[Quantitative evaluation of global left ventricular myocardial work in patients with hepatitis B cirrhosis by pressure-strain loop].

Objective: To quantitatively evaluate myocardial work in patients with hepatitis B cirrhosis by using left ventricular pressure-strain loop. Methods: 70 cases with hepatitis B cirrhosis who were hospitalized in Henan Provincial People's Hospital from March to December 2020 were selected as the study group. Patients were divided into three subgroups according to the Child-Pugh score of liver cirrhosis (Child-Pugh class A, B, and C groups: 25, 25, and 20 patients, respectively). At the same time, 25 healthy volunteers were included as the control group. Global longitudinal strain (GLS), global myocardial work index (GWI), global work efficiency (GWE), global constructive work (GCW), and global wasted work (GWW) were obtained by applying pressure-strain loops. The differences were analyzed and compared among the four groups parameters. Results: Compared with the control group, the Child-Pugh class A group had decreased GLS, while Child-Pugh class B and C had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class A group, Child-Pugh class B group had decreased GLS, GWE, and increased GWW, while Child-Pugh class C group had decreased GLS,GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class B group, Child-Pugh class C group had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Conclusion: The pressure-strain loop can detect early myocardial dysfunction, and has a certain value in the diagnosis, treatment and prognosis evaluation of myocardial function changes in patients with hepatitis B cirrhosis.

[Impact of health literacy on patient experience of outpatients in China and its mechanism].

OBJECTIVE: To understand the relationship between health literacy and patient experience of outpatients in China, and to explore its mechanism. METHODS: The conceptual framework was developed based on Andersen's behavioral model of health services use and health literacy skills framework. An online cross-sectional survey was conducted with snowball sampling method, while the health literacy was measured by self-designed patient health literacy scale, and the patient experience was measured by the Chinese patient experience questionnaire for ambulatory care developed by Peking Union Medical College. And a structural equation model was built to explore the relationship between them and test the mechanism of health literacy influencing patient experience. RESULTS: A total of 2 773 subjects were investigated. The average score of health literacy was (90.72±12.90) points, accounting for 78.89% of the full score, and the dimension of seeking social support had the lowest score. The average score of overall rating of patient experience was (3.71±0.74) points, and the scores of each dimension of patient experience were between 3.56 and 3.80. The model fit indices of structural equation model for overall rating of patient experience among the outpatients were χ2/df=9.29 (χ2=4 107.27, df=442), root mean square error of approximation (RMSEA)=0.055 (< 0.06), comparative fit index (CFI)=0.926 (>0.90), Tucker-Lewis index (TLI)=0.918 (>0.90), standardized root mean square residual (SRMR)=0.061 (< 0.08), the model was acceptable. The variance in patient experience explained by the model was 0.108. The structural equation model analysis results showed that the overall rating of outpatient experience was directly affected by health literacy (ß=0.263, P < 0.001), also indirectly affected by health literacy (ß=0.012, P < 0.001). In other words, the overall rating increased by 0.275 units for each standard deviation increase of health literacy. Self-evaluated health status mediated the relationship between health literacy and the overall rating of outpatient experience. In terms of diffe-rent dimensions of patient experience, the standardized path coefficient of the total effect of health literacy on patient experience was as follows: Information guidance 0.337, humanistic care 0.319, communication with doctors 0.294, service efficiency 0.240, and hospital environment 0.173. CONCLUSION: The patients with higher level of health literacy were more likely to have a better outpatient experience in China, and the information guidance experience and humanistic care experience were most affected by health literacy. And the communication and information utilization ability had the greatest influence on patient experience.

[Research on the characteristics of the formation and inheritance of Lei's medicine in Quzhou from the perspective of regional medicine].

Lei's medicine is the main school of traditional Chinese medicine in Quzhou, Zhejiang Province. It originated from Xin'an medical school. It has been passed on for more than 200 years, but it is still lack of in-depth study. From the perspective of regional medicine, combined with the regional characteristics of Quzhou, absorbing the research results of local social history and environmental history, starting with the historical materials such as Lei's medical works, local chronicles literature and so on, the school characteristics are summarized as: the formation of "treatment in accordance with three types of disease causes" , the academic inheritance of "inheriting the past and integrating the present" , the inheritance mode of "multiple integration" , the cultural connotation of "combining medicine with Confucianism" , and the school characteristics of "integration and innovation" . The purpose of this paper is to provide reference for the research of academic schools and the inheritance of traditional Chinese medicine.

[The changes of processing method and theoretical pharmacodynamic analysis of largehead atractylodes rhizome].

Largehead atractylodes rhizome, known as "the first essential medicine for invigorating qi and strengthening spleen" , is one of the most commonly used Chinese materia medica. According to the different clinical treatment requirements, largehead atractylodes rhizome can be processed into a variety types of products, such as raw, fried with earth, stir-frying with bran, and deep-fried largehead atractylodes rhizome. The processing quality is of great significance to ensure the efficacy, drug safety and improve the preparation process. Through the detailed research on the processing methods of largehead atractylodes rhizome in ancient books, modern documents and norms, this study clarifies the history and evolution of the processing technology of largehead atractylodes rhizome in ancient and modern times, and summarizes the internal laws and external factors of the processing technology changes by combining the processing technology differences, materials addition and theoretical analysis of pharmacodynamics. It not only saves the tedious and repeated steps, but also improves and optimizes the efficacy and quality of the preparation, and gets standardization and unification in the follow-up practice, which provides a reference for the research and development of the processing technology of largehead atractylodes rhizome and other Chinese materia medica.

[Research progress on urogenital function preservation in extralevator abdominoperineal resection].

Extralevator abdominoperineal excision (ELAPE) has been suggested to potentially improve oncological outcomes in advanced low rectal cancer patients. However, the urogenital function impairment as one of the main complications deteriorates the quality of life in these patients. The key point to prevent urogenital function impairment is to avoid autonomic nerve injury, including the superior and inferior hypogastric nerve plexus and neurovascular bundle. Three areas should be especially focused during surgery, including the posterolateral aspect of the prostate during the separation of the rectum from prostate, the lateral wall of ischioanal fossa and the area in front of anal canal. Previous presumption supposed that extended resection, though promoting oncologic outcomes, might lead to enlarged injury to surrounding vessels and nerves that deteriorated patients' urogenital function. But recent studies show that postoperative urogenital function outcomes of rectal cancer patients who underwent ELAPE are not inferior to conventional APE after the induction of minimal invasive approaches including laparoscopic and robotic surgery. Their quality of life can be comparable with patients who underwent conventional APE, and are even better in some particular area. Moreover, as further improvement of ELAPE procedure has been made, the concept of individualized ELAPE addressed the importance of personalized surgical procedure based on tumor stage and location, dedicating to avoid injury to vessels and nerves through preserving more surrounding tissues. Urogenital function outcomes, as part of postoperative outcomes, get more and more attention in recent years. We review current studies on urogenital function after ELAPE from anatomy to clinical research, in order to raise surgeons' attention of nerve preservation technique and to improve their understanding of ELAPE procedure.

Drought tolerance as a driver of tropical forest assembly: resolving spatial signatures for multiple processes.

Spatial patterns in trait variation reflect underlying community assembly processes, allowing us to test hypotheses about their trait and environmental drivers by identifying the strongest correlates of characteristic spatial patterns. For 43 evergreen tree species (> 1 cm dbh) in a 20-ha seasonal tropical rainforest plot in Xishuangbanna, China, we compared the ability of drought-tolerance traits, other physiological traits, and commonly measured functional traits to predict the spatial patterns expected from the assembly processes of habitat associations, niche-overlap-based competition, and hierarchical competition. We distinguished the neighborhood-scale (0-20 m) patterns expected from competition from larger-scale habitat associations with a wavelet method. Species' drought tolerance and habitat variables related to soil water supply were strong drivers of habitat associations, and drought tolerance showed a significant spatial signal for influencing competition. Overall, the traits most strongly associated with habitat, as quantified using multivariate models, were leaf density, leaf turgor loss point (π(tlp); also known as the leaf wilting point), and stem hydraulic conductivity (r2 range for the best fit models = 0.27-0.36). At neighborhood scales, species spatial associations were positively correlated with similarity in π(tlp), consistent with predictions for hierarchical competition. Although the correlation between π(tlp) and interspecific spatial associations was weak (r2 < 0.01), this showed a persistent influence of drought tolerance on neighborhood interactions and community assembly. Quantifying the full impact of traits on competitive interactions in forests may require incorporating plasticity among individuals within species, especially among specific life stages, and moving beyond individual traits to integrate the impact of multiple traits on whole-plant performance and resource demand.

Breeding of new Rehmannia glutinosa variety.

Huaidi 81, a new variety of Rehmannia glutinosa with excellent comprehensive characters, was screened by space mutation of hybrid seeds of 85-5 and Beijing No.1. The fresh weight, index composition, resistance, chlorophyll, anthocyanin and photosynthetic characteristics of Huaidi 81 and the main cultivars were determined. The results showed that: the per plant fresh weight of Rehmannia ranked in the order as follows: Huaidi 81 > 85-5 > Golden Nine >Huaifeng >Qinhuai>Beijing No.3, there was extremely significant difference between Huaidi 81 and others. The catalpol content ranked in the following order: Beijing No.3 (1.601%)> Qinhuai (1.588%)> Huaidi 81 (1.314%)> Golden Nine > 85-5 (1.073%)> Huaifeng (0.924%). There was no significant difference between Huaidi 81 and Golden Nine, but extremely significant difference between was found in Huaidi 81 and other varieties; The acteoside content ranked in the following following order: Huaidi 81 (0.096%) > Qin Huai (0.069%) >85-5 (0.047%) > Beijing No.3 (0.035%) > Huaifeng (0.023%) > Golden Nine (0.022%). There was significant difference between Huaidi 81 and other varieties. Huaidi 81 showed high resistance to Septoris digitalis Pass and middle resistance against leaf ring rot, which indicated that Huaidi 81 had good resistance to leaf diseases. Huaidi 81 with highest chlorophyll content and moderate anthocyanin content showed the highest photosynthetic rate. All these results indicated that the new variety Huaidi 81 with best comprehensive properties was suitable for popularizing as a new Rehmannia glutinosa variety.

Seroepidemiology of Toxoplasma gondii and Neospora caninum infections in goats in Hubei province, China.

Scarce information is available about the seroprevalence of Toxoplasma gondii (T. gondii) and Neospora caninum (N. caninum) infections in goats in Hubei province, China. In the present study, the prevalence of T. gondii and N. caninum infections in goats were investigated in Hubei province, China between 2014 and 2015. A total 2007 serum samples were collected from 6 counties of Hubei province, China and were tested for antibodies to N. caninum and T. gondii by an enzyme-linked immunosorbent assay (ELISA) and an indirect agglutination test (IAT), respectively. Antibodies against T. gondii and N. caninum were detected in 13.4% and 3.9%, respectively in goats. 2% (41) serum samples were positive to both parasites. There was no apparent association of T. gondii and N. caninum infection with gender of the animals. There were significant differences of T. gondii (p < 0.01), N. caninum (p < 0.05) and both parasites (p < 0.01) infection with season. This is the first time that antibodies to T. gondii and N. caninum have been detected in goats in Hubei province, China.

Seroepidemiology of Toxoplasma gondii and Neospora caninum infections in goats in Hubei province, China

Scarce information is available about the seroprevalence of Toxoplasma gondii (T. gondii) and Neospora caninum (N. caninum) infections in goats in Hubei province, China. In the present study, the prevalence of T. gondii and N. caninum infections in goats were investigated in Hubei province, China between 2014 and 2015. A total 2007 serum samples were collected from 6 counties of Hubei province, China and were tested for antibodies to N. caninum and T. gondii by an enzyme-linked immunosorbent assay (ELISA) and an indirect agglutination test (IAT), respectively. Antibodies against T. gondii and N. caninum were detected in 13.4% and 3.9%, respectively in goats. 2% (41) serum samples were positive to both parasites. There was no apparent association of T. gondii and N. caninum infection with gender of the animals. There were significant differences of T. gondii (p < 0.01), N. caninum (p < 0.05) and both parasites (p < 0.01) infection with season. This is the first time that antibodies to T. gondii and N. caninum have been detected in goats in Hubei province, China.

Antioxidant and Hypoglycemic Activities of Exopolysaccharide by Submerged Culture of Inocutus Hispidus.

This work was to investigate the hypoglycemic and antioxidant activities of the exopolysaccharides produced in a stirred-tank bioreactor by Inocutus hispidus. The exopolysaccharides showed significant antioxidant activities, up to 70.7±2.5% inhibition of hydroxyl radicals, 50% inhibition of 2,2-diphenyl-1-picrylhydrazyl radicals, and a Trolox equivalent antioxidant capacity of 3.3 mM. The exopolysaccharide also showed notable hypoglycemic effects in streptozotocin-induced diabetic mice, reducing the plasma glucose, total cholesterol and triacylglycerol concentrations by 18.2±1.5, 20.9±0.8 and 14.4±0.4, respectively. The results demonstrated the potential of this EPS for human health protection against oxidative damage and hyperglycemia.

Delayed axonal degeneration in slow Wallerian degeneration mutant mice detected using diffusion tensor imaging.

Previous studies have shown the feasibility of using diffusion tensor imaging (DTI) as a noninvasive imaging modality to evaluate neurodegeneration in humans and animals. The axial and radial diffusivities derived from DTI were demonstrated to be sensitive markers for axonal and myelin damage, respectively. This study used DTI to evaluate optic nerve degeneration in wild-type and slow Wallerian degeneration (Wld(S)) mutant mice. Longitudinal DTI was performed on optic nerves following high intraocular pressure-induced transient retinal ischemia. The axial diffusivity of wild-type nerves decreased 30% (P<0.05) at 3 days and 40% (P<0.05) at 5-30 days after transient elevation of intraocular pressure. In contrast, the axial diffusivity of Wld(S) nerves did not change at 3 days; decreased by 20% (P<0.05) at 5 days, and continued to decrease by 30% (P<0.05) at 15 days and 40% (P<0.05) at 30 days after transient intraocular pressure elevation, suggesting delayed axonal damage in Wld(S) mice. Radial diffusivity increased 200% (P<0.05) at 15-30 days in the wild-type mice and 100% (P<0.05) at 30 days in the Wld(S) mice after transient intraocular pressure elevation, suggesting delayed myelin damage in Wld(S) mice. DTI detected damage was confirmed with immunohistochemistry using phosphorylated neurofilament and myelin basic protein for assessing axonal and myelin integrity, respectively. These findings support the use of DTI not only to evaluate the progression of neurodegeneration but also to noninvasively demonstrate Wld(S) mutation to delay the Wallerian degeneration.

Diffusion tensor imaging reveals white matter reorganization in early blind humans.

Multiple functional methods including functional magnetic resonance imaging, transcranial magnetic stimulation, and positron emission tomography have shown cortical reorganization in response to blindness. We investigated microanatomical correlates of this reorganization using diffusion tensor imaging and diffusion tensor tractography (DTT). Five early blind (EB) were compared with 7 normally sighted (NS) persons. DTT showed marked geniculocalcarine tract differences between EB and NS participants. All EB participants showed evidence of atrophy of the geniculocortical tracts. Connections between visual cortex and the orbital frontal and temporal cortices were relatively preserved in the EB group. Importantly, no additional tracts were found in any EB participant. Significant alterations of average diffusivity and relative anisotropy were found in the white matter (WM) of the occipital lobe in the EB group. These observations suggest that blindness leads to a reorganization of cerebral WM and plausibly support the hypothesis that visual cortex functionality in blindness is primarily mediated by corticocortical as opposed to thalamocortical connections.

Characterization of FITC-albumin encapsulated poly(DL-lactide-co-glycolide) microspheres and its release characteristics.

In this study, the fluorescein isothiocyanate (FITC)-albumin distribution, the amount of FITC-albumin release and the degradation of poly (DL-lactic-co-glycolic acid) (PLGA) microspheres were evaluated. The higher the FITC-albumin concentration in the W1 phase, the higher the protein concentration and loading efficiency in the microspheres, the larger the particle size of microspheres. Confocal laser scanning microscopy (CLSM) showed that the FITC-albumin was distributed uniformly in the microspheres with a low concentration while it was aggregated at higher concentrations. The high protein concentration in the microspheres showed significantly large initial release (above 70% w/w) during the 10 days. A higher PVA concentration in the W2 phase resulted in a smaller particle size, higher protein contents and loading efficiency and decreased release rate. After a 10 day incubation period, the microspheres with a low FITC-albumin concentration had an almost spherical morphology, while microspheres with a high FITC-albumin concentration had a more distorted morphology, suggesting that rapid morphological changes and microspheres ruptures can be induced by an initial burst release.

Improving relative anisotropy measurement using directional correlation of diffusion tensors.

A method employing directional correlation of the diffusion tensor, directional-correlation weighted relative anisotropy (DRA), was developed to improve the accuracy of estimated relative anisotropy (RA). The intravoxel directional correlation was established on the same voxel between two identically acquired diffusion tensor images, and the correlation coefficient derived from tensor dot product was employed as the weighting factor applied in the calculation of RA. The effect of noise influence was reduced since the random noise between repeated scans is not directionally correlated. The RA and the inter- and intravoxel DRA estimations were examined on rat brains in vivo. The background noise alters the direction of eigenvectors and the magnitude of eigenvalues. The dispersion angle between repeatedly obtained eigenvectors, representing the extent of directional alteration of eigenvectors, depends on the tissue anisotropy as well as the signal-to-noise ratio (SNR) of the source images. Current results demonstrate that the intravoxel DRA improves the accuracy of RA estimation, increases the relative contrast of gray and white matter, and avoids the partial volume effect commonly seen in the intervoxel operations.

Colonic motility abnormality in patients with irritable bowel syndrome exhibiting abdominal pain and diarrhea.

OBJECTIVES: Although colon dysmotility is recognized as a pathophysiological factor in irritable bowel syndrome (IBS), it has not been characterized. We have investigated motility patterns in IBS patients with abdominal pain and frequent defecation or diarrhea and in healthy volunteers. METHODS: A recording catheter that had six polyvinyl tubes with infusion ports was placed in the transverse, descending, and sigmoid colon under fluoroscopy. After 2-h basal recordings, motility responses to cholecystokinin octapeptide (CCK-8) and a meal were studied for 3 h. The motility index (MI) and number of high amplitude propagating contractions (HAPCs) in 10 IBS patients were compared with those of 10 controls. HAPCs were correlated with abdominal pain, and colon transit time using radio-opaque markers was determined. Using human colon muscle strips, the effect of CCK-8 on muscle contractions was also studied. RESULTS: The MI and mean number and peak amplitude of HAPCs in IBS patients were significantly greater than in controls. These abnormalities paralleled markedly shortened colonic transit time. Abdominal pain coincided with >90% of HAPCs. Dose-dependent muscle contraction by CCK-8 was profoundly suppressed both by loxiglumide and atropine. CONCLUSIONS: The dysmotility in this subset of IBS patients was characterized by significantly increased occurrences of powerful HAPCs that paralleled rapid colon transit and were accompanied by abdominal pain. Thus, it is suggested that this powerful contraction is one of the causes of abdominal pain. The action of CCK-8 seems to be mediated via the colon enteric nervous system.

Determination of bisbenzylisoquinoline alkaloids by high-performance liquid chromatography (II).

After the earlier analysis of nine bisbenzylisoquinoline alkaloids with ion pair chromatography, seven other bisbenzylisoquinoline alkaloids were analyzed using gradient elution with an acetonitrile-phosphate buffer (pH 8.0) mixture, and UV detection. Four alkaloids were detected in the stem woods of a Lauraceous plant, Dehaasia triandra Merr. and their contents determined. LC-MS suggested that a major unknown compound in the plant was also a bisbenzylisoquinoline alkaloid.

Attachment, adolescent competencies, and substance use: developmental considerations in the study of risk behaviors.

Social-control-based deviance theories highlight parental bonding as a protective factor for problem behaviors in that bonds are viewed as reflecting the adolescent's adoption of conventional societal attitudes and values. Developmental theory and research suggest an alternative conceptualization of the linkages between family bonding and adolescent risk behaviors. This conceptualization requires concurrent examination of a range of adolescent competencies as well as consideration of parent and peer contexts. Support is found for several hypotheses derived from a developmental approach proposing: (a) positive associations between adolescent-parent attachment and adolescent competencies--autonomy, peer relationship competency, and coping; (b) coherence in the pattern of negative associations between attachment/competencies and substance use problems; and (c) a disjunctive pattern of associations with substance use reflected by positive associations with peer competencies but not with parental attachment.

Family correlates of adolescent self-monitoring and social competence.

The purpose of this study was to investigate linkages between adolescent self-monitoring, global social competence, and parenting and family environment dimensions of support and encouragement of autonomy. The sample consisted of 233 young women and 199 young men at 2 southwestern universities. The primary measures used were the Family Environment Scale (R. H. Moos, 1981), the Parent Behavior Form (L. Worell & J. Worell, 1974), the revised Self-Monitoring Scale (M. Snyder, 1987), and the Texas Social Behavior Inventory (R. Helmreich, J. Stapp, & C. Ervin, 1974). Findings indicated that family variables are more strongly associated with social competence than with self-monitoring; family support was, overall, a more important ingredient of social competence than was autonomy. Women and men had different patterns of associations among specific variables.