi Fructus extract， the number of TRACP positive cells， the number of bone resorption lacunae and their area were changed in varying degrees. TRACP activity， the number of its positive cells， the number of bone resorption lacunae and the percentage of bone lacunae area in different dosage groups of L. lucidi Fructus ethanol extract and high-dose of water extract； the TRACP activity， the number of its positive cells and the percentage of bone lacunae area in L. lucidi Fructus water extract medium-dose group were decreased significantly， while the number of bone resorption lacunae in L. lucidi Fructus water extract low-dose group was increased significantly （P＜0.05 or P＜0.01）. The relative proliferation rate of cells in L. lucidi Fructus extract low-dose and medium-dose groups and APK activity of cells in extract groups were significantly increased， while the relative proliferation rate of cells were decreased significantly in L. lucidi Fructus ethanol extract and water extract high-dose groups （P＜0.01）. CONCLUSIONS： L. lucidi Fructus extract can inhibit TRACP activity of osteoclasts， change the bone resorption function of osteoclasts and the proliferation behavior of osteoblasts and increase APK activity of osteoclasts.