Meta-analysis on failure mode and effect analysis for the prevention of ICU-acquired infection / 中国感染控制杂志

Objective To systematically evaluate the effectiveness of failure mode and effect analysis(FMEA)in the prevention of intensive care unit(ICU)-acquired infection.Methods Two researchers independently searched relevant literatures from foreign and Chinese databases,with a search deadline of July 15,2022.Independent screening of literatures,extraction of data and evaluation on overall quality were performed according to inclusion and exclusion criteria.RevMan 5.4 software was used to conduct Meta-analysis on the preventive effect of the in-cluded literatures.Results A total of 19 literatures were included in analysis.Meta-analysis results showed that ap-plication of FMEA method reduced the incidences of ventilator-associated pneumonia(OR=0.40,95％CI[0.31-0.51],P＜0.01),catheter-associated urinary tract infection(OR=0.29,95％CI[0.17-0.51],P＜0.01),cen-tral line-associated bloodstream infection(OR=0.28,95％CI[0.18-0.46],P＜0.01),and multidrug-resistant organism infection(OR=0.46,95％CI[0.37-0.58],P＜0.01)in ICU patients,as well as incidence of health-care-associated infection(HAI)in ICU(OR=0.46,95％CI[0.37-0.59],P＜0.01),and significantly improved the satisfaction of ICU patients and their families(OR=2.34,95％CI[1.72-3.17],P＜0.01).Conclusion FMEA can effectively prevent ICU-acquired infection and improve the quality of HAI management.

Light and heat of moxibustion for knee osteoarthritis：a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To explore the clinical therapeutic effect of light and heat of moxibustion for knee osteoarthritis (KOA).@*METHODS@#A total of 216 patients with KOA were randomized into a traditional moxibustion group (72 cases, 8 cases dropped off), a moxibustion light group (72 cases, 9 cases dropped off) and a moxibustion heat group (72 cases, 10 cases dropped off).The special light-heat separation moxibustion cup was applied, the patients in the traditional moxibustion group received the treatment of moxibustion, the patients in the moxibustion light group received the treatment of moxibustion light and the patients in the moxibustion heat group received the treatment of moxibustion heat. The acupoint selection of the three groups was Neixiyan (EX-LE 4), Dubi (ST 35) and Zusanli (ST 36), the treatment was given 20 min each time, 3 times a week, 4 weeks were required totally, and the follow-up surveys were made 4 and 8 weeks after treatment. The scores of Western Ontario and McMaster University osteoarthritis index (WOMAC) and visual analogue scale (VAS) were observed before treatment, after 2 and 4 weeks of treatment, 4 and 8 weeks after treatment. The therapeutic effects were evaluated according to the criterion of patient global assessment (PGA) after 4 weeks of treatment and 8 weeks after treatment.@*RESULTS@#Compared with before treatment, the pain scores, stiffness scores, physical function scores and total scores of WOMAC were reduced after 2, 4 weeks of treatment and 4 weeks after treatment in the three groups (<0.05). The pain scores, stiffness scores, physical function scores and total scores of WOMAC were reduced 8 weeks after treatment in the traditional moxibustion group and the moxibustion heat group (<0.05). The stiffness score, physical function score and total score of WOMAC were reduced 8 weeks after treatment in the moxibustion light group (<0.05). The pain score, physical function score and total score of WOMAC in the traditional moxibustion group after 4 weeks of treatment were lower than the moxibustion light group (<0.05). Compared with before treatment, the VAS scores were reduced after 2, 4 weeks of treatment and 4 , 8 weeks after treatment in the three groups (<0.05). The improvement rates in the traditional moxibustion group and the moxibustion heat group after 4 weeks of treatment and 8 weeks after treatment were superior to the moxibustion light group (<0.05).@*CONCLUSION@#The light and heat of moxibustion have therapeutic effect for KOA, and the therapeutic effect of moxibustion heat is superior to moxibustion light.

Establishment and verification of preeclampsia risk assessment model / 中华疾病控制杂志

Objective To analyze the risk factors affecting pre-eclampsia, to establish a pre-eclampsia risk assessment model, and to assess the risk of pre-eclampsia early. Methods A face-to-face questionnaire survey was conducted for all women who gave birth in the Department of Obstetrics, the First Hospital of Shanxi Medical University from March 2012 to September 2016. A total of 10 319 qualified questionnaires were collected to exclude 9 623 cases of other hypertensive diseases related to pregnancy. A total of 70% of the subjects were randomly selected as training samples to analyze the influencing factors of pre-eclampsia, and a Logistic regression model was established. The remaining 30% of the objects are used as test samples to verify the effect of the model. Results Logistic regression model was established with training samples. Logit P=-2.517-0.696×Pre-pregnancy lean +0.200 ×Pre-pregnancy overweight +0.944×Pre-pregnancy obesity -1.995×Residential in city -0.409×Folic acid supplemented before pregnancy +1.323×Twin and multiple pregnancy +1.708× History of previous pregnancy hypertension. Homer-Lemeshow test P=0.377. Model AUC=0.767 (95%CI:0.747-0.786, P<0.001). Using the test sample to verify the model, the model sensitivity was 81.68%, the specificity was 75.05%, the positive likelihood ratio was 3.27, and the negative likelihood ratio was 0.24. The test sample model AUC = 0.771 (95%CI=0.763-0.790,P<0.001). Conclusion This study establishes a simple and effective pre-eclampsia risk assessment model with controllable factors. The model has good fit and sensitivity and specificity.

Simultaneous determination of nine components of Scutellaria Baicalensis in different habitats and growth years by HPLC / 中草药

Objective To establish an HPLC method for simultaneous determination of nine main chemical constituents in Scutellaria baicalensis (scutellarin, baicalin, scutellarin, wogonoside, apigenin, baicalein, wogonin, aspen, and melaleuca (A). Methods 0.5 g powders of S. baicalensis was extracted two times by ethanol (each for 30 min), and the extracts were merged into 50 mL. Separation was carried out on Ultrasil C18 chromatography column (250 mm × 4.6 μm, 5 μm), by using acetonitrile-0.1% formic acid water as the flow phase for gradient elution; with volume flow at 1 mL/min, detection wavelength at 274 nm and column temperature at 30 ℃. Results The linear relation of nine main active components measured in the range of mass concentration was good with perfect precision, repeatability and stability, the r value of which was all more than 0.999 5. The average recovery rate was 95.94%-99.88%, RSD was 0.68%-1.90%. Conclusion The HPLC method established for the simultaneous determination of nine main chemical compositions in S. baicalensis is accurate, simple, sensitive and specific, which can provide references for the quality evaluation of S. baicalensis.

Effect observation of a kind of assistant cleaner for oral care in clinical application / 中国医学装备

Objective: To explore the clinical effect of a kind of assistant cleaner for oral care of severe patients who couldn't eat through mouth. Methods: 80 patients who couldn't eat through mouth were divided into observation group (n=40 cases) and control group (n=40 cases). The oral cavity of patients of observation group were cleaned by using self-made assistant cleaner before oral care, and then cotton ball with physiological saline (NS) were used to scrub their oral cavity. While the patients of control group were directly scrubbed by using cotton ball with NS. The operation time and oral clean situation of the two groups were observed and recorded. Results: The preparing time before oral care of observation group was significantly longer than that of control group (t=4.282, P<0.05), while the operation time of oral care and total time of observation group was significantly shorter than that of control group (t=31.3, P<0.05). The method of observation group could more effectively clean oral peculiar smell, eliminate massive furred tongue and reduce residual sputum scab than that of control group. And it could significantly reduced complication of oral cavity than that of control group (t=32.111, P<0.05). Conclusion: The application of assistant cleaner before oral care not only can effectively improve oral hygiene condition for severe patients, but also can shorten the time of oral care of nurses for these patients and reduce the operation time of stoop. Therefore, it is a new method with advantage of saving time and saving labour.

Therapeutic Effect of Recombinant Human Stem Cell Factor on Rhesus Monkeys with Severe Acute Radiation Sickness / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the therapeutic effect of rhSCF early administration on rhesus monkeys with severe acute radiation sickness(ARS).</p><p><b>METHODS</b>Twelve adult monkeys totally exposed to 7.0 GyCo were divided into radiation control and SCF groups, and monkeys in SCF group were subcutaneously injected recombinant human SCF(rhSCF) 200 µg/kg at half an hour and 24 hour after irradiation, while the radiation control monkeys were injected physiological saline. Survival was monitored and hematopoiesis was evaluated at 40 days following early treatment.</p><p><b>RESULTS</b>6 animals treated with rhSCF all survived, while 2 in irradiated controls survived on 40 day after radiation. rhSCF treatment promoted hematopoiesis recovery significantly, increased the nadir of white blood cells, neutrophils and platelets, and simplified supportive care in ARS rhesus monkeys.</p><p><b>CONCLUSION</b>RhSCF injection soon after TBI taken shows an significant therapeutic efficiency on rhesus monkeys with severe acute radiation sickness.</p>

A(1)H NMR-based metabonomic study on the SAMP8 and SAMR1 mice and the effect of electro-acupuncture.

A (1)H NMR-based metabonomic method was used to investigate the metabolic change of plasma in senescence-prone 8 (SAMP8) mice before and after electro-acupuncture (EA). Sixteen SAMP8 male mice (aged 8 months) were randomly divided into model group and acupuncture treatment group while the later group received EA treatment for 21 days. Eight senescence-resistant 1 (SAMR1) mice were used as the control group. Morris water maze was used to evaluate the effects of EA. All mice plasma samples obtained from different groups were analyzed by using 600 MHz (1)H nuclear magnetic resonances ((1)H NMR) spectroscopy. The data sets were analyzed by Principal Components Analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA) to discriminate the key plasma metabolites among different groups. Results indicated that both the escape and probe tasks of SAMP8 could be improved by EA treatment. Metabonomic study showed that SAMR1 and SAMP8 were separated clearly in both CPMG_OSC_PLS and LED _OSC_PLS score plots. Interestingly, samples obtained from EA group were distributed closely to SAMR1 group in CPMG_OSC_PLS score plot, but away from SAMP8 group in LED_OSC_PLS score plot. Corresponding loading plots showed that much less lactate was seen in SAMP8 mice plasma. Other changes including higher levels of dimethylamine (DMA) Choline and α-glucose but lower levels of leucine/isoleucine, HDL, LDL/VLDL, 3-Hydroxybutyrate (3-HB), and Trimethylamine N-oxide (TMAO) were observed in the SAMP8 mice plasma than in the SAMR1. After EA treatment, the levels of lactate, DMA, choline and TMAO were improved. Results of this work can provide valuable clues to the understanding of the metabolic changes in the senile impairment of mice. It is also hoped that the methodology can be used in evaluating the effects of EA and understanding the underlying acupuncture mechanism in treating neurodegenerative diseases.

Protective effect of HS-6101 on rhesus monkeys with severe hematopoietic acute radiation sickness / 中国实验血液学杂志

This study was purposed to investigate the protective effects of lipoprotein HS-6101(6101) on rhesus monkey total body irradiated with 7.0 Gy ⁶⁰Coγ-ray. A total of 30 health adult rhesus monkeys were randomly divided into symptomatic therapy (ST), WR2721 and HS-6101 30, 90 and 270 mg/kg groups (n = 6), the rhesus monkeys of each groups were injected with physiological saline 0.3 ml/kg, WR-2721 30 mg/kg, or HS-6101 30, 90 and 270 µg/kg, respectively. All agents were once intramuscularly injected at 1 hr prior irradiation. General observation, peripheral blood cell counts, colony forming unite assay of bone marrow hemopoietic progenitor cells, and histopathological examination were performed. The results showed that animals in symptomatic therapy group begin to die on the 13(th) day and 4 animals died within 24 days, the average survival time was 18.2 ± 4.3 days; 2 animals in WR-2717 groups died on day 15.8 and day 18.5 post irradiation respectively. 1 animal in HS-6101 270 mg/kg group died on day 35.8, all other animals survived. Nadirs of peripheral blood white blood cells, neutrophils and platelets of animals in HS-6101 treatment groups were significantly higher than those in other 2 groups including ST and WR-2721 groups, and the hemopoietic recovery were also significantly speeding up(P < 0.05 and 0.01). In vitro results showed that HS-6101 obviously promoted 7.0 Gy ⁶⁰Coγ irradiated monkey's bone marrow mononuclear cells to form various hematopoietic progenitor cell colonies (P < 0.05 and 0.01) . Compared with symptomatic therapy and WR-2717 groups, bone marrow histopathological changes in HS-6101 treatment groups showed more active hemopoietic cell proliferation and higher density structure. It is concluded that HS-6101 90 µg/kg treatment can promote the bone marrow recovery of 7.0 Gy ⁶⁰Coγ irradiated monkey, alleviate their animal symptom, simplify the treatment measures and improve the animal survival rate. The HS-6101 shows remarkable radioprotective effects as compared with the currently internationally acknowledged radioprotectant of WR-2721.

Transfection of ECSOD to Rhesus bone marrow mesenchymal stem cells in vitro / 中国实验血液学杂志

This study was aimed to investigate the biological effects of Rhesus bone marrow mesenchymal stem cells (R-BMMSC) transfected by adenovirus bearing extracellular superoxide dismutase gene (AD-ECSOD). Using density gradient centrifugation and adherent culture way, the R-BMMSC transfected by AD-ECSOD and reporter gene EGFP were isolated, cultured and purified; the transfection efficiency was detected by fluorescence microscopy and flow cytometry; the ECSOD protein expression in cell culture supernatant were detected by ELISA; the surface antigens on R-BMMSC (CD34, CD29, CD45, CD90, HLA-DR) were detected by flow cytometry; and differentiation capability of transfected R-BMMSC were detected by oil red O and alizarin staining; the proliferation capability of R-BMMSC was assay by MTT method. The results showed that the transfection efficiency of AD-ECSOD (MOI 500, 1 000, 1 500 and 2 000) for R-BMMSC was > 95%. At 24 h after transfection, the ECSOD protein could be detected in cell culture supernatant, and its level was significantly higher than that of control group (P < 0.01). At 48 h after transfection, the expression level of ECSOD protein on MOI 1 500 and 2 000 was the highest. The proliferative capability, surface antigen expression and multi directive differentiation ability of transfected R-BMMSC were similar to non-transfected R-BMMSC. It is concluded that the AD-ECSOD can effectively transfect the R-BMMSC without influences on its biological features.

Radiation protection effect of rhIL-12 on monkey hematopoietic system / 中国实验血液学杂志

This study was aimed to investigate the radioprotective effects of recombinant human interleukin-12 (rhIL-12) on monkey hematopoietic system, and to provide experimental evidence for future clinical prophylaxis and treatment for patients who suffered from acute radiation syndrome. In in vitro study, the effect of rhIL-12 in different concentrations (0, 1, 5, 25, 125 and 625 ng/ml) on colony forming capacity of human or monkey bone marrow-derived mononuclear cells was examined in methylcellulose H4434 medium. In in vivo study, the acute radiation syndrome model was established in 11 Rhesus monkeys which received lethal total body irradiation by 6 Gy (60)Co γ in single time irradiation. The irradiated monkeys were randomly divided into 3 subgroups: control group (n = 4) which received subcutaneous PBS injection, rhIL-12 single-dose group (n = 3) which received subcutaneous single injection of rhIL-12 (4 µg/kg) at 2 h after irradiation, and multiple-dose group (n = 4) which received subcutaneous injection of rhIL-12 (1 µg/kg per injection) at 2 h, day 3, 6 and 9 after irradiation respectively. Peripheral blood cells were counted before and after irradiation every other day. The survival status of animals were observed daily. In vitro test results showed that different concentrations of rhIL-12 obviously promoted human and healthy monkeys' bone marrow mononuclear cells to form various hematopoietic progenitor cell colonies, especial CFU-E and CFU-GM. All animals in control group died within 22 d after lethal total body irradiation, average survival time was (20.3 ± 1.2) d. Only one monkey in multiple-dose group died due to anemia on day 17. All monkeys in single-dose group survived. Compared with control group, rhIL-12-administrated monkeys' white blood cell count, hemoglobin level, platelet and reticulocyte counts showed faster recovery from high dose radiation. It is concluded that the rhIL-12 treatment can promote the bone marrow hematopoietic stem/progenitor cell colony formation in vitro and protect lethally-irradiated monkeys. There is an obvious therapeutic effect of rhIL-12 on monkeys suffered from bone marrow failure caused by severe acute radiation exposure.

New advance of research on therapy of severe acute radiation sickness with mesenchymal stem cells / 中国实验血液学杂志

Mesenchymal stem cells (MSC) are a kind of non-hematopoietic adult stem cells with self-renewal and multilineage differentiation potential, which have special biological characteristics, such as secreting various cytokines, promoting hematopoiesis, accelerating stem cells homing and reconstructing hematopoietic microenvironment. MSC are collected and amplified easily, and can be transfected by exogenous gene. Many reports indicated that MSC were applied in therapy for variety of tissues and organs injury, meanwhile the treatment for acute radiation sickness has made significant progress. In this review, the biological characteristics and new research advance on MSC in treatment of severe acute radiation sickness are summarized and discussed.

Effect of electro-acupuncture on the expression of NCAM and NF-kB in SamP8 mouse hippocampus / 中华神经医学杂志

Objective To investigate the effect of electro-acupuncture (EA) therapy on the syuaptic plasticity of hippocampal neurons in senescence-accelerated mouse (SAMP8) by examining the changes in neural cell adhesion molecule (NCAM) and nuclear factor-κB (NF-κB) expression, and explore the mechanism behind the therapeutic effect of EA on Alzheimer's disease (AD) in view of neural cell adhesion. Methods Twenty-four SAMP8 mice as the animal model of AD were randomized equally into the model group and EA treatment group, with 12 senescence-accelerated resistant mice (SAMR1) mice as the blank control group. EA on Baihui (Du20) and Yongquan (Kid1) was administered once daily for 21 consecutive days in mice in the EA group. The expressions of NCAM and NF-κB mRNA and proteins in the hippocampal neurons were detected by immunohistochemistry and in situ hybridization. Results Compared with the model group, the mice in EA group showed significantly increased expression of NCAM and NF-κB mRNA and proteins (P<0.05). Conclusion EA can increase the expression of NCAM and NF-κB in mouse hippocampal neurons. EA can promote the cell adhesion and synapse plasticity of the neurons possibly by upregulating NF-κB expression to induce increased NCAM production.

Pathologic diagnosis of endometrial carcinoma in curettage specimens in women under forty years of age / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic pathological features of endometrial carcinomas present in women under 40 years of age (by curettage samples).</p><p><b>METHODS</b>A retrospective analysis was performed on 20 cases of endometrial carcinomas in women under 40 years of age.</p><p><b>RESULTS</b>The patients included 18 endometrioid adenocarcinoma cases, one adenosquamous carcinoma case, and one papillary serous carcinoma case. The morphological features of the endometrial adenocarcinoaare loss of polarity (orientation) of the endometrial glands. The tumor cells have large round vesicular nuclei, prominent nucleoli and coarse chromatin. In addition, endometrial stroma was instead of by the fibrous and/or granulation tissue type stroma, usually with inflammatory response. Majority cases of endometrioid adenocarcinomas had superficial invasion of myometrium and no lymph node metastasis. The adenosquamous case metastasized to the ovaries and the papillary serous carcinoma case metastasized to the pelvic lymph nodes.</p><p><b>CONCLUSIONS</b>Endometrial carcinomas which are highly differentiated endometrioid adenocarcinomas occur frequently in women under 40 years of age. An important differential diagnosis of the endometrioid carcinoma in a curettage specimen is to differentiate it from atypical endometrial hyperplasia and atypical polypoid adenomyoma.</p>