Supplementing pelvic floor muscle training with attention training can more effectively relieve women′s stress urinary incontinence / 中华物理医学与康复杂志

Objective:To explore any effect of pelvic floor muscle training and/or attention training on pelvic floor function and women′s symptoms of stress urinary incontinence (SUI).Methods:Fifty incontinent women were divided into a control group ( n=25) and an experimental group ( n=25). Both groups received conventional pelvic muscle rehabilitation training, but the experimental group was additionally provided with attention training for 6 weeks. Before and after the 6 weeks of treatment, both groups were evaluated using surface electromyography of the pelvic floor. The short form of the International Urinary Incontinence Advisory Committee′s urinary incontinence questionnaire (ICIQ -SF) was used to assess the severity of incontinence and quality of life (I-QOL). Results:Before the treatment there was no significant difference between the 2 group′s pelvic floor myographs, nor in their average ICIQ-SF and I-QOL scores. After the treatment, however, compared with the control group, significant improvement was observed in experimental group′s peak amplitude during rapid contraction, average EMG in tonic contraction and endurance contraction. Their average ICIQ-SF and I-QOL scores were also better.Conclusion:Supplementing pelvic floor muscle training with attention training can effectively improve the urinary continence and the life quality of women with stress urinary incontinence.

Effect of Dendrobii Caulis Mixture on Cell Inflammatory Response and Apoptosis in Diabetic Rats with Nonalcoholic Fatty Liver Disease Based on NF-κB/NLRP3/IL-1β Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Dendrobii Caulis mixture on cell inflammatory response and apoptosis in diabetic rat with non-alcoholic fatty liver disease（NAFLD） and its possible mechanism. MethodForty male SD rats were randomly divided into blank group and model group of type 2 diabetes mellitus（T2DM） with NAFLD according to body weight. The model was established by high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin（STZ）， which was randomly divided into the model group， Dendrobii Caulis mixture group（16.67 g·kg-1·d-1） and metformin group（100 mg·kg-1·d-1） according to blood glucose and body weight， and 10 rats in each group. Rats in each group were administered by continuous gavage for 4 weeks， the blank and model groups were given saline by gavage at 10 mL·kg-1·d-1. Fasting blood glucose（FBG）， serum insulin（INS）， glycosylated serum protein（GSP）， triglyceride（TG）， total cholesterol（TC）， high density lipoprotein（HDL-C）， low density lipoprotein（LDL-C）， alanine aminotransferase（ALT） and aspartate aminotransferase（AST） were detected in each group of rats. The liver tissues of rats in each group were stained with hematoxylin-eosin（HE） to observe the pathological changes， and the positive expressions of nuclear transcription factor（NF）-κB， NOD-like receptor heat protein structural domain-related protein 3（NLRP3）， interleukin（IL）-1β and tumor necrosis factor（TNF）-α were observed by immunohistochemistry. Western blot and fluorescence quantitative polymerase chain reaction（Real-time PCR） were used to detect the protein and mRNA expression of B-cell lymphoma-2（Bcl-2）， Bcl-2 associated X protein（Bax）， Caspase-3 and NF-κB p65， NLRP3， IL-1β， TNF-α in liver tissue of rats in each group. ResultCompared with the blank group， FBG， GSP， TC， TG， LDL-C， AST and ALT levels were increased， INS and HDL-C levels were decreased， Bax， Caspase-3， NLRP3， IL-1β， TNF-α protein and mRNA expression were increased in model group， the ratio of p-NF-κB/NF-κB protein increased， the expression of Bcl-2 protein and mRNA decreased， and the positive immunohistochemical expression of NF-κB， NLRP3， IL-1β and TNF-α increased， and the differences were statistically significant（P<0.01）. The morphological structure of the liver was disrupted， and obvious fat vacuoles were seen. Compared with the model group， FBG， GSP， TC， TG， LDL-C， AST and ALT levels of Dendrobii Caulis mixture group and metformin group were decreased， INS and HDL-C levels were increased， and protein and mRNA expressions of Bax， Caspase-3， NLRP3， IL-1β and TNF-α were decreased， the protein ratio of p-NF-κB/NF-κB decreased， the expression of Bcl-2 protein and mRNA increased， and the positive immunohistochemical expressions of NF-κB， NLRP3， IL-1β and TNF-α decreased， and the differences were statistically significant（P<0.01）. The liver morphology and structure were relatively complete， and the fat vacuoles were reduced. ConclusionDendrobii Caulis mixture can inhibit cell apoptosis， reduce inflammatory response and alleviate liver injury in rats with T2DM and NAFLD， the mechanism may be related to inhibiting the activation of NF-κB pathway， blocking the activation of NLRP3 inflammatory vesicles， reducing IL-1β secretion， attenuating Caspase-3 activity and reducing the ratio of Bcl-2/Bax.

Optimization of the Formulation of Polygala japonica Cream by Central Composite Design-response Surface Methodology Based on AHP-CRITIC Analysis and Its Quality Evaluation / 中国药房

OBJECTIVE：To optimize the formul ation of Polygala japonica cream，and to evaluate the quality of prepared cream. METHODS ：With centrifugal stability ，heat resistance stability and viscosity as evaluation indexes ，the weight coefficient was determined by analytic hierarchy process （AHP），criteria importance through intercriteria correlation （CRITIC）method and mixed weighted AHP-CRITIC ，and the comprehensive score was calculated. The amount of octadecyl alcohol ，hexadecanol and mixed emulsifier （polysorbate 60 mixed with glycerin monostearate at the mass ratio of 2.82）in the formulation of P. japonica cream were screened by central composite design-response surface methodology. The optimized formulation was validated. P. japonica cream prepared by the optimal preparation was evaluated in terms of apperance ，particle，pH，stability and rheological characteristics. RESULTS ：The weight coefficients of centrifugal stability ，heat resistance stability and viscosity were 0.428 5， 0.415 6 and 0.155 9 respectively，according to the mixed weighted AHP-CRITIC. The optimal formulations were 1.96 g of hexadecyl alcohol ，5.17 g of octadecyl alcohol ，2.48 g of mixed emulsifier ，1.83 g of polysorbate 60，0.65 g of glyceride monostearate，1 g of benzyl alcohol ，5 g of propylene glycol ，6 g of isopropyl myristate and 5 g of P. japonica extract，and then added water to 100 g. Prepared cream was a light yellow fluid paste with particle size of 0.5-2.5 μm and pH value of 6.5；the results of centrifugal test ，heat resistance test and cold resistance stability test showed that the cream had no oil-water separation or thickened paste. The prepared cream was shear-thinning non-Newtonian fluid. CONCLUSIONS ：P. japonica cream is prepared successfully，which shows good apperance ，particle，acidity and stability.

Characteristics of oral methicillin-resistant Staphylococcus epidermidis isolated from dental plaque / 国际口腔科学杂志·英文版

The oral microbial community is widely regarded as a latent reservoir of antibiotic resistance genes. This study assessed the molecular epidemiology, susceptibility profile, and resistance mechanisms of 35 methicillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from the dental plaque of a healthy human population. Broth microdilution minimum inhibitory concentrations (MICs) revealed that all the isolates were nonsusceptible to oxacillin and penicillin G. Most of them were also resistant to trimethoprim (65.7%) and erythromycin (54.3%). The resistance to multiple antibiotics was found to be largely due to the acquisition of plasmid-borne genes. The mecA and dfrA genes were found in all the isolates, mostly dfrG (80%), aacA-aphD (20%), aadD (28.6%), aphA3 (22.9%), msrA (5.7%), and the ermC gene (14.3%). Classical mutational mechanisms found in these isolates were mainly efflux pumps such as qacA (31.4%), qacC (25.7%), tetK (17.1%), and norA (8.6%). Multilocus sequence type analysis revealed that sequence type 59 (ST59) strains comprised 71.43% of the typed isolates, and the eBURST algorithm clustered STs into the clonal complex 2-II(CC2-II). The staphyloccoccal cassette chromosome mec (SCCmec) type results showed that 25 (71.43%) were assigned to type IV. Moreover, 88.66% of the isolates were found to harbor six or more biofilm-associated genes. The aap, atlE, embp, sdrF, and IS256 genes were detected in all 35 isolates. This research demonstrates that biofilm-positive multiple-antibiotic-resistant ST59-SCCmec IV S. epidermidis strains exist in the dental plaque of healthy people and may be a potential risk for the transmission of antibiotic resistance.

Clinicopathological features of intestinal mucosal lesions in AIDS patients and their relation with CD4+ T lymphocytes / 中华病理学杂志

Objective@#To observe the histopathological features of different opportunistic infections and tumors of the intestinal mucosa in AIDS patients, and to explore the correlation between different lesions and CD4+ T lymphocyte levels.@*Methods@#Colonic mucosal biopsy specimens of 263 patients with clinically diagnosed AIDS and abdominal pain, diarrhea, blood in the stool and other gastrointestinal symptoms were collected from Beijing Ditan Hospital from 2010 to 2018. There were 232 males and 31 females, with age range 10-81 (mean 40±13) years. HE staining, histochemical special staining, immunohistochemical staining, and in-situ hybridization were used to detect the expression of different opportunistic infection pathogens, tumors and CD4+ T lymphocytes. Peripheral blood was also taken for CD4+ T lymphocytes, CD8+ T lymphocytes, HIV viral load and routine indicators.@*Results@#The cohort included 263 intestinal mucosal biopsy specimens. There were 175 cases (66.5%) of non-specific inflammation, and pathogens were detected in 41 cases (15.6%), including 20 cases(7.6%) of cytomegalovirus (CMV) infection, 12 cases (4.6%) of mycobacterial infection, eight cases (3.0%) of amoeba infestation, and one case (0.3%) of talaromycesmarneffei infection; there were also 41 (15.6%) neoplastic lesions including 25 cases (9.5%) of intraepithelial neoplasia, 10 cases (3.8%) of adenocarcinoma and squamous cell carcinoma, six cases (2.3%) of lymphoma; and six cases (2.3%) of ulcerative colitis. The peripheral blood CD4+T lymphocyte levels of patients with CMV, mycobacteria and talaromycesmarneffei were less than 200/μL; the peripheral blood CD4+ T lymphocyte level (P<0.01) and intestinal mucosa CD4+T lymphocytes (P<0.01) were all significantly lower than those in patients with non-specific inflammation. The peripheral red blood cells and hemoglobin levels of patients with CMV and mycobacterial infection (P<0.01), adenocarcinoma and squamous cell carcinoma (P<0.05) were significantly lower than those of non-specific inflammation patients.@*Conclusions@#Pathologic examination of intestinal mucosa can identify specific infections and neoplastic lesions in AIDS patients; the most common lesions are non-specific inflammation, and CMV infection is the most common opportunistic infections; CMV, mycobacteria and talaromycesmarneffei infections are associated with decreased levels of CD4+ T lymphocytes in peripheral blood and intestinal mucosa; entamoeba histolytica infestation and non-HIV-related neoplastic lesions such as intraepithelial neoplasia, adenocarcinoma and squamous cell carcinoma are not associated with changes in AIDS immune function.

Construction of artificial intelligence assisted diagnosis model for colonoscopy / 中华消化内镜杂志

Objective To establish an artificial intelligence deep learning model using clinical colonoscopy images and video to assist the diagnosis by colonoscopy. Methods More than 600000 colonoscopy images were collected in endoscopic center of the Second Affiliated Hospital of Zhejiang University School of Medicine from 2014 to 2018, and endoscopic experts recorded a large number of high-quality operation video of colonoscopy as analysis data. After repeated discussion by six experts, the classified intestinal sites and pathological features were determined, and fuzzy and confusable images were deleted. The final selection result was approximately 1 out of 4. And then the features of images were marked using an independently developed software. The deep learning algorithm was developed using TensorFlow platform of Google. Results After repeated comparison and analysis of the results of machine training and judgment results combined with pathology from endoscopic experts, the sensitivity of the model for some diseases ( such as colon polyps) was 99％ under laboratory conditions. In the clinical colonoscopy test, the sensitivity, specificity, and overall accuracy of this model for diagnosis of colon polyps were 98. 30％(4187/4259), 88. 10％ (17620/20000), and 92. 92％ [2×98. 30％×88. 10％/(98. 30％+88. 10％)], respectively. The sensitivity and specificity for ulcerative colitis were 78. 32％ ( 2671/3410) , and 67. 06％(13412/20000), respectively. The diagnosis time spent on a single image was 0. 5±0. 03 s, and it was the real time for application, including system recognition, text prompt in video image, background record and storage. Conclusion The artificial intelligence assisted diagnosis model developed by our team can identify colonic polyps, colorectal cancer, colorectal eminence, colonic diverticulum, ulcerative colitis, etc. The auxiliary diagnosis model of colon disease can guide beginners to carry out colonoscopy, and can improve lesion detection rate, reduce misdiagnosis rate, and improve the overall operating efficiency of endoscopic center, which is conducive to the quality control of colonoscopy.

Expression and clinical significance of LKB1 and PTEN in hepatocellular carcinoma / 中华普通外科杂志

Objective To investigate the expression of liver kinase B1 (LKB1) and phosphatase and tensin homology deleted on chromosome ten (PTEN) in hepatocellular carcinoma (HCC) and their relationship with pathological characteristics and prognosis of HCC.Methods hnmunohistochemistry was used to detect expression of LKB1 and PTEN in 115 HCC cases.The relationship between clinicopathologic factors and the expressions was analyzed.Results The positive expression rate of LKB1 and PTEN was 10.4％ (12/115) and 28.7％ (33/115) respectively.The coexpression ratio of LKB1 and PTEN was 5.2％ (6/115).LKB1 and PTEN double deletion rate was 66.1％,with the latter most often found in those ≥ 50 years of age group (x2 =7.968,P =0.001),middle low differentiation HCC group (x2 =11.297,P =0.025) and vascular tumor thrombus group (x2 =6.797,P =0.011).The 5 year survival rates of LKB1 and PTEN protein coexpression and double deletion patients were 100％ and 36.5％ (x2 =10.969,P =0.004),respectively.Multivariate COX regression analysis showed that vascular tumor thrombus,PTEN deletion and LKB1/PTEN double deletion were independent risk factors for the prognosis of HCC.Condusions Double deletion of LKB1/PTEN protein is one of the independent factors that affect the survival time of HCC patients.

Osteoprotegerin/receptor activator of nuclear factor-κB ligand expression in mandibular distraction osteogenesis regulated by parathyroid hormone / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This research aimed to investigate the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in mandibular distraction osteogenesis (DO) regulated by parathyroid hormone (PTH) and to explore the mechanism by which PTH promotes DO.</p><p><b>METHODS</b>A rabbit mandibular DO model was established. The rabbits were randomly divided into experimental group and control group. The former were subcutaneously injected with different doses of PTH on alternate days, the latter was injected with normal saline every other day. Serum OPG levels were detected through enzyme-linked immunosorbent assay. The OPG and RANKL expression levels in the DO-induced formation of a new bone tissue were examined through immunohistochemistry staining.</p><p><b>RESULTS</b>The serum OPG levels gradually increased during distraction. At the end of the stretch, the OPG expression in the experimental group was significantly stronger than that in the control group. As the fixed period was extended, the OPG expression in the new bone gradually decreased, but the RANKL expression increased.</p><p><b>CONCLUSION</b>Intermittent subcutaneous PTH injection can upregulate the OPG expression and accelerate bone metabolism. Thus, this procedure promotes the early generation of a new bone in the mandible through DO.</p>

Influencing factorial analysis of the relapse of alcohol dependence / 中华行为医学与脑科学杂志

ObjectiveTo investigate environmental factors of the relapse of alcohol dependence.MethodsOne hundred and seventeen in-patients with alcohol dependence were assessed with a home-designed questionnaire,Family Environment Scale Chinese Version (FES-CV),Clinic Institute Alcohol Withdrawal Syndrome Scale Chinese Version(CIWA-Ar) and the Scale of Personality Change Post-Traumatic Brain Injury(SPCPTBI).One hundred and five patients reassessed with alcohol dependence syndrome diagnostic criteria 1 year after hospitalization.t -test,chi-square and logistic regression were used for analysis.Results 57 of 105 were relapse and 48 of them were not relapse.The results showed that relapse group had a higher divorce or separated or remarried rate (21/36) than the no-relapse one (7/41 ) ( chi-square =6.60,P =0.010) ; a less number of years of education (5.2 ± 1.8 vs 7.2 ± 1.7,t =5.64,P =0.000) ; a bigger daily drinking ( (512 ± 186) ml vs (396 ± 109) ml,t =3.93,P =0.000) ; a higher drinking frequency in relapse group ( (2.6 ± 0.9 ) vs ( 1.8 ± 0.6) times,t =5.38,P=0.000) ;a higher rates in personality change(47/57 vs 15/48 ),brain damages (27/57 vs 13/48 ) and mood disorders (35/57 vs 17/48 ),They also showed that relapse group had more problems on intimate degree (5.66 ±1.40 vs 6.20 ± 1.20),emotional expression (4.59 ± 1.54 vs 5.41 ± 1.26,independence (3.61 ± 1.29 vs 4.64± 1.49),organization (4.26 ± 1.56 vs 5.22 ± 1.18 ),and self-controlling (4.21 ± 1.43 vs 5.12 ± 1.12 ),the differences were significant (P＜0.05) ;a higher contradiction score(4.35 ± 1.73 vs 3.64 ± 1.22,t =2.42,P =0.017).Logistic regression analysis showed that the number of daily drinking,intelligent damaged,emotional problems,arid dependence were the risk factors for the alcoholic relapse ( OR =7.44,3.99,3.92,2.96) ;Self-controlling was the protective factors for the alcoholic relapse ( OR =0.19).ConclusionProblem marital status,less education,and heavy drinking,and the number of drinking times,personality change,intellectual impairment and mood change,and poor family environment were the risk factors for the relapse of alcohol dependence.