Nitrogen-fixing bacteria promote growth and bioactive components accumulation of Astragalus mongholicus by regulating plant metabolism and rhizosphere microbiota.

BACKGROUND: The excessive application of chemical fertilizers in the cultivation of Astragalus mongholicus Bunge results in a reduction in the quality of the medicinal plant and compromises the sustainable productivity of the soil. PGPB inoculant is a hot topic in ecological agriculture research. In the cultivation of Astragalus mongholicus, the screened nitrogen-fixing bacteria can promote plant growth, however, whether it can promote the accumulation of main bioactive components remains unknown. In this study, mixed inoculants containing 5 strains of growth promoting bacteria (Rhizobium T16 , Sinorhizobium T21 , Bacillus J1 , Bacillus G4 and Arthrobacter J2) were used in the field experiment. The metabolic substances in the root tissues of Astragalus mongholicus were identified during the harvest period by non-targeted metabolomics method, and the differential metabolites between groups were identified by statistical analysis. Meanwhile, high-throughput sequencing was performed to analyze the changes of rhizosphere soil and endophytic microbial community structure after mixed microbial treatment. RESULTS: The results of non-targeted metabolism indicated a significant increase in the levels of 26 metabolites after treatment including 13 flavonoids, 3 saponins and 10 other components. The contents of three plant hormones (abscisic acid, salicylic acid and spermidine) also increased after treatment, which presumed to play an important role in regulating plant growth and metabolism. Studies on endosphere and rhizosphere bacterial communities showed that Rhzobiaceae, Micromonosporaceae, and Hypomicrobiaceae in endophytic, and Oxalobactereae in rhizosphere were significantly increased after treatment. These findings suggest their potential importance in plant growth promotion and secondary metabolism regulation. CONCLUSIONS: This finding provides a basis for developing nitrogen-fixing bacteria fertilizer and improving the ecological planting efficiency of Astragalus mongholicus.

Effect of hyodeoxycholic acid on the activity of steatosis hepatocytes and its mechanism / 临床肝胆病杂志

ObjectiveTo investigate the role and mechanism of hyodeoxycholic acid （HDCA） in the progression of metabolic associated fatty liver disease （MAFLD）， and to provide a new theoretical basis for further clarifying the pathogenesis of MAFLD. MethodsL02 hepatocytes were used as experimental cells， and palmitic acid was used to induce steatosis in L02 cells. The farnesoid X receptor （FXR） siRNA interference chain technique was used to construct a hepatocyte cell line with low FXR expression. CCK8 assay was used to observe the effect of HDCA on L02 steatosis hepatocytes at different concentrations （0， 100， 200， 300， and 400 μmol/L） and time points （12， 24， 36， and 48 hours）. The method of qRT-PCR was used to measure the mRNA expression levels of FXR， proliferating cell nuclear antigen （PCNA）， Cyclin D1， phosphatidylinositol 3-kinase （PI3K）， and protein kinase-B （AKT）， and Western blot was used to measure the protein expression levels of FXR， Cyclin D1， PCNA， PI3K， phosphorylated PI3K （p-PI3K）， AKT， and phosphorylated （p-AKT）. A one-way analysis of variance was used for comparison of normally distributed continuous data with homogeneity of variance between multiple groups， and the Tukey HSD test was used for further comparison between two groups； the Welch analysis of variance was used for comparison of normally distributed continuous data with heterogeneity of variance between multiple groups， and the Games-Howell test was used for further comparison between two groups. The independent-samples t test was used for comparison between two groups. ResultsCCK8 assay showed a significant reduction in the viability of L02 cells and steatosis hepatocytes treated by 300 μmol/L HDCA （P<0.05）， and qRT-PCR showed a significant increase in the mRNA expression level of FXR and significant reductions in the mRNA expression levels of PCNA， Cyclin D1， PI3K， and AKT （all P<0.05）. Western blot showed a significant increase in the protein expression level of FRX （P<0.05）， and after interference of FXR expression in L02 cells， there were significant increases in the protein expression levels of PCNA， PI3K， p-PI3K， AKT， and p-AKT （all P<0.05）. ConclusionHDCA inhibits the PI3K/AKT signaling pathway by upregulating FXR expression， thereby inducing a reduction in the viability of steatosis hepatocytes.

Clinical analysis of labial mucosa graft coupled preputial island flap urethroplasty for recurrent penile curvature after hypospadias repair / 中华泌尿外科杂志

Objective:To investigate the clinical efficacy of labial mucosa graft coupled preputial island flap urethroplasty for recurrent penile curvature after hypospadias repair.Methods:The data of 35 patients with recurrent penile curvature after hypospadias repair who underwent labial mucosa graft coupled preputial island flap urethroplasty in four hospitals from January 2021 to March 2023 were retrospectively reviewed. The median age of the patients was 15(13, 18)years old, five of them had penile dehiscence, and four had urethrocutaneous fistula. All patients received labial mucosa graft coupled preputial island flap urethroplasty, the penile flexion was confirmed by artificial erection test, and the urethra is obliquely cut at the most obvious curvature of the penis. By removing the ventral fibrotic scar tissue, the length of the urethral defect was measured. The urethral plate was reconstructed with the same length of labial mucosa graft and an adjacent preputial island flap was transplanted to cover the reconstructed urethra plate to form a new urethral lumen. The inner urethral stent tube was extracted three days after the operation, and the outer urethral stent tube was removed three weeks after the surgery. Diagnostic urethral exploration was performed 5 weeks post-operation, uroflowmetry examination was performed seven weeks after the procedure, and the perioperative and postoperative follow-up data were analyzed.Results:All patients underwent a successful surgery, with the average duration of the procedure being (114.7±20.1)minutes. After mean follow-up of (15.5±5.9)months, no penile curvature occurred, and 32 patients were successfully repaired. Uroflowmetry examination was achieved in 21 patients at the seventh week after surgery showed their mean maximum flow rate was (18.4±3.7)ml/s. Three cases (8.6%, 3/35) developed urethrocutaneous fistula, who were repaired successfully 6 months after surgery.Conclusions:Utilizing the combination of labial mucosa grafts and preputial island flaps for urethroplasty has been proven to be a reliable and safe option for individuals with recurrent penile curvature following hypospadias repair, with a high success rate and few complications.

Executive functions of obese adolescents / 中国学校卫生

Objective@#To explore of executive function in obese adolescents, so as to provide a reference for executive function enhancement intervention in obese adolescents.@*Methods@#A convenience sample of 1 227 adolescents aged 13-18 years was selected from 2 secondary schools in Taiyuan City during March-April 2023. The Flanker task, N-back task and More odd shifting task was used to compare the different subfunctions of executive function (refreshing function, shifting function, inhibiting function) of 61 obese adolescents and 70 normal weight adolescents. Independent samples t-tests was used for between group comparisons and Cohen s d -tests was used to calculate between group differences in executive function between the two groups of adolescents.@*Results@#Compared with the group of normal weight, time responses of the inhibitory function [(29.73±19.55)ms], the refreshing function [1-back: (1 088.75±275.76)ms, 2-back:( 1 285.44± 355.16)ms] and the shifting function [(380.34±153.18) ms] in the obese group were significantly longer than those in the normal weight group [(14.86±20.27, 888.38±286.57, 1 126.20± 287.43 , 323.12±134.71) ms] ( t =4.26, 4.06, 1.92,2.26, P < 0.05 ); inhibitory function (0.91±0.09) and 1-back (0.73±0.24) were also significantly less correct than in the normal weight group (0.94±0.05, 0.83±0.21) ( t =-2.04, -2.04, P <0.05). Obese adolescents showed moderate adverse effect sizes in the inhibition function ( d =0.746,0.712) and the refresh function 1-back, and smaller adverse effect sizes in the refresh function 2-back and the conversion function( d =0.497,0.398).@*Conclusion@#Obese adolescents have significant executive function deficits, but the degree of adverse varies across sub-functions, with inhibitory function being the core deficit component of executive function in obese adolescents.

Characteristic changes in morphology and function of skeletal muscles in a rat model of"tendon off-position" / 中国组织工程研究

BACKGROUND:"Tendon off-position"is a disease name included in the International Classification of Diseases 11th Revision,and also a clinical indication of manipulation,acupuncture and other treatments.However,its specific mechanism is still unclear.It is urgent to establish an animal model that can reflect the clinical and pathological characteristics of"tendon off-position,"so as to further study the mechanism of effective clinical treatments. OBJECTIVE:To establish an animal model of"tendon off-position"in rats based on isometric contraction of skeletal muscles,and to explore the changes of skeletal muscle function and morphological phenotype after"tendon off-position." METHODS:Sixty rats were randomly divided into control group,static-loading group and extra loading group,with twenty rats in each group.Rats in the control group were kept normally without treatment.In the latter two groups,the rats were fixed by the self-made static-loading modeling device and a static-loading(the body mass of each rats was applied as the static-loading)was applied to cause sustained isometric contraction of the upper limb muscles.Then,animal models of"tendon off-position"were successfully established.In the extra loading group,50%of the body mass was added to the ankle joint after modeling.The skeletal muscle samples were harvested at 2 and 4 weeks after modeling.The changes of limb grip strength,wet mass of skeletal muscle,and serum levels of creatine kinase-muscle and lactate dehydrogenase A were measured,and the changes of skeletal muscle histomorphology and ultrastructure were observed. RESULTS AND CONCLUSION:At 2 weeks after modeling,the rats in the static-loading group and extra loading group showed significantly decreased grip strength and wet muscle mass,significantly increased serum levels of creatine kinase-muscle and lactate dehydrogenase A,and abnormal muscle fiber morphology and structure accompanied by a large number of deposited collagen fibers.Electron microscopy results showed that the structure of myofibrils was disordered,the Z-line was distorted,and the light and dark boundaries were blurred.At 4 weeks after modeling,the grip strength of the model rats was increased compared with that at 2 weeks,the serum creatine kinase-muscle and lactate dehydrogenase A levels were decreased,and the changes of muscle fiber morphology and ultrastructure were recovered to varying degrees.It is suggested that the rat skeletal muscle injury model based on continuous isometric contraction of skeletal muscle can well reflect the pathological characteristics of"tendon off-position"at 2 weeks,and can be used to study the mechanism of acupuncture and manipulation in the treatment of"tendon off-position."

Effects of long intergenic non-coding RNA 467 on proliferation,apoptosis and migration,invasion ability of endometrial carcinoma cells / 新乡医学院学报

Objective To investigate the effects of long intergenic non-coding RNA 467(linc00467)on the proliferation,apoptosis and migration,invasion ability of endometrial carcinoma cells.Methods Human endometrial carcinoma cells HC1A,Ishikawa,KLE and RL-95-2 were cultured in vitro,the expression level of linc00467 in the four cells was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).Endometrial carcinoma cell lines HEC-1A and Ishikawa with the highest linc00467 expression levels were selected for subsequent experiment.Two Iinc00467 lentivirus silencing expression vectors of sh-linc00467#1 and sh-linc00467#2,and empty lentivirus plasmids were constructed,respectively;the HEC-1A and Ishikawa cells in logarithmic growth phase were divided into sh-NC group,sh-linc00467#1 group,and sh-linc00467#2 group.The cells in the sh-NC group were transfected with empty lentivirus plasmids,the cells in the sh-linc00467#1 group and sh-linc00467#2 group were transfected with sh-linc00467#1 and sh-linc00467#2,respectively;the relative expression level of linc00467 in cells of the three groups was detected by RT-qPCR,the proliferation ability of cells in the three groups was detected by 5-ethynyl-2-deoxyuridine(EdU)assay and colony formation assay,the migration ability of cells in the three groups was detected by scratch assay,the invasion ability of cells in the three groups was detected by Transwell assay,and the cell apoptosis in the three groups was detected by flow cytometry.Results The relative expression level of linc00467 mRNA in HEC-1A cells was significantly higher than that in KLE and RL-95-2 cells(P＜0.05);the relative expression level of linc00467 mRNA in Ishikawa cells was significantly higher than that in KLE and RL-95-2 cells(P＜0.05);there was no statistically significant difference in the relative expression level of linc00467 mRNA between HEC-1A and Ishikawa cells(P＞0.05);the relative expression level of linc00467 mRNA in KLE cells was significantly lower than that in RL-95-2 cells(P＜0.05).The relative expression levels of linc00467 mRNA in HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group were significantly lower than those in the sh-NC group(P＜0.01);there was no statistically significant difference in the relative expression level of linc00467 mRNA in HEC-1A and Ishikawa cells between the sh-linc00467 # 1 group and the sh-linc00467#2 group(P＞0.05).The number of EdU positive HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group was significantly lower than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the number of EdU positive HEC-1A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).The number of cloned HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group was significantly lower than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the number of cloned HEC-1A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).The apoptosis rates of HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group were significantly higher than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the apoptosis rates of HEC-1A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467 #2 group(P＞0.05).The scratch healing rates of HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group were significantly lower than those in the sh-NC group(P＜0.01);there was no statistically significant difference in the scratch healing rates of HEC-1 A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).The number of invasive cells of HEC-1 A and Ishikawa in the sh-linc00467#1 group and sh-linc00467#2 group was significantly lower than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the number of invasive cells of HEC-1 A and Ishikawa between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).Conclusion Down-regulation of linc00467 expression can inhibit the proliferation,migration and invasion,and promote apoptosis of endometrial carcinoma cells.

Molecular mechanism of ATF6 regulating the reproduction related gene HSPA1L / 基础医学与临床

Objective To explore the effect of endoplasmic reticulum stress activating transcription factor 6(ATF6)on the expression of reproduction related gene heat shock protein family A member 1 like(HSPA1L)and preliminari-ly clarify its regulatory molecular mechanism.Methods The ATF6 over-expression plasmid was transfected into HEK-293T cells and the over-expression efficiency was verified by RT-qPCR and Western blot.The transcriptome sequen-cing information of testis tissue of male ATF6 knockout mice was used to screen five reproduction related genes down-stream of ATF6.The dual luciferase reporter assay selected the downstream genes with high promoter activity and de-tected the effect of over-expression of ATF6 on the promoter activity of downstream genes.The possible binding sites of ATF6 and downstream gene promoters were predicted by gene-regulation.RT-qPCR and Western blot were used to detect the effect of over-expression of ATF6 on downstream gene expression in HEK-293T cells.Whether ATF6 binds to downstream gene promoters was determined by electrophoretic mobility shift assay(EMSA).Results The expres-sion of ATF6 mRNA(P＜0.001)and protein(P＜0.001 and P＜0.05)in HEK-293T cells was significantly increased after transfection.HSPA1L(P＜0.001 and P＜0.05),a reproductive related gene downstream of ATF6 was screened by transcriptome sequencing and dual luciferase reporter assay.ATF6 promoted the truncated promoter activity of HSPA1L(P＜0.001).After over-expression of ATF6,the expression of HSPA1L was significantly increased(P＜0.001).The differences were statistically significant.ATF6 protein could bind to the aagtcgtcac DNA sequence of HSPA1L promoter.Conclusions ATF6,a key molecule of endoplasmic reticulum stress,regulates the expression of reproduction related gene HSPA1L by binding to the promoter of HSPA1L.This result will lay a foundation for further research on the prevention or treatment of endoplasmic reticulum stress(ERS)related male infertility.

Mechanism research progress of traditional Chinese medicine intervening in lung cancer by regulating p53 signaling pathway / 中国药房

Lung cancer， the most common malignant tumor， is characterized by a complex pathogenesis and high malignancy， and poses a significant threat to the health and lives of affected individuals. p53 signaling pathway plays a crucial role in the progression of lung cancer and is considered one of the potential targets for targeted therapy. In recent years， multiple studies have indicated that traditional Chinese medicine （TCM） can exert anticancer effects by modulating the p53 signaling pathway. Based on this， this article systematically summarizes the current status and progress of research on TCM intervening in lung cancer by regulating p53 signaling pathway. It was found that TCM formula and preparations， such as Qingjin desheng tablet， Tiaoqi xiaoji decoction， Bufei tongluo jiedu formula， Jianpi bushen formula and Yiqi fuzheng jiedu formula， can promote autophagy and apoptosis of lung cancer cells， inhibit the growth and metastasis of lung cancer cells and strengthen the immune function of the body by activating p53 signaling pathway， thereby inhibiting lung cancer. TCM monomers， such as pseudoginsenoside-Rh2， saikosaponin D， polyphyllin Ⅶ， dendrobiine， sophoridine， gambogic acid， triptolide and triptolide succinate monoester YJ-4， can accelerate cell apoptosis， inhibit the proliferation of lung cancer cells and regulate cell cycle by activating p53 signaling pathway， thereby inhibiting lung cancer.

Mechanism research progress of traditional Chinese medicine intervening in lung cancer by regulating p53 signaling pathway / 中国药房

Lung cancer， the most common malignant tumor， is characterized by a complex pathogenesis and high malignancy， and poses a significant threat to the health and lives of affected individuals. p53 signaling pathway plays a crucial role in the progression of lung cancer and is considered one of the potential targets for targeted therapy. In recent years， multiple studies have indicated that traditional Chinese medicine （TCM） can exert anticancer effects by modulating the p53 signaling pathway. Based on this， this article systematically summarizes the current status and progress of research on TCM intervening in lung cancer by regulating p53 signaling pathway. It was found that TCM formula and preparations， such as Qingjin desheng tablet， Tiaoqi xiaoji decoction， Bufei tongluo jiedu formula， Jianpi bushen formula and Yiqi fuzheng jiedu formula， can promote autophagy and apoptosis of lung cancer cells， inhibit the growth and metastasis of lung cancer cells and strengthen the immune function of the body by activating p53 signaling pathway， thereby inhibiting lung cancer. TCM monomers， such as pseudoginsenoside-Rh2， saikosaponin D， polyphyllin Ⅶ， dendrobiine， sophoridine， gambogic acid， triptolide and triptolide succinate monoester YJ-4， can accelerate cell apoptosis， inhibit the proliferation of lung cancer cells and regulate cell cycle by activating p53 signaling pathway， thereby inhibiting lung cancer.

Analysis of the characteristics and related factors of executive function in adolescents / 中国学校卫生

Objective@#To explore the characteristics and related factors of adolescent executive function, so as to provide theoretical basis for promoting the development of adolescent executive function.@*Methods@#A total of 5 018 adolescents aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi were selected by convenient cluster random sampling method from September to December 2022, and their basic information, family status, lifestyle behavior, physical fitness and executive function were investigated by questionnaire survey. Considering the heterogeneity between schools, a multilevel Logistic model was established to analyze the related factors of adolescent executive function.@*Results@#The inhibitory function of high school students was better than that of middle school students (Z=-2.69). In terms of refreshment function, high school students were superior than middle school students (1-back:Z=-11.32; 2-back:Z=-11.36), and male students were superior than female students (2-back:Z=-2.18); in terms of shifting function, high school students were superior than middle school students (Z=-2.63), and boys were superior than girls (Z=-7.10)(P<0.05). The results of multilevel model analysis showed that the executive function of adolescents was clustered at the school level. At the individual level, junior high school refreshment function (1-back:β=56.94; 2-back:β=127.00), and shifting function (β=35.64) were worse than that of high school students; the refreshment function 2-back (β=-21.24) and shifting function (β=-28.42) of male students were better than those of female students; the refreshment function 2-back of nononly child was better than that of only child (β=-19.36); refreshment function of low fitness was worse than that of high fitness (β=37.35); the shifting function of the video screen time not up to standard was better than that of the standard (β=-14.30)(P<0.05).@*Conclusions@#The executive function of high school students is better than that of middle school students, the refreshment function and shifting function of boys are better than that of girls. Family environment, lifestyle and physical health are significant factors related to executive function of Chinese adolescents. By raising awareness of the major supporting and impeding factors for executive functioning in adolescents, it can help to develop effective intervention programs for adolescents.

Comparative studies on ovary and serum hormone levels in silver and blue foxes and their hybrids.

The silver and blue fox appear closely related despite their belonging to different genera, and the male and female fox hybrids are completely sterile in mating inter se or back to either of the parental groups. In the present study, we compared ovarian morphology and serum hormone concentrations among silver foxes, blue foxes, HSBs (silver fox male × blue fox female hybrids) and HBSs (blue fox male × silver fox female hybrids) during the pre-breeding and the breeding period. We found that either the fertile blue and silver foxes or the infertile hybrid foxes showed typical characteristics of ovary, with primordial, primary, secondary, antral and Graafian follicles. The diameters and quantities of different follicle classes in fertile foxes were greater than that in hybrids during the two period, while the thickness of zona pellucida (ZP) represented an opposite trend (P < 0.05). The relative weight of bilateral ovaries in fertile foxes was greater than that in hybrids during the pre-breeding period, while mean serum FSH represented an opposite trend during the breeding period (P < 0.05). The mean serum estradiol in fertile foxes was greater than that in HBS foxes during the pre-breeding period, and greater than hybrids during the breeding period (P < 0.05). These findings indicated that in the infertile hybrid foxes, lower estradiol levels produced by lesser and smaller antral follicles, thicker ZP during the two period, higher FSH levels during the breeding period, could be the basis of interpretations in cases of female fox hybrid infertility.

Associations between the sense of school belonging and mental health status among medical students during the post-epidemic period / 中华医学教育探索杂志

Objective:To explore the status of medical students' sense of school belonging and its relationship with depression and anxiety symptoms in the context of COVID-19 prevention and control.Methods:An online questionnaire survey was conducted among 1 629 full-time students from 8 medical universities. The 18-item psychological sense of school membership scale (PSSM-18), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder scale (GAD-7) were used as measurements. Spearman correlation coefficients were used to analyze the correlations between PSSM-18, PHQ-9, and GAD-7 scores. Logistic regressions were used to analyze the impact of lack of school belonging on depression and anxiety symptoms.Results:The mean score of school belonging was (77.31±14.12), and the detection rates of depression and anxiety symptoms were 25.97% (423/1 629) and 21.92% (357/1 629), respectively. PSSM-18 score was negatively correlated with PHQ-9 scores ( r=-0.52, P<0.001) and GAD-7 scores ( r= -0.49, P < 0.001). After adjusting for covariates, students with low school belongingness had 4.33 times the risk of depression symptoms ( OR=4.33, 95%CI=2.48-7.43) and 5.85 times the risk of anxiety symptoms ( OR= 5.85, 95%CI=3.76-8.15) compared to students with high school belongingness. Conclusion:Lack of school belonging increases the risk of depression and anxiety symptoms. Under the normalization of COVID-19 prevention and control, the school should strengthen health education and support services to improve the students' sense of belonging and alleviate their mental health problems.

Analysis of influencing factors and impact path of self-management in tumor patients with PICC of the intermission of chemotherapy / 中国实用护理杂志

Objective:To analysis the effect of health-promoting lifestyle and patient activation on self-management among tumor patients with PICC of the intermission of chemotherapy, so as to provide a basis for the targeted caring intervention programs.Methods:Using cross-sectional survey methods, from January 2021 to December 2022, the tumor patients with PICC of the intermission of chemotherapy of Tianjin Third Central Hosptial were investigated, using the General Demographic Questionnaire, Cancer Patients PICC Self-management Scale, Health Promotion Lifestyle Profile Ⅱ and Patient Activation Measure. Pearson correlation analysis and multiple linear stepwise regression analysis were used to analyze the data, and the structural equation model between related factors were established.Results:A total of 251 patients were collected in the this study, the scores of self-management were (153.12 ± 20.33) points, health-promoting lifestyle were (98.58 ± 16.05) points, and patient activation were (50.52 ± 6.51) points. The dimensions scores and total scores of self-management were positively correlated with the health-promoting lifestyle and patient activation in tumor patients with PICC ( r values were 0.503-0.910, all P<0.01). Multiple linear regression analysis showed that the health-promoting lifestyle and the patient activation were the influencing factors of the patient's self-management ability ( t=2.67, 1365, both P<0.05). Pathway analysis results showed that patient activation played a partially mediating role between health-promoting lifestyle and self-management, the effect value was 0.33 (95% CI 0.301-0.557), accounting for 46.5% of the total effect. Conclusions:Health-promoting lifestyle and the patient activation were the influencing factors of the self-management ability of tumor patients with PICC, patient activation played a partially mediating role between health-promoting lifestyle and self-management.

Two-dimensional speckle tracking echocardiography for evaluating the effect of enhanced external counterpulsation on left ventricular function in elderly patients with coronary slow flow phenomenon / 中华老年医学杂志

Objective:This study aimed to evaluate the effect of enhanced external counterpulsation(EECP)on left ventricular function in elderly patients with coronary slow flow phenomenon(CSFP)using two-dimensional speckle tracking echocardiography(2D-STE).Methods:This prospective case-control study included 30 patients aged ≥60 years with no stenotic lesions in the coronary arteries but with slow blood flow phenomenon in more than one major coronary artery who were treated at the Department of Geriatrics, Qilu Hospital, Shandong University, between December 2017 and December 2018, and were divided into a medication group with 16 participants and a medication plus EECP group with 14 participants, using the numerical lottery method.Patients in the group treated with EECP received 6-week 36-h EECP therapy in addition to lifestyle modification and drug treatment.Fourteen patients with normal coronary blood flow served as the control group.Conventional echocardiography and 2D-STE were used to evaluate changes in left ventricular function in the CSF patients before and after drug treatment and EECP.Results:Compared with the control group before treatment, patients in the drug treatment group and the drug treatment plus EECP group showed a decrease in mitral annular early diastolic velocity( P<0.01), an increase in the ratio of peak mitral early diastolic blood flow velocity to the mean peak mitral annular early diastolic velocity( P<0.05), and a decrease in left ventricular longitudinal strain during systole( P<0.01), the longitudinal systolic myocardial strain rate( P<0.01)and the early diastolic longitudinal peak strain rate( P<0.01).There was no statistically significant difference in values from conventional echocardiographic parameters before and after treatment in CSF patients of the medication group(all P>0.05).In the group receiving EECP, there were statistically significant differences in pre-and post-treatment values in ventricular septal early diastolic velocity[(6.22 ± 0.64)cm/s vs.(6.69 ± 0.44)cm/s], lateral wall early diastolic velocity[(8.01±0.68)cm/s vs.(8.41±0.29)cm/s], mitral valve to mitral annulus early diastolic peak velocity ratio[(10.51±1.38) vs.(9.74±0.37)], longitudinal left ventricular systolic strain[(-16.21±0.46)% vs.(-16.80±0.48)%], left ventricular systolic longitudinal strain rate[(-1.29±0.03)s -1vs.(-1.35±0.04)s -1], and early diastolic longitudinal strain rate[(1.35±0.03)s -1vs.(1.40±0.03)s -1](t-values were -3.70、-2.74、2.23、10.25、12.30、-19.15, all P<0.05). Conclusions:2D-STE can evaluate subclinical myocardial dysfunction early and quantitatively in elderly patients with CSF, and objectively reflect changes in left ventricular function before and after clinical intervention with EECP.

Personal audio device use and hearing impairment among high school students in Beijing / 中国学校卫生

Objective@#To explore the use of personal audio devices and hearing impairment among high school students, so as to provide reference for the development of adolescent hearing health work.@*Methods@#The simple random sampling method was used to collect research data relating to 1 768 high school students. The situation of personal audio players, headphone and hearing damage were investigated by using a self designed questionnaire, so as to identify the related factors of hearing impairment which were analyzed statistically by multivariate Logistic regression.@*Results@#The use rate of PAP and earphones was 98.64% and 94.12 %, respectively, and the use rate of female students(99.68%, 96.42%) was higher than that of male students(97.43%, 91.43 %)( χ 2=16.69, 19.79, P <0.01). Hearing impairment accounted for 13.35%. The Logistic regression analysis showed that PAP service years ( OR =1.59, P <0.05) were related to hearing impairment. Gender ( OR =0.60), in ear earphones ( OR =1.38), earplug earphones ( OR =1.37), and quiet use >1 h ( OR =1.50) were independently influenced with symptoms of hearing impairment during/after earphone use( P <0.05).@*Conclusion@#High usage rates of personal audio equipment among high school students lead to hearing impairment and related symptoms. Non essential use should be reduced.

Effects of multi-disciplinary collaborative nursing on patients with transcatheter aortic valve implantation / 中国胸心血管外科临床杂志

@#Objective     To analyze the clinical intervention effect of multi-disciplinary team (MDT) nursing mode on patients after transcatheter aortic valve implantation (TAVI). Methods     A total of 89 patients who were admitted to our hospital and underwent TAVI surgery from April to December 2021 were selected, including 64 males and 25 females, with an average age of 64.7±11.8 years. The subjects were divided into a MDT intervention group (n=42) and a control group (n=47) according to different postoperative nursing intervention methods. Clinical effectivenesses were compared between the two groups. Results     The left ventricular ejection fraction in the two groups significantly increased on the 7th day after the operation, and the increase in the MDT intervention group was more obvious, with no statistical  difference between the two groups (P=0.14). On the 7th day after surgery, forced vital capacity/predicated value and forced expiratory volume in one second/predicated value significantly decreased, and decreased more significantly in the control group than those in the MDT intervention group with statistical differences (P=0.01). The ICU stay time (P=0.01), hospital stay time (P<0.01) and total postoperative pulmonary complications rate (P=0.03) in the MDT intervention group were significantly shorter or lower than those in the control group The evaluation results of the anxiety and depression status of the patients before and after nursing intervention showed that the scores of anxiety and depression in the two groups were significantly lower than before, and the scores of each scale in the MDT intervention group were lower. The score of quality of life of the two groups significantly improved at the end of 6 months after surgery, and in the MDT intervention group it was significantly higher than that in the control group (P=0.02). Conclusion     MDT intervention mode can promote the rapid recovery of patients after TAVI, effectively reduce the risk of postoperative pulmonary complications, and improve the postoperative quality of life.

Factors for catch-up growth of 12-months low birth weight infants during the period of COVID-19 prevention and control / 上海预防医学

ObjectiveTo investigate the factors influencing the catch-up growth of 12-months low birth weight infants in Suyu District of Suqian City during the period of COVID-19 prevention and control. MethodsAll 301 low birth weight infants were selected with clustered sampling from the database under authorized use， who made their regular check-ups and follow-ups to 12 months in Suyu District of Suqian City from January 2020 to May 2021. Data were collected on infants’ basic information， their birth situation and their weight upon birth and at12 months， while maternal situation during pregnancy and the infants’ postnatal feeding and diseases were investigated with a questionnaire.Z scores were calculated. All infants were divided into the catch-up growth group and the uncompleted catch-up growth group according to whether the △Z score was ≥0.67. The influencing factors were analyzed for catch-up growth of the low birth weight infants during the period of COVID-19 prevention and control. ResultsThere were statistically significant differences in the rate of small for gestational age， preterm birth， intrauterine growth retardation， postnatal nutrition enhancement and feeding mode between the two groups. The results in the multifactor logistics regression analysis showed that intrauterine growth retardation （OR=0.070， 95%CI： 0.015‒0.327） was an obstacle factor for catch-up growth， while postnatal fortified nutrition （OR=6.518， 95%CI 1.215‒34.955） was a promoting factor for catch-up growth. ConclusionThere is catch-up growth in postnatal weight among most of the low birth weight infants. Postnatal fortified nutrition is beneficial to catch-up growth， while intrauterine growth retardation may induce uncompleted catch-up growth.

Allgrove syndrome: A case report and literature review / 中国综合临床

Objective:To discuss the clinical manifestations, diagnosis and treatment of a patient with Allgrove syndrome.Methods:Retrospective analysis of the clinical data of a patient with Allgrove syndrome admitted to Gansu Provincial People's Hospital on August 8, 2018, and review of relevant literature.Results:The patient, female, 20 years old, presented with dysphagia for 10 years and aggravated for 4 years. No tears since childhood. The upper digestive tract barium meal showed that lower esophageal stenosis, a "beak" shaped change. Esophageal manometry suggested multiple peristalsis failures. Laboratory tests showed low plasma cortisol and high ACTH. The clinical diagnosis was Allgrove syndrome. POME was performed to improve dysphagia, and hormone replacement therapy was given. The symptoms were improved after long-term follow-up.Conclusion:Allgrove syndrome is a multisystem disease. The possibility of Allgrove syndrome should be vigilant when suspicious symptoms appear. If necessary, gene detection is helpful for early diagnosis.Treatment, which focuses on the appropriate management of the manifested signs and symptoms, requires the mutual assistance of multiple disciplines.

To explore the effects of blood-letting at jing points and auricular tips on body temperature and inflammatory factors in emergency patients with coronavirus disease 2019 based on real world / 中国中西医结合急救杂志

Objective To observe the effect of exsanguination at jing points and auricular tips on antipyretic effect and inflammation factors level in patients with fever caused by coronavirus disease 2019(COVID-19).Methods A retrospective study was conducted.A total of 521 febrile patients with COVID-19 admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 1 to 10,2023 were selected as the study subjects.The patients were divided into the control group(treated with conventional treatment)and the experimental group(treated with exsanguination of jing points and auricular tips based on the control group)according to whether they received traditional Chinese medicine(TCM)exsanguination treatment.The body temperature before treatment and 30 minutes and 4 hours,24 hours after treatment,the immediate(within 30 minutes)antipyrexia efficiency,the time of body temperature returning to normal,and the levels of inflammatory factors before treatment and 48 hours after treatment were collected,and the differences between the two groups were compared.According to the standard of fever relief≥1℃within 4 hours,the differences of the average onset time of fever and the rate of fever relief at 2.5,3 and 4 hours after treatment were compared between the two groups.Kaplan-Meier curve was drawn to analyze the change of 4-hour antipyrexia rate in the two groups before and after matching.Results A total of 169 cases in the experimental group and 352 cases in the control group were finally included.Because this study was retrospective,there were significant differences in the course of disease and underlying diseases(chronic bronchitis,diabetes,renal insufficiency,hepatobiliary diseases)between the two groups at baseline(all P＜0.05).In order to reduce the differences,the above 4 factors were included in the predictor variables,and a 1∶1 propensity matching was performed to match 166 pairs of case samples,which were comparable.The result showed body temperature of the two groups gradually decreased with the extension of time,and the body temperature of the experimental group was significantly lower than that of the control group at each time point(℃:30 minutes was 38.32±0.22 vs.38.43±0.24,4 hours was 37.67±0.32 vs.38.13±0.51,24 hours was 37.03±0.38 vs.37.14±0.51,all P＜0.05),the immediate antipyrexia efficiency was significantly higher than that of the control time group[63.86%(106/166)vs.44.58%(74/166),P＜0.05],and the time of body temperature recovery to normal was significantly shorter than that of the control group(hours:19.25±7.79 vs.38.90±17.17,P＜0.05).In terms of the 4 hours antipyretic onset dynamic time,the average antipyretic onset time of the experimental group was significantly shorter than that of the control group[hours:4.39(4.11,4.68)vs.7.16(6.71,7.61),P＜0.05],the fever relief rates at 2.5,3 and 4 hours were significantly higher than those in the control group[6.63%(11/166)vs.0.60%(1/166),24.10%(40/166)vs.4.82%(8/166),74.10%(123/166)vs.38.55%(64/166),respectively,all P＜0.05].Kaplan-Meier curve analysis showed that there were statistically significant differences in 4 hours fever reduction rates between the two groups before and after matching(all P＜0.05).In terms of inflammatory factors,high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups after treatment were significantly lower than those before treatment[hs-CRP(mg/L):control group was 32.03±15.38 vs.79.78±13.34,experimental group was 33.21±16.07 vs.80.03±14.66;TNF-α(μg/L):control group 2.91±0.88 vs.5.09±0.95,experimental group 2.83±0.98 vs.5.10±0.87;IL-6(ng/L):control group was 96.30±48.12 vs.206.48±56.70,experimental group was 94.01±45.13 vs.202.38±55.38,all P＜0.05],but there was no significant difference in the levels of the above indicators between the two groups after treatment.Conclusion Exsanguination at the jing points and auricular tips has a good antipyretic effect in the treatment of fever caused by COVID-19,which can accelerate the antipyretic time,improve the antipyretic efficiency,and reduce the level of inflammatory factors.

Analysis of clinical characteristics and prognosis of newly-treated acute lymphoblastic leukemia patients with MLL-AF4 fusion gene-positive / 白血病·淋巴瘤

Objective:To investigate the development of MLL-AF4 fusion gene-positive in newly-treated acute lymphoblastic leukemia (ALL) and to analyze the clinical characteristics and prognosis of patients with MLL-AF4 fusion gene-positive ALL.Methods:The clinical data of 455 patients with primary newly-treated ALL from February 2010 to February 2021 in Zhumadian Central Hospital were retrospectively analyzed. Fluorescence in situ hybridization was used to detect the presence of MLL gene rearrangement, and multiplexed nested reverse transcription polymerase chain reaction was used to detect the development of MLL-AF4 fusion gene-positive, and to compare the clinical characteristics and prognosis of patients with positive and negative MLL-AF4 fusion gene.Results:Among 455 patients with primary newly-treated ALL, 30 cases (6.6%) were positive for MLL gene rearrangement, including 21 positive for MLL-AF4 fusion gene (MLL-AF4 positive group), 6 cases positive for MLL-ENL fusion gene, 2 cases positive for MLL-AF9 fusion gene, and 1 case positive for MLL-AF10 fusion gene. A total of 60 ALL patients without any detection of fusion gene during the same period were randomly selected as the MLL-AF4-negative group. The proportion of those with hepatomegaly or splenomegaly, central nervous system (CNS) invasion, and the median peripheral blood leukocyte count and median peripheral blood na?ve cells absolute value in the MLL-AF4-positive group were higher than those in the MLL-AF4-negative group (all P < 0.05). The complete remission rates on day 15 of chemotherapy were 81.0% (17/21) and 90.0% (54/60), respectively in the MLL-AF4-positive group and MLL-AF4-negative group ( χ2 = 0.49, P = 0.484), and the cumulative relapse rates of 3 months were 38.1% (8/21) and 13.3% (8/60), respectively in the MLL-AF4-positive group and MLL-AF4-negative group ( χ2 = 4.56, P = 0.033). The overall survival in the MLL-AF4-positive group was worse than that in the MLL-AF4-negative group ( χ2 = 5.93, P = 0.015). Conclusions:Patients with MLL-AF4 fusion gene-positive ALL have a higher tumor load, a higher recurrence rate, a lower overall survival rate, and a poorer prognosis compared with negative patients at the initial diagnosis.