Efficacy of different administration methods for labor analgesia / 中国基层医药

Objective:To investigate the clinical efficacy of different administration methods for labor analgesia.Methods:This randomized controlled study was conducted on 152 parturient women who underwent vaginal delivery at the Xinxiang Central Hospital from February to June 2023. These women were divided into a control group and an observation group, with 76 women per group. Women in the control group received 3 mL of 0.1% ropivacaine hydrochloride after routine epidural catheterization, followed by 3 mL of analgesic drugs after 3 minutes. For those without any special reactions, an analgesic pump containing 9 mL of medication was used after 3 minutes until the end of labor. In the observation group, 3 mL of 0.1% ropivacaine hydrochloride was administered as a trial dose before the epidural catheter was inserted into the epidural space. After 3 minutes, the postpartum woman lay flat and was given another 3 mL of analgesic pump medication. After 3 additional minutes, an additional 9 mL of the medication was administered. The analgesic pump was connected and turned on until the catheter was removed after delivery. The epidural catheter failure rate was assessed in each group. Before epidural puncture (T 1), within 30 minutes after the onset of anesthesia (T 2), and at the time of full dilation of the cervix (T 3), Visual Analogue Scale scores, the number of patient attempts to additionally use an analgesia pump, maternal satisfaction, the number of cases requiring cesarean section conversion, the incidence of adverse reactions (such as nausea, vomiting, and fever), and Apgar scores for newborns were recorded in each group. Results:The epidural catheter failure rate in the observation group was 1.3% (1/76), which was significantly lower than 10.5% (8/76) in the control group ( χ2 = 5.79, P < 0.05). At T 2 and T 3, the Visual Analogue Scale score in the observation group was (0.89 ± 0.08) points and (2.1 ± 0.07) points, respectively, which were significantly lower than (2.55 ± 0.07) points and (3.35 ± 0.07) points in the control group ( t = 238.54, 133.17, both P < 0.001). The number of patient attempts to additionally use an analgesia pump in the observation group was (1.00 ± 0.84) counts, which was significantly less than (4.00 ± 0.65) counts in the control group ( t = 29.47, P < 0.001). Maternal satisfaction in the observation group was 100% (76/76), which was significantly higher than 92.1% (70/76) in the control group ( χ2 = 6.25, P < 0.05). The number of cases requiring cesarean section conversion in the observation group was 0 (0/76), which was significantly lower than 52.6% (4/76) in the control group ( χ2 = 4.10, P < 0.05). Conclusion:Administering a trial dose (3 mL) of 0.1% ropivacaine hydrochloride before placing the epidural catheter during labor analgesia can greatly increase the placement success rate of the catheter and enhance pain relief effectiveness. This has a certain clinical application value.

Association between short-term exposure to atmospheric fine particulate matter and ozone and inflammatory indicators in peripheral blood of patients with pneumonia / 上海预防医学

ObjectiveTo explore the association between short-term exposure to atmospheric fine particulate matter （PM2.5） and ozone （O3） and systemic inflammatory indicators in patients with pneumonia， and to identify the susceptible populations. MethodsFrom September 2018 to April 2020， data of 1 480 patients admitted for pneumonia was collected from a tertiary hospital in Taiyuan City. Generalized additive models （GAMs） were used to explore the associations between PM2.5 and O3 exposure and inflammatory indicators of patients with pneumonia； and to explore the susceptibility factors and susceptible populations to PM2.5 and O3 exposures through stratified analyses. ResultsThe short-term exposure to PM2.5 was associated with changes in peripheral blood C-reation protein （CRP）， erythrocyte sedimentation （ESR）， easinophil （EOS）， neutrophil （NEU） and neutrophil-lymphocyte ratio （NLR） in patients with pneumonia， and there were different degrees of hysteresis effects， with the effect values reaching a maximum at lag03， lag03， lag0， lag03， lag03， respectively， which were 4.13% （95%CI： 0.43%‒7.84%）， 3.10% （95%CI： 0.24%‒5.97%）， 5.27% （95%CI： 3.12%‒7.42%）， 1.85% （95%CI： 0.36%‒3.34%）， and 2.53% （95%CI： 0.53%‒4.74%） for every 10 μg·m-3 of PM2.5. The changes in O3 concentration were associated with the elevation of peripheral blood PCT and ESR in patients with pneumonia， and their effect values all reached the maximum at lag01 d， every 1 μg·m-3 of O3 elevation increased by 0.38% （95%CI： 0.04%‒0.73%） and 0.47% （95%CI： 0.19%‒0.76%）， respectively. Stratified analyses showed that the associations of PM2.5 with peripheral blood CRP， ESR， NEU， and NLR in pneumonia patients were more significant in males， the elderly， and those with onset in the cold season； the associations of O3 with peripheral blood PCT and ESR in pneumonia patients were more significant in the elderly and those with onset in the warm season， and the peripheral blood CRP and PCT in female patients with pneumonia were more susceptible to the changes of O3. ConclusionShort-term exposure to atmospheric PM2.5 and O3 are positively associated with changes in inflammatory indicators in patients with pneumonia， and the effects of PM2.5 on patients with pneumonia are more extensive than those of O3， with a longer lag effect. In addition， elderly patients with pneumonia are more sensitive to air pollution， male patients with pneumonia are more sensitive to PM2.5， and female patients with pneumonia are more sensitive to O3. Cold and warm seasons can exacerbate the effects of PM2.5 and O3 on inflammatory indicators in patients with pneumonia， respectively， and the patients must be protected well.

Epidemiologic and etiologic characteristics of foodborne diseases in Minhang， Shanghai 2016‒2020 / 上海预防医学

ObjectiveTo learn the epidemiological features of foodborne diseases， and to provide scientific basis for disease control. MethodsThe monitoring data of foodborne diseases in Minhang from 2016 to 2020 were analyzed. Stool or swab specimens were collected to detect salmonella， Vibrio parahaemolyticus， Escherichia coli， Shigella， Campylobacter jejuni and norovirus. ResultsThe information of15 951 foodborne disease cases and 11 176 samples were collected， with the positive rate of 12.03%.The cases with diarrhea accounted for 99.90% of the total. The cases with fever accounted for 14.70% of the total. The cases with water stool accounted for 89.70% of the total. May to October were the epidemic periods of foodborne diseases in Minhang（79.78%）. The detection rate was the highest in the 30‒39 age group and cadre staff occupation（13.53%，13.49%）. The detection rates of foodborne bacteria and virus were 5.39% （Vibrio parahaemolyticus）， 3.25% （salmonella），1.44% （norovirus）， 1.06%（Escherichia coli）， 0.56% （Campylobacter jejuni）， 0.34% （mixed infection） and 0% （Shigella）. During this 5-year period， the positive rate of Vibrio parahaemolyticus decreased significantly， while the positive rate of salmonella and Escherichia coli and Campylobacter jejuni increased significantly. The main suspected food were aquatic products （29.44%）， meat （25.80%） and fruits （10.78%）. The main processing methods of suspected food were family workshop （41.12%） and restaurants （37.55%）. The total detection rate of the cases was the highest in the canteen， reaching 20.51%. ConclusionFoodborne disease cases have a seasonal peak. The positive detection of pathogens tends to be similar year by year. The main suspected food is aquatic products. The main resources of suspected food are family workshop， restaurants， and canteen. Targeted health education， supervision and management should be taken to prevent the occurrence of foodborne diseases and the outbreak of food poisoning

TGR5 deficiency activates antitumor immunity in non-small cell lung cancer via restraining M2 macrophage polarization

The bile acid-responsive G-protein-coupled receptor TGR5 is expressed in monocytes and macrophages, and plays a critical role in regulating inflammatory response. Our previous work has shown its role in promoting the progression of non-small cell lung cancer (NSCLC), yet the mechanism remains unclear. Here, using Tgr5-knockout mice, we show that TGR5 is required for M2 polarization of tumor-associated macrophages (TAMs) and suppresses antitumor immunity in NSCLC via involving TAMs-mediated CD8+ T cell suppression. Mechanistically, we demonstrate that TGR5 promotes TAMs into protumorigenic M2-like phenotypes via activating cAMP-STAT3/STAT6 signaling. Induction of cAMP production restores M2-like phenotypes in TGR5-deficient macrophages. In NSCLC tissues from human patients, the expression of TGR5 is associated with the infiltration of TAMs. The co-expression of TGR5 and high TAMs infiltration are associated with the prognosis and overall survival of NSCLC patients. Together, this study provides molecular mechanisms for the protumor function of TGR5 in NSCLC, highlighting its potential as a target for TAMs-centric immunotherapy in NSCLC.

An investigation on a food-borne outbreak caused by norovirus infection / 上海预防医学

ObjectiveTo determine the epidemiological characteristics and risk factors of a norovirus GII.17 outbreak in Minhang District of Shanghai in 2018， and provide evidence for prevention and control measures of norovirus infection. MethodsDescriptive epidemiological analysis was performed. In addition， a retrospective cohort study was conducted to determine the risk factors. ResultsFrom May 30th to June 1st of 2018， a total of 132 cases （126 clinical cases and 6 confirmed cases） were documented，with an attack rate of 29.20%（132/452）.All cases were children in a kindergarten， with the average age of 5 years and 43.9% being male. The cases were reported in all the classes， with no clustering by class or floor．The epidemic curve was characterized by a point source exposure， which was estimated to be probably between 7 AM on May 30thand 0：30 AM on May 31st. The retrospective cohort study showed that the attack rate significantly differed between the children who had taken and did not take the school lunch （RR=∞） on May 30th，and those who had taken and did not take seafood noodles （RR=4.11， 95%CI：1.09-15.55） （P<0.05）. Among a total of 73 specimens， six specimens collected in child cases and one specimen in an asymptomatic chef tested positive for GII.17 type of norovirus. In addition， one retained food specimen of seafood noodles was positive for Aeromonas hydrophila. Viral shedding in the asymptomatic chef remained over 30 days. ConclusionThe outbreak was caused by seafood noodles contaminated by norovirus. It warrants enhancement in the regulation of food safety in canteens and regular examination of norovirus infection in catering industry employees.

An investigation on aluminum content in commercially available flour products and risk assessment of dietary aluminum exposure of population in Minhang District, Shanghai / 公共卫生与预防医学

Objective To investigate aluminum content in commercially available flour products in Minhang District, Shanghai, and to assess the risk of dietary aluminum exposure among permanent residents in Minhang. Methods From 2018 to 2019, a total of 227 samples including fried flour products, steamed flour products, puffed products and baked flour products, were collected in Minhang District to detect the aluminum content. The food frequency table was used to investigate the consumption of flour foods by permanent residents in Minhang District and to assess population dietary aluminum exposure risk. Results The average content of aluminum in 227 kinds of flour products was 31.66 mg/kg, and the exceeding standard rate was 3.96%. The over-standard foods were all fried flour products, and the over-standard rate reached 10.47%. Moreover, the aluminum over standard rate of flour products produced by itinerant vendors and restaurants was significantly higher than that of flour products produced by supermarkets and manufacturers. The average dietary intake of aluminum in Minhang residents was 0.18 mg/kg per week, accounting for 9.03% of the provisional tolerable weekly intake (PTWI). The aluminum exposure of the population with high consumption of foods was 1.4 mg/kg per week, accounting for 69.90% of the PTWI. Among the four types of flour products, fried flour products had the highest contribution rate to aluminum exposure. The daily consumption of fried flour products in males was significantly higher than that in females (P<0.05), and the 18-34 age group was significantly higher than the 60 years old and above group (P<0.05). Conclusion The risk of the average dietary aluminum exposure of flour foods among Minhang residents is relatively low, but people with high consumption of foods would be confronted with increased health risks. It is necessary to strengthen the supervision on the use of aluminum-containing additives in itinerant vendors and restaurants, and actively advocate reducing the frequency and the consumption of fried flour products, thus reduce the exposure to the high risk of dietary aluminum in fried flour products

Effects of tedrogesterone tablets combined with clomiphene on polycystic ovary syndrome with infertility and its influence on serum levels of apolipoprotein B/apolipoprotein A1 ratio, anti-mullerian hormone, advanced glycation end products / 中国基层医药

Objective:To observe the efficacy of tedrogesterone tablets combined with clomiphene on polycystic ovary syndrome(PCOS) with infertility, and investigate its influence on serum levels of apolipoprotein B/apolipoprotein A1 ratio(ApoB/ApoA1), anti-mullerian hormone(AMH), advanced glycation end products(AGEs).Methods:From January 2017 to December 2018, 80 PCOS patients with infertility who met the criteria were screened and randomly divided into control group and observation group according to the digital table, with 40 cases in each group.The control group received clomiphene 50 mg/d, qd, and for 5 consecutive days.In the observation group, on the basis of the control group, tedrosterone tablet was added, 10 mg/time and qd, and continuously administered for 21 days.The two groups were treated for 4 menstrual cycles.The ovarian volume, follicular development, pregnancy rate, hormone levels, the endometrial receptivity, and serum ApoB/ApoA1, AMH, AGEs levels were compared between the two groups.Results:After treatment, the ovarian volume[(5.62±0.87)cm 3]of the observation group was significantly smaller than that of the control group[(7.94±1.03)cm 3]( t=7.722, P=0.000), and the maximum diameter of follicles in the observation group[(13.30±2.04)mm] was significantly larger than that in the control group[(11.12±1.83)mm]( t=5.530, P=0.0001). The pregnancy rate in the observation group was significantly higher than that in the control group(χ 2=4.990, P=0.025). The serum levels of follicle stimulating hormone(FSH)[(4.80±0.56)IU/L], luteinizing hormone(LH)[(7.35±0.11)IU/L], uterine pulse index(PI)(2.77±0.41), and uterine artery resistance index(RI)(0.61±0.09) in the observation group were significantly lower than those in the control group( t=5.003, P=0.000; t=6.449, P=0.000; t=5.304, P=0.000; t=5.008, P=0.000), and the estradiol(E 2)[(190.51±23.11)ng/L] and endometrial thickness[(10.11±1.57)mm] were significantly higher than those in the control group( t=38.521, P=0.000; t=6.001, P=0.000). The serum levels of ApoB/ApoA1(0.62±0.08), AMH[(4.13±0.61)μg/L], and AGEs[(118.04±13.35)ng/L] in the observation group were significantly lower than those in the control group( t=5.553, P=0.000; t=5.790, P=0.000; t=18.043, P=0.000). Conclusion:The efficacy of tedrogesterone tablets combined with clomiphene on PCOS with infertility is significant, and can down-regulate serum levels of ApoB/ApoA1, AMH, and AGEs.

Exploration of establishing a metastatic nude mouse model of double-tagging papillary thyroid cancer / 中华内分泌代谢杂志

Objective To obtain a thyroid cancer cell line integrated with luciferase and fluorescence,and to establish a metastatic nude mouse model of papillary thyroid cancer monitored with in vivo imaging system. Methods Lentivirus carrying recombinant plasmid containing luciferase gene and mCherry gene infected high malignant papillary thyroid cancer cell line (BHP10-3SCmice). The stable thyroid cancer cell line (BHP10-3mluc) labeled with luciferase and mCherry selected by hygromycin, analyzed for fluorescence with fluorescence microscopy and bioluminescence with in vitro analysis and in vivo imaging. 0.25 ml(5×106/ml)BHP10-3mluc cell suspension were injected into the left thigh intramuscular tissue of 5-week-old nude mice to establish BALB/C nude mice metastatic tumor model. The growth and metastasis of the tumors were monitored weekly with in vivo imaging system. The nude mice were sacrificed on the 42th day and the tissues with metastatic tumors were analyzed by fluorescent imaging ex vivo. The ectopic implanted tumors and metastatic lesions were verified by tissue sections with Hematoxylin and Eosin staining. Results BHP10-3mluc cells showed similar growth characteristics to the original BHP10-3SCmice cells and stably expressed luciferase and mCherry. At the end of the first week after ectopic implantation,the xenograft tumors were found and in the 6th week,the tumors were found to metastasized to adjacent lymph nodes and lungs,which was consistent with the results of pathology.The growth and metastasis of tumors can be accurately monitored with in vivo imaging system. Conclusions A PTC cell line stably expressing bioluciferase and fluorescence was successfully established.The nude mouse model of PTC metastatic tumor generated by intramuscular inoculation of those cells can be well monitored with in vivo imaging system, which provides ideal models for researches on tumor growth, metastasis,and drug treatment.

The Expression of Galectin-7 in Bronchial Mucosa of Asthmatic Children and Its Effect on the Apoptosis of Bronchial Epithelial Cells / 现代生物医学进展

Objective:To investigate the expression of Galectin-7 in the bronchial mucosa of asthmatic children and its effect on the apoptosis of bronchial epithelial cells.Methods:Bronchial mucosa of asthmatic children and children with bronchial dilation were collected and the expression of Galectin-7 was detected by Western blot.Human bronchial epithelial cells were cultured in vitro,the cells were transfected with Galectin-7 siRNA to interfere the Galectin-7 expression,while siRNA control was transfected as the control group.The experiment was divided into normal group,control group,infected group and experimental group.The normal group was normal human bronchial epithelial cells,the cells in the control group was transfected with siRNA control,the infected group was infected with RSV,the experimental group was transfected with Galectin-7 siRNA and infected with RSV.After 24h culture,Galectin-7 protein expression and cell apoptosis were detected in the cells of each group.Western blot was used to detected the expression of Bcl-2,Bax,STAT3 and p-STAT3.Results:The expression of Galectin-7 in bronchial mucosa of asthmatic children was significantly higher than that of the non asthmatic children (P＜0.01).There was no significant difference in the Galectin-7 level between the normal group and the control group (P＞0.05).The levels of Galectin-7,Bax and apoptosis in the infected group were significantly higher than those in the normal group,while the levels ofp-STAT3 and Bcl-2 were significantly lower than those in the normal group (P＜0.01).The levels of Galectin-7,Bax and apoptosis in the experimental group were significantly lower than those in the infected group,while the levels of p-STAT3 and Bcl-2 were significantly higher than those in the infected group (P＜0.01).Conelusions:The expression of Galectin-7 was up-regulated in the bronchial mucosa of asthmatic children,which might promote the apoptosis of bronchial epithelial cells by activating STAT3.

Optimal timing of antenatal taurine supplementation for improvement of neuron and neural stem cell proliferation in fetal rats with intrauterine growth restriction / 中华围产医学杂志

ObjectiveTo determine the optimal timing of antenatal taurine supplementation to improve neuron and neural stem cell proliferation in fetal rats with intrauterine growth restriction.Methods Twenty-five pregnant SD rats were randomly divided into five groups (five rats in each group): group A was the control group, group B to E were the fetal growth restriction (FGR) model groups with low-protein diet during the experiment, group C, D, and E were supplemented with taurine [300 mg/(kg·d)] at day 9, 11 and 15, respectively. The birth weight of newborn rats was measured after natural delivery. The rats with body weight two standard deviations lower than the average weight in group A were diagnosed as FGR. There were five litters of newborn rats in each group, and two were randomly selected from each litter, resulting in ten newborn rats in each group. Proliferating cell nuclear antigen (PCNA) and fatty acid binding protein 7 (FABP7) positive cell expression in newborn rat brain tissues were detected by immunohistochemistry. Single factor analysis of variance, LSD tests were used for statistical analysis.ResultsThe average birth weight of newborn rats in group A, B, C, D and E were (6.61±0.45), (4.65±0.23), (5.37±0.17), (5.74±0.21), and (5.00±0.24) g, respectively. Average birth weight was lower in group B than in group A (t=2.447), higher in group D and E than in group B (t=2.306 and 2.306), higher in group D than in group C and E (t=2.306 and 2.306), and the differences were statistically significant (allP0.05). The IOD in group D was higher than that in group E, and the difference was statistically significant (t=4.182,P<0.05).ConclusionsAntenatal taurine supplementation can promote neuron and neural stem cell proliferation in rats with FGR. The effect is most obvious on the 11th day of pregnancy, and may lead to the promotion of brain development.

Observation on the effect of the trinity comprehensive therapy for adolescent pseudo-myopia / 中国基层医药

Objective To observe the effect of the trinity comprehensive therapy for adolescent pseudo-myopia.Methods According to the digital table,149 patients(298 eyes) were divided into the observation group75 patients(150 eyes) and the control group74 patients(148 eyes).The observation group were given with the trinity comprehensive therapy:herbal acupoint massage,auricular-plaster therapy and to wear the crystal apparatus.The control group were given with 0.5％ tropicamide eye drops.Based on the naked distant vision,this paper will observe their respective curative effect,and then make the statistical analysis afterwards.Results The effective rate in the observation group was(95.14％),which was significantly higher than (78.26％)of the control group (Z =-12.563,P ＜ 0.05).Meanwhile,the effect of the treatment on the naked visual acuity in pseudo-myopia who were with (0.8 ± 0.1) was significantly higher than that of the naked visual acuity of the patients with low vision.And after a half-a-year treatment,the vision loss rate in the observation group was significantly lower than that in the control group(P ＜0.05).Conclusion The curative effect of the trinity comprehensive therapy for adolescent pseudo-myopia is definite,and can be maintained for a long time,which has a certain value to prevent the occurrence and development of juvenile myopia.

Taurine and its effect on the protection of the central nervous system / 中华实用儿科临床杂志

Taurine is one of the extremely important amino acids in the body,and is also the most abundant free amino acids in the central nervous system(CNS).Taurine as a conditional essential amino acids exerts a wide range of physiological and pharmacological effects.Taurine,especially as a neurotransmitter in the developing CNS,can maintain the structural integrity of the membrane,regulate calcium transport and calcium homeostasis,also as nutritional factors,osmolyte,neuromodulator,neuroprotective agents,plays an important role.In this paper,physiological and biochemical properties of taurine,source and distribution in vivo,synthesis and metabolism,absorption and transport,and its protective effect on the CNS are reviewed.

Impact of vitamin D supplementation on the outcome of tuberculosis treatment: a systematic review and meta-analysis of randomized controlled trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vitamin D supplementation is believed to be beneficial in the treatment of patients with tuberculosis (TB), however, results from clinical trials have been inconclusive.</p><p><b>METHODS</b>We performed a systematic literature search across MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, EBSCO, ProQuest, HighWire Press, and Web of Science, published as of December 2013. We individually inspected citations and extracted data independently. We estimated pooled risk ratios (RR) and 95% confidence intervals (CI) using random-effect models. We also assessed risk of bias using the Jadad scale and the quality of the evidence using GRADE. We included all randomized controlled trials comparing vitamin D with or without standard TB therapy or placebo.</p><p><b>RESULTS</b>A total of five studies were analyzed in our meta analysis covering 841 newly-diagnosed TB cases. Patients receiving vitamin D supplementation had a 39% reduced risk of sputum smear or culture positive after six weeks of anti-TB treatment than those in the control group, although this is not statistically significant (pooled RR 0.61, 95% CI 0.24 to 1.56, P = 0.30). Apart from an increased serum vitamin D level in the supplement group after eight weeks of treatment there was no evidence of any additional adverse effects related to vitamin D.</p><p><b>CONCLUSIONS</b>The meta analysis results indicate that vitamin D supplementation does not seem to have any beneficial effect in the treatment of TB. Future rigorous randomized controlled trials are needed to explore whether the supplementation of vitamin D could shorten treatment duration and to confirm whether the polymorphisms of vitamin D receptor have any potentially beneficial effect.</p>

Perspective of Clinical Psychology of Practice of Social Inclusion of Intellectually Disabled Adults(review) / 中国康复理论与实践

@#As social views on disability changed,how to support intellectual disabled adult so they can be involved in ordinary social life is not only the hot topic of special education and rehabilitation service system,but also the concern of psychologists.For the improvement of social inclusion,psychologists should provide assessment,intervention and support for intellectual disabled adults at personal and social supportive levels,and relative policy advices for the government should be included.