[Protective effect of ophiopogonin D against isoproterenol-induced cardiomyocyte injury and targets].

This study aims to unveil the effect of ophiopogonin D(OPD) on isoproterenol(ISO)-induced apoptosis of rat cardiomyocytes and the possible targets, which is expected to provide clues for further research on the myocardial protection of ophiopogonins. Cell count kit-8(CCK-8) assay was used to detect viability of cells treated with OPD and ISO, Western blot to examine the effect of OPD and ISO on the expression of endoplasmic reticulum stress-related Bip, Bax, Perk, ATF4, caspase-12, and CHOP, flow cytometry to determine cell apoptosis rate, and Hoechst 33258 and Tunel staining to observe cell apoptosis and morphological changes. In addition, the probe for calcium ion-specific detection was employed to investigate calcium ion release from the endoplasmic reticulum, and OPD-bond epoxy-activated agarose solid-phase microspheres were prepared and used as affinity matrix to capture OPD-binding target proteins in H9 c2 cell lysate. For the target proteins of OPD identified by high-resolution mass spectrometry, the related signal pathways were enriched and the potential targets of OPD against cardiomyocyte injury were discussed. The experimental result showed that 10 µmol·L~(-1) ISO can significantly induce the expression of endoplasmic reticulum stress-related proteins and promote cell apoptosis. Different concentration of OPD can prevent the damage of myocardial cells caused by ISO. According to mass spectrometry results, 19 proteins, including Fam129 a and Pdia6, were involved in multiple signaling pathways such as the unfolded protein reaction bound by the ERN1 sensor, tricarboxylic acid cycle, and Nrf2 signal transduction pathway. The above results indicate that OPD protects cardiomyocytes by regulating multiple signaling pathways of target proteins and affecting cell cycle progression.

Residents' perception of duty hour limits through teaching hospital accreditation status-experience in Taiwan.

Residents' work overload is a rising issue in Taiwan. Duty hours of the residents in the United States have been limited by the Accreditation Council for Graduate Medical Education Common Program Requirements since 2003; similar standards were not implemented in Taiwan until 2013. Taiwanese duty hour standards are the work hour limits adopted as part of the required teaching hospital accreditation status. In January 2015, the Ministry of Health and Welfare conducted a national survey for all house officers in Taiwan. We collected data including those on demographics and perceptions of residents regarding duty hour limits. Most respondents reported positive perceptions of the duty hour standards. They felt that these limits will improve resident education, quality of life, and patient safety. The strong incentive to follow the regulations (through teaching hospital accreditation) could help protect residents (and patients) from unsafe working conditions. However, further studies on the influence of shortened duty hour on professional development are necessary for future improvement.

[Effect of electro-acupuncture at Neiguan (PC6) and Lieque (LU7) on the expression of protein kinases in cardiomyocytes of myocardial ischemia rats].

OBJECTIVE: To study the effect of electro-acupuncture (EA) at Neiguan (PC6) and Lieque (LU7) on the expression of protein kinases in cardiomyocytes of myocardial ischemia (MI) rats. METHODS: Healthy male SD rats were randomly divided into the control group, the model group, the Neiguan point group, the Lieque point group, and the non-meridian non-acupoint group, 10 in each group by random digit table. The MI rat model was established by injecting isoprenaline hydrochloride (85 mg/kg). EA at Neiguan (PC6), Lieque (LU7), and non-meridian non-acupoint were respectively performed. Changes of the expression of protein kinases [such as protein kinase A (PKA), protein kinase C (PKC), protein kinase G (PKG)] in rat cardiomyocytes were observed using Western blot. RESULTS: Compared with the control group, expression levels of PKA, PKC, and PKG increased obviously in the model group (P < 0.01). Compared with the model group, expression levels of PKA, PKC, and PKG decreased in the Neiguan point group and the Lieque point group (P < 0.01, P < 0.05). Expression levels of PKA decreased in the non-meridian non-acupoint group (P < 0.01). Compared with the Neiguan point group, expression levels of PKA, PKC, and PKG increased in the non-meridian non-acupoint group and the Lieque point group (P < 0.01, P < 0.05). Compared with the Lieque point group, expression levels of PKA, PKC, and PKG increased in the non-meridian non-acupoint group (P < 0.01, P < 0.05). CONCLUSION: EA at Neiguan (PC6) and Lieque (LU7) could decrease protein expression levels of PKA, PKC and PKG in rat myocardial cells, and the effect of acupuncture at Neiguan (PC6) was better than that obtained by EA at Lieque (LU7).

Positive benefit-risk ratio of Psoraleae Fructus: Comprehensive safety assessment and osteogenic effects in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Psoraleae Fructus (PF), the dried fruit of Psoralea corylifolia L., is a commonly used traditional medicine that has contributed to the treatment of orthopedic diseases for thousands of years in China. However, recent PF-related liver injury reports have drawn widespread attention regarding its potential hepatotoxicity risks. AIM OF THE STUDY: This study was aimed to evaluate the long-term efficacy and chronic toxicity of PF using a 26-week administration experiment on rats in order to simulate the clinical usage situation. MATERIALS AND METHODS: The PF aqueous extract was consecutively administrated to rats daily at dosages of 0.7, 2.0, and 5.6 g/kg (equivalent to 1-8 times the clinical doses for humans) for as long as 26 weeks. Samples were collected after 13, 26, and 32 weeks (withdrawal for 6 weeks) since the first administration. The chronic toxicity of PF was evaluated by conventional toxicological methods, and the efficacy of PF was evaluated by osteogenic effects in the natural growth process. RESULTS: In our experiments, only the H group (5.6 g/kg) for 26-week PF treatment demonstrated liver or kidney injury, which the injuries were reversible after 6 weeks of withdrawal. Notably, the PF treatment beyond 13 weeks showed significant benefits for bone growth and development in rats, with a higher benefit-risk ratio in female rats. CONCLUSIONS: PF displayed a promising benefit-risk ratio in the treatment and prevention of osteoporosis, a disease that lacks effective medicine so far. This is the first study to elucidate the benefit-risk balance associated with clinical dosage and long-term use of PF, thereby providing valuable insights for rational clinical use and risk control of PF.

The personality profile of excellent nurses in China: the 16PF.

In recent years, there has been growing interest in examining the relationship between personality characteristics and nursing service. Nurses' personality characteristics affect nursing quality and contribute toward success in the field of nursing, but little is known about excellent nurses' personality characteristics that promote the quality of nursing care. The purpose of this study was to identify excellent nurses' personality characteristics through comparison and examination of the characteristics between excellent and average nurses. A cross-sectional survey research was conducted with the 16PF. Data were collected from three hospitals in the People's Republic of China. The participants were comprised of a total of 159 excellent (N = 78) and average (N = 81) qualified nurses. Excellent nurses possess higher social boldness, openness to change, self-reliance, perfectionism, and lower dominance, vigilance, shrewdness than average nurses. The study revealed the personality profile of excellent nurses. Nurses may be selected, employed and trained according to the personality characteristics of excellent nurses. Thus nursing strategies should be developed and adjusted to get the right person in the right job the first time.

[Effects of L-carnosine in preventing and treating rat cataract induced by sodium selenite].

OBJECTIVE: To explore the effect of L-carnosine in preventing and treating rat cataract induced by sodium selenite. METHODS: This was an experimental study. Cataract was induced in the rats by sodium selenite. Rats were divided into 3 groups and each group has 3 ones. L-carnosine eye drops (50 g/L or 20 g/L ) and 0.9% normal saline were respectively instilled to the rat eye for 3 weeks and examined. L-carnosine was added to the medium of cultured rat cataract lens at 1.00, 0.10 and 0.01 g/L for 1 week and then examined. Cataract lens were studied by using two-dimensional electrophoresis. RESULTS: One week after instillation of L-carnosine, the scores of rat cataract were 2.22 +/- 0.65, 2.39 +/- 0.98 and 2.83 +/- 0.38 in 50 g/L, 20 g/L L-carnosine and control groups, respectively. The lesion in 50 g/L L-carnosine group was lighter than that of the control group. There was significant difference between these two groups (P = 0.013). On the 2nd and 3rd weeks, there was no difference among these three groups. After 1 week for culturing cataract lens, there was no difference between these three groups. The results of two-dimensional electrophoresis showed that the protein number was 182 and 161 in the L-carnosine and control groups, respectively. High molecular weight protein decreased and low molecular weight protein increased in L-carnosine group. CONCLUSIONS: L-carnosine at 50 g/L could restrain the development of early stage rat cataract. L-carnosine could modulate the rat lens protein in vitro, but could not affect lens cataract scores.

Lessons from the MOHW compensation pilot program on birth incidents: First step and looking forward.

OBJECTIVE: In Taiwan, the number of medical disputes and litigation has increased dramatically over the past 20 years. The seriousness of medical disputes continuing grows in clinical practice, especially in obstetricians. This study provided a possible solution to the medical dispute litigation issue. MATERIALS AND METHODS: The Ministry of Health and Welfare (MOHW) compensation program for birth incidents has been implemented since 2012 and it provided pecuniary compensation for mothers, newborns, and fetuses who got injured or died in birth-related medical incidents. We analyzed the amount and distribution of compensation, and assessed the effect of compensation on the number of medical dispute litigation. RESULTS: From 2012 to 2015, a total of 348 applications was received, 322 of which were examined by the committee. Among the examined cases, 278 were approved for compensation. The total amount of compensation had reached 266.16 million NTD (8.32 million USD). For the medical dispute litigation, a dramatic decrease in number was observed after the implementation of this compensation pilot program. CONCLUSION: Prompt compensation provided instant economic and spiritual support for patients and families. Pecuniary compensation could be an alternative choice of justice, which might encourage the injured to receive economic compensation, instead of filing a lawsuit against the physician or hospital institution. As a result, the number of dispute litigation has decreased. This indicates that the compensation program is an efficient way to improve medical dispute litigation difficulties.

Acupuncture for the Treatment of Oculomotor Paralysis: A Pilot Randomised Controlled Trial.

This study consisted of a single centre randomised controlled trial with two parallel arms: an acupuncture group (n = 20) with 27 affected eyes and a sham group (n = 20) with 23 affected eyes. Participants in the acupuncture group received acupuncture treatment once daily, three times weekly for four weeks. Participants assigned to the control group received sham acupuncture, the same protocol as that used for the acupuncture group but without insertion of needles into the skin. The primary outcome measure was the cervical range of motion (CROM) score. Secondary outcome measures were the palpebral fissure size, response rate, and adverse events. All 40 participants completed the study. In the comparison of acupuncture and sham acupuncture, a significant difference was observed between acupuncture and sham acupuncture in CROM score (21.37 ± 15.16 and 32.21 ± 19.54, resp.) (P < 0.05) and palpebral fissure size (7.19 ± 2.94 and 5.41 ± 2.45, resp.) (P < 0.05). Response rate was also significantly different in the acupuncture group (P < 0.05). No adverse events were reported in both groups in this study. In summary, it was demonstrated that acupuncture had a feasibility positive effect on oculomotor paralysis.

Endemic Variation of H9N2 Avian Influenza Virus in China.

Forty-two H9N2 subtype AIV strains were isolated from vaccinated commercial chickens in China from 2012 to 2015. Their HA genes had nucleotide sequence homology from 86.7% to 99.7%, and similarity to the classic vaccine strain was 88.6%-92.6%. A comparison was carried out with published HA genes (410 H9 strains) and whole genomes (306 strains) isolated in China during 2012-2015. Interestingly, 99.1% (448/452) of Chinese H9N2 AIV belonged to lineage h9.4.2, and 98.5% (445/452) of the viruses belonged to h9.4.2.5. Meanwhile, 99.6% (443/445) of lineage 9.4.2.5 viruses had PSRSSR↓GLF instead of PARSSR↓GLF motifs in the HA cleavage sites; 98.2% (444/452) of HA genes showed human receptor binding associated mutation Q226L. A total of 96.8% (337/348) of the viruses had three amino-acid deletions at 63-65 in the NA stalk, associated with enhanced virulence in chickens and mice; 97.1% (338/348) of M2 proteins had the S31N mutation associated with adamantane resistance in humans. Two H9 viruses isolated in this study were highly homologous to the human-origin H9N2 virus reported in 2013. The isolates were divided into four different genotypes (U, S, V, and W). Genotype S was the major one, accounting for 94.8% (330/348). Genotypes V and W were new reassortment genotypes, with genotype W recombined with the PB2 gene originating from the new wild waterfowl-like lineage. According to the cross-HI antibody titer data, HA gene evolution, and isolation history, the isolates were divided into A, B, and C antigenic groups successively. All the antigenic group viruses were found to circulate throughout China. This study emphasizes the importance of updated vaccine and strengthened veterinary biosecurity on poultry farms and trade markets.

Comparison of FGFR1 expression on lens epithelial cells between adults and fetuses.

AIM: To study the differences of fibroblast growth factor receptor 1 (FGFR1) gene on human lens epithelial cells (HLECs) of adults and fetuses. METHODS: Indirect in situ RT-PCR was adopted for detection of FGFR1 gene. The cDNA of the mRNA in the paraffin sections of fetus and adult HLEC was synthesized by reverse transcription reaction. After PCR amplification, in situ hybridization test was performed with synthesized oligonucleotide probe and relative quantification was carried out using image analysis. RESULTS: HLECs of adults and fetuses expressed FGFR1 gene, the expression level was higher in fetuses than in adults. The difference between them had significance (P<0.05). CONCLUSIONS: FGFR1 exist in HLEC and the expression is age-related, which could be one of causes of the high occurrence of post operational after-cataract in children.

Differences of bFGF gene expression in lens epithelial cells between fetuses and cataract patients.

AIM: To study the differences of basic fibroblast growth factor (bFGF) gene expression in lens epithelial cells (LECs) between fetuses and cataract patients. METHODS: In situ hybridization was used to detect bFGF mRNA in the LECs that were cultured and in tissue sections from fetuses and in the LECs from the anterior capsule of cataract patients. Image analysis was used for the relative quantitative analysis of bFGF mRNA. RESULTS: bFGF gene existed in the LECs that were cultured and in tissue sections from fetuses and in the LECs from the anterior capsule of cataract patients. The integral absorbance for the fetal cultured cells, the fetal tissue sections and the capsule membrane cells of cataract patients were 627.1±268.7, 131.5±42.8 and 79.2±26.3 respectively. The integral absorbance of fetal cultured LECs was significantly higher than that of fetal section LECs (P<0.01). The integral absorbance of cataract LECs was significantly lower than that of fetal LECs (P<0.01). CONCLUSION: The in vitro culture of LECs can improve bFGF gene expression. The bFGF gene expression in fetal LECs is significantly higher than that in cataract LECs.

[Isolation and identification of a Banna virus strain from mosquitoes in Yunnan province].

OBJECTIVE: To isolate and identify Banna virus (BAV) from mosquitoes collected in Mengla county of Yunnan province. METHODS: Mosquito samples were collected in houses and stock yards in Mengla county, 2008. Mosquitoes were homogenized and incubated onto both C6/36 and BHK21 cells. The new isolate was identified by using ELISA and RT-PCR. The sequences of segment 5, 8 and 11 of BAV were amplified by RT-PCR and determined. Phylogenetic analysis on the new BAV were performed using MEGA4 program. RESULTS: 1731 mosquitoes representing 7 species were collected with one strain of BAV isolated and identified. Phylogenetic analysis based on sequences of segment 8 showed the new isolate was closed to BAV strain isolated in Yunnan, but segment 11 sequence was closed to Vietnam strain. CONCLUSION: Results of phylogenetic analysis implied that the BAV re-assortment might have been occurred both in Chinese and Vietnam strains.

[Prospective study on the gastro-pulmonary infection route of ventilator-associated pneumonia].

OBJECTIVE: To explore the role of gastro-pulmonary infection route in the development of ventilator-associated pneumonia (VAP), so as to improve the management of VAP. METHODS: Forty-three patients who received mechanical ventilation (MV) were enrolled in the study. Intra-gastric contents were labeled with (99)mTc-DTPA. Randomized two-period crossover trial was employed to determine the radioactive level in the oropharyngeal and bronchial secretion when patients were in supine or semi-reclining position. Gastric juice, oropharyngeal secretion and tracheal lavage fluid were collected for bacterial culture every other day. Bronchoalveolar lavage fluid (BALF) was harvested from those suspected of VAP for quantitative bacterial culture. Infrequent-restriction site amplification (IRS-PCR) was employed in the identification of the identity of the bacteria from intra-gastric colonization with those causing VAP. The sIgA content in the BALF was determined. RESULTS: The gastroesophageal regurgitation rate was higher (89.7%) with lower aspiration rate (28.5%) in patients receiving MV. Moreover, the aspiration rate and the radioactivity of deep tracheal aspirates in patients in supine position were significantly higher than those in semi-reclining position (P < 0.01). There was high homology of the bacteria isolated from intra-gastric colonization with that causing VAP (55.8%). The sIgA content in BALF in VAP patients was evidently lower than that in non-VAP patients (P < 0.01). CONCLUSION: Regurgitation and aspiration of stomach contents are very common in patients receiving MV. Intra-gastric colonized bacteria might be one of the important origins causing VAP. The lowering of sIgA in BALF in patients with MV could be a risk factor for VAP.