The Effect of Yiqi Huoxue Formula （益气活血方） in the Treatment of Chronic Pulmonary Heart Disease and Heart Failure with Qi Deficiency and Blood Stasis Pattern of 58 Cases： A Randomized Controlled Trial / 中医杂志

ObjectiveTo explore the effectiveness and safety of Yiqi Huoxue Formula （益气活血方， YHF） in the adjuvant treatment of chronic pulmonary heart disease （CPHD） and heart failure （HF）with qi deficiency and blood stasis pattern. MethodsOne hundred and twenty patients with CPHD and HF with qi deficiency and blood stasis pattern were allocated randomly into treatment group and control group， with 60 case in each group. The control group was given conventional basic western medicine， while the treatment group was given oral administration of YHF granules in addition， one dose per day. The treatment course for both groups was 8 weeks. The TCM symptom scores， Minnesota Life Quality Scale （MLHF-Q） scores， echocardiographic indicators including right ventricular end-diastolic diameter （RVEDD）， left ventricular end-diastolic diameter （LVEDD）， left atrial end-diastolic diameter （LAEDD） and pulmonary artery mean pressure （PAMP）， six-minute walking distance （6MWD）， and plasma N-terminal pro-B-type natriuretic peptide （NT-ProBNP） level were compared between the groups. The effectiveness regarding cardiac function and TCM syndromes were compared between the two groups after treatment， and the occurrence of adverse events was observed. ResultsWith two drop-outs both in the treatment group and control group， and 58 cases in each group were included in the outcome analysis. The total effective rate regarding cardiac function and TCM syndromes in the treatment group were 91.38% （53/58） and 96.55% （56/58）， respectively， significantly higher than the corresponding 70.69% （41/58） and 48.27% （28/58） in the control group （P＜0.05）. After treatment， the TCM symptom scores and RVEDD level were significantly reduced in the treatment group， and MLHF-Q score， plasma NT-ProBNP level and PAMP level decreased significantly， while 6MWD increased in both groups （P＜0.01）. Compared to those in the control group， the TCM symptom scores， MLHF-Q score， plasma NT-ProBNP level and PAMP level significantly decreased， while 6MWD increased in the treatment group （P＜0.01）. There were no obvious abnormalities in the blood， urine， stool routine and liver and kidney function indicators in both groups. One adverse reaction each occurred in both groups， and there was no statistically significant difference in the incidence rates（P＞0.05）. ConclusionYHF combined with conventional western medicine can significantly improve the clinical efficacy， improve the clinical symptoms and cardiac function， increase the quality of life and exercise tolerance， and is relatively safe.

Analysis of the influencing factors on the perceptions of e cigarette among adolescents in Shanghai / 中国学校卫生

Objective@#To assess the status of current e cigarette perception and its influencing factors among adolescents in Shanghai, so as to provide reference for the refinement of the prevention and control measures of teenagers e cigarette use.@*Methods@#From May to June 2021, a stratified random cluster sampling was used to investigate 7 456 junior high and high school students in Shanghai. Harm and benefit perception of e cigarette as well as its social environment benefits were collected.@*Results@#The rate of adolescents ever and current e cigarette use was 3.19% and 1.09%, respectively. The top four risk factors for low harm perception of e cigarette were adolescent e cigarette use( OR=2.74, 95%CI =2.10-3.59), high school students ( OR=1.47, 95%CI = 1.32 - 1.64 ), family members ( OR=1.45, 95%CI =1.24-1.70) and friends ( OR=1.36, 95%CI =1.20-1.54) using e cigarette. Adolescent ecigarette use ( OR=2.77, 95%CI =1.97-3.89), high school students( OR=2.11, 95%CI =1.89-2.36), friends ( OR= 1.63, 95%CI =1.42-1.87) and family members using e cigarette( OR=1.39, 95%CI =1.18-1.65) were the top four associated factors for high benefit perception of e cigarette. And, adolescent e cigarette use ( OR=1.95, 95%CI =1.47-2.59), high school students ( OR= 1.73, 95%CI =1.55-1.93), friends ( OR=1.60, 95%CI =1.40-1.82) and pocket money≥200 yuan using e cigarette( OR= 1.29 , 95%CI =1.17-1.43) were the top four risk factors for high social environmental benefit perception of e cigarette. Moreover, perception of e cigarette harm, benefit and social environmental benefit were associated with the risk of future use of e cigarette( OR = 0.78,1.44,1.21, P <0.01).@*Conclusion@#Being high school students and using e cigarette by oneself, friends, and family members are the important influencing factors for adolescents e cigarette perception. Both low harm and high benefit perception of e cigarette elevate the risk of future e cigarette use among adolescents, so effective measures should be taken to promote control education about e cigarette and smoke free environment construction.

Mechanism of anterior cingulate cortex in modulating pain and anxiety-like behavior in chronic non-specific low back pain model rats / 中华行为医学与脑科学杂志

Objective:To explore the potential mechanisms of anterior cingulate cortex (ACC) in modulating pain behavior and anxiety-like behavior of rats with chronic non-specific low back pain induced by nerve growth factor (NGF).Methods:Ninety-six male SPF grade SD rats aged 8 weeks were randomly divided into four groups according the random number table method: control group, model group, control+ D-2-amino-5-phosphonopentanoate (D-AP5) group (control+ D-AP5 group) and model+ D-AP5 group, with 24 rats in each group.Low back pain model of rat was established by injection of NGF into multifidus muscle (left side) of the low backs of rats(two times with a five-day interval). Five days after modeling, rats in model+ D-AP5 group and control+ D-AP5 group were injected with the N-methyl-D-aspartate (NMDA) receptor antagonist D-AP5(2 μg, 0.3 μL) at the right side of the ACC once a day for consecutive 3 days, and rats in control group and model group were injected with the same amount of 0.9% sodium chloride solution. Seven days after modeling, the pain threshold of rats was evaluated by mechanical stimulation test and hot and cold plate test.The anxiety-like behavior was tested by open field test.The density of glial fibrillary acidic protein (GFAP) positive cells and c-Fos(a kind of immediate early gene) positive cells of the spinal cord were observed by immunofluorescence. The expression of GFAP, c-Fos, phosphorylated-c-Jun N-terminal kinases (p-JNK), monocyte chemoattractant protein-1 (MCP-1), and chemokine (C-X-C motif) ligand 1 (CXCL-1) proteins in the L2 segment of the spinal cord were detected by Western blot. SPSS 23.0 software was used for statistical analysis. One-way ANOVA was used to analyze normal distribution measurement data for comparison among multiple groups, and Tukey test was used for further pairwise comparisons. The Kruakal-Wallis H test was used for non-normal distribution measurement data, and Mann-Whitney U test was used for further pairwise comparisons with Bonferroni-corrected P-values. Results:In the experiments measuring pressure pain threshold (PPT) and paw withdrawal threshold (PWT), there were statistically significant differences in the PPT and PWT of rats among the four groups ( F=53.498, 41.939, both P<0.001). Seven days after modeling, PPT ((418.5±46.9) g) and PWT ( (55.6±7.1) g) in the ipsilateral side of the rats in model+ D-AP5 group were higher than those in model group ((290.0±32.0) g, (30.5±7.5) g) (both P<0.001). In the open field test, there were statistically significant differences in percentage of the inner zone distance ( H=11.922, P<0.01) and the percentage of inner zone time ( H=21.614, P<0.001) of rats among the four groups. The percentage of inner zone time in model+ D-AP5 group was higher than that in model group (5.6(4.3, 7.9) %, 3.1(2.1, 3.8) %) ( P<0.01). The results of immunofluorescence showed that there were statistically significant differences in the density of GFAP positive cells and c-Fos positive cells at the ipsilateral side of the superficial laminae of rats among the four groups ( H=49.085, F=18.120, both P<0.001). The density of GFAP positive cells (34.3(21.1, 47.5) cells/mm 2) and c-Fos positive cells ((52.7±39.4) cells/mm 2) at the ipsilateral side of the superficial laminae in model+ D-AP5 group were less than those in model group (76.5(68.6, 94.9) cells/mm 2, (112.4±63.7) cells/mm 2) (both P<0.001). The Western blot results showed that there were statistically significant differences in the protein expression of GFAP, c-Fos, p-JNK, MCP-1 and CXCL-1 in the L2 segment of rats among the four groups ( F=49.413, 38.437, 41.867, 36.735, 130.951, all P<0.001). The protein expression of GFAP (1.7±0.5), c-Fos (1.1±0.1), p-JNK (1.7±0.3), MCP-1 (1.0±0.4) and CXCL-1 (0.8±0.1) in the L2 segment in model+ D-AP5 group were lower than those in model group ((4.3±0.7), (2.6±0.5), (2.8±0.4), (2.9±0.4), (3.5±0.4)) (all P<0.01). Conclusion:ACC modulates mechanical hyperalgesia and anxiety-like behavior in chronic non-specific low back pain rats, which might be associated with the involvement of spinal astrocytes, p-JNK signal pathway and chemokines such as MCP-1 and CXCL-1.

Death of hospitalized neonates of different gestational age in Shaanxi Province: a multi-center survey / 中华围产医学杂志

Objective:To investigate the current status of hospitalized neonatal death of different gestational ages in Shaanxi Province.Methods:All neonatal deaths in six hospitals in Shaanxi Province from 2016 to 2020 were retrospectively analyzed, and the differences in perinatal complications, the causes of death, and the age at death were compared using Chi-square (or Fisher's exact ) test. Results:(1) Totally, 220 488 neonates were delivered in the obstetric department of the six hospitals during the study period; 71 782 out of them were admitted to the neonatal department. While 424 neonatal death was reported, giving the total hospitalized neonates mortality rate of 5.5‰ (394/71 782), which included 152 deaths of transferred patients ( n=9 103, 16.7‰), 226 premature (53.3%), 196 term (46.2%), and two post-term infants (0.5%). (2) Among mothers of dead neonates, 73.6% were found to have at least one perinatal complication. The most common one was fetal distress (146 cases, 34.4%), followed by gestational diabetes mellitus (113 cases, 26.7%), amniotic fluid abnormalities ( n=73, 17.2%), maternal infectious diseases ( n=71, 16.8%), and hypertensive disorders in pregnancy (HDP) ( n=52, 12.3%). The lower the gestational age, the higher the proportion of multiple pregnancies and assisted reproduction technology applied (Fisher exact test, P<0.05). On the contrary, the higher the gestational age, the higher the cesarean section rate ( χ 2=26.69, P<0.001). HDP was more likely to occur in the gestational age of 28-31 +6 and 32-34 +6 weeks ( χ 2=37.16, P<0.001), and amniotic fluid abnormalities were more likely to occur in those over 37 weeks ( χ 2=27.47, P<0.001). (3) The five leading causes of neonatal death were neonatal respiratory distress syndrome (NRDS, n=100, 23.6%), neonatal asphyxia ( n=88, 20.8%), maternal infectious diseases ( n=80, 18.9%), and birth defects ( n=54, 12.7%), and pulmonary hemorrhage ( n=22, 5.2%). The first three causes of death in term and post-term infants were neonatal asphyxia ( n=65, 32.8%), birth defects ( n=42, 21.2%), and infectious diseases ( n=26, 13.1%). NRDS ( n=83, 36.7%), infectious diseases ( n=54, 23.9%), and neonatal asphyxia ( n=23, 10.2%) were the three leading causes of death of premature babies. (4) Out of the 326 (76.9%) neonatal deaths within seven days after birth, 162 (38.2%) died within 24 h after birth and 164 cases (38.7%) between one to seven days after birth. Conclusions:Most neonatal deaths occurred among preterm ones and within seven days after birth, whose mothers suffered perinatal complications. The causes of neonatal death vary among different gestational age groups.

Clinical and genetic analysis of essential hypertension with CYB gene m.15024G>A mutation / 浙江大学学报·医学版

OBJECTIVES@#To explore the role of mitochondrial CYB 15024G>A mutation in the development of essential hypertension.@*METHODS@#Mitochondrial genome sequences of hypertensive patients were obtained from previous studies. Clinical and genetic data of a hypertensive patient with mitochondrial CYB 15024G>A mutation and its pedigree were analyzed. Lymphocytes derived from patient and family members were transformed into immortalized lymphoblastoid cell lines, and the levels of adenosine triphosphate (ATP), mitochondrial membrane potential and intracellular reactive oxygen species (ROS) were detected.@*RESULTS@#The penetrance of this essential hypertension family was 42.9%, and the age of onset was 46-68 years old. Mitochondrial genome sequencing results showed that all maternal members carried a highly conserved mitochondrial CYB 15024G>A mutation. This mutation could affect the free energy of mitochondrial CYB for secondary and tertiary structure and protein folding, thereby changing its structural stability and the structure of the electron transfer function area around the mutation site. Compared with the control, the cell line carrying the mitochondrial CYB 15024G>A mutation showed significantly decreased levels of mitochondrial CYB, ATP and mitochondrial membrane potential, and increased levels of ROS (P<0.01).@*CONCLUSIONS@#Mitochondrial CYB 15024G>A mutation may affect the structure of respiratory chain subunits and mitochondrial function, leading to cell dysfunction, which suggests that the mutation may play a synergistic role in essential hypertension.

Clinical characteristics of neonatal gastric perforation and risk factors of mortality / 中国新生儿科杂志

Objective:To study the clinical characteristics of neonatal gastric perforation (NGP) and risk factors of mortality.Methods:From January 2015 to May 2022, infants with NGP admitted to NICU of our hospital were retrospectively studied. They were assigned into the survival group and the death group. Clinical manifestations, laboratory and imaging results, surgical treatments and prognosis were compared and risk factors of mortality were determined.Results:A total of 27 infants with NGP were enrolled, including 17 males and 10 females. 24 were premature infants and 3 were term infants. 26 infants had low birth weight. 3 infants had neonatal resuscitation due to asphyxia, 10 received positive pressure ventilation before the onset of perforation symptoms, 2 showed gastrointestinal malformations and 3 with septic shock before surgery. The median age of onset was 2.0 d. The main presenting symptom was abdominal distension, with most perforations occurring at the greater curvature of the stomach. 20 cases had congenital gastric muscular layer defects. 21 cases survived and 6 cases died. Age of onset was later in the death group than the survival group [2.5 (2.0, 7.8) days vs. 1.9 (1.4, 3.0) days]. The survival group had higher preoperative platelet count than the death group [(218±80) ×10 9/L vs. (126±73)×10 9/L]. The incidences of thrombocytopenia, septic shock and multi-organ dysfunction syndrome before surgery in the survival group were significantly lower than the death group ( P<0.05). Logistic regression analysis showed that preoperative thrombocytopenia was a risk factor for NGP mortality ( OR=19.000, 95% CI 2.029-177.932, P=0.010). Conclusions:NGP is more common in male infants, premature infants and low birth weight infants. The most common etiology is congenital gastric muscular layer defects. The mortality rate is high and preoperative thrombocytopenia is a risk factor for mortality.

Effect of milk on sebaceous gland spots and the IGF-1/SREBP-1/ACC-1 signaling pathway in golden hamsters / 中华皮肤科杂志

Objective:To investigate the effect of milk on sebum secretion in golden hamsters, and to explore its possible mechanism of action.Methods:Eighteen golden hamsters were randomly and equally divided into 3 groups: blank control group receiving no intervention, whole-milk group gavaged with whole milk, and skimmed-milk group gavaged with skimmed milk. The gavage feeding was performed at a dose of 2.5 ml twice a day for 4 consecutive weeks. The maximum transverse diameter and maximum longitudinal diameter of bilateral sebaceous gland spots were measured on days 0, 7, 14, 21 and 28 after the start of intervention, and the area of sebaceous gland spots was calculated; at 24 hours after the last gavage, bilateral sebaceous gland spot tissues were resected, and subjected to immunohistochemical study to determine the expression of insulin-like growth factor-1 (IGF-1) /sterol regulatory element-binding protein-1 (SREBP-1) /acetyl-coenzyme A carboxylase (ACC-1) signaling pathway in sebaceous gland spots. Statistical analysis was carried out by using repeated measures analysis of variance, one-way analysis of variance for independent groups, Kruskal-Wallis H test, and least significant difference- t test for multiple comparisons. Results:Repeated measures analysis of variance showed that there was no significant difference in the area of sebaceous gland spots of golden hamsters among the 3 groups ( F= 0.96, P= 0.417) . The IGF-1 expression was significantly higher in the skimmed-milk group (0.39 ± 0.03) than in the blank control group (0.35 ± 0.03, t= 2.62, P= 0.021) and whole-milk group (0.33 ± 0.02, t= 3.82, P= 0.002) ; compared with the blank control group (0.36 ± 0.02) , the skimmed-milk group showed significantly increased SREBP-1 expression (0.42 ± 0.04, t= 2.64, P= 0.021) ; the ACC-1 expression was significantly higher in the skimmed-milk group (0.40 ± 0.03) and whole-milk group (0.40 ± 0.05) than in the blank control group (0.34 ± 0.03; t= 2.39, 2.47, P= 0.031, 0.026, respectively) . Conclusion:Milk may promote sebum secretion in golden hamsters through the IGF-1/SREBP-1/ACC-1 signaling pathway.

Countermeasures for standardized residency training of physicians in post-epidemic era / 中华医学教育探索杂志

Objective:To explore the methods of standardized residency training for internal medicine residents in the post-epidemic era, and to provide theoretical basis for improving and optimizing the standardized residency training.Methods:A total of 228 resident physicians from Batch 2017 to Batch 2019 were recruited, and a questionnaire survey was conducted to investigate their basic information, their attitudes and actions in facing the epidemic and the epidemic impact on the occupational planning and rotation plan. Original data of this study were exported through the questionnaire platform "Questionnaire Network", sorted out by Microsoft Excel, and plotted and analyzed by Origin software.Results:Residents of our hospital, socialized medical residents, other unit sponsor residents and combined professional masters willing to go to Hubei for medical support accounted for 100% (30 people), 86% (6 people), 84% (80 people) and 77% (72 people) respectively. Almost all of the residents were willing to learn the knowledge of COVID-19 and to educate the public (99%-100%). Eighty percent (24 people) of the residents of our hospital participated in anti-epidemic, while the proportion of other unit sponsor residents, socialized medical residents and combined professional masters were 46% (44 people), 14% (1 people) and 12% (11 people), respectively. Additionally, 97% (29 people) of our hospital residents, 89% (85 people) of other unit sponsor residents, 86% (6 people) of the socialized medical residents, and 82% (76 people) of the combined professional masters would still like to engage in the clinical work in the future. What's more, the resident physicians who thought that phylaxiology, epidemiology, general practice medicine, traditional Chinese medicine and critical care medicine should be strengthened to train accounted for 98% (221 people), 98% (221 people), 90% (203 people), 70% (158 people) and 60% (135 people) respectively.Conclusion:Most resident physicians have strong awareness and active actions in fighting against the epidemic. In the future, the standardized residency training of physicians should further strengthen the training of phylaxiology, epidemiology, general practice medicine, traditional Chinese medicine and critical care medicine.

Effects of ankle exoskeleton assistance during human walking on lower limb muscle contractions and coordination patterns / 生物医学工程学杂志

Lower limb ankle exoskeletons have been used to improve walking efficiency and assist the elderly and patients with motor dysfunction in daily activities or rehabilitation training, while the assistance patterns may influence the wearer's lower limb muscle activities and coordination patterns. In this paper, we aim to evaluate the effects of different ankle exoskeleton assistance patterns on wearer's lower limb muscle activities and coordination patterns. A tethered ankle exoskeleton with nine assistance patterns that combined with differenet actuation timing values and torque magnitude levels was used to assist human walking. Lower limb muscle surface electromyography signals were collected from 7 participants walking on a treadmill at a speed of 1.25 m/s. Results showed that the soleus muscle activities were significantly reduced during assisted walking. In one assistance pattern with peak time in 49% of stride and peak torque at 0.7 N·m/kg, the soleus muscle activity was decreased by (38.5 ± 10.8)%. Compared with actuation timing, the assistance torque magnitude had a more significant influence on soleus muscle activity. In all assistance patterns, the eight lower limb muscle activities could be decomposed to five basic muscle synergies. The muscle synergies changed little under assistance with appropriate actuation timing and torque magnitude. Besides, co-contraction indexs of soleus and tibialis anterior, rectus femoris and semitendinosus under exoskeleton assistance were higher than normal walking. Our results are expected to help to understand how healthy wearers adjust their neuromuscular control mechanisms to adapt to different exoskeleton assistance patterns, and provide reference to select appropriate assistance to improve walking efficiency.

Pain characteristics and outcomes in patients with Parkinson′s disease / 中华神经科杂志

Objective:To investigate the clinical characteristics and influencing factors of pain symptoms in patients with idiopathic Parkinson′s disease.Methods:The King′s Parkinson′s Disease Pain Scale (KPPS) was used to evaluate pain of 106 patients with Parkinson′s disease. The Pittsburgh Sleep Quality Index (PSQI), the Fatigue Scale-14 (FS-14), the Unified Parkinson′s Disease Rating Scale Ⅲ, Hoehn-Yahr scale (H-Y), Mini-Mental State Examination (MMSE), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to assess the sleep status of patients, the degree of fatigue, motor function, severity of symptoms, cognitive function, anxiety and depression. Fifty-eight patients were followed up for three to six months.Results:The incidence of pain in Parkinson′s disease patients was 50.0% (53/106), of which skeletal muscle pain was the most common. Parkinson′s disease patients with a longer course of disease were more likely to have pain [course of disease in Parkinson′s disease with pain was 3.0 (1.5, 5.0) years, in Parkinson′s disease without pain was 2.0 (1.5, 2.5) years, Z=-2.0, P=0.046]. Male patients had more severe pain than female patients [KPPS scores in males were 14.5 (8.0, 21.5), in females were 10.0(4.0, 15.3), Z=-2.81, P=0.005]. In the first evaluation, the H-Y grading and the FS-14 scores of Parkinson′s disease patients with pain were significantly higher than those without pain [H-Y grading in Parkinson′s disease patients with pain was 2.0 (1.5, 2.5), in Parkinson′s disease patients without pain was 2.0 (1.5, 2.0), Z=-2.02, P=0.043; FS-14 scores in patients with pain were 10.0 (8.0, 11.0), in patients without pain was 8.0 (5.0, 10.0), Z=-3.32, P=0.001]. The KPPS scores were positively correlated with the scores of HAMA and HAMD ( r=0.39, P=0.005; r=0.38, P=0.007). Binary Logistic regression analysis showed that Parkinson′s disease patients with higher scores of FS-14 had an increased risk of developing pain ( OR=1.27, 95% CI: 1.09-1.48, P=0.002). The changes of KPPS scores were associated with the changes of PSQI and FS-14 scores ( r=0.54, P=0.002; r=0.50, P=0.003). The decrease of KPPS scores was only positively correlated with the decrease of FS-14 scores when the drug and medication status remained unchanged ( r=0.421, P=0.045). Multiple linear regression analysis showed that the decrease of FS-14 scores was associated with the decrease of the KPPS scores ( OR=2.02, P=0.033). Conclusions:Parkinson′s disease patients have a high incidence of pain, and fatigue is a factor for predicting the occurrence and outcome of pain in Parkinson′s disease. The severity and change of pain in Parkinson′s disease patients are related to anxiety, depression, sleep and fatigue, suggesting that there may be a common pathogenesis of pain, emotion, sleep and fatigue in Parkinson′s disease patients.

Expression of macrophage migration inhibitory factor in acute myeloid leukemia and its effect on the expression of interleukin-8 in bone marrow mesenchymal stem cells / 白血病·淋巴瘤

Objective:To investigate the expression of macrophage migration inhibitory factor (MIF) in bone marrow fluid and peripheral blood of patients with acute myeloid leukemia (AML) and its effect on the expression of interleukin-8 (IL-8) in bone marrow mesenchymal stem cells (BM-MSC).Methods:Fifty bone marrow fluid samples and 50 peripheral blood samples were collected from 50 patients with AML diagnosed in the First People's Hospital of Yunnan Province from October 2017 to January 2019, of which 17 patients were newly diagnosed, 26 patients were complete remission (CR), and 7 patients were partial remission (PR) or non-remission (NR). Fifty plasma samples from 50 healthy subjects and 50 bone marrow fluid samples from 50 patients with iron deficiency anemia were used as the controls. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of MIF protein in the samples, and the relationship between MIF expression level and clinicopathological characteristics of AML patients was analyzed. BM-MSC was successfully isolated and cultured from 42 bone marrow fluid samples of AML patients, the suitable samples for experiment were chosen and divided into BM-MSC control group (untreated BM-MSC), recombinant human macrophage migration inhibitory factor (rhMIF) group and rhMIF+ISO-1 group. ELISA and real-time fluorescence quantitative polymerase chain reaction were used to detect the expression level of IL-8 protein and mRNA in each BM-MSC group.Results:The expression levels of MIF protein in bone marrow fluid and plasma in AML group were (24.9±7.7) ng/ml and (60.5±12.1) ng/ml, the difference was statistically significant ( P < 0.01), and those in control group were (5.3±2.6) ng/ml and (2.0±1.1) ng/ml, respectively, and there were statistical differences between the two groups (t values were 136.71, 33.97 and 17.58, all P < 0.01). MIF protein expression levels in bone marrow fluid and plasma of AML patients in newly diagnosed group and PR+NR group were higher than those in CR group, and the differences were statistically significant (all P < 0.01). MIF protein expression levels were higher in bone marrow fluid and plasma of patients with ≥60 years of age, peripheral blood white blood cell count ≥30×10 9/L and bone marrow myeloblast ratio > 0.50 (all P < 0.05), but the differences were not statistically significant between patients with different gender (both P > 0.05). The detection results of each BM-MSC group showed that rhMIF promoted the IL-8 expression in BM-MSC at the gene and protein levels, which could be inhibited by the MIF inhibitor ISO-1 (all P < 0.01). Conclusion:The increased expression levels of MIF in bone marrow fluid and plasma of patients with AML are associated with the disease progression, and rhMIF can promote the expression of IL-8 in BM-MSC.

The clinical features of patients: transfered by "Qilu " interhospital transfer center / 中华急诊医学杂志

Objective To explore new models for interhospital transfer and provide theoretical basis for the interhospital transfer system construction through analyzing the clinical features of the patients transfered by "Qilu" interhospital transfer center.Methods Totally 258 patients aged over 18 years who were transferred to or from Qilu Hospital of Shandong University from August 2014 to December 2016 were analyzed.The data including sex,age,transport index,modified early warning score (MEWS) and outcome of patients with successful transport were collected.According to the results,the transferred patients were divided into the improved group and the non-improved group,and the differences of the above indicators between the two groups were analyzed.In the numerical variable analysis,Student's t test or Mann-whitney non-parametric test was applied,and the categorical variable was applied with x2 test.The correlation between clinical indicators and outcomes of the patients was analyzed by logistic regression analysis.Results The total transfer success rate was 98.5％.The transported male patients were more than female patients.Patients transferred to Qilu Hospital were mainly diagnosed with nervous system disease,trauma and circulatory system disease,and patients transferred from QiLu Hospital were respiratory disease,circulatory system disease,and nervous system disease.Tracheal intubation,tracheotomy,and invasive mechanical ventilation rates were 11.9％-22.2％.The patients ratio of transferred from Qilu Hospital with vasoactive drugs and the ratio of patients with deep venous catheter were three times and five times than those transferred to Qilu Hospital.Eighty-one percent patients transferred to Qilu Hospital recovered,and 45.5％ patients transferred from the hospital recovered.The age,heart rate,MEWS score,length of stay,ICU ratio,mechanical ventilation ratio and tracheal intubation ratio were significantly different between the improved group and the non-improved group (P＜0.05).Among the critically patients transferred to ICU,the length of stay was correlated with the outcome of the improvement.(OR=1.213,95％CI:1.085-1.357).Conclusions "Qilu" Interhospital Transfer Center has a high success rate and high recovery rate of patients,and can be a new model for the construction of interhospital transfer system.

Interaction between Respiration and Swallowing and Its Application (review) / 中国康复理论与实践

@#Dysphagia is often associated with incoordination between breathing and swallowing, resulting in the occurrence of aspiration, cough and aspiration pneumonia. This article reviewed the specific physiological mechanisms of respiration and swallowing and their clinical applications, which aimed to focus on the relationship between respiration and swallowing systems in health and disease, and to explore its guiding value in the clinical treatment of dysphagia.

Pregnancy outcome of patients ≥ 35 years old with diminished ovarian reserve treated with growth hormone / 中国医师杂志

Objective To explore the application effect of growth hormone in patients ≥35 years old with diminished ovarian reserve (DOR),and to analyze pregnancy outcome.Methods A total of 120 cases with diminished ovarian reserve (≥35 years old) in our hospital were randomly divided into observation group and control group,each group of 60 cases.The control group was given conventional treatment,while the observation group added growth hormone.Changes of follicle stimulatng homone (FSH) and luteinizing hormone (LH),FSH/LH,serum estradiol (E2) level were compared between the two groups before and after treatment,along with the pregnancy outcome of two groups such as normal fertilization rate,excellent embryo rate,quantity of egg,cleavage rate,cycle cancellation rate.Results After treatment,the FSH and FSH/LH of the observation group were significantly lower than those of the control group,the serum E2 was significantly higher than that of the control group (P ＜ 0.05);the normal fertilization rate,cleavage rate and excellent embryo rate in the observation group were 53.96％,86.67％ and 35.38％ respectively,which were significantly higher than those of 33.58％,71.11％ and 15.63％ in the control group (P ＜ 0.05);the cycle cancellation rate of the observation group was 6.67％,which was significantly lower than that of 21.67％ in the control group (P ＜ 0.05);the biochemical pregnancy rate and clinical pregnancy rate of the observation group were 38.33％ and 28.33％,which were significantly higher than those of 20％ and 13.33％ in the control group (P ＜ O.05).Conclusions Diminished ovarian reserve in patients ≥35 years old with growth hormone therapy,can promote the improvement of ovarian function,the biochemical pregnancy rate and clinical pregnancy rate,it is worthy of clinical promotion.

Investigation on the influencing factors of hyperuricemia in different genders / 重庆医学

Objective To compare the clinical characteristics and influence factors of hyperuricemia between genders,in order to provide references for better controlling and preventing the occurrence and development of hyperuricemiaprovide.Methods A total of 5 783 people who underwent physical examination in two Baoding Health Screening Centers from January 1st to June 1st,2016 were enrolled in this study,and all volunteers completed physical examination,laboratory examination and questionnaire survey.Patients with hyperuricemia were selected to analyse the clinical characteristics and influence factors.Results There were statistically significant differences in clinical characteristics,including obesity,blood pressure,blood glucose,blood lipids,liver function,renal function,anemia,blood rheology examination,thyroid ultrasound and lateral radiographs,between male and female patients with hyperuricemia (P＜0.05).The survey showed that there were statistically significant differences in age,education level,marital status,work status,sleeping status,smoking and drinking between male and female patients with hyperuricemia (P＜0.05).The red blood cells counts,marital status and education level were influence factors for female patients with hyperuricemia,while have little effect on male patients.The smoking,creatinine and diastolic blood pressure were influence factors for male patients with hyperuricemia,while have no effect on female patients.Conclusion The clinical characteristics and the influencing factors of male and female patients with hyperuricemia are different,so corresponding preventive and therapeutic measures should be taken for male and female patients.

Detection and Identification of Volatile Constituents from Leaves and Fruits of Piper nigrum by HS-SPME-GC-MS / 中国药房

OBJECTIVE:To establish a method for the detection of volatile constituents from the leaves and fruits of Piper ni-grum. METHODS:HS-SPME-GC-MS was used. The chromatographic conditions:column was HP-5 MS quartz elastic capillaries, carrier gas was high purity helium(99.999%),flow rate was 1.0 mL/min,the inlet temperature was 250 ℃,initial temperature of column was 50 ℃(temperature programmed),split injection with split ratio of 10:1. MS conditions:ionization mode was electron impact ion source,ionization energy was 80 eV,ion source temperature was 230 ℃,quadrupole temperature was 150 ℃,trans-mission line temperature was 280 ℃,electron multiplier voltage was 1588 V,mass scanning range was m/z 30-400. The spectra were retrieved using RTLPEST3. L and NIST08. L,and the relative contents of the volatile constituents were determined by area normalization method. RESULTS:There were 28 volatile constituents in the leaves and 15 in the fruits,respectively accounting for 67.13% and 36.85%. The major volatile constituents of leaves were β-caryophyllene (15.72%),limonene (9.39%),3-carene (9.32%),β-pinene(6.80%),α-terpine(4.98%),etc.,the main volatile constituents of fruits were 1,7,7-trimethyl-2-vinylbicyclo [2.2.1]hept-2-ene(10.45%),espatulenol(8.28%),caryophyllene oxide(4.81%),etc. 5 constituents were owned in both. CON-CLUSIONS:The study basically clears the main volatile constituents from the leaves and fruits of P. nigrum,and verifies existing obvious differences.

Effect of hepatitis C virus nonstructural protein 5A and its domains II on hepatocyte gluconeogenesis in mice / 中华肝脏病杂志

Objective@#To investigate the role of hepatitis C virus nonstructural protein 5A (NS5A) and its domains I, II, and III in regulating gluconeogenesis in mice and the underlying mechanism.@*Methods@#A total of 60 male C57BL/6J mice were randomly divided into six groups. Recombinant lentiviral particles with specific expression of full-length NS5A, NS5A domain I, NS5A domain II, or NS5A domain III were injected via the caudal vein to establish a mouse model, and the group without injection and the group with the injection of the lentiviral particles containing enhanced green fluorescent protein (EGFP) were established as negative control. The effect of full-length NS5A protein and its domains on fasting blood glucose (FBG) and fasting serum insulin (FINS) were measured. Liver tissue was collected to prepare a paraffin section. Immunohistochemistry was used to measure the expression of phosphoenolpyruvate carboxykinase (PEPCK) in hepatocytes, quantitative real-time PCR and/or Western blot were used to measure the expression of NS5A, phosphorylated adenosine monophosphate-activated protein kinase (p-AMPK), sterol regulatory element-binding protein-1 (SREBP-1), and PEPCK.@*Results@#Compared with the group without injection and the group with the injection of the lentiviral particles containing EGFP, the groups with the injection of the lentiviral particles containing full-length NS5A and NS5A domain II had significant increases in FBG and homeostasis model assessment of insulin resistance index (P < 0.01). Immunohistochemistry and quantitative real-time PCR showed a significant increase in the expression of PEPCK, a key enzyme involved in gluconeogenesis. Western blot showed that full-length NS5A protein and NS5A domain II inhibited the level of p-AMPK and increased the levels of SREBP-1 and PEPCK.@*Conclusion@#NS5A protein and NS5A domain II may affect glucose metabolism in hepatocytes in mice by regulating AMPK/SREBP-1/PEPCK, and NS5A domain II may play an important role in insulin resistance in hepatocytes caused by HCV infection.

Role of fibroblast growth factor 8 in process of dental epithelium-induced directional differentiation of human postnatal dental pulp stem cells into odontoblasts and pulp cells / 中国病理生理杂志

AIM: To study the effects of fibroblast growth factor 8 (FGF8) on directional differentiation of human dental pulp stem cells (hDPSCs) into odontoblasts and pulp tissue.METHODS: hDPSCs were isolated and cultured, and identified with flow cytometry by detecting cell surface markers of hDPSCs.FGF8 at concentration of 50 μg/L was added into the mineralization fluid to induce the differentiation of the hDPSCs.The mRNA expression of dentin sialophosphoprotein (DSPP), alkaline phosphatase (ALP), bone sialoprotein (BSP) and core-binding factor alpha 1 (Cbfa-1) in differentiated cells was detected by real-time PCR.FGF8 and mouse E11.5 dental epithelium formed restructuring cell group with hDPSCs, and then the restructuring cell group was transplanted under renal capsule membrane in nude mice for tissue culture.DNA in situ hybridization was used to identify the sources of odontoblasts and pulp cells.RESULTS: The surface markers of CD29 and CD90 showed positive in isolated hDPSCs.FGF8 induced hDPSCs to form a distinct mineralization nodule, and the expression of dentin-specific proteins, DSPP, BSP and Cbfa-1, was increased.hDPSCs were induced to differentiate into odontoblasts and pulp cells by E11.5 dental epithelium and FGF8.CONCLUSION: FGF8 can assist dental epithelium to induce directional differetiation of hDPSCs into odontoblasts and pulp cells, and formation of dentin and dental pulp cavity structure.

Treatment of Quadruple Therapy Combined with Saccharomyces boulardii Sachets on Helicobacter pylori Infection: A Report of 125 Cases / 医药导报

Objective To discuss whether Saccharomyces boulardii sachets can improve the eradication rate and reduce some untoward effects of gastrointestinal tract when adding in the Helicobacter pylori (Hp) standard quadruple therapy.Methods 249 cases infected with Hp were randomly divided into control group(124 cases) and treatment group (125 cases).The control group was treated with standard quadruple therapy:colloidal bismuth pectin capsules,100 mg,tid,po;furazolidone tablets,0.1 g,bid,po;amoxil capsule,1 g,bid,po;rabeprazole sodium enteric-coated capsules,20 mg,qd,po.The treatment group was treated with Saccharomyces boulardii sachets(0.25 g,bid,po)besides.Both groups were treated for 4 weeks.Evaluate the effect of Hp eradication rate by using the method of intent of treatment (ITT) analysis and consistent scenario set (PP)analysis.Results According to the ITT analysis,the eradication rate of control group was 89.52%,and that of treatment group was 96.00%.According to the PP analysis,the eradication rate of control group was 90.00%,and the rate of treatment group was 97.39%.Both analysis results showed the eradication rate of Hp in treatment group was significantly higher than control group(P<0.05).As for reducing the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra,control group was obviously lower than treatment group (P<0.05).Conclusion Compared with standard quadruple therapy only,adding Saccharomyces boulardii sachets can significantly improve the eradication rate of Hp and obviously reduce the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra.It is worth to be generalized and applied in clinical practice.

Relationships between implicit and explicit attitude toward death in college students / 中国心理卫生杂志

Objective:To explore the implicit attitude and explicit attitude toward death of college students,and the relationship between the two kinds of attitude.Methods:Totally 65 college studems participated in this study.The Single Category Implicit Association Test (SC-IAT,including cognition,affection and behavior) was used to exam the implicit attitude toward death of undergraduate students.The Death Attitude Profile-Revised (DAP-R,including five dimensions,i.e.,fear of death,death avoidance,death acceptance,escape acceptance,and neutral acceptance) was used to measure the explicit attitude.Results:Data of the SC-IAT indicated that the differences between the mean reaction time of the incompatible task and compatible in all three dimensions and the total SC-IAT were significant (Ps ＜0.01),and both the D scores of the total SC-IAT and three dimensions were larger than zero.The mean score of neutral acceptance was the highest in the five factors of SC-IAT.Relationships between the implicit effect of SC-IAT and the Mean scores of the DAP-R's five factors were not significant(Ps ＞ 0.05).Conclusion:The implicit attitude toward death of college students is negative,the explicit attitude toward death of college students is neutral.The implicit and explicit attitude toward death of college students is incongruent,and they are relatively independent.