Cognitive behavioral stress management effectively facilitates neurologic recovery, alleviates mental distress, and elevates health status in acute ischemic stroke patients

Cognitive behavioral stress management (CBSM) relieves physical and psychological burdens in patients with some central nervous system diseases, while its utility in acute ischemic stroke (AIS) patients is unclear. This study aimed to explore the effect of CBSM on neurologic recovery and psychosomatic health in AIS patients. Totally, 176 naive AIS patients were randomized into routine care (RC) group (n=88) and CBSM group (n=88) to receive a 3-month corresponding intervention. Modified Rankin scale (mRS) scores at the first month after discharge (M1) (P=0.008) and the third month after discharge (M3) (P=0.016) were lower in the CBSM group than in the RC group. The proportion of AIS patients with mRS score >2 at M3 was reduced in CBSM group vs RC group (P=0.045). Hospital anxiety depression scale (HADS)-anxiety score at M3 (P=0.016), HADS-depression score at M3 (P=0.005), and depression rate at M3 (P=0.021) were decreased in the CBSM group vs the RC group. EuroQol-5 dimension scores at M1 (P=0.024) and M3 (P=0.012) were decreased, while EuroQol-visual analogue scale score at M3 (P=0.026) was increased in the CBSM group vs the RC group. By subgroup analyses, CBSM had favorable outcomes in AIS patients with age ≤65 years. CBSM was beneficial to neurologic recovery and distress relief in AIS patients with an education level of middle school or above, and to health status in those with an education level of primary school or uneducated. In conclusion, CBSM benefitted neurologic recovery and psychosomatic health in AIS patients with minor neurological deficits, however, further studies should verify these results with a larger sample size and longer follow-up.

Epidemiological characteristics of acute hepatitis B in Jiangxi Provincefrom 2014 to 2021 / 预防医学

Objective @#To learn the epidemiological characteristics of acute hepatitis B in Jiangxi Province from 2014 to 2021, so as to provide insights into perfecting hepatitis B prevention and control strategy.@*Methods@#Data pertaining to acute hepatitis B was collected through the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distributions of acute hepatitis B were analyzed using a descriptive epidemiological method. The trend in incidence of acute hepatitis B was analyzed using annual percent change (APC). @*Results@#Totally 8 890 cases of acute hepatitis B were reported in Jiangxi Province from 2014 to 2021, with the reported incidence showing a tendency towards a decline (APC=-11.730%, P<0.05). The average annual reported incidence rate of acute hepatitis B was 2.42/105. Acute hepatitis B occurred all the year round, without obvious seasonal characteristics. The top three highest incidence rates were reported in Pingxiang City (7.12/105), Ganzhou City (3.12/105) and Fuzhou City (2.87/105). The lowest and highest incidence rates of acute hepatitis B were seen among residents aged under 10 years (0.30/105) and 20-29 years (3.86/105). The incidence rate of males was higher than that of females (3.25/105 vs. 1.55/105, P<0.05). Farmers were predominant population affected acute hepatitis B (5 764 cases, 64.84%). @*Conclusions@#The incidence of acute hepatitis B showed a downward trend in Jiangxi Province from 2014 to 2021, and the disease predominantly affected young males, farmers. Health education should be strengthened, and hepatitis B vaccination coverage should be promoted.

Effect of football on rehabilitation of ankle injury patients / Efeito do futebol na reabilitação de pacientes com lesão no tornozelo / Efecto del fútbol en la rehabilitación de pacientes con lesiones de tobillo

ABSTRACT Introduction: Brief introduction: Ankle tendon and ligament sports injuries are common in football players. Objective: To continue to improve special strength training related to the characteristics of football after rehabilitation of injured ankle tendons and ligaments. Methods: Two master football sportsmen were rehabilitated by multi-point equal-length, short-arc and long-arc equal-speed training combined with balance ability exercises. Results: There were two long muscle L be maintain muscle tone plantar flexors force four times of 96 n/m, n/m 121, 140 n/m, 145 n/m than back flexors force of 63 n/m, 52 n/m, 60 n/m, 74 n/m tall. Plantar flexor fatigue was 57%, 30%, 29%, 12%, 28%, 18%, 20%, 21%. Conclusions: With the passing of time, the relative peak moment value of the right ankle plantar flexor muscle group of the two patients kept rising, the dorsiflexor muscle was basically flat, and the work fatigue index decreased step by step, indicating that the right ankle muscle strength level was significantly improved, the anti-fatigue ability was improved, and the rehabilitation treatment had a good effect. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: Introdução breve: Lesões esportivas nos tendões e ligamentos do tornozelo são comuns em jogadores de futebol. Objetivo: Atingir melhora no treinamento de força especial relacionado com as lesões características do futebol depois de reabilitação de tendões e ligamentos do tornozelo. Métodos: Dois futebolistas de primeira linha foram reabilitados por treinamento multipontos de comprimento igual, arco curto e arco longo em velocidade igual, combinado com exercícios de habilidade de equilíbrio. Resultados: Havia dois músculos longos L para manter o tônus muscular, força dos flexores plantares antes e depois de quatro vezes de 96 n/m, 121 n/m, 140 n/m, 145 n/m e força dos flexores dorsais de 63 n/m, 52 n/m, 60 n/m, 74 n/m de altura. A fadiga do flexor plantar foi de 57%, 30%, 29%, 12%, 28%, 18%, 20%, 21%. Conclusões: Com o passar do tempo, o valor do momento de pico relativo do grupo de músculos flexores plantares do tornozelo direito dos dois pacientes continuou aumentando; o músculo flexor do dorso estava basicamente plano e o índice de fadiga no trabalho diminuiu gradativamente, indicando que o nível de força muscular do tornozelo direito melhorou significativamente, assim como a capacidade antifadiga e, portanto, que o tratamento de reabilitação teve efeito positivo. Nível de Evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: Breve introducción: Las lesiones deportivas en los tendones y ligamentos del tobillo son comunes en los jugadores de fútbol. Objetivo: Lograr una mejora en el entrenamiento de fuerza especial relacionado con las lesiones características del fútbol tras la rehabilitación de los tendones y ligamentos del tobillo. Métodos: Dos jugadores de fútbol de alto nivel fueron rehabilitados mediante un entrenamiento multipunto de igual longitud, arco corto y arco largo a igual velocidad, combinado con ejercicios de habilidad de equilibrio. Resultados: Hubo dos músculos L largos para mantener el tono muscular, fuerza de los flexores plantares antes y después de cuatro veces de 96 n/m, 121 n/m, 140 n/m, 145 n/m y fuerza de los flexor dorsales de 63 n/m, 52 n/m, 60 n/m, 74 n/m de altura. La fatiga de los flexores plantares fue del 57%, 30%, 29%, 12%, 28%, 18%, 20%, 21%. Conclusiones: Con el paso del tiempo, el valor del momento máximo relativo del grupo de músculos flexores plantares del tobillo derecho de los dos pacientes continuó aumentando; el músculo flexor dorsal estaba básicamente plano y el índice de fatiga de trabajo disminuyó gradualmente, lo que indica que el nivel de fuerza muscular del tobillo derecho mejoró significativamente, al igual que la capacidad antifatiga, y, por tanto, que el tratamiento de rehabilitación tuvo un efecto positivo. Nivel de Evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Efficacy and safety of nivolumab plus ipilimumab versus nivolumab monotherapy in the treatment of malignant tumors: A Meta-analysis / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To systematically evaluate the efficacy and safety of nivolumab plus ipilimumab versus nivolumab monotherapy in the treatment of malignant tumors, so as to provide evidence-based medical proof for clinical administration. Methods: Databases, such as PubMed, CNKI, VIP, and Wanfang Data, were searched from January 2000 to January 2022 to collect the clinical trial data in terms of nivolumab plus ipilimumab versus nivolumab monotherapy for malignant tumors were published in both domestic and abroad. Two reviewers independently evaluated the quality of included RCTs, and extracted and cross-checked the data. RevMan 5. 4 was used for the Meta-analysis. Results: A total of 7 RCTs studies including 10 articles were included. Compared with the nivolumab monotherapy group, the OS of patients in the combined treatment group was significantly improved (HR=0.86, 95% CI:0. 75-0.99, P=0. 03), and the PFS was significantly prolonged (HR=0.69, 95% CI: 0.55-0.85, P=0.000 6). However, as for safety, treatment-related adverse events (OR=3.18, 95% CI: 1.55-6.55, P=0.002) and adverse events leading to drug discontinuation (OR=7.11, 95% CI: 4.85-10.42, P<0.000 01) in the combination therapy group were significantly higher than those in the monotherapy group. Conclusion: Compared with nivolumab monotherapy, nivolumab plus ipilimumab can significantly improve the OS and PFS of tumor patients, but is also associated with more treatment-related adverse events and adverse events leading to drug discontinuation. Therefore, it is necessary to pay attention to follow-up and regular monitoring to prevent the occurrence of serious adverse reactions.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games / 世界急诊医学杂志（英文）

BACKGROUND: Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS: We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS: In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11％ of the athletes incurred at least one injury and nearly 3％ incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3％) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5％) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65％). CONCLUSION: Overall, 11％ of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2％ of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

The characteristic of otoacoustic emissions in full-term neonates according to ABO blood groups / Característica das emissões otoacústicas em neonatos a termo segundo grupos sanguíneos do sistema ABO

Abstract Introduction: Previous research has suggested that individuals with different blood groups show varied incidences of noise-induced hearing loss. The reduced otoacoustic emissions amplitudes indicate the higher possibilities of outer hair cell damage for noise exposure. Objective: The objective is to analyze the characteristics of otoacoustic emissions, including the occurrence of spontaneous otoacoustic emission and the amplitudes of distortion product otoacoustic emission at certain frequencies in full term neonates with different ABO blood groups. Methods: A total of 80 selected full-term female neonates who passed the initial newborn hearing screen were enrolled into the study, with equal number of participants in four ABO blood groups (Blood Group A, Blood Group B, Blood Group AB, Blood Group O). Measurements of spontaneous otoacoustic emission and distortion product otoacoustic emission were performed in both ears for all participants. Results: (1) The blood group O participants showed significantly fewer spontaneous otoacoustic emission occurrences than the other three blood groups (A = 70%, B = 80%, AB = 67%, O = 25%, p < 0.05). (2) The blood group O participants showed lower DPOAE amplitudes at 1257 Hz (M = 4.55 dB, SD = 8.36), 1587 Hz (M = 11.60 dB, SD = 6.57), 3174 Hz (M = 7.25 dB, SD = 5.99), 5042 Hz (M = 13.60, SD = 6.70) than participants with the other three blood groups in left ears (p < 0.05). In right ears, the blood group O participants showed reduced amplitudes at 1257 Hz (M = 6.55 dB, SD = 8.36), 1587 Hz (M = 13.60 dB, SD = 6.57), 3174 Hz (M = 7.65 dB, SD = 6.43), 5042 Hz (M = 13.65 dB, SD = 6.50) than participants from non-O blood groups (p < 0.05). Conclusion: Female individuals with blood group O have lower otoacoustic emissions values than individuals with the other three blood groups. We need to further investigate the possible relationships between ABO blood group and cochlear function, including the potential influences of noise damage on cochlear outer hair cells.

Resumo Introdução: Pesquisas anteriores sugeriram que indivíduos de diferentes grupos sanguíneos apresentam incidências distintas de perda auditiva induzida por ruído. As amplitudes reduzidas das emissões otoacústicas indicaram maiores ou menores possibilidades de danos às células ciliadas por exposição a ruídos. Objetivo: Analisar as características das emissões otoacústicas, inclusive a ocorrência de emissões otoacústicas espontâneas e as amplitudes de emissões otoacústicas por produto de distorção em determinadas frequências em neonatos a termo de diferentes grupos sanguíneos do sistema ABO. Método: Foram incluídos 80 neonatos a termo selecionados na triagem auditiva neonatal inicial para participar do estudo, com número igual de participantes de grupos sanguíneos do sistema ABO (grupo sanguíneo A, grupo sanguíneo B, grupo sanguíneo AB e grupo sanguíneo O). As emissões otoacústicas espontâneas e emissões otoacústicas por produto de distorção foram medidas em ambas as orelhas de todos os participantes. Resultados: (1) Os participantes do grupo sanguíneo O apresentaram ocorrências de emissões otoacústicas espontâneas significantemente menores do que os dos outros três grupos sanguíneos (A = 70%, B = 80%, AB = 67%, O = 25%, p < 0,05). (2) Os participantes do grupo sanguíneo O apresentaram amplitudes de emissões otoacústicas por produto de distorção mais baixas a 1257 Hz (M = 4,55 dB, DP = 8,36), 1587 Hz (M = 11,60 dB, DP = 6,57), 3174 Hz (M = 7,25 dB, DP = 5,99), 5042 Hz (M = 13,0, DP = 6,70) do que os participantes dos outros três grupos sanguíneos nas orelhas esquerdas (p < 0,05). Nas orelhas direitas, os participantes do grupo sanguíneo O apresentaram amplitudes reduzidas em 1257 Hz (M = 6,55 dB, DP = 8,36), 1587 Hz (M = 13,60 dB, DP = 6,57), 3174 Hz (M = 7,65 dB, DP = 6,43), 5042 Hz (M = 13,65 dB, DP = 6,50) em comparação aos participantes de grupos sanguíneos não O (p < 0,05). Conclusão: Os indivíduos do sexo feminino do grupo sanguíneo O apresentaram valores menores de emissões otoacústicas do que os indivíduos dos outros três grupos sanguíneos. É necessário continuar a investigar as possíveis relações entre o grupo sanguíneo ABO e a função coclear, inclusive as possíveis influências do dano por ruídos às células ciliadas externas da cóclea.

Hydrogen sulfide protects H9c2 cardiomyoblasts against H2O2-induced apoptosis

Reactive oxygen species (ROS) are highly reactive chemical species that may cause irreversible tissue damage, and play a critical role in cardiovascular diseases. Hydrogen sulfide (H2S) is a gasotransmitter that acts as a ROS scavenger with cardio-protective effects. In this study, we investigated the cytoprotective effect of H2S against H2O2-induced apoptosis in cardiomyocytes. H9c2 rat cardiomyoblasts were treated with H2S (100 μM) 24 h before challenging with H2O2 (100 μM). Apoptosis was then assessed by annexin V and PI, and mitochondrial membrane potential was measured using a fluorescent probe, JC-1. Our results revealed that H2S improved cell viability, reduced the apoptotic rate, and preserved mitochondrial membrane potential. An increased Bcl-2 to Bax ratio was also seen in myocytes treated with H2S after H2O2-induced stress. Our findings indicated a therapeutic potential for H2S in preventing myocyte death following ischemia/reperfusion.

Review of Modern Hospital Management System in China / 中国医院管理

General Secretray Xi Jinping clearly proposed that modern hospital management system should be perfected in The Parly's Nineteenth Report.Through reviewing the research of modern hospital management system by domestic scholars,the research progress is summarized from external governance system,corporate governance mechanism and internal management system aspects.The virgin lands and shortcomings of existing research are analyzed to make readers have a better understanding of the research of modern hospital management system in China,to provide suggestions for further study,and to provide reference for policy makers at all levels to perfect modern hospital management system.

The establishment of a bisphosphonate-related osteonecrosis of the jaw rat model / 口腔疾病防治

@#With the wide use of bisphosphonates in bone diseases such as osteoporosis and bone metastases of malignant tumors, bisphosphonate-related osteonecrosis of the jaw has gained widely attention as a severe side effect. Animal model is a useful way to study bisphosphonate-related osteonecrosis of the jaw, among which rat model is used most usually. This article reviewed the establishment of rat model of bisphosphonate-related osteonecrosis of the jaw and relevant examinations.

Xiaochaihutang attenuates liver fibrosis in rats through activation of Nrf2 pathway / 中国药理学与毒理学杂志

OBJECTIVE Oxidative sress is one of the key factor responsible for occurrence and development of hepatic fibrosis, a common consequence of chronic liver injury of multiple etiology. Nuclear factor erythroid 2-related factor 2 (Nrf2) serves as a major regulator of a celular defense system against oxidative stress. Xiaochaihutang (XCHT), a compound of seven botanical extracts used for liver diseases traditionally in East Asia. However, few studies have investigated its anti-hepatic fibrosis effects and pathophysiological mechanism of action. The present study was designed to confirm the anti-hepatic fibrosis effects and explore its potential mechanism of action by investigating the intervention of Nrf2 pathway. METHODS Liver fibrosis was induced by repeated injection of Carbon tetrachloride (CCl4) over a period of 9 weeks. Starting from the 6th week, the animals in treatment groups were given the appropriate dose of XCHT granules and silybin. Biochemical parameters, histological changes of the liver and alpha-smooth muscle actin (α-SMA) were determined. The expressions of Nrf2, Keap1, Nqo1, HO-1, Gclc and Gclm were assessed by RT-PCR and Western blot. RESULTS CCl4 caused a significant fibrosis damage in the rat liver and the liver functions and fibrosis degree were significantly improved by XCHT (5 g·kg- 1 and 10 g·kg- 1). XCHT (5 g·kg- 1 and 10 g·kg- 1) treatment significantly decreased the number of cells labeled with α-SMA antibodies. Moreover, XCHT (5 g·kg-1 and 10 g·kg-1) significantly increase Nqo1, HO-1, Gclc and Gclm expressions in the liver. CONCLUSION These studies establish XCHT is a potentially useful therapeutic agent for treatment of hepatic fibrosis and it might be via regulation of Nrf2 pathway in rats against oxidative stress, making further efforts to inhibiting the activated HSCs. Activation or up-regulation of Nrf2 pathway may be an alternative treatment strategy for liver fibrosis.

Discovery of a small-molecule bromodomain-containing protein 4 inhibitor that induces AMP-activated protein kinase-modulated autophagy-associated cell death in breast cancer / 中国药理学与毒理学杂志

OBJECTIVE To discover a small-molecule bromodomain-containing protein 4 (BRD4) inhibitor that induces AMP- activated protein kinase- modulated autophagy- associated cell death in breast cancer and exploreits potential mechanisms. METHODS BRD4 interactors were analyzed by PPI network prediction and The Cancer Genome Atlas (TCGA) analysis. The interaction between BRD4 and AMPK was confirmed by co- immunoprecipitation assay. Novel BRD4 inhibitors were designed and synthesized based upon pharmacophore analysis of BRD4 (1), then screened by anti-proliferative activity and Alpha Screen of BRD4 (1). The selectivity of the best candidate compound 8f was validated by co-crystallization, FRET assay and co-immuno precipitation assay. The mechanisms of 8f were investigated by fluorescence microscopy, electron microscopy, Western blotting, immunocy?tochemistry, siRNA and GFP-mRFP-LC3 plasmid transfections, as well as immunohistochemistry and immunofluorescence. Potential mechanisms were discovered by iTRAQ- based proteomics analysis and the therapeutic effect of 8f was assessed by xenograft breast cancer mouse and zebrafish models. RESULTS We identified that BRD4 interacted with AMPK, which was remarkably downregulated in breast cancer. We next designed and synthesized 49 candidate compounds, and eventually discovered a selective small-molecule inhibitor of BRD4 (8f). Subsequently, 8f was discovered to induce autophagy-associated cell death (ACD) by BRD4- AMPK interaction, and thus activating AMPK- mTOR- ULK1-modulated autophagic pathway in breast cancer cells. Interestingly, the iTRAQ- based proteomics analyses revealed that 8f induced ACD pathways, involved in HMGB1, VDAC1/2 and eEF2. Moreover, 8f displayed a therapeutic potential on both xenograft breast cancer mouse and zebrafish models. CONCLUSION We discovered a novel small-molecule inhibitor of BRD4 that induces BRD4-AMPK-modulated ACD in breast cancer, which may provide a candidate drug for future cancer therapy.

Association between microRNA single nucleotide polymorphisms and the risk of hepatocellular carcinoma / Asociación entre polimorfismos de un nucleótido en microRNA circulante y riesgo de carcinoma hepatocelular

Background: Hepatocellular carcinoma (HCC) has a high morbidity and mortality. Single nucleotide polymorphisms (SNPs) of microRNA (miRNA) may be associated with the susceptibility to develop certain malignant tumors. Aim: To study the association between SNPs of miRNA and hepatocellular carcinoma in peripheral blood samples. Material and Methods: Three SNPs in miRNA were studied in peripheral blood samples of 498 patients with HCC and 520 controls. Results: A significant association was observed between rs13299349 in miRNA3152 and HCC. AA genotype or A allele were significantly associated with increased risk of HCC. A allele was associated with the size and number of tumor foci. There was also a relationship between rs10061133 in miRNA449b and HCC. The G allele was significantly associated with increased risk of HCC compared with A allele. Conclusions: This study links rs13299349 in miRNA3152 and rs10061133 in miRNA449b with the risk of developing HCC.

Antecedentes: El carcinoma hepatocelular (CHC) tiene una alta morbilidad y mortalidad. Polimorfismos de un nucleótido (SNP) presentes en el microRNA (miRNA) circulante pueden asociarse a ciertos tumores. Objetivo: Estudiar la asociación entre la presencia de SNPs en miRNA circulante y la presencia de carcinoma hepatocelular. Material y Métodos: Se determinó la presencia de tres SNP en microRNA de sangre periférica en 498 pacientes con CHC y 520 controles. Resultados: El SNP rs13299349 en el miRNA3152 se asoció con CHC. El genotipo AA o el alelo A se asociaron con un riesgo mayor de presentar un CHC. El alelo A se asoció además con el tamaño y número de focos del tumor. Se observó también una relación entre el SNP rs10061133 en el miRNA449b y HCC. En este caso, el alelo G se relacionó con un mayor riesgo de CHC. Conclusiones: Los SNP rs13299349 en el miRNA3152 y rs10061133 en el miRNA449b se asocian al riesgo de desarrollar CHC.

Effects of breathing patterns on flow field in upper airway of an OSAHS patient during natural sleep / 医用生物力学

Objective To study the effects of different pressure boundary conditions and breathing patterns on the airflow of upper airway and related physiological status of the obstructive sleep apnea hypopnea syndrome (OSAHS) patient at sleep stage with eupnea and apnea, respectively. Methods The CT scan data of an OSAHS patient during natural sleep in supine position were acquired and used to reconstruct a three-dimensional finite element model of upper airway. Meanwhile the pressure changes in laryngeal cavity of the OSAHS patient were clinically measured and then used as the boundary conditions, and four typical breathing patterns (nasal inhaling and nasal exhaling, nasal inhaling and oral exhaling, oral inhaling and nasal exhaling, oral inhaling and oral exhaling) were considered for computational fluid simulation. Results The airflow of the OSAHS patient during sleep was an unstable, whorled and bidirectional flow, which was significantly affected by pressure boundary conditions and breathing patterns. Compared with nasal breathing, the maximum velocity of airflow by mouth breathing was increased, resulting in an increase of pressure drop in oral cavity, with was about 30% in inspiration and 100% in expiration. Conclusions It is significant to use CT data of an OSAHS patient during natural sleep for model reconstruction and the clinically measured pressure in laryngeal cavity as boundary conditions for finite element simulations, and the results will contribute to understand the characteristics of flow field in upper airway of the OSAHS patient during real natural sleep.

Progress of biomechanical research on obstructive sleep apnea hypopnea syndrome / 医用生物力学

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a kind of disease characterized by repetitive pharyngeal collapse during sleep, and its pathogenesis involves multiple aspects. In this paper, from the aspect of biomechanics, various factors that might induce sleep apnea were studied based on anatomic and physiological characteristics of human upper respiratory system, and biomechanical models of OSAHS reported in recent years as well as potential mechanical pathogenesis of OSAHS were then analyzed. Finally, the prospects of future researches on OSAHS biomechanics were discussed. Establishing the biomechanical model of upper airways is an effective method not only important for studying pathogenesis of OSAHS, but also helpful for preoperative assessment and postoperative predictions for OSAHS treatment in clinic.

Mutation and clinical relevance in a large cohort of unrelated Chinese patients with hypertrophic cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the genetic basis and phenotypic correlation with disease severity in a large cohort of Chinese patients with hypertrophic cardiomyopathy (HCM).</p><p><b>METHODS</b>A total of 179 unrelated Chinese HCM patients admitted to our department from 2002 to 2011 were enrolled in this study. Direct gene sequencing of β-myosin heavy chain (MYH7), myosin binding protein-C ( MYBPC3), and cardiac troponin T (TNNT2) were performed and clinical data were obtained in these patients.</p><p><b>RESULTS</b>A total of 34 mutations were identified in 40 patients (22.3%), 79.4% (27/34) mutations occurred only once and a possible hot spot, A26 in MYH7, was found. Distribution of mutations was 52.9% (18/34) (MYBPC3), 35.3% (12/34) ( MYH7) and 11.8% (4/34) (TNNT2) respectively. Double mutations were identified in 2.2% (4/179) patients. Genotype-positive patients were associated with an earlier symptom onset, severer left ventricular hypertrophy, a higher incidence of syncope, and were more likely to have positive family history of HCM or sudden cardiac death (SCD) , and were more likely to progress into heart failure (24.2% vs. 5.0%, P = 0.002) and at a higher risk of SCD (9.1% vs. 0, P = 0.009) during the 6.5-year follow-up. No statistical difference in any clinical parameters and outcomes was found between patients carrying MYBPC3 and MYH7 mutations. Double mutations were associated with malignant clinical progression in this cohort. Different phenotype severity could be seen in HCM patients with same genotype (e. g. MYH7-1736T, TNNT2-R92W).</p><p><b>CONCLUSION</b>MYBPC3 is the most predominant gene mutation in this HCM cohort. The presence of a sarcomere mutation in patients with HCM is associated with poor clinical outcome, although no specific genes or mutations can exactly predict the severity of clinical phenotypes.</p>

Reduction of Insulin Resistance in HepG2 Cells by Knockdown of LITAF Expression in Human THP-1 Macrophages / 华中科技大学学报（医学）（英德文版）

The molecular mechanism by which obesity induces insulin resistance is not completely understood.The aim of this study was to determine how lipopolysaccharide-induced tumor necrosis-α factor (LITAF) influenced obesity-induced insulin resistance using a cellular co-culture system.The cells were divided into 3 groups:palmitic acid (PA) stimulation group,LITAF small interfering RNA (siRNA) group and untreated (NC) group.The LITAF siRNA was used for knockdown of LITAF expression in human THP-1 macrophages.The expression levels of LITAF,IRS-2,IRS-2Tyr465,PI3K,and GLUT2 in each group were measured by using quantitative reverse transcriptase real-time polymerase chain reaction and Western blotting.The expression of LITAF was much higher in the PA group than in the siRNA and NC groups (*P＜0.05); meanwhile,the expression of IRS-2,IRS-2Tyr465,PI3K,and GLUT2 was much lower in the PA group than in the NC group (*P＜0.05); however,IRS-2,IRS-2Tyr465,PI3K,and GLUT2 had much higher expression in the siRNA group than in the PA group (*P＜0.05).It is concluded that PA can induce insulin resistance in liver cells and knockdown of LITAF expression can reduce insulin resistance in liver cells,suggesting LITAF may regulate the insulin signal transduction pathway involved in obesity-induced insulin resistance.

Centralized monitoring and analysis on 400 cases of Danhong injection treatments / 国际中医中药杂志

Objective To re-evaluate Danhong injection and analyze the rationality of medication. Methods 400 patients treated with Danhong injection in Taiyuan Centre Hospital from February to August, 2010 were monitored centralizedly.Their medication and the results were analyzed and evaluated. Results The improvement rate was 95.1%, and the incidence of adverse reaction was 0.5%. The problems showed in the use of the drug were non-indication medication,inappropriate selection of solvent, and unsuitable compatibility with other drugs. Conclusion Danhong injection has the advantages of perfect effects and safe. The mode of medication monitoring by clinical pharmacist is worth promoting.

p38 MAPK Regulates Th2 Cytokines Release in PBMCs in Allergic Rhinitis Rats / 华中科技大学学报（医学）（英德文版）

Th2 cytokines play a pivotal role in the pathogenesis of allergic rhinitis.To investigate the effect of p38 mitogen-activated protein kinase(MAPK)on the production of Th2 cytokines such as IL-4 and IL-5 in allergic rhinitis,a model of allergic rhinitis was established in SD rats.The expression level of p38 MAPK mRNA in PBMCs was detected by means of real time quantitative RT-PCR.The p38 MAPK activity in PBMCs was detected by Western blotting.PBMCs were cultured with various concentrations of p38 MAPK inhibitor SB 239063 or without the treatment,and then IL-4,IL-5 levels of the supernatant were determined by using sandwich ELISA.The results showed that mRNA expression and activity of p38 MAPK in PBMCs were significantly higher in allergic rhinitis rats than in control rats(P<0.05).The p38 MAPK inhibitor SB 239063 decreased the production of IL-4 and IL-5 in a dose-dependent manner.It is concluded that p38 MAPK plays an important role in the pathogenesis of allergic rhinitis which is associated with Th2 cytokines release.

Construction and Identification of a Yeast Two-Hybrid Bait Vector and Its Effect on the Growth of Yeast Cells and the Self-Activating Function of Reporter Genes for Screening of HPV18 E6-Interacting Protein / 华中科技大学学报（医学）（英德文版）

By using a yeast two-hybrid system,a yeast two-hybrid bait vector was constructed and identified for screening of the HPV18 E6-interacting proteins,and its effects on the growth of yeast cells and the activation of reporter genes were investigated.Total mRNA extracted from Hela cells was reversely transcribed into cDNA.Fragment of HPV18 E6 cDNA was amplified using RT-PCR and directly ligated to the pGBKT7 vector.The recombinant plasmid was confirmed by restriction endonuclease analysis and DNA sequencing.The recombinant pGBKT7-HPV18 E6 plasmid and empty pGBKT7 vector were transformed into the yeast cell AH109,respectively.After they were cultured respectively in YPDA liquid medium and nutrition-deficient culture medium,their toxicity and transcriptional activation were tested by both the phenotype assay and the color assay.The bait plasmid HPV18 E6 was successfully obtained.After being cultured in YPDA liquid medium for 16h,the A600 nm values of two yeast fluids were 0.98±0.03 and 0.99±0.02,respectively.The recombinant pGBKT7-HPV18 E6 plasmid and empty pGBKT7 vector could grow to white colonies on SD/-Trp/X-α-gal plates,while no colony could survive on SD/-His/-Trp/X-α-gal,SD/-Ade/-Trp/X-α-gal plates,indicating that the bait plasmid pGBKT7-HPV18 E6 was constructed successfully and expressed correctly,and could not activate the transcription of reporter gene alone.The yeast two-hybrid GAL4 system 3 can be utilized to find HPV18 E6 interacting proteins.

Clinicopathological Features and Prognosis of Small Cell Carcinoma of the Cervix / 华中科技大学学报（医学）（英德文版）

Small cell carcinoma of cervix (SCCC) is a rare disease with highly aggressive behaviour and is pathologically hard to diagnose. In this study, the clinicopathological features, diagnosis,treatment and prognosis of the condition were examined. Clinical records and follow-up data of 7 cases of SCCC were retrospectively studied. Our results showed that five non-recurrent cases initially presented irregular vaginal bleeding or increased apocenosis of varying degrees. Pathological examination revealed that the stroma was diffusely infiltrated with small monomorphous cells ranging from round to oval shape. Three cases were immunohistochemically confirmed. One case was accompanied with squamous cell cancer. Of the 7 cases, one case was classified as stage Ⅰ bl, two stage Ⅰ b2,one stage Ⅱ a, one stage Ⅱ b, and one stage Ⅲb. On the basis of their stages of condition, one subject with stage Ⅲ b underwent chemotherapy, and one with stage Ib2 received extensive hysterectomy plus pelvic lymphadenectomy, while the other 5 cases were treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre- and/or post-operative adjuvant chemotherapy and radiotherapy. Of the 7 patients, 4 had relapse-free survival of 14, 14, 16 and 28 months respectively.It is concluded that SCCC is an aggressive tumor with propensity for early pelvis lymph node metastases. Early-stage patients should be treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre- and/or post-operative adjuvant chemotherapy and radiotherapy.