GCNT3 regulated MUC13 to promote the development of hepatocellular carcinoma through the GSK3ß/ß-catenin pathway.

BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Extensive research is currently directed at identifying novel targets for its diagnosis and treatment. AIMS: We investigated the biological functions and clinical significance of mucin-type N-acetylglucosaminyltransferase 3 (GCNT3) in HCC. METHODS: Variations in the mRNA expression of GCNT3 were examined in normal and HCC tissues. Cell function assays and animal models characterized the effects of GCNT3 on the proliferation, invasion, and migration abilities of HCC cells. Western blot and immunofluorescence analyses were performed to explore further the specific mechanisms whereby GCNT3 affects HCC progression. RESULTS: There is a strong correlation between GCNT3 overexpression and tumor formation and metastasis in vivo and in vitro. GCNT3 acted as a regulator of the synthesis of mucin-type O-glycans by interacting with mucin 13 (MUC13) to regulate its expression levels, activating the GSK3ß/ß-catenin signaling pathway. The activation of GSK3ß/ß-catenin signaling by GCNT3 was mitigated by MUC13 knockdown. In clinical HCC specimens, GCNT3 expression was upregulated in HCC tissues compared to non-tumor tissues. Further, there was a significant correlation between high GCNT3 expression and poor patient survival. CONCLUSIONS: GCNT3 regulated tumor progression in HCC through the MUC13/GSK3-ß/ß-catenin signaling pathway.

Comprehensive Landscape of Heparin Therapy for COVID-19.

The pandemic coronavirus disease 2019 (COVID-19), caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading globally. Clinical observations found that systemic symptoms caused by SARS-CoV-2 infection are attenuated when using the anticoagulant agent heparin, indicating that heparin may play other roles in managing COVID-19, in addition to prevention of pulmonary thrombosis. Several biochemical studies show strong binding of heparin and heparin-like molecules to the Spike protein, which resulted in inhibition of viral infection to cells. The clinical observations and in vitro studies argue for a potential multiple-targeting effects of heparin. However, adverse effects of heparin administration and some of the challenges using heparin therapy for SARS-CoV-2 infection need to be considered. This review discusses the pharmacological mechanisms of heparin regarding its anticoagulant, anti-inflammatory and direct antiviral activities, providing current evidence concerning the effectiveness and safety of heparin therapy for this major public health emergency.

Value of tissue elastography in the prediction of efficacy of neoadjuvant chemotherapy in breast cancer.

PURPOSE: The purpose of the present study was to explore the value of real-time tissue elastography (RTE) in predicting the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer. METHODS: A total of 60 patients with breast cancer who received NAC in our hospital were evaluated. According to the pathological results, 47 patients were included in the significant response group and 13 patients in the non-significant response group. The maximum diameter and strain ratio (B/A ratio) of lesions before and 1st, 2nd, 4th and 6th week after NAC were recorded and compared. The RECEIVER OPERATION CHARACTERISTIC (ROC) curve of the lesion diameter and strain rate ratio (B/A value) were used to predict the value of NAC efficacy. RESULTS: The lesions in the two groups showed a honeycomb-like reduction after NAC. The blue color in the elastic image gradually decreased, and the green color gradually increased. Repeated measurement ANALYSIS OF VARIANCE (ANOVA) found that the maximum diameter and B/A value showed a downward trend within 6 weeks of NAC treatment. The maximum diameter and B/A value in the significant response group were significantly lower than the non-significant response group before and after the NAC. There was an interaction in the maximum diameter and B/A value between the significant response group and the non-significant response group. The above differences were statistically significant (all p<0.05). The AREA UNDER CURVE (AUC) of △B/A value at 2nd week of NAC was maximal (0.944), and the best diagnostic point was 5.64. The sensitivity was 92.31% and the specificity 87.23%. CONCLUSION: △B/A value at 2nd week of NAC is helpful in predicting the therapeutic effect of NAC in breast cancer.

HPV16 E6 mediates oncogenic transformation of cervical epithelial cells by downregulating DHRS2 expression / 陆军军医大学学报

Objective To explore the effects of HPV16 E6 on genes and signaling pathways in cervical epithelial cells and to screen genes associated with oncogenic transformation.Methods HUCEC models infected with HPV16 E6 were constructed,and transcriptome sequencing was performed to screen for differentially expressed genes(DEGs),which were subjected to Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment to analyze the differential signaling pathways.RT-qPCR was used to validate major differentially down-regulated expressed genes.After predicting the major differentially expressed proteins by molecular docking analysis,the expression of major differential genes in HUCEC cell model was verified by RT-qPCR and Western blotting.In addition,RT-qPCR and Western blotting were used to further verify the expression of major differential genes in cervical cancer cell lines,SiHa and CaSki.Results A total of 55 genes with more than two-fold differential expression were screened.The results centering on down-regulated genes showed that the negatively regulated differential gene was mainly enriched in redox processes;KEGG enrichment analysis revealed that it was mainly associated with carbohydrate metabolism and cancer.RT-qPCR results showed that the down-regulated differential expression trends of the selected 10 genes were basically consistent with the sequencing results.Molecular docking analysis predicted an interaction between DHRS2 and HPV16 E6,and RT-qPCR and Western blotting confirmed that HPV16 E6 down-regulated DHRS2 mRNA(P＜0.01)and protein(P＜0.05)and ETV5 protein expression(P＜0.01).In SiHa and CaSki cells,compared with the control group,the mRNA and protein expression of DHRS2 was downregulated and positively correlated with the trend of P53 protein expression(P＜0.05).Conclusion HPV16 E6 can mediate oncogenic transformation of cervical cells and promote cervical carcinogenesis through downregulating DHRS2 expression.

Pathogenic spectrum and molecular characteristics of infectious diarrhea among children in Putuo District， Shanghai / 上海预防医学

ObjectiveTo investigate the pathogenic spectrum and molecular characteristics of infectious diarrhea among children in Putuo District of Shanghai from 2018 to 2023， and to provide scientific basis for the prevention and control of infectious diarrhea in children. MethodsFecal samples from the cases visited sentinel hospitals for children’s diarrheal disease in Putuo District， Shanghai， were collected from January 2018 to December 2023. A total of 11 species of bacteria were isolated and cultured， and 5 species of viruses were detected by real-time fluorescent polymerase chain reaction （PCR）. The molecular typing of some positive strains was analyzed by the standard pulsed-field gel electrophoresis （PFGE） method. The polymerase-capsid protein linkage region of some norovirus-positive samples was amplified by reverse transcription PCR， and was sequenced and analyzed by bioinformatics software. The Chi-square test and Fisher’s exact probability test were used to compare the pathogen-positive rates in 2018‒2019 and 2020‒2023. ResultsOf the 707 cases of children with infectious diarrhea， the total positive rate was 47.67%， with a single bacterial positivity rate of 16.27%， a single viral positivity rate of 22.63%， and a mixed positivity rate of 8.77%， respectively. The dominant pathogens were rotavirus （10.75%）， norovirus （10.33%）， enteropathogenic Escherichia coli （8.06%）， Salmonella （6.36%）， enteroaggregative Escherichia coli （5.52%）， and Campylobacter （5.23%）. Bacterial infections were predominant in summer and fall， and viral infections were predominant in winter and spring. The total positive rate decreased in 2020‒2023 compared with that of 2018‒2019 （χ2=5.753，P<0.05）. Thirty-seven strains of Salmonella， 81 strains of diarrheagenic Escherichia coli， and 19 strains of Campylobacter were completed for the molecular typing analysis by PFGE， which were classified into 28， 80 and 18 banding types， respectively， with a wide range of banding similarity. Nineteen copies of norovirus GⅡ group gene sequences were analyzed and classified into 5 genotypes， which were mainly GⅡ.Pe-GⅡ.4 and GⅡ.P16-GⅡ.2 types. ConclusionRotavirus， norovirus， diarrheagenic Escherichia coli， Salmonella， and Campylobacter are the dominant pathogens of infectious diarrhea in children in Putuo District of Shanghai. The pathogen spectrum shows a trend of seasonal epidemic characteristics， with a diversity of molecular characteristics of some pathogens. Surveillance and monitoring on molecular characteristics of the pathogens of infectious diarrhea in children should be strengthened in different seasons， so as to provide a laboratory basis for the prevention and control of infectious diarrhea.

Advances in genetic etiology of isolated growth hormone deficiency / 国际儿科学杂志

Isolated growth hormone deficiency(IGHD)is a growth disorder characterized by short stature.The etiology and pathogenesis of IGHD are still not fully understood.IGHD can be caused by congenital(heredity and/or malformations)or acquired(tumors, physical trauma, inflammation, brain infections, or radiation therapy)factors.The most common genes in its genetic etiology are the growth hormone 1(GH1)and growth hormone-releasing hormone receptor(GHRHR). In rare cases, IGHD may be caused by mutations in transcription factors such as HESX1, SOX3, OTX2, POU1F1, etc.The disease phenotype of IGHD patients is highly variable.Correct diagnosis and early treatment are crucial for the long-term prognosis of IGHD patients.This review mainly discusses advance of IGHD gene mutation and disease phenotype.

Investigation of the association between sleep problems and food allergies in preschool children with/ without siblings: a cross-sectional study in Chongqing, China / 한국영양학회지

Purpose@#This study investigated the association between sleep problems and food allergies (FAs) in Chinese preschoolers and assessed whether there is a difference in this association among children with/without siblings. @*Methods@#A cluster-stratified sampling approach was employed to select four districts in Chongqing based on demographic considerations. A total of 16 kindergartens (n = 966 parents) participated in this study. Parents completed the Children’s Sleep Habits Questionnaire (CSHQ) and a standard FAs questionnaire. Analysis of covariance and multiple logistic regression were used to assess the associations between sleep problems and FAs after adjusting for relevant confounders. @*Results@#The study found that 16.3% of children had FAs, with eggs, shellfish, and fruit being the most common allergenic foods. The prevalence of FAs was significantly higher in single children (20.63%) than in children with siblings (13.36%). A total of 70.39% of children had CSHQ scores above the clinical cut-off for sleep disorder. Factor analysis revealed five underlying dimensions from the CSHQ. Factor scores, except for the ‘difficulty morning waking’ factor, were not significantly different between the two groups. Remarkably, the factor scores of ‘parasomnias’ and ‘sleep anxiety’ were significantly higher when children had both siblings and FAs. For all subjects, the odds ratios (ORs) of FAs significantly increased with the presence of sleep disorder (OR, 2.35; 95% confidence interval [CI],1.50–3.68) and ‘difficulty falling asleep’ (OR, 1.34; 95% CI, 1.22–1.48). The subgroup analysis showed that the probability of FAs significantly increased with the ‘difficulty falling asleep’ (OR, 1.32 vs. 1.38) and sleep disorder (OR, 2.48 vs. 2.14) in children with and without siblings, respectively. The ‘parasomnias’ was positively associated only with children with siblings. @*Conclusion@#This study suggests that children with siblings might be more susceptible to FAs when accompanied by certain sleep problems. Further studies are warranted to address the underlying dimensions and possible mediation effects of having siblings with sleep problems.

Diagnostic value of thin-layer three-dimensional reconstruction technology combined with personalized scanning for benign and malignant solid solitary pulmonary nodules / 中国基层医药

Objective:To investigate the diagnostic value of thin-layer three-dimensional reconstruction technology combined with personalized scanning for benign and malignant solid solitary pulmonary nodules.Methods:The clinical data of 140 patients with solid solitary pulmonary nodules admitted to Jiangshan People's Hospital form January 2020 to July 2021 were retrospectively analyzed. These patients consisted of 40 patients with benign solid solitary pulmonary nodules (benign group) and 100 patients with malignant solid solitary pulmonary nodules (malignant group). All patients underwent thin-layer three-dimensional reconstruction combined with personalized scanning. The pulmonary nodule signs achieved by thin-layer three-dimensional reconstruction combined with personalized scanning and the diagnostic performance of the combined technology were compared between benign and malignant groups.Results:The proportions of patients with lung cavity sign, lobular sign, vascular convergence sign, vacuole sign, emphysema distribution sign, split pleura sign, and distal perforating vascular sign in the malignant group were 11.0%, 81.0%, 77.0%, 49.0%, 6.0%, 10.0% and 31.0%, respectively, and they were 42.5%, 62.5%, 55.0%, 27.5%, 20.0%, 32.5%, and 5.0%, respectively in the benign group ( χ2 = 15.80, 5.00, 5.66, 4.55, 4.76, 8.96, 9.33, all P < 0.05). The most sensitive sign was lobular sign, which had the highest efficiency, up to 82.0%, in differentiating benign and malignant pulmonary nodules. Conclusion:Lung cavity sign, lobular sign, vascular convergence sign, vacuole sign, emphysema distribution sign, split pleura sign, and distal perforating vascular sign differ greatly between patients with benign and malignant solid solitary pulmonary nodules. Lobular sign has the highest sensitivity in differentiating benign and malignant solid solitary pulmonary nodules. Thin-layer three-dimensional reconstruction combined with personalized scanning has a diagnostic value for benign and malignant solid solitary pulmonary nodules.

Study of application of 3D printed oral stents in radiotherapy for head and neck malignancies / 中华放射肿瘤学杂志

Objective:To analyze the dosimetric differences between 3D printed oral stents and corked oral stents in the target area and perioral organ at risk (OAR) in radiotherapy for head and neck cancer, and the effectiveness in reducing acute adverse reactions associated with radiotherapy.Methods:A total of 58 patients with head and neck cancer admitted to Department of Oncology of Affiliated Hospital of North Sichuan Medical College were selected and divided into experimental group (Group A, n=28, wearing 3D printed oral stents during radiotherapy) and control group (Group B, n=30, wearing corked oral stents during radiotherapy) in this retrospective cohort study. The incidence of radiotherapy - induced oral mucositis (RTOM), xerostomia and oropharyngeal mucosal pain was compared between two groups. Meanwhile, informed consent was obtained from 21 patients in Group A. Using the self control method, each patient wore a 3D printed oral stent (Group C) and a corked oral stent (Group D) to make two radiotherapy plans. The differences in the conformity index (CI), homogeneity index (HI) and exposure dose of OAR (D max, D mean) in the target area were analyzed between two groups. SPSS 25.0 statistical software was used for statistical analysis. Measurement data were expressed as Mean±SD. Comparison between two groups was conducted by paired t-test or repeated measurement analysis. Count data were expressed as ratio. Comparison between two groups was performed by Chi - square test or Fisher's exact test. P<0.05 was considered as statistically significant difference. Results:The severity of RTOM ( P<0.05), oropharyngeal mucosal pain ( P=0.004) and xerostomia score ( P<0.001) in Group A were significantly lower than those in Group B. There was no significant difference in the HI and CI of the target area between Group C and Group D (both P>0.05). The D max ( P=0.014, 0.009) and D mean ( P<0.001, P=0.033) of the upper lip and the affected buccal mucosa in Group C were significantly lower than those in Group D. Conclusion:3D printed oral stents obtain favorable HI and CI in radiotherapy for head and neck cancer, significantly reduce the irradiated dose to perioral OAR, and effectively lower the incidence and mitigate the severity of acute RTOM, xerostomia and oropharyngeal mucosal pain associated with radiotherapy.

Relationship between left ventricular mass index and left ventricular myocardial work index in patients with end －stage renal disease with preserved ejection fraction / 安徽医科大学学报

Objective @#To quantitatively evaluate the left ventricular myocardial work index (MWI) of patients with end-stage renal disease (ESRD) with preserved ejection fraction using left ventricular pressure-strain loop (PSL) ， and group them according to left ventricular mass index( LVMI) ，in order to compare the effect of different LVMI levels on left ventricular MWI．@*Methods@#81 patients with stage 5 chronic kidney disease，including 43 males and 38 females，were divided into left ventricular hypertrophy group ( LVH group) ( n = 44) and non-left ventricular hypertrophy group (NLVH group) ( n = 37) according to LVMI，and 37 healthy people matched in age and sex with the ESRD groups were randomly selected as the control group．The general clinical data，conventional echocardiographic parameters，global longitudinal strain ( GLS) ，and MWI namely global work index ( GWI) ，global constructive work ( GCW) ，global wasted work ( GWW) and global work efficiency ( GWE) of the three groups were compared．The correlation between MWI and various parameters were analyzed，and the independent predictors of MWI were analyzed too. @*Result @#The results showed that there were no significant differences in age，gender，height，weight and other general clinical data as well as left ventricular ejection fraction ( LVEF) among the three groups．In two ESRD groups，GWW was higher than that in control group，GWE was lower than that in control group，and were more significant in LVH group (P＜0. 05) ．LVMI was positively correlated with GWW，and negatively correlated with GWE ，respectively ，with specific independent correlation．@*Conclusion@#GWW and GWE can detect early impairment of left ventricular systolic function in ESED patients，and myocardial function impairment in LVH group is more serious than that in NLVH group．LVMI is an independent positive factor of GWW and an independent negative factor of GWE.

Analysis of 5 ischemic stroke patients caused by pulmonary arteriovenous fistula / 中华神经科杂志

Objective:To investigate the correlation between pulmonary arteriovenous fistula (PAVF) and ischemic stroke, and to improve the diagnosis and treatment of embolic strokes of undetermined source.Methods:Five patients with ischemic stroke caused by PAVF admitted to Xiangya Hospital of Central South University from January 2017 to December 2020 were collected. The diagnosis, treatment and prognosis of stroke caused by PAVF were summarized based on literature review.Results:Among the 5 patients, 1 is male and 4 are females, with age of (34.4±9.3) years. Weakness of unilateral limb, slurred speech, vision changes, drooping eyelids, etc., were the first manifestations of stroke. The location of cerebral infarction was indefinite. In this study, 5 patients were all isolated PAVF, including 3 cases of left lower lung, 1 case of left upper lung and 1 case of right lower lung. All 5 patients underwent interventional therapy, were followed-up for 6 months and 12 months after surgery, and none of them had a new stroke attack, and only 1 case had recanalization of PAVF.Conclusions:PAVF is a rare vascular lesion, stroke caused by which is even rarer, with a lack of specificity in clinical manifestations. For young patients with unexplained embolic stroke, if the stroke has a sudden onset, the anterior and posterior circulation can be involved, and multiple vascular distribution regions are often involved, and it is difficult to find a clear emboli basis, with manifestations such as hypoxemia, PAVF should be considered. Percutaneous catheter intervention for PAVF is safe and effective, and is the preferred method for the treatment of PAVF.

Effects of Jianpi Mixture on Colonic miRNA Expression Profile in Diarrheal Irritable Bowel Syndrome Rats / 世界科学技术-中医药现代化

Objective To observe the difference in the expression of micro-ribonucleic acid(miRNA)in the colon tissue of irritable bowel syndrome-diarrhea(IBS-D)rats and rats treated with Jianpi Mixture,and predict The miRNA and corresponding genes involved in the treatment of IBS-D with Jianpi Mixture,providing a basis for finding potential therapeutic targets for IBS-D.Methods The rats were randomly divided into a blank group,a model group and a traditional Chinese medicine group,with 8 rats in each group.Both the model group and the Chinese medicine group used acute and chronic stimulation + senna leaf gavage to make the IBS-D model.The Chinese medicine group was gavaged with Jianpi Mixture after model building for 14 days.General condition,body weight and Bristol score were observed and recorded.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes of colon in each group of rats.Transcriptome sequencing of rat colon tissue in each group to screen and map differentially expressed miRNAs.Perform GO(Gene oncology)functional enrichment analysis and KEGG(Kyoto Encyclopedia of Genes and Genomes)pathway enrichment analysis on the target genes corresponding to the screened common miRNAs.Results Compared with the model group,the weight of the rats in the Chinese medicine group increased significantly(P<0.01),and the Bristol score of the feces decreased significantly(P<0.01).The pathological damage of the colon tissue of rats in the Chinese medicine group was significantly reduced.Compared with the blank group,there were 109 differentially expressed genes in the model group,of which 80 were up-regulated and 29 were down-regulated.Compared with the model group,there were 109 differentially expressed genes in the traditional Chinese medicine group,of which 19 were up-regulated and 90 were down-regulated.Mapping the genes of the two comparisons found that 74 miRNAs in the model group were increased and 7 were decreased.The changes of these miRNAs were all reversed after the intervention of traditional Chinese medicine.The GO function enrichment analysis of target genes showed that Jianpi Mixture was mainly involved in synaptic vesicle positioning and transport,cytoplasmic transport,negative regulation of growth and development,and sugar transport after acting on rats.KEGG pathway enrichment analysis showed that MAPK,Wnt,Hippo,TNF,oxygen toxin,cAMP and other pathways were enriched.Conclusion After the intervention of Jianpi Mixture,IBS-D-related miRNA expression profiles have changed significantly;Jianpi Mixture may play a protective role in the treatment of IBS-D by regulating the MAPK signaling pathway and Wnt signaling pathway.Screening the core genes and predicting the miRNAs interacting with them provide a theoretical basis for the study of the pathogenesis of IBS-D and the therapeutic targets of Jianpi Mixture.

The Effects of Banxia Xiexin Decoction on Gut Microbiota and 5-HT in DSS-UC Mice were Investigated Based on Brain-Gut Axis / 世界科学技术-中医药现代化

Objective To observe the effects of Banxia Xiexin Decoction on intestinal microbes and 5-HT in ulcerative colitis(UC)model mice induced by drinking sodium dextran sulfate(DSS),and to analyze the mechanism of Banxia Xiexin Decoction in treating UC from the perspective of brain-gut axis.Methods 40 male C57BL6/J mice were randomly divided into control group,model group,positive drug(mesalazine)group and Banxia Xiexin decoction group.All mice except control group were induced by 2.5%DSS solution for 7 days to establish UC model.From the 8th day,mice in the above groups were given intragastric administration of sterilized water,mesalazine aqueous solution and Banxia Xiexin decoction aqueous solution.HE staining was used to observe histopathological changes of colon,ELISA to detect 5-HT content in serum,colon and brain tissues,and 16S rRNA sequencing to further detect the changes of fecal flora in model mice.Results Compared with model group,DAI index of experimental mice model group was significantly decreased after Banxia Xiexin Decoction intervention(P<0.05);IL-2,IL-4 and IFN-γ were significantly recovered(P<0.05).The histopathological score of proximal and distal colon was significantly decreased(P<0.01).Moreover,the peripheral 5-HT level was significantly decreased(P<0.05),but the central had an increasing trend.Results of intestinal flora showed that the relative abundance of Clostridium_sensu_stricto_1,unclassified_p__Firmicutes increased(P<0.05),while Lachnospiraceae_NK4A136_group,Lachnoclostridium,norank_f__Oscillospiraceae and Eubacterium_xylanophilum_group decreased(P<0.05).It was also found that there were significant correlations between intestinal microflora and peripheral and central 5-HT levels.Conclusion Banxia Xiexin Decoction could play a role in treating ulcerative colitis by improving the intestinal microbial composition structure of UC mice to reduce peripheral 5-HT levels and increase central 5-HT levels,thereby improving intestinal inflammatory response and relieving anxiety.

Trend analysis of Cite Space-based research on non-suicidal self-injury / 中国实用护理杂志

Objective:To summarize the hotspots and developmental status of non-suicidal self-injury research by clustering and co-occurrence to the literature on non-suicidal self-injury on the basis of Cite Space, and in order to provide references for future research and intervention.Methods:Non-suicidal self-injury literature included in the Web of science core collection from January 1975 to August 2020 was searched, and the included literature was visualized and analyzed using Cite Space 5.5.R2 knowledge mapping software.Results:A total of 974 articles were retrieved, and the number of articles published showed an increasing trend year by year, mostly in developed countries. The country with the highest cumulative number of articles was the United States, with a total of 412 articles, and the first organization was Katholieke Univ Leuven, with a total of 42 articles. Key words co-occurrence and clustering showed that the current research focus was on adolescents, suicidal behavior, dialectical behavior therapy, and borderline personality disorder. The most cited literature was by Muehlenkamp.Conclusions:Non-suicidal self-injury research has developed rapidly in recent years. At present, non-suicidal self-injury population, related intervention measures, screening and evaluation tools, Meta-analysis and risk factor analysis are its research frontiers and hot spots.

Quantitative evaluation for payment policy of diagnosis-related groups in China based on PMC index model / 中国药房

OBJECTIVE To quantitatively evaluate the existing payment policies of diagnosis-related groups （DRGs）in China ， so as to provide reference for the formulation and improvement of policies. METHODS Totally 58 documents related to DRGs payment issued by the national and provincial medical security bureaus from 2017 to 2022 were processed by text mining method. PMC index evaluation model of DRGs payment policy was established. Nine typical DRGs payment policies were quantitatively evaluated and analyzed by 10 primary variables and 40 secondary variables. RESULTS Among the 9 policies，5 were excellent and 4 were acceptable. The average score of PMC index was 6.882. Generally ，there was still room for improvement because of the acceptable level. By comparing the two representative policies ，it was found that the main reasons was a lack of consideration in terms of supervision and management ，incentives and constraints when facing policy changes ，reason of the lower level of urban development. CONCLUSIONS Although DRGs payment policy in China is basically perfect ，there is still a lot of room for improvement in terms of extending the time limit of the policy ，summarizing and spreading the successful experience of pilot cities.

Effects of different processing methods on the contents of the pharmacodynamic index components and antioxidant activity of Citrus aurantium / 中国药房

OBJECTIVE To stu dy the effects of different processing me thods on the contents of the pharmacodynamic index components in Citrus aurantium and their antioxidant activity. METHODS According to the general principles of 2020 edition of Chinese Pharmacopoeia （volume Ⅳ） and the relevant processing methods in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province ，the samples of C. aurantium were prepared by steaming with water ，boiling with water ，stir-frying with vinegar ，stir-frying with wine ，stir-frying with bran ，processing with bran and processing with honey. The contents of moisture and ash in different products of C. aurantium were detected. The contents of naringin and neohesperidin in different products of C. aurantium were determined by high performance liquid chromatography. The antioxidant activity of different products was investigated by DPPH and ABTS + radical scavenging experiments and the total reducing power test. RESULTS The contents of moisture ，ash，naringin and neohesperidin were in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The content of naringin in descending order was as follow ： unprocessed sample ＞sample processed with honey ＞sample processed with bran ＞sample boiled with water ＞sample stir-fried with vinegar＞sample stir-fried with wine ＞sample stir-fried with bran ＞sample steamed with water. The content of neohesperidin in descending order was as follow ：unprocessed sample ＞sample boiled with water ＞sample processed with bran ＞sample processed with honey ＞sample stir-fried with vinegar ＞sample steamed with water ＞sample stir-fried with wine ＞sample stir-fried with bran. The samples after boiling with water ，processing with bran ，and stir-fried with bran had better DPPH radicals scavenging ability （IC50 were 7.49，8.37 and 10.22 mg/mL，respectively）. The samples after boiling with water ，steaming with water ，and processed with bran had better ABTS + radicals scavenging ability （IC50 were 1.76，2.03 and 2.72 mg/mL，respectively）. In addition ， compared with sample stir-fried with wine and processed with 发。E-mail：wanglu1286@163.com honey，unprocessed sample and other processed products of C.aurantium had bet ter total reducing ability. CONCLUSIONS After processing ，the contents of the main pharmacodynamic index components in C. aurantium have been reduced ，but they were also in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The antioxidant ability of some processed products has been enhanced.

Establishment and validation of population pharmacokinetic model of docetaxel in malignant tumor patients / 中国药房

OBJECTIVE To establis h and validate a population pharmacokinetic model of docetaxel in malignant tumor patients. METHODS The clinical data of malignant tumor patients treated with chemotherapy regimen containing docetaxel in our hospital from June 2019 to December 2021 were retrospectively collected . According to the results of blood concentration detection ， based on the three -compartment model the nonlinear mixed effect model （NONMEM）was used ；covariates（age，weight，height， body surface area ，Karnofsky performance scale ，total protein ，albumin，total bilirubin ，aspartate aminotransferase ，alanine aminotransferase and serum creatinine ）affecting clearance （CL）were screened by “forward inclusion and backward exclusion ”； the population pharmacokinetic model of docetaxel was established . The model was tested for goodness -of-fit diagnosis and internal validation by Bootstrap . RESULTS A total of 264 measured blood concentrations of 132 patients with malignant tumors during chemotherapy were included . The covariates that had significant effect on CL of docetaxel were serum creatinine and total bilirubin （P＜0.01）. The results of Bootstrap analysis （parameter median values and 95% confidence intervals ）were close to predict results of the established model ；the final model estimated that the population typical value of docetaxel CL was 37.82 L/h. CONCLUSIONS The population pharmacokinetic model of docetaxel in malignant tumor patients is established successfully ， which can be used for the formulation and optimization of clinical individualized regimen .

Prognostic value of a predictive model based on lower limb skin mottling score in determining the prognosis of patients with sepsis / 中国实用护理杂志

Objective:To develop and analyze the predictive value of a combined predictive model based on the lower limb skin mottling score (SMS) for the outcome of sepsis patients admitted to ICU.Methods:Using a multicenter prospective, observational study, 458 patients admitted to six ICUs in 4 grade A tertiary hospitals in Fujian Province from March 1, 2019 to December 31, 2019 with first diagnosis of sepsis were selected as study subjects. Demographic data, clinical biochemical indexes, lower limb SMS, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) were collected. Binary Logistic regression was used to analyze the outcome of patients with sepsis after admission to ICU, a joint prediction model was constructed, ROC curves were drawn, and a comparison of the predictive efficacy of the lower limb SMS and the joint prediction model was performed.Results:Logistic multifactorial regression analysis showed that lower limb SMS, SOFA score, APACHEⅡscore, lactate, mean arterial pressure were the influencing factors of outcome of patients with sepsis after admission to ICU (all P<0.05). The area under the curve of lower limb SMS predicted ICU outcome risk was 0.718 (95% CI 0.675-0.959, P<0.001) with the sensitivity of 51.96% and specificity of 85.11%. The area under the curve of predictive ability of the combined model based on the lower limb SMS for ICU outcome of sepsis patients was 0.835 (95% CI 0.762-0.878, P<0.01) with the sensitivity of 81.40% and specificity of 73.00%, the difference was significant ( P<0.05). Conclusions:The combined prediction model based on lower limb SMS can more accurately predict the prognosis of sepsis patients after admission to ICU, which can be a new nursing assessment tool for nurses to evaluate the prognosis of sepsis patients and help nurses to make more accurate clinical care decisions and reduce the morbidity and mortality rate.

Long-term outcomes of postcardiotomy patients undergoing venoarterial extracorporeal membrane oxygenation and related risk factors / 中华胸心血管外科杂志

Objective:To examine the long-term survival outcomes and identify mortality risk factors for coronary artery bypass grafting patients who received venoarterial extracorporeal membrane oxygenation(VA-ECMO) for postcardiotomy cardiogenic shock.Methods:Data from 121 consecutive venoarterial extracorporeal membrane oxygenation-treated coronary artery bypass grafting(CABG) patients at Beijing Anzhen Hospital between June 2012 and December 2016 were analyzed. There were 84 males and 24 females. The median age was 62(55, 67) years, and the median body mass index was 25(23, 27)kg/m 2. Thirty-seven patients(34%) had left main artery disease, and 56 patients(52%) underwent off-pump CABG. According to the 3 year survival outcome after ECMO, patients were divided into survival group(35 cases) and non-survival group(73 cases). The differences of clinical indicators between the two groups were compared and analyzed. Multivariable Cox regression modeling was used to identify factors independently associated with 36 month mortality. Results:Sixty-five patients(60%) could be weaned from VA-ECMO, 49 patients(45%) survived to hospital discharge, and 35 patients(32%) survived to 3 years. The median( IQR) time on VA-ECMO support was 4(3, 5) days. The median( IQR) length of ICU stay and hospital stay duration were 8(5, 12) and 20(13, 29) days, respectively. Older age( HR=1.06, 95% CI: 1.03-1.10, P<0.001), left main coronary artery disease( HR=1.62, 95% CI: 1.00-2.60, P=0.048), and vasoactive inotropic score( HR=1.09, 95% CI: 1.03-1.17, P=0.007)were independent risk factors associated with 3-year mortality. The area under the receiver operating characteristic curve for the model, which was constructed with age≥60years, left main coronary artery disease, and vasoactive inotropic score>60, was 0.88(95% CI: 0.80-0.95). Conclusion:Long-term survival of patients who survive to discharge appears favorable. Older age, left main coronary artery disease, and vasoactive inotropic score were associated with 3-year mortality in coronary artery bypass grafting patients who received VA-ECMO.

Features in digitorum muscular tension and shear-wave elastography in hemiplegic patients with stroke before and after manual digitorum sensory stimulation / 中国康复理论与实践

@#Objective To demonstrate the changes in flexor digitorum and extensor digitorum tension in the affected hands with shear-wave elastography (SWE) before and after manual digitorum sensory stimulation (MDSS) in hemiplegic patients with stroke. Methods A total of 51 hemiplegic post-stroke inpatients in the Department of Rehabilitation Medicine in Second Hospital of Anhui Medical University from April to June, 2020, underwent MDSS completed by a researcher who used a bare thumb and index finger to squeeze each nail bed as well as the sides of each fingertip in the affected hand. The stimulation intensity was the minimum that could cause finger extension without obvious pain, and the interval between two stimulations was five to ten seconds. Muscular tension of the flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus and extensor digitorum were assessed with modified Ashworth Scale (MAS) and shear-wave velocity (SWV) of SWE on the affected side before and immediately after MDSS. MAS score was -1 as low muscular tension. Results The MAS scores of all the muscles significantly reduced after MDSS (|Z| > 2.843, P < 0.001); while the changes of SWV were not significantly in all the muscles with initially MAS score of 0 or -1 (t < 1.052, P > 0.05), and it reduced in those muscles with initial MAS scores of one to three (t > 2.672, P < 0.05). The SWV were positively correlated with the MAS scores both before and after MDSS (r > 0.334, P < 0.05). Conclusion MDSS can effectively, immediately, and safely relieves muscle spasms of the flexor digitorum and facilitate active finger extension in the affected hand for hemiplegic patients with stroke. SWE is useful for quantitatively and objectively evaluating muscular tension in the affected hand for hemiplegic patients with stroke.