Application of teach-back-based role transition shock model in knee arthroplasty nursing internship teaching / 中华医学教育探索杂志

Objective:To explore the application of a role transition shock model based on the teach-back technique in knee arthroplasty nursing teaching.Methods:We assigned 50 nursing student interns practicing in the knee arthroplasty team of Orthopedics Department of Nanjing First Hospital between August 2020 and August 2022 into control group ( n=25, traditional teaching) and observation group ( n=25, teach-back-based role transition shock model teaching) according to the order of admission. At the end of internship, the examination scores, the impact of transition shock on comprehensive abilities, and teaching satisfaction of the students were assessed and analyzed using the t test and Fisher's exact test with the use of SPSS 22.0. Results:Compared with the control group, the observation group scored significantly lower in the physical, psychological, knowledge and skills, and sociocultural and developmental dimensions of the transition shock assessment scale ( P<0.05). The observation group showed significantly higher scores of nurse-patient communication, nursing practice, disease observation, health education, humanistic care, team cooperation, clinical thinking, and emergency response than the control group ( P<0.05). The examination results of the observation group were significantly better than those of the control group ( t=12.31, 11.52, P<0.001). The teaching satisfaction rate of the observation group was significantly higher than that of the control group [100.00% (25/25) vs. 68.00% (17/25), χ2=9.52, P=0.002]. Conclusions:The teach-back-based role transition shock model can help alleviate the transition impact faced by nursing student interns when entering clinical practice, and also improve their comprehensive abilities as well as satisfaction with teaching.

Rabdosichuanin C inhibits productions of pro-inflammatory mediators regulated by NF-κB signaling in LPS-stimulated RAW264.7 cells.

Chronic pharyngitis (CP) is an inflammatory disease of the pharyngeal mucosa and its lymphatic tissues that is difficult to treat clinically. However, research on the exact therapeutic agents and molecular mechanisms of CP is still unclear. In this study, we investigated Rabdosichuanin C (RC) to attenuate lipopolysaccharide (LPS)-induced inflammatory damage in RAW264.7 cells by a combination of targeted virtual screening and in vitro activity assay and further clarified its molecular mechanism of action centering on the IκB/nuclear factor kappa B (NF-κB) pathway. Molecular docking and pharmacophore simulation methods were used to screen compounds with IκB inhibitory effects. Expression of genes and proteins related to the IκB/NF-κB signaling pathway by RC in LPS-induced inflammatory injury model of RAW264.7 cells was detected by PCR, enzyme-linked immunosorbent assay, and Western blot. The docking of RC with IκB protein showed good binding energy, and pharmacophore simulations further confirmed the active effect of RC in inhibiting IκB protein. RC intervention in LPS-induced RAW264.7 cells significantly reduced the expression levels of inflammatory factors tumor necrosis factor-α, interleukins-6, iNOS, and CD-86 at the messenger RNA and protein levels, downregulated IκB, p65 protein phosphorylation levels, and significantly inhibited IκB/NF-κB signaling pathway activation. Virtual screening provided us with an effective method to rapidly identify compounds RC that target inhibit the action of IκB, and the activity results showed that RC inhibits NF-κB signaling pathway activation. It is suggested that RC may play a role in the treatment of CP by inhibiting the IκB/NF-κB signaling pathway.

Eculizumab for treatment of thrombotic microangiopathy secondary to systemic lupus erythematosus in children: two cases report and literature review / 中华肾脏病杂志

Systemic lupus erythematosus (SLE) is a serious autoimmune disease that affects multiple systems and organs throughout the body. Thrombotic microangiopathy (TMA) is a rare clinical syndrome that can lead to multiple organ dysfunction and even threaten life. Clinically, SLE patients with TMA are relatively rare, especially in children, but the mortality of SLE patients with TMA is significantly increased. The article reports 2 cases of successful remission of SLE complicated with TMA after treatment with eculizumab, and discusses the diagnosis, clinical manifestations and treatment of SLE complicated with TMA in children, so as to provide clinical basis for the diagnosis and treatment of SLE complicated with TMA in children.

Analysis on the Social Advantages and Practical Paths of Integrating Medical Social Work Services in the Medical Field / 中国医学伦理学

There are some issues in the process of patient treatment in the medical field, such as knowledge inequality, difficulties in doctor-patient trust and interdisciplinary cooperation, disciplinary barriers, excessive diagnosis and treatment, and structural imbalance of medical resources. In response to these issues, combined with the advantages of conceptual integration, professional integration, and resource integration of medical social work, this paper proposed a practical path for integrating medical social work services in the medical field. The main paths include micro path that systematization, comprehensiveness, and personalization of patient’s diagnosis and treatment process, the integration of intermediary path that integration of disciplinary and professional perspectives, concepts, and practices, and macro path that collaboration and coordination among society, community, and healthcare systems.

Progressive diaphyseal dysplasia with right transverse sinus stenosis: a case report / 中华神经科杂志

Progressive diaphyseal dysplasia , also called Camurati-Engelmann disease (CED), is a kind of autosomal dominant disease mainly involved in long diaphysis , characterized as progressive and symmetric cortical thickening as well as low prevalence.The pathogenic gene of the disease is TGFB 1 located in 19q13, resulting in abnormal bone metabolism.We report a young woman suffering from CED , mainly presented as decreased visual acuity , chronic high intracranial pressure and skull damages by cerebral angiography.The digital subtraction angiography revealed the right transverse sinus stenosis .We first revealed a CED patient with chronic high intracranial pressure caused by sinus stenosis , and selected intravascular therapy for the sinus stenosis.

Gastrin Enhances Autophagy and Promotes Gastric Carcinoma Proliferation via Inducing AMPKα.

Gastric cancer (GC) is one of the most frequent epithelial malignancies worldwide. The gastrointestinal (GI) peptide gastrin is an important regulator of the secretion and release of gastric acid from stomach parietal cells, and it also plays a vital role in the development and progression of GC. The aim of the current study was to investigate the role and underlying mechanism of gastrin and autophagy in regulating GC tumorigenesis. Gastrin-17 amide (G-17) was applied in the GC cell lines SGC7901 and MGC-803. The results showed that G-17 maintained the high viability of SGC7901 and MGC-803. The expression of autophagy marker proteins LC3II and Beclin1 was significantly increased, while the autophagy substrate p62 was obviously decreased in the gastrin group compared with the control group. Moreover, G-17 strengthened the expressions of AMPKα, Ras, Raf, MEK, and ERK1/2. Additionally, administration of AMPKα siRNA counteracted the effect of gastrin in SGC7901 cells. Finally, in an in vivo study of the tumor growth and survival rate of rats, the levels of AMPKα/Ras/Raf/MEK/ERK were significantly increased in the gastrin group and decreased following AMPKα shRNA injection. In conclusion, these findings indicate that gastrin plays a tumorigenic role by promoting autophagy in GC and may provide a novel therapeutic target for GC treatment.

Observation of HSP60 and Ras Protein in Gastric Mucosa of Atrophic Gastritis Induced by High-salt Hot Water in Rats Using Immune Fluorescence and Laser Scanning Confocal Microscope / 医学研究杂志

Objective To study the relationship between long-term high-salt water and the morbidity mechanism of chronic atrophic gastritis (CAG), The expression of HSP60 and ras protein were detected in the gastric mucosa of CAG rates induced by high-salt water.Methods The atrophic gastritis rat model was made by high-salt-hot water perfusion and the ultrastructure of gastric mucosa was observed by Laser Scanning ConfocaI Microscopy. Results There was no expression in gastric mucosa in normal group. The expression of HSP60 and ras was observed in the cell plasm of rats at 12 weeks. The higher expression was observed in the rats at 24, 32 and 65 weeks. Using laser scanning confocaI microscopy and immunofluorescence technique had observed coexistence of HSP60 and ras.Conclusion Long time high-salt-hot water can induce CAG and increasing the expression of HSP60 and ras. HSP60 and ras play an important role in the formation of atrophic gastritis.

Clinical and pathological characteristics and pathogenesis of autoimmune hepatitis / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To explore the clinical and pathological characteristics and pathogenesis of autoimmunohepatitis (AIH).</p><p><b>METHODS</b>The serum and liver biopsy specimens and clinical data of 26 cases with patients with AIH were analyzed and scored according to the criteria of International autoimmune hepatitis (IAIHG, 1999). The changes of dendritic cells (DC) in the liver tissues were observed with a panel of DC markers (CD-80/B7-1, CD-86/B7-2, CD-1a and HLA-DR) and immunohistochemistry, and the activation of hepatic stellate cells (HSC) and the expression of TGF-alpha were also detected. Liver tissue specimens from 10 patients with chronic viral hepatitis B and C respectively and 5 normal liver specimens were chosen as controls.</p><p><b>RESULTS</b>Mean aggregate scores of 26 AIH cases, including 21 cases of type B (80.8%) and 5 cases of type C (19.2%), which were 18.6 +/- 1.4 and 19.1 +/- 2.1 respectively. There were significant differences between the type B and type C in the average age levels of serum ALT and AST, and alpha-Glo (P <0.001 or P< 0.01 or P <0.05). Histological features of all the AIH liver tissues showed the lesions of chronic active hepatitis such as interface hepatitis/piecemeal necrosis (100%), obvious lobular inflammation (type B 95.2%, type C 100%), bridging necrosis (57.1% type B, 80.0% type C, P<0.05), rosetting of liver cells (71.4% type B, 100% type C, P<0.01), central lobular confluent necrosis (33.3% type B, 80.0% type C, P<0.001), predominant plasmacytic infiltration (type B 95.2%, type C 20.0%, P<0.001). The rates of increased and concentrated DC in the portal and lobular areas, especially in the active lesions in type B and type C AIH were 85.7% (18/21) and 5/5 respectively. It was found that DC and lymphocytes surrounded the hepatocytes which partly expressed HLA-DR antigen, while there were no or a few HLA-DR positive hepatocytes in controls. Meanwhile, the number of alpha-SMA positive HSC and the expression of TGF- were obviously increased in AIH liver tissues.</p><p><b>CONCLUSIONS</b>Several clinical and pathological features of AIH were identified in this study. As an antigen-presenting cell, DC might play an important role in the pathogenesis of AIH. In China, sub-type B of AIH might be more frequent than sub-type C and there were differences in clinical aspects, serology and pathology between the two types.</p>

Preparation of human single chain Fv antibody specifically against hepatitis C virus E2 antigen / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To identify human single chain Fv antibody (ScFv) against hepatitis C viral E2 antigen and its value clinically.</p><p><b>METHODS</b>The recombinant phages were panned by E2 antigen which was coated in a microtiter plate. After five rounds of biopanning, 56 phage clones were identified specific to E2 antigen. The affinity and specificity of ScFv were evaluated by ELISA and immunohistochemistry, respectively.</p><p><b>RESULTS</b>The data of E2-ScFv DNA digestion and DNA sequencing showed that the ScFv gene was composed of 750bp. ELISA and immunohistochemistry demonstrated that the human single chain Fv antibody against HCV E2 antigen had a specific combination character with hepatitis C virus E2 antigen.</p><p><b>CONCLUSIONS</b>ScFv, having a sutestantial affinity and specificity and being easy to prepare, is valuable in the detection of HCV E2 antigen.</p>

Screening and cloning gene of hepatocyte protein interacting with hepatitis C virus core protein / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To clone the unknown gene of hepatocyte protein interacting with hepatitis C virus core protein.</p><p><b>METHODS</b>Using the yeast dual hybrid system 3, bait plasmids of hepatitis C virus core were constructed. After identifying hepatitis C virus core protein that could stably expressed in AH109 yeast strains, we performed yeast two hybrid by mating AH109 with Y187 that transformed with liver cDNA library plasmids pACT2 and then plated on quadrople dropout (QDO) medium and assayed for alpha-gal activity. The genes of yeast colonies that could grow on QDO and had alpha-gal activity were sequenced.</p><p><b>RESULTS</b>Among the 30 positive colonies, we blasted the gene of the sixth colony; we coined human hepatitis C virus binding protein 6(Hu Hcbp6) with Genbank, realized that the Hu Hcbp6 shares as much as 98% homology with two cDNA without knowing functions. We have proved that Hu Hcbp6 could interact with hepatitis C virus core protein.</p><p><b>CONCLUSIONS</b>Hepatitis C virus core binding protein (Hu Hcbp 6 Genbank number: AY032594) was successfully cloned and identified. The study partly paved the way for investigating physiological function of the Hu Hcbp6.</p>

Screening and application of human-derived HBsAg bacteriophage single chain antibody in clinical diagnosis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To identify human single chain Fv antibody (ScFv) against hepatitis B viral surface antigen.</p><p><b>METHODS</b>The recombinant phages were panned by HBsAg which was coated in a microtiter plate, after five rounds of biopanning, 56 phage clones were identified specific to HBsAg. The specificity of ScFv was evaluated by ELISA and immunohistochemistry, respectively.</p><p><b>RESULTS</b>The data of HB sAg-ScFv DNA digestion and DNA sequencing showed that the ScFv gene is composed of 750 bp. ELISA and immunohistochemistry demonstrated that the human single chain Fv antibody against hepatitis B surface antigen has a specific combination character with hepatitis B surface antigen of different sources and paraffin-embedded patients tissue specimens, it did not react with normal liver tissue and HCV.</p><p><b>CONCLUSIONS</b>The application of HBsAg specific ScFv in immunohistochemistry was successfully achieved.</p>

Scanning electromicroscope observation of gastric mucosa with atrophic gastritis caused by salt water in rats / 中国医师杂志

Objective To observe the tissular pathological and ultrastructural changes of gastric mucosa with experimental atrophic gastritis caused by salt-water in rats and to explore the relationship between atrophic gastritis and high-salt diet.Methods The atrophic gastritis rat model was made by salt-water perfusion(0.15g/ml,2.5ml/d).The tissue of sinus ventriculi was detected with histopathologic examination and the ultrastructure of gastric mucosa was observed by scanning electron microscope.Results Under light microscope,the gastric gland was shrunk obviously in high-salt water perfusion group after high-salt water was given for 24 weeks.The muscle in muscular layer was hyperplasia and cramped into the lamina propria.The glandular epithelium in the upper 1/3～2/3 edge of the gland was atrophic.The gastric micro-depression became broaden and the width of cervical part of gastric pit became narrow.Under the scanning electromicroscope,the gastric mucosa was comparted into many gastric areas in the control group.Round or elliptic epithelium cells lined on the wall of gastric pits were in the same size and had short and spare microvillus.The epithelium was lined regularly and covered by laminar mucus.In salt-water perfusion group after the salt-water was given for 24 weeks,the surface of the gastric mucosa became thin and flat,and the glandular cells became rough.The mucosa between lumens of gland was broadened and the limited exfoliation of mucosa also could be seen.When the salt-water was given for 32 weeks,the gastric epithelial cells were shrunk,and the diameter of lumen of gland was broadened.There was breakage in the cell surface.Erosions with various size and shape and fibrous exudation could be seen.Conclusion Salt-water perfusion may cause the damage of the epithelia of gastric mucosa in experimental rats and long-term high-salt stimulation can induce the injury and atrophy of gastric mucosa.

Biological activities of four kinds of leeches / 中成药

AIM: To provide scientific references for leeches by means of the antithrombin,antitrypsin and antichymotrypsin activities of the four kinds of leeches. METHODS: Using antithrombin,antitrypsin and antichymotrypsin activity analysis methods,the four kinds of leeches,they were,Whitmania pigra Whitman,Hirudo nipponia Whitman,Hirudo medicinalis Linnaeus,Hirudinaria manillensis Lesson,were detected. RESULTS: The blood-sucking leeches except whitnania pigra whitman had high antithrombin activity,and these four kinds of leeches were the same antitrypsin and antichymotrypsin activities. CONCLUSION: These three biological activity methods could be considered as reliable indexes in assessing the qualitity of leeches.

THE STUDY ON DIFFERENTIATION AND DETECTION OF MYCOBACTERIUM SPECIES BY PCR AMPLIFICATION / 微生物学通报

Using the prime b(special to M. tuberculosis) to amplify 21 mycobacterium and 13 nonmycobacterium, the products amplified were detected by agarose gel electrophoresis. The sensitivity was 50fg at annealing temperature 61℃,and only M. tuberculosis, M. gastri were amplified, those results showed: the clinical isolated mycobacterium can be differentiated and detected quickly and efficiently by using the prime b(using the prime a when necessary) to amplify 16S～23S rDNA spacer sequence of mycobacterium.

TREATMENT OF CIRRHOTIC ASCITES COMPLICATED WITH PRIMARY PERITONITIS: ANALYSIS OF 55 CASES / 解放军医学杂志

Fifty-five cases of cirrhotic ascites complicated with primary peritonitis were treated and analysed clinically. The results showed that high fever and diarrhea were common and severe, and the positive rate of the ascitic culture, rich in B. coli, was higher in the death group, while tenderness and reboun ding pain were prominent and typical in the survival group. The total mortality was 67.27% and the survival rate was 25.45%. 32 out of the 76 cases (some of them had been treated repeatedly) of primary peritonitis were cured (42.11%). The state of restoring health in relation to the drug sensitivity, the mode of administration and the duration of therapy were fully discussed. It was believed that the combined therapy was more effective than the single one, and the duration of the two weeks' treatment seemed to be most suitable. The early diagnosis, effective therapy and prevention were the key points for a good prognosis and better survival rate.

THE PRELIMINARY STUDY ON INDIVIDUALLY CHARACTERIZED QUASISPECIES OF HEPATITIS B VIRUS / 解放军医学杂志

Primers were synthesized according to DNA sequence of HBV found in China, and the reverse transcriptase (RT) region in polymerase gene, HBV preC/C region and the whole genome were amplified by PCR method from the serum of 8 patients with chronic HBV infection. Then the PCR products were ligated into pGEM Teasy vectors. 27 clones were sequenced. Deduced amino acid sequences were compared, and the results showed that mutations were widely distributed in structural and non structural viral proteins. The substitution mutations occur in clones isolated from specific patients, which led to a characteristic mutation in the quasispecies group. The results indicated that the diversity of HBV gene might play an important role in the pathogenesis of chronic HBV infection.