Co-word Analysis of the Current Situation of Narrative Medicine Research in China in the Past Decade / 中国医学伦理学

【Objective:】 The co-word analysis method was used to analyze narrative medical literature studied in China in the past 10 years to explore the research status in this field and lay a foundation for further research. 【Methods:】 Using "narrative medicine" as the theme term, with the limited time interval of 2013—2022 to retrieve for relevant literature in CNKI, Wanfang, and VIP databases, and include literature that meets the research standards. Bicomb2 was used to perform keyword statistics and analysis on the downloaded literature. Ucinet6.0 and Netdraw were used to draw co-occurrence analysis graphs to visualize the co-occurrence relationship between high-frequency keywords. 【Results:】 A total of 565 papers were included and 31 high-frequency keywords were extracted. The co-occurrence relationship diagrams showed that the current research hotspots of narrative medicine in China include traditional Chinese medicine, nursing, general practice, evidence-based medicine, medical ethics, hospice care, chronic diseases, cancer and other popular disciplines and diseases. Most of them were about enhancing the empathy and humanistic caring ability of medical personnel and improving doctor-patient communication to improve the doctor-patient relationship, as well as doing well in medical humanities education and cultivating narrative ability through parallel medical records and reflective writing. The research on gerontology, improving the professional identity of medical staff, integrating literature and medicine, and the impact on patients were relatively few. 【Conclusion:】 At present, narrative medicine in China has achieved many achievements in fields such as nursing, traditional Chinese medicine, general practice medicine, chronic diseases, cancer, medical humanities education, and improving doctor-patient relationships. In the future, in-depth exploration can be conducted from the use of narrative medicine in multi-disciplinary and disease fields, trying different training methods, and synchronous cultivation of teachers and students, so as to build a more comprehensive narrative medicine system.

Transcriptome profile and its partly verification of human hepatocellular carcinoma cells exposed to Yuzhizi () seed extract.

OBJECTIVE: To investigate the efficacy of Yuzhizi seed extract (FAQSE) on inhibiting the proliferation of hepatocellular carcinoma (HCC) cells in vitro and to explore the anti-HCC action mechanism of FAQSE. METHODS: Human HCC HepG2 and Huh7 cells were used to investigate the anti-HCC effect of FAQSE. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) method was used to measure cell viability. Affymetrix microarray was adopted to detect the expression of transcriptome. The differentially expressed genes (DEGs) of each cell line were identified. For co-DEGs of both cell lines, the gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were enriched using the Database for Annotation, Visualization and Integrated Discovery (DAVID), and the network analysis of protein-protein interaction (PPI) was mapped using the Retrieval of Interacting Genes/Proteins (STRING) and Cytoscape software. Some important genes in the PPI network of co-DEGs were selected to verify by quantitative real-time reverse transcription-polymerase chain reaction, Western blot and enzyme-linked immunosorbent assay. RESULTS: FAQSE decreased the viability of HepG2 and Huh7 cells. There were 211 co-upregulated and 86 co-downregualted genes in both cell lines after FAQSE treatment. The enriched GO terms of co-upregulated DEGs were primarily involved cell-cell adhesion, viral process, transcription initiation from RNA polymerase II promoter, positive regulation of transcription from RNA polymerase II promoter and actin cytoskeleton organization. The GO terms of co-downregulated DEGs were mainly enriched in the processes of SRP-dependent cotranslational protein targeting to membrane, viral transcription, nuclear-transcribed mRNA catabolic process, nonsense-mediated decay, translational initiation and rRNA processing. Main KEGG pathways of co-upregulated DEGs were endocytosis, glutathione metabolism, protein processing in endoplasmic reticulum, synaptic vesicle cycle and lysosome. The major KEGG pathways of co-downregulated DEGs were ribosome, biosynthesis of amino acids, arginine and proline metabolism, systemic lupus erythematosus and complement and coagulation cascades. The top 10 co-DEGs with high hub nodes in STRING analysis were ribosomal protein S27a, transferrin, ribosomal protein S20, ribosomal protein L9, protein phosphatase 2 regulatory subunit B alpha, transthyretin, thioredoxin reductase 1, ribosomal protein L3, ribophorin I and ribosomal protein L24. Alpha-fetoprotein (AFP) was also co-downregulated and contained in the PPI network. The mRNA and protein expression of most verified genes was consistent with the results of co-DEGs analysis. And the AFP level was significantly reduced after FAQSE treatment. CONCLUSIONS: A series of genes and pathways of HepG2 and Huh7 cells were changed after FAQSE treatment, which might be the targets of FAQSE against HCC and worthy of further study. AFP might be important one of them.

Inhibiting silence information regulator 2 and glutaminase in the amygdala can improve social behavior in autistic rats / 浙江大学学报·医学版

OBJECTIVE@#To investigate the underlying molecular mechanisms by which silence information regulator (SIRT) 2 and glutaminase (GLS) in the amygdala regulate social behaviors in autistic rats.@*METHODS@#Rat models of autism were established by maternal sodium valproic acid (VPA) exposure in wild-type rats and SIRT2-knockout ( SIRT2 -/-) rats. Glutamate (Glu) content, brain weight, and expression levels of SIRT2, GLS proteins and apoptosis-associated proteins in rat amygdala at different developmental stages were examined, and the social behaviors of VPA rats were assessed by a three-chamber test. Then, lentiviral overexpression or interference vectors of GLS were injected into the amygdala of VPA rats. Brain weight, Glu content and expression level of GLS protein were measured, and the social behaviors assessed.@*RESULTS@#Brain weight, amygdala Glu content and the levels of SIRT2, GLS protein and pro-apoptotic protein caspase-3 in the amygdala were increased in VPA rats, while the level of anti-apoptotic protein Bcl-2 was decreased (all P<0.01). Compared with the wild-type rats, SIRT2 -/- rats displayed decreased expression of SIRT2 and GLS proteins in the amygdala, reduced Glu content, and improved social dysfunction (all P<0.01). Overexpression of GLS increased brain weight and Glu content, and aggravated social dysfunction in VPA rats (all P<0.01). Knockdown of GLS decreased brain weight and Glu content, and improved social dysfunction in VPA rats (all P<0.01).@*CONCLUSIONS@#The glutamate circulatory system in the amygdala of VPA induced autistic rats is abnormal. This is associated with the upregulation of SIRT2 expression and its induced increase of GLS production; knocking out SIRT2 gene or inhibiting the expression of GLS is helpful in maintaining the balanced glutamate cycle and in improving the social behavior disorder of rats.

LncRNA Gm13568 regulates the activation of A1 astrocytes and affects the EAE process in mice / 中华微生物学和免疫学杂志

Objective:To investigate the effects of long non-coding RNA (lncRNA) Gm13568 on the activation of A1 astrocytes and the progress of experimental autoimmune encephalomyelitis (EAE) in mice.Methods:A recombinant lentiviral vector (LV-Inhibit-Gm13568) carrying astrocyte-specific promoter of glial fibrillary acidic protein (GFAP) was established to inhibit the function of endogenous Gm13568. A control vector (LV-ctrl) was established as well. The recombinant vectors were packaged. C57BL/6 mice were injected with 1×10 7 transforming units of viral suspension via the tail vein and 7 d after the injection, myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55) was used to establish the mouse model of EAE. Four groups, PBS group, EAE group, LV-ctrl+ EAE group and LV-Inhibit-Gm13568+ EAE group, were included in this study. Clinical signs of the mice were monitored daily in a double-blinded manner. The mice were sacrificed 23 d after the EAE model was established and the spinal cord tissues were collected. The expression of Serping 1, C3, Srgn and H2-T23 at mRNA level was detected by real-time PCR. Changes in the expression of IL-6, TNF-α, macrophage chemotactic protein-1 (MCP-1) and interferon-inducible protein-10 (IP-10) were measured. Western blot was used to investigate the expression of GFAP and Notch1 in spinal cord tissues and the phosphorylation of signal transduction and transcription activator 3 (STAT3). The expression of Notch1 intracellular domain (NICD) and GFAP in spinal cord tissues was detected by immunofluorescence. Furthermore, the infiltration of inflammatory cells and the demyelination of spinal cord were observed using HE and Luxol fast blue (LFB) staining methods. Results:Compared with PBS group, A1 astrocytes were activated and Notch1 expression was significantly up-regulated in EAE group and LV-ctrl+ EAE group. The clinical score of mice in LV-Inhibit-Gm13568+ EAE group was decreased from an average score of 3.5 to less than 1 on 23 d after antigen induction and the clinical symptoms were alleviated as compared with the mice in LV-ctrl+ EAE group. Meanwhile, the activation of A1 astrocytes was down-regulated, and the production of inflammatory cytokines and chemokines was also reduced. The expression of Notch1, GFAP and NICD at protein level and the phosphorylation of STAT3 were significantly reduced. Moreover, the infiltration of inflammatory cells and demyelination of spinal cord tissues were alleviated significantly.Conclusions:LncRNA Gm13568 might regulate the activation of A1 astrocytes via the Notch1/STAT3 pathway, thus affecting the production of inflammatory cytokines and chemokines and participating in the process of EAE.

Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-course methotrexate for low-risk gestational trophoblastic neoplasia: a multi-centric randomized clinical trial / 医学前沿

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

SARS-CoV-2 mRNA vaccines induce a greater array of spike-specific antibody isotypes with more potent complement binding capacity than natural infection

Antibodies (Abs) are essential for the host immune response against SARS-CoV-2, and all the vaccines developed so far have been designed to induce Abs targeting the SARS-CoV-2 spike. Many studies have examined Ab responses in the blood from vaccinated and infected individuals. However, since SARS-CoV-2 is a respiratory virus, it is also critical to understand the mucosal Ab responses at the sites of initial virus exposure. Here, we examined plasma versus saliva Ab responses in vaccinated and convalescent patients. Although saliva levels were significantly lower, a strong correlation was observed between plasma and saliva total Ig levels against all SARS-CoV-2 antigens tested. Virus-specific IgG1 responses predominated in both saliva and plasma, while a lower prevalence of IgM and IgA1 Abs was observed in saliva. Antiviral activities of plasma Abs were also studied. Neutralization titers against the initial WA1 (D614G), B.1.1.7 (alpha) and B.1.617.2 (delta) strains were similar but lower against the B.1.351 (beta) strain. Spike-specific antibody-dependent cellular phagocytosis (ADCP) activities were also detected and the levels correlated with spike-binding Ig titers. Interestingly, while neutralization and ADCP potencies of vaccinated and convalescent groups were comparable, enhanced complement deposition to spike-specific Abs was noted in vaccinated versus convalescent groups and corresponded with higher levels of IgG1 plus IgG3 among the vaccinated individuals. Altogether, this study demonstrates the detection of Ab responses after vaccination or infection in plasma and saliva that correlate significantly, although Ig isotypic differences were noted. The induced plasma Abs displayed Fab-mediated and Fc-dependent functions with comparable neutralization and ADCP potencies, but a greater capacity to activate complement was elicited upon vaccination.

Role of IgM and IgA Antibodies to the Neutralization of SARS-CoV-2

SARS-CoV-2 has infected millions of people and is on a trajectory to kill more than one million globally. Virus entry depends on the receptor-binding domain (RBD) of the spike protein. Although previous studies demonstrated anti-spike and -RBD antibodies as essential for protection and convalescent plasma as a promising therapeutic option, little is known about the immunoglobulin (Ig) isotypes capable of blocking virus entry. Here, we studied spike- and RBD-specific Ig isotypes in plasma/sera from two acutely infected and 29 convalescent individuals. Spike- and RBD-specific IgM, IgG1, and IgA1 antibodies were produced by all or nearly all subjects at varying levels and detected at 7-8 days post-disease onset. IgG2, IgG3, IgG4, and IgA2 were also present but at much lower levels. All samples also displayed neutralizing activity. IgM, IgG, and IgA were capable of mediating neutralization, but neutralization titers correlated better with binding levels of IgM and IgA1 than IgG.

Identification of Chemical Constituents in Fengliaoxing Fengshi Dieda Wine / 中国药房

OBJECTIVE：To identify t he chemical constituents of Fengliaoxing fengshi dieda wine. METHODS ：An ultra-high performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry （UPLC-Q-Exactive- MS）technique was used for identifying chemical constituents of Fengliaoxing fengshi dieda wine. The determination was performed on Thermo Accucore aQ RP 18 column with mobile phase consisted of 0.1％ formic acid-methanol （gradient elution ）at the flow rate of 0.3 mL/min. The column temperature was 30 ℃，and the sample size was 2 μL. HESI source was adopted，ion mode was positive and negative ion mode ，nitrogen as sheath gas and auxiliary gas. The positive ion mode had spray voltage of 3.5 kV， capillary heating temperature of 350 ℃，sheath gas pressure of 35 psi，auxiliary gas pressure of 15 arb，and ion source heating temperature of 320 ℃. The negative ion mode had spray voltage of 3.2 kV，capillary heating temperature of 350 ℃， sheath gas pressure of 35 psi，auxiliary gas pressure of 15 arb，and ion source heating temperature of 300 ℃. The mass axis was calibrated by external standard method （mass error less than 5 ppm）. The scanning range of the first mass spectrometry was m/z 80.0-1 200.0 （the resolution was 70 000），the scanning range of secondary mass spectrometry was m/z 80.0-1 200.0（the resolution was 17 500），and the collision voltage was 20，40，60 eV. Retrieved from CNKI ，VIP，PubMed and other database ，the chemical constituents information of each Chinese traditional medicine in Fengliaoxing fengshi dieda wine were collected to establish chemical constituents database. The structure of the compounds was identified on the basis of above constituents database ，the relevant literature ，retention time of reference substance and MS fragmentation regularity. RESULTS & CONCLUSIONS ： Fifty-nine compounds were identified in Fengliaoxing fengshi dieda wine ，including 12 flavones（e.g. neoeriocitrin ，hesperidin.），8 alkaloids （e.g. baogongteng C or erycibellin ， ephedrine，pseudoephedrine）， 9 organic acids （e.g. chlorogenic acid ， cryptochlorogenic acid ，neochlorogenic acid ），7 coumarins（e.g. xanthotoxol）， 4 esters， 4 amino acids ， and 15 other categories（including volatile oils ，terpenes，amides）. UPLC- 5103YX11SF37（17）] Q-Exactive-MS technology can quickly and accurately identify the chemical constituents in Fengliaoxing fengshi dieda wine.

Regulatory effects of sphingosine kinase-2 on astrocyte function and EAE progression in mouse model / 中华微生物学和免疫学杂志

Objective:To investigate the regulatory effects of sphingosine kinase-2 (SphK2) on the function of activated astrocytes and the progression of experimental autoimmune encephalomyelitis (EAE) in mice.Methods:Primary mouse astrocytes were isolated from wild-type (WT) C57BL/6 mice and sphk2 gene knock-out ( sphk2 -/-) mice and stimulated in vitro with interleukin 17 (IL-17). Real-time PCR was used to measure the expression of inflammatory cytokines and chemokines at mRNA levels. Western blot and immunofluorescence were used to detect the expression of glial fibrillary acidic protein (GFAP) and the phosphorylation of signal transducer and activator of transcription 3 (p-STAT3). An EAE mouse model was constructed using myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55) polypeptide. Western blot was used to detect the expression of GFAP and p-STAT3 at protein level and real-time PCR was used to detect the expression of inflammatory cytokines and chemokines at mRNA level in spinal cords. Hematoxylin-Eosin (HE) and Luxol fast blue (LFB) staining were used to observe the changes in inflammatory cell infiltration and demyelination in spinal cords. Results:Compared with the WT group, the phosphorylation of STAT3 was obviously reduced in in vitro activated mouse astrocytes of sphk2 -/- mice, and the expression of inflammatory cytokines and chemokines including monocyte chemotactic protein 1 (MCP-1), TNF-α and IL-6 at mRNA level was also significantly decreased. Compared with the WT EAE group, changes in the above-mentioned cytokines and relative proteins in sphk2 -/- EAE mice in vivo were similar to those in vitro. Moreover, inflammatory cell infiltration and demyelination were significantly reduced in spinal cords of sphk2 -/- EAE mice. However, no significant difference in in vitro or in vivo GFAP expression was observed between WT and sphk2 -/- mice. Conclusions:SphK2 might regulate the function of reactive astrocytes through STAT3 molecular pathway, thereby regulating the production of inflammatory cytokines and chemokines and participating in the pathological process of EAE.

Effect of serum vitamin A and E on children with recurrent respiratory tract infection based on propensity score matching / 中国医师杂志

Objective:To explore the association between vitamin A, E and recurrent respiratory tract infections (RRTIs) in children.Methods:1 853 children with RRTIs and 2 695 health children were separately selected as cases and controls. Propensity score matching (PSM) analysis were conducted to reducing confounding bias between groups. Blood samples were collected to measure serum levels of vitamins A and E by high performance liquid chromatographie (HPLC). Paired logistic regression was used to determine odds ratios ( OR) and 95% confidence intervals ( CI) to evaluate the association of RRTIs with the serum levels of vitamin A and E. Results:After propensity score estimation and 1∶1 matching, the study cohort included 1 507 cases with RRTIs and 1 507 health children as controls. The main characteristics between the two groups were all not significantly different after matching ( P>0.05). The average levels of vitamin A in two groups were different ( P<0.05). Paired logistic regression analysis showed that greater serum levels of vitamin A had a lower risk of RRTIs ( OR=0.46, 95% CI: 0.22-0.98), similarly, deficiency of vitamin A would also increase the risk of RRTIs ( OR=1.18, 95% CI: 1.00-1.38). The statistical difference was not found between VitE and RRTIs ( P>0.05). Conclusions:The serum levels of vitamin E didn′t have a statistically significant association with RRTIs. However, we observed an obvious association between vitamin A and RRTIs. Hence vitamin A clinical monitoring and supplementation are vital for preventing and treating RRTIs.

Practice and reflections on the teaching reform of Experimental Traditional Chinese Medicine guided by scientific research cases / 中华医学教育探索杂志

Experimental Traditional Chinese Medicine is an emerging discipline that plays an important role in cultivating innovative talents of traditional Chinese medicine (TCM). In recent years, with the rapid development of TCM and the new requirements of positioning, and also combined with the college students' cognitive characteristics, we have revised and republished the "Experimental TCM" (Third Edition) textbook, which focuses on introducing knowledge by adopting relevant scientific research cases. This test book was used in the teaching of undergraduates of batch 2013 in the eight-year program in Shanghai University of Traditional Chinese Medicine. After-class questionnaires showed that this teaching mode, guided by scientific research case, is not only helpful for students to develop their quality and ability of adopting modern experimental methods initially in the study and development of TCM, but also able to spread the great achievements of TCM researches. The teaching mode is also conducive to enhancing students' sense of responsibility for the modernization of TCM. Therefore, it is suggested that the course of Experimental TCM should be promoted in the colleges and universities of TCM.

Application and evaluation of moral education materials of scientific research cases in the teaching of Experimental Traditional Chinese Medicine / 中华医学教育探索杂志

Objective:To evaluate the teaching effect of moral education materials implied in scientific research cases in the teaching of "Experimental Traditional Chinese Medicine (TCM)".Methods:The moral education materials implied in scientific research cases of "Experimental TCM" were extracted and skillfully integrated into the teaching of professional knowledge. A questionnaire survey was conducted with questions as "whether it is good to demonstrate the potential humanistic spirit by case teaching, whether this helps improve your interest in science and whether this teaching form affects your study, life and work attitude in the future" "Ten specific items from scientists' moving deeds that touch students and their recognitions" to assess the teaching effect.Results:95.8 percent of students affirmed this teaching form and thought it helped improve their interest in scientific exploration. 87.5 percent of students considered the humanistic spirit would affect their study, life and work in the future. 77.1-89.6 percent of students held a positive attitude to the ten items derived from the scientists' moving stories. Among these items, the percentages of the two items, "the spirit of being able to endure loneliness, work hard to make contributions selflessly without seeking for rewards or reputations" and "having respect forpeople and their scientific research achievements with courage to challenge the authorities of scientific research" are the lowest and highest, respectively.Conclusion:It is good to apply the moral education materials implied in the scientific research cases in the teaching of "Experimental TCM", which basically achieves the teaching goal, but there is still room for improvement.

Tropisms of rAAV2, 6, 8, 9 serotypes for intravitreal injection in the mouse retina / 中华实验眼科杂志

Objective:To compare the tropism of different adeno-associated virus (AAV) serotypes in retinal cells.Methods:The plasmids pFastBacDual-inCap and pFastBacDual-ITR-CMV-EGFP were constructed for AAV packaging with the baculovirus expression system.Recombinant adeno-associated virus type 2(rAAV2), 6, 8 and 9 serotypes were packaged, and the infectivity of rAAV was evaluated by infecting HEK293T cells at multiplicity of infection(MOI)2000.Twenty-five C57BL/6 mice were divided into five groups, with five mice per group.In the three experimental groups, both eyes of each mouse were injected 1 μl rAAV intravitreally, and 1 μl phosphate buffered saline (PBS) for the eyes of the control group.Two weeks after injection, the retinal tissues were collected for preparing flat mounts and cryosections.Enhanced green fluorescent protein (EGFP) gene expression was observed via fluorescence microscopy and laser scanning confocal microscopy.The study protocol was approved by the Ethics Committee of Suzhou Institute of Biomedical Engineering and Technology.Results:The infection efficiency of the recombinant virus to HEK293T cells was rAAV2>rAAV6>rAAV8>rAAV9, and the transduction efficiency was 39.5%, 18.4%, 8.7% and 4.6%, respectively.In mouse retinal transduction, rAAV2 and rAAV6 were highly expressed in the ganglion cells, and rAAV8 and rAAV9 were highly expressed in the retinal pigment epithelium (RPE) and photoreceptor cells.rAAV2-mediated EGFP expression in retinas was stable within three months after injection.Conclusions:Different rAAV serotypes have varying tropism and transduction efficiencies in retinal cells through intravitreal injection, rAAV2 has a high transduction efficiency and it can be stably expressed in retinas within three months after injection.

Co-word analysis of current researches on pediatric nursing teaching in China / 中华医学教育探索杂志

Objective@#To investigate the current development status quo of child healthcare by analyzing Chinese literatures on pediatric nursing teaching published over the recent five years via co-word analyzing method.@*Methods@#Literatures published between 2013-2017 and had subject headings including "pediatrics", "nursing" and "teaching" were retrieved from the Chinese National Knowledge Integrated Database, VIP website and Wanfang Data; all included literatures were analyzed via Bicomb 2; keyword co-occurrence diagram was drawn using Ucinet 6.0 and Netdraw to visualize the co-occurrence relations among high-frequent words.@*Results@#A total of 396 literatures were included and 29 high-frequency keywords were extracted. Results showed that studies on pediatric nursing teaching in China focused on the teaching mode reform, especially PBL teaching method, CBL teaching method, situational simulation teaching method, clinical pathway teaching method, etc.; literatures on undergraduates, higher vocational education and teaching quality evaluation were more than those on secondary vocational education, experimental teaching and humanistic care.@*Conclusion@#Researches about pediatric nursing have made some progress in teaching reform, teaching quality evaluation and undergraduate education in China. In the future, we can further explore appropriate teaching mode for each part, and attach more attention to researches on secondary vocational education, experimental teaching and humanistic care teaching.

Co-word analysis of current researches on pediatric nursing teaching in China / 中华医学教育探索杂志

Objective To investigate the current development status quo of child healthcare by analyzing Chinese literatures on pediatric nursing teaching published over the recent five years via co-word analyzing method. Methods Literatures published between 2013-2017 and had subject headings including "pediatrics", "nursing" and "teaching" were retrieved from the Chinese National Knowledge Integrated Database, VIP website and Wanfang Data; all included literatures were analyzed via Bicomb 2; keyword co-occurrence diagram was drawn using Ucinet 6.0 and Netdraw to visualize the co-occurrence relations among high-frequent words . Results A total of 396 literatures were included and 29 high-frequency keywords were extracted. Results showed that studies on pediatric nursing teaching in China focused on the teaching mode reform, especially PBL teaching method, CBL teaching method, situational simulation teaching method, clinical pathway teaching method, etc.; literatures on undergraduates, higher vocational education and teaching quality evaluation were more than those on secondary vocational education, experimental teaching and humanistic care. Conclusion Researches about pediatric nursing have made some progress in teaching reform, teaching quality evaluation and undergraduate education in China. In the future, we can further explore appropriate teaching mode for each part, and attach more attention to researches on secondary vocational education , experimental teaching and humanistic care teaching.

Psychological assessment and hierarchical management for non-psychiatric inpatients at general hospitals / 中华医院管理杂志

Early intervention contributes to improving patient experience and doctor-patient relationship in the case of non-psychiatric outpatients with psychological problems.The authors studied the psychological assessment and hierarchical management for non-psychiatric inpatients at a general hospital. Measures taken include establishing multi-disciplinary and inter-department teams, building an intra-hospital joint-action system, and implementing the psychological assessment and hierarchical management for non-psychiatric inpatients.These efforts explored ways for a general hospital in psychological counseling, offering humanistic service, and transformation of medical pattern.

The expression and significance of Tipα and PTEN in gastric cancer / 中国医师杂志

Objective To investigate the correlation between tumor necrosis factor-α inducing protein (Tipα),phosphatase and tensin homologue deleted onchromosome ten (PTEN) and gastric cancer.Methods To detecte the relative quantification of Tipα and lost phosphatase gene of tenth chromosome PTEN in gastric cancer,paracancerous tissues and normal gastric tissues by real-time quantitative polymerase chain reaction (RT-qPCR) technique.Results (1) The expression levels of Tipα and PTEN in gastric cancer,paracancerous tissues and normal gastric tissues were 0.83 ± 0.07,0.16 ± 0.10,0.10 ± 0.12,0.23 ±0.05,0.92 ±0.07,1.84 ±0.13,respectively.Comparison of gastric cancer with paracancerous tissues and normal gastric tissue,there were significant statistical differences(P ＜0.05).(2) The expression levels of Tipα and PTEN in low and well differentiated gastric carcinoma were1.10 ± 0.04,0.36 ± 0.05,0.08 ± 0.05,0.36 ± 0.04,respectively,both of which are significantly associated with the degree of differentiation of gastric cancer(P ＜ 0.05);The expression levels of Tipα and PTEN in gastric cancer tissues with or without lymph node metastasis were 0.18 ±0.12,0.82 ±0.09,0.10 ±0.12,0.38 ±0.10,both had significant correlation with lymph node metastasis of gastric cancer(P ＜ 0.05);The expression of PTEN in gastric cancer tumor node metastasis (TNM) Ⅰ-Ⅱ and Ⅲ-Ⅳ were 0.25 ±0.04,0.06±0.07,which means PTEN was significantly correlated with gastric cancer TNM staging(P ＜ 0.05).(3) The expressions of Tipα and PTEN were negatively correlated in gastric cancer tissues (r =-0.883,P ＜ 0.05).Conclusions (1) Tipα may be a cancer-promoting factor;PTEN maybe a tumor suppressor factor;(2) There is a negative correlation between the expression of Tipα and PTEN in gastric carcinoma.

Clinical research progress on cervical persistent human papillomavirus infection / 国际生物医学工程杂志

Cervical cancer is a common malignant tumor of women,which is caused by human papillomavirus(HPV) infection especially high risk HPV infection(HR-HPV).According to the statistics from the World Health Organization (WHO),the incidence and fatality rate of cervical cancers are obviously rising and getting younger in resent years,which seriously threatens the health of women.In China,the mortality of cervical cancer is the first in the female reproductive tract malignant tumor.Although cervical cancer screening has received more and more attention,which reduces the risk of cervical cancer,it does not prevent the necessary factors of cervical cancer,i.e.the HPV infection.Therefore,effective prevention and treatment methods are urgently needed to control the occurrence and development of HPV infection.Both Chinese and Western medicine have made significant progress in the treatment of persistent HPV infection,and they have own advantages and can complement each other.The combination of Chinese and Western medicine is expected to be an effective way to treat cervical persistent HPV infection.

Effects of angiogenic factors on lung development in rats with congenital esophageal atresia / 国际儿科学杂志

Objective To investigate the gene expression of Efnb2 and Ephb4 in the lung tissue of congenital esophageal atresia and tracheoesophageal fistula(EA-TEF) rat,and to explore the effect on lung development in EA rat.Methods Twenty-four female Wistar rats were randomly divided into experimental group(EATEF group)and control group(CON group)with 12 rats in each group.Adriamycin(ADR)-treated rats were established by intrapedtoneal injection of adriamycin at 1.75 mg / kg on day E7-9.The rats were sacrificed by caesarean on day 15 (E15),day 18 (El8) and day 21 (E21).The expression of Ephb4 and Efnb2 in fetal lung was detected by Q-PCR and immunohistochemistry.Results (1) It showed significantly higher mRNA expression levels of Efnb2 at the canalicular stage,which decreased and returned to pseudoglandular level at the sacular stage.The trend of Ephb4 mRNA and Efnb2 mRNA in the two groups was basically the same.The expression of Efnb2 mRNA in EA-TEF group(50.65 ± 12.65) was significantly higher than that in control group(23.63 ± 11.31) at the canalicular stage (P ＜ 0.05),but there was no statistical significance between the two groups at both pseudoglandular stage and sacular stage;The expression of Ephb4 mRNA in EA-TEF group (4.32 ± 2.88) was significantly higher than that in control group (1.01 ± 0.19) at the pseudoglandular stage (P ＜ 0.05),but there was no statistical significance between the two groups at both canalicular stage and sacular stage.(2)Efnb2 and Ephb4 proteins were expressed on the surface of vascular epithelium,alveolar and bronchial epithelium at different developmental stages,and there was no statistical significance in the distribution pattern.The expression of Efnb2 (162.70 ± 10.04) and Ephb4 (152.20 ± 12.32) in EA-TEF group was enhanced at the canalicular stage,while returned to normal level at the sacular stage.Conclusion The angiogenesis factor Efnb2 and its receptor Ephb4 can regulate the branching development of fetal lung tissue,which maybe a compensatory mechanism for pulmonary dysplasia in adriamycin-induced EA-TEF model.

Protective effect of tanshinone ⅡA sodium sulfonate on skeletal muscle after exhaustive exercise in high temperature environment / 重庆医学

Objective To analyze the protective effect of tanshinone Ⅱ A sodium sulfonate on rat skeletal muscle after exhaustive exercise in high temperature environment.Methods Ninety rats were divided into the observation group,blank group and control group,30 cases in each group.The rats in the blank group received no intervention,while which in the observation group and control group received the exhaustive exercise intervention under high temperature environment.The rate in the control group was injected with 8 mg/kg normal saline by femoral vein at 5 h after exhaustive exercise under high temperature environment,while which in the observation group was injected with 40 mg/kg tanshinone Ⅱ A sodium sulfonate by femoral vein.The arterial blood in each group was collected by tail vein before killing the rat,and the right leg gastroc nemius muscle of each group was removed and frozen.The serum CK,LDH activity,TNF-alpha,IL-6,IL-1β,MDA,SOD and GSH-PX levels in skeletal muscles were examined.The rat skeletal muscle samples were conducted the HE staining for observing the morphological change.Results The levels of serum TNF-α,IL-6 and IL-1β and activity of CK and LDH in the observation group were significantly lower than those in the control group,while higher than those in the blank group,the difference was statistically significant (P＜0.05).The skeletal muscle MDA,SOD and GSH-PX levels had statistical difference between the observation group and other two groups (P＜0.05).The skeletal muscle structure was disordered,and the distribution of muscle nuclei was uneven.The structure of rat skeletal muscle in the blank group was normal,and the muscle nuclei were evenly distributed.The morphology and structure of skeletal muscle in the observation group were normal,but the distribution of muscle nuclei was slightly uneven.Conclusion Tanshinone Ⅱ A sodium sulfonate can effectively protect skeletalmuscle after exhaustive exercise inhigh temperature environment.