A retrospective analysis of clinical characteristics and prognostic factors for 152 cases of Staphylococcus aureus bloodstream infection / 中华预防医学杂志

To understand the clinical characteristics of Staphylococcus aureus bloodstream infection and the main risk factors affecting clinical prognosis, providing a reference for clinical prevention and control of Staphylococcus aureus bloodstream infection. In this study, the clinical data of 152 patients with Staphylococcus aureus bloodstream infection admitted to Guangdong Provincial People's Hospital from January 2019 to December 2021 were retrospectively analyzed by reviewing the electronic medical record system, including underlying diseases, clinical characteristics, risk factors, and bacterial resistance. Statistical methods such as Chi-Squared Test and t Test were used to analyze the related risk factors that may affect the clinical characteristics and prognosis of patients with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection, then the variables with P<0.05 in univariate analysis were included in the multivariate logistic regression model to analyze the independent risk factors of poor prognosis. The results showed among 152 patients with Staphylococcus aureus bloodstream infection, 50 patients (32.89%) were infected with MRSA. In comparison, 102 patients (67.11%) were infected with methicillin-sensitive Staphylococcus aureus (MSSA). Except for rifampicin, the resistance rate of MRSA to commonly used antibiotics was all higher than that of MSSA, and the difference was statistically significant (Chi-square values were 8.272, 11.972, 4.998, 4.776, respectively;all P-values are less than 0.05). Strains resistant to vancomycin, linezolid, and quinupristin/dalfopristin were not found. In the MRSA group, indwelling catheter and drainage tube, carbapenems, and β-lactamase inhibitor treatment were significantly higher than the MSSA group. The difference was statistically significant (P<0.05). The incidence of poor prognosis of bloodstream infection in the MRSA group was higher than that in the MSSA group (34.00% vs 13.73%), and the difference was statistically significant (χ2=8.495, P<0.05). No independent risk factors associated with poor prognosis were found in the included patients with MRSA bloodstream infection.Multivariate Logistic regression model analysis showed that solid malignant tumors (OR=13.576, 95%CI: 3.352-54.977, P<0.05), mechanical ventilation (OR=7.468, 95%CI: 1.398-39.884, P<0.05) were the most important independent risk factors for poor prognosis in patients with Staphylococcus aureus bloodstream infection. In summary, the poor prognosis rate of MRSA bloodstream infection is higher than that of MSSA. The clinical evaluation of related risk factors should be strengthened, targeted prevention and control interventions should be taken to improve the prognosis of patients with Staphylococcus aureus bloodstream infection, and the use of antibiotics should be rational and standardized, to control bacterial infection and drug resistance effectively .

L-carnitine treatment attenuates renal tubulointerstitial fibrosis induced by unilateral ureteral obstruction

Background/Aims@#Accumulating evidence indicates that L-carnitine (LC) protects against multiorgan damage through its antioxidant properties and preservation of the mitochondria. Little information is available about the effects of LC on renal fibrosis. This study examined whether LC treatment would provide renoprotection in a rat model of unilateral ureteral obstruction (UUO) and in vitro. @*Methods@#Sprague-Dawley rats that underwent UUO were treated daily with LC for 7 or 14 days. The influence of LC on renal injury caused by UUO was evaluated by histopathology, and analysis of gene expression, oxidative stress, mitochondrial function, programmed cell death, and phosphatidylinositol 3-kinase (PI3K)/ AKT/forkhead box protein O 1a (FoxO1a) signaling. In addition, H2O2-exposed human kidney cells (HK-2) were treated with LC. @*Results@#LC treatment inhibited expression of proinflammatory and profibrotic cytokines, and was followed by a significant attenuation of tubulointerstitial inflammation and fibrosis. The increased oxidative stress caused by UUO was associated with mitochondrial dysfunction and excessive apoptosis and autophagy via PI3K/AKT/FoxO1a-dependent signaling, and this was abrogated by administration of LC. In H2O2-exposed HK-2 cells, LC decreased intracellular production of reactive oxygen species, and suppressed expression of profibrotic cytokines and reduced the number of apoptotic cells. @*Conclusions@#LC protects against the progression of tubulointerstitial fibrosis in an obstructed kidney.

Characterization of Vibrio parahaemolyticus isolated from diarrhea patients in Jinshan District，Shanghai / 上海预防医学

Objective:To determine the distribution and epidemic characteristics of Vibrio parahaemolyticus in Jinshan District of Shanghai from 2016 through 2018. Methods:Serotype analysis，examination of virulence genes， including thermolabilehemolysin（TLH），thermostable direct hemolysin（TDH），and TDH related hemolysin（TRH），and antimicrobial susceptibility test and pulsed field gel electrophoresis （PFGE） molecular typing were performed on 218 Vibrio parahaemolyticus isolated from diarrhea patients. Results:A total of 218 strains were divided into 8 groups and 21 serotypes. Of them， 147 strains were serotyped，with O3：K6 as the most common serotype （57.3%）. All tested strains were divided into 25 clusters based on the similarity of 85% and above，in which the dominant cluster was JSVP02，and the total similarity was 56.3%-100.0%. Two hundred and one strains （92.2%） carried tdh gene，13 strains （6.0%） carried trh gene，and 7 strains were negative for both tdh and trh. A total of 35 strains were completely sensitive to 17 kinds of antibiotics，while the remaining 183 strains showed different drug resistance. Conclusion:Vibrio parahaemolyticus isolated from diarrhea patients in Jinshan District from 2016 through 2018 is diverse. Majority of the strains have TDH gene and are resistant to the first generation cephalosporins such as cefazolin and penicillin ampicillin. Construction of regional PFGE molecular typing database will facilitate screening，identification and early warning of high-risk strains.

Semi-quantitative risk assessment of the contamination of Vibrio parahaemolyticus in oysters from Jinshan District, Shanghai / 上海预防医学

Objective To investigate the prevalence of Vibrio parahaemolyticus(VP)in oysters in Jinshan District, Shanghai and make assessment on the risks that may cause, providing the basis for prevention and control of foodborne disease. Methods Raw oyster samples with shells were randomly collected from markets, supermarkets and restaurants in Jinshan District from July to October in 2017. The content of VP in oysters was tested in accordance with the national standard methods. The semi-quantitative risk assessment for VP in oysters was made by Risk Ranger combining with the monitoring results of diet and health status of residents in Jinshan District of Shanghai in 2012-2013. Results The overall positive rate of VP in the 40 oyster samples was 80.0%(32/40). The positive rate of VP in oyster samples from farmer's markets was the highest, 85.7%(12/14), followed by those from restaurants and supermarkets. The relative risk for VP in raw oysters was 63. The probability of illness caused by VP in oysters per day per consumer of interest was 6.85×10-4, and the total predicted patients annual incidence rate in this population was 1 247.8/105. Conclusion The contamination of VP in seafood oysters in Jinshan District is serious. Eating raw oysters is at high risk; consumers are advised to reduce or avoid eating raw oysters, and processing food before eating is an effective method to decrease VP infection. Strengthening surveillance and management is imperative in this regard.

Risk assessment of cadmium contamination and dietary exposure in market aquatic products in one district of Shanghai / 上海预防医学

Objective To investigate the status of cadmium contamination in commercially sold aquatic products and to analyze the risk of dietary intake of cadmium among residents in one district of Shanghai. Methods Multistage sampling was used to collect 397 animal aquatic products from agricultural markets and supermarkets in 11 communities (townships), the District from 2018 to 2019.Cadmium content was tested according to national standard.The status of cadmium contamination was assessed by single factor pollution index(Pi)method.Risk of dietary intake of cadmium among residents was assessed by point evaluation method in combination with food consumption and dietary survey in 2013 and calculation of safe limits for cadmium in various aquatic diets(MOS). Results The detection rate of cadmium was 75.06% in the 397 animal aquatic products and the content of cadmium in 10 samples which crabs were totally exceeded the standard, accounting for 2.52%.The average contents of cadmium in crabs, bivalves which were higher than in shrimps(11.0 μg/kg), gastropods(7.6 μg/kg) and marine fish(3.8 μg/kg) were respectively 140.0 μg/kg and 90.0 μg/kg(χ2=186.41, P < 0.005), but no cadmium was detected in freshwater fish.The single factor pollution index(Pi) of crabs was 0.280 which meant light pollution and the Pi of other kinds of aquatic products was respectively under 0.100 that meant no cadmium contamination.The consumption of animal aquatic products was the highest in freshwater fish followed by shrimps, marine fish and crabs.The MOS of every kind of aquatic products is higher than 1 which meant cadmium intake from commercially sold animal products was an acceptable health risk for the population. Conclusion The risk level of cadmium intake by residents in the district through commercially sold animal aquatic products is relatively low, but the cadmium pollution status of commercially sold crustacean crabs should be vigilant, and the intake of crabs is advised to be reduced as far as possible.Relevant departments should also pay attention and strengthen monitoring and management in this regard.

The effect of procyanidin on periprosthetic osteolysis caused by TCP wear particles in the mouse calvaria and its mechanism / 中国应用生理学杂志

OBJECTIVE@#To investigate the protective effects of procyanidin on periprosthetic osteolysis caused by tricalcium phosphate (TCP) wear particles in the mouse calvaria and its mechanism.@*METHODS@#Forty-eight male ICR mice were randomly divided into sham group, TCP group, and procyanidin (0.2 mg/kg, 1 mg/kg, 5 mg/kg)-treated group (n=12). A periprosthetic osteolysis model in the mouse calvaria was established by implanting 30 mg of TCP wear particles onto the surface of bilateral parietal bones following removal of the periosteum. On the 2 day post-operation, procyanidin (1 mg/kg, 5 mg/kg) was locally injected to the calvaria under the periosteum every other day. After 2 weeks, all the mice were sacrificed to collect the blood samples and the calvaria. Periprosthetic osteolysis and osteoclastogenesis in the mouse calvaria were observed by tartrate resistant acid phosphatase (TRAP) staining and HE staining. mRNA levels of TRAP, capthesin K, c-Fos and NFATc1 in the periprosthestic bone tissue were examined by real-time fluorescence quantitative PCR. Serum contents of total anti-oxidation capacity (T-AOC) and MDA, and superoxide dismutase (SOD) activity were determined by chemical colorimetry. Protein expressions of autophagic biomarkers such as Beclin-1 and LC-3 in periprosthetic bone tissue of the calvaria were examined by Western blot.@*RESULTS@#Compared with sham group, periprosthetic osteolysis, osteoclastogenesis, mRNA levels of TRAP, capthesin K, c-Fos and NFATc1, and serum MDA content were increased significantly in the TCP group (P＜0.05), whereas serum T-AOC level and SOD activity were decreased. The protein expressions of Beclin-1 and LC-3, and the conversion of LC3-II from LC3-I were both up-regulated markedly in the mouse calvaria of TCP group (P＜0.05). Compared with TCP group, osteolysis, osteoclastogenesis, mRNA levels of TRAP, capthesin K, c-Fos and NFATc1 and serum MDA content were decreased obviously in the procyanidine group (P＜0.05), serum T-AOC level and SOD activity were increased, the expressions of Beclin-1 and LC-3, and the conversion of LC3-II from LC3-I were down-regulated obviously in the mouse calvaria of procyanidin group (P＜0.05).@*CONCLUSION@#Procyanidin has a protective effect of periprosthetic osteolysis caused by TCP wear particles in the mouse calvaia, its mechanism may be mediated by inhibition of oxidative stress and autophagy.

Relationship between dietary patterns and non-alcoholic fatty liver disease among college freshmen in Hangzhou / 中国学校卫生

Objective@#To explore the relationship between dietary patterns and non-alcoholic fatty liver disease(NAFLD) among college freshmen of Hangzhou area, and provide scientific evidence for the prevention of NAFLD in universities.@*Methods@#The 1 752 freshmen students from six universities were selected to perform a questionnaire survey, including general information, and dietary survey in the last year, by using a random sampling method. Factor analysis was used to achieve the major dietary patterns.@*Results@#Three dietary patterns were obtained from the analysis, including the animal food, Western fast food, and traditional Chinese patterns. After adjusting for confounding factors, participants in the highest tertile of the animal food and Western fast food pattern had significantly higher BMI (P<0.01). Besides, participants in the highest tertile of the Western fast-food pattern had higher ALT and AST than those in the lowest tertile(P<0.05). Conversely, participants in the highest tertile of the traditional Chinese pattern had lower BMI, ALT and AST than those in the lowest tertile(P<0.05). Logistic regression analysis showed that Western pattern might increase the risk of NAFLD (OR=1.26, 95%CI=1.09-1.72, P<0.05), whereas the traditional Chinese pattern might decrease the risk of NAFLD (OR=0.51, 95%CI=0.38-0.74, P<0.05).@*Conclusion@#Different dietary patterns are closely related to NAFLD in college freshmen. Chinese traditional food should be kept their diet, red meat and fried food should be reduced to decrease. the risk of NAFLD.

Shen-Kang protects against tacrolimus-induced renal injury

BACKGROUND/AIMS@#Evidence suggests that Shen-Kang (SK), a traditional Chinese herbal medicine, protects against various types of renal injury. In this study, we evaluated whether SK treatment confers renoprotection in a rat model of chronic tacrolimus (TAC) nephropathy.@*METHODS@#Rats were treated daily with TAC (1.5mg/kg, subcutaneously) and SK (450 mg/kg, intravenously) for 4 weeks. The effects of SK on TAC-induced renal injury were assessed by measuring renal function, urine albumin excretion, histopathology, inflammatory cell infiltration, expression of profibrotic (transforming growth factor β1 [TGF-β1] and TGF-β inducible gene-h3 [βig-h3]) and proinflammatory cytokines, oxidative stress, and apoptotic cell death.@*RESULTS@#Administration of SK preserved glomerular integrity (fractional mesangial area and Wilms tumor 1-positive glomeruli), attenuated tubulointerstitial fibrosis, and reduced the number of ectodermal dysplasia 1-positive cells, and this was paralleled by improved urine albumin excretion and renal dysfunction. At the molecular level, SK treatment suppressed expression of TGF-β1/Smad2/3, βig-h3, and proinflammatory cytokines. Oxidative stress and apoptotic cell death were significantly decreased with SK treatment, and apoptosis-related genes were regulated toward cell survival (active caspase-3 and the B-cell lymphoma-2/Bcl2-associated X [Bcl-2/Bax] ratio).@*CONCLUSIONS@#SK protects against TAC-induced renal injury.

Mechanical properties and cytocompatibility of a new-type nano-bionic anti-adhesion hernia mesh / 中国组织工程研究

BACKGROUND:A new-type nano-bionic anti-adhesion hernia mesh was developed in our previous research.OBJECTIVE:To investigate the mechanical properties and cytocompatibility of the new-type nano-bionic anti-adhesion hernia mesh.METHODS:The tensile strength of the compound hernia mesh was detected using a textile detector.Mouse fibroblasts (L929) were cultured with the compound hernia mesh,and cell structures on the mesh surface were observed under electron microscope at 1,3,5 days after culture.In addition,L929 cells were co-cultured with compound hernia mesh,polypropylene patch,and polyester patch,respectively.Cells cultured alone were used as negative controls.After 1,3,5 days of culture,MTS array was used to detect cell proliferation and evaluate cytotoxicity;after 3 days of culture,western blot was used to detect the content of type Ⅰ and Ⅲ collagens.RESULTS AND CONCLUSION:The average tensile strength of the compound hernia mesh was 31.2 N The number of fibroblasts on the nanofibrous layer of the compound hernia mesh increased as long as cultured.The cells spread along the nanofibers and pseudopodia extended from the cells formed polygon and fusiform structures,with a good cross-linking with the mesh.A complete cell layer covered all pores of the nanofibers at 5 days.The cytotoxicity of the nanofibrous layer of the compound hernia mesh was graded 0,and the cytotoxicity was graded 1 of polypropylene and polyester patches.All the three kinds of patches fulfilled the implantation requirements,and the compound hernia mesh had better biological properties.No significant differences were found among groups in the contents of type Ⅰ and Ⅲ collagens at 3 days of culture.To conclude,the new-type nano-bionic anti-adhesion hernia mesh has good mechanical properties and cytocompatibility.

Therapeutic Observation of Acupoint Thread Embedding plus Thunder-fire Moxibustion for Hyperlipidemia Due to Spleen-kidney Yang Deficiency / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint thread embedding plus thunder-fire moxibustion in treating hyperlipidemia due to spleen-kidney yang deficiency. Method Sixty patients with hyperlipidemia due to spleen-kidney yang deficiency were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by acupoint thread embedding plus thunder-fire moxibustion, while the control group was intervened by oral administration of Atorvastatin calcium tablets. After 8-week treatment, changes in the serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and traditional Chinese medicine (TCM) syndrome score were observed in the two groups, and the clinical efficacies were compared. Result The blood lipids indexes (TC, TG, HDL-C and LDL-C) and TCM syndrome score were significantly changed after the treatment in both groups (P<0.05). After the treatment, the blood lipids indexes and TCM syndrome score of the treatment group were insignificantly different from those of the control group (P>0.05). The total effective rate was 90.0％ in improving the blood lipids in the treatment group, versus 93.3％ in the control group, and the between-group difference was statistically insignificant (P>0.05). The total effective rate was 83.3％ in improving the TCM syndrome score in the treatment group versus 63.3％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Acupoint thread embedding plus thunder-fire moxibustion is an effective method in treating hyperlipidemia due to spleen-kidney yang deficiency.

Inhibitory Effect of Pueraria Isoflavones on Prostatic Hyperplasia in Rats / 中国药学杂志

OBJECTIVE: To investigate the inhibitory effect and possible mechanisms of puerariae isoflavone(PI) on prostatic hyperplasia induced by testosterone propionate.METHODS: Forty-eight male Wistar rats were randomly divided into six groups according to their body weight including normal control group, model group, 40, 80, 160 mg•kg-1•d-1 PI group, and finasteride positive control group. In addition to the sham operation for rats in the normal control group, the rats in other five groups performed castration surgery. After the restoration, the five groups of rats were subcutaneously injected with testosterone propionate (10 mg•kg-1•d-1) for 10 d to establish a benign prostatic hyperplasia model and then the subcutaneous injection was maintained every 2 d. High, middle and low dose PI groups were intragastrically administered (40, 80, 160 mg•kg-1•d-1) from the second day when the benign prostatic hyperplasia model was successfully constructed. The positive control group was given finasteride (1.0 mg•kg-1•d-1).Rats in normal and model groups were given an equal volume of saline for 28 d. After the last administration, the prostate and seminal vesicles were separated under anesthesia in rats, the wet weight and volume of the prostate and seminal vesicles were measured. The prostate and seminal vesicles index were calculated too. Rat blood was drawn and dihydrotestosterone(DHT) and estradiol (E2) in the serum were measured. Nitric oxide (NO), nitric oxide synthase (NOS), superoxide dismutase (SOD) and malondialdehyde (MDA) levels in prostate tissues were measured. The prostate tissue in each group was randomly selected for HE staining. The pathological structure of the prostate tissue was observed under an optical microscope.RESULTS: Compared with the normal control group, the prostate gland index and seminal vesicle gland index of the model group increased significantly (P<0.01), and the DHT and E2 levels in serum increased significantly (P<0.01). MDA content was increased while NO levels, NOS and SOD activities were significantly decreased (P<0.01). HE staining showed that the size of the prostate gland in the model group was different, there were obvious dilation, hyperplasia and papillary protrusions, and the cavity was full of pink and homogeneous density. The interstitial tissue showed obvious dilations of blood vessels, infiltration of inflammatory cells, and proliferation of fibrous connective tissues. Compared with the model group, the index and volume of prostate and seminal vesicles in the PI and positive control groups were significantly decreased (P<0.05 or P<0.01), and the levels of serum DHT and E2 in the middle and high doses PI groups were significantly lower (P<0.05 or P<0.01). In all treatment groups, MDA content was decreased and NO, NOS, and SOD levels were increased (P<0.05 or P<0.01) except the low-dose PI groups. There was moderately hyperplasia in low-dose PI group, mild prostatic hyperplasia in positive control group and middle-dose PI group, basically no hyperplasia in high-dose PI group.CONCLUSION: PI has a certain inhibitory effect on prostate hyperplasia induced by testosterone propionate, especially in the medium and high dose PI groups. The mechanism may be related to the effects of pueraria isoflavone on antioxidant,free radical scavenging in vivo, increasing NOS activity and increasing NO level.

Efficacy of Different Treatment Regimens for Antiphospholipid Syndrome-related Recurrent Spontaneous Abortion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Antiphospholipid syndrome (APS)-related immune factors are considered as an important cause of recurrent spontaneous abortion (RSA). Anticoagulant and anti-inflammatory treatments are believed to effectively improve adverse pregnancy outcomes by affecting the abnormal autoimmune response of the maternal-fetal interface. The aim of this study was to observe the clinical characteristics and treatment outcomes of anticoagulant regimens and anti-inflammatory plus anticoagulation regimens for APS-related RSA.</p><p><b>METHODS</b>APS-related RSA cases from September 2011 to September 2016 at Peking University Third Hospital were retrospectively analyzed. The patients were assigned to study group (anti-inflammation plus anticoagulation) and control group (simple anticoagulation). The incidence of repeat abortion, the incidence of placental dysfunction, the gestational weeks of pregnancy, and the mean weight of the fetus were observed.</p><p><b>RESULTS</b>The pregnancy and neonatal outcome indicators of the repeat pregnancy loss rate (11.11% vs. 22.70%), placental dysfunction-related diseases (6.35% vs. 15.60%), the mean birth weight of infants born after 24 weeks gestation (3152.41 ± 844.67 g vs. 2765.76 ± 816.40 g), full-term delivery weight (3456.28 ± 419.79 g vs. 3076.18 ± 518.79 g), the proportions of low birth weight infants (12.70% vs. 21.98%), and small for gestational age (6.35% vs. 14.18%) differed significantly between the study and control groups (all P< 0.05). The incidence of preterm delivery, term delivery, and stillbirth was not significantly different between the two groups, and there was no significant difference between the study and control groups in gestational age at birth (37.6 ± 3.3 weeks vs. 36.9 ± 3.2 weeks; P > 0.05).</p><p><b>CONCLUSION</b>The anti-inflammatory and anticoagulation regimen is more effective than the simple anticoagulation regimen in the treatment of APS recurrent abortion.</p>

Effect of enteral immunonutriton on patients undergoing renal transplantation / 肠外与肠内营养

Objective:To evaluate the safety and effectiveness of early enteral immunonutrition on the patients undergoing renal transplantation.Methods:Forty-six patients undergoing renal transplantation were randomly divided into two groups,named enteral immunonutrition (EIN) group and regular enteral nutrition (EN) group (given EIN and EN respetively).The humoral immunity,cellular immunity,serum albumin,prealbumin,hemoglobin,cholesterin and the incidence of rejection were observed in order to compare the therapeutic efficacy of two kinds of nutrition therapy.Results:At the 1 st day,humoral immunity and cellular immunity were no significant differences between two groups.At the 7th day,the serum levels of IgM and IgA were significant higher in EIN group than those in EN group (P ＜ 0.05) except IgG (P ＞ 0.05).The serum level ofCD3+ was also significant higher in EIN group than in EN group at the 7th day after operation.The humoral immunity and cellular immunity were significant higher in EIN group than in EN group (P ＜ 0.05) at the 28th day after operation.The serum albumin,prealbumin,hemoglobin,cholesterin level had no significant differences between two groups before operation or at the 1 st,7th,28th day after operation (P ＞0.05),although they were higher on the 28th day than 1st day both in two groups (P ＜ 0.05).But cholesterin level had no significant differences between two groups at the 28th day and 1st day (P ＞ 0.05).The incidence of rejection was similar in two groups within 30 days after operation.Conclusion:The EIN can improve the humoral immunity and cellular immunity with a better effect than EN.The early postoperative EIN can improve the clinical outcomes of the patients undergoing renal transplantation.

Feasibility of helical CT multiplanar reconstruction in evaluation of C2 pedicle screw placement / 中国医学影像技术

Objective To evaluate the feasibility of the posterior C2 pedicle screw placement (C2 PSP) by MPR techniques of helical CT.Methods Totally 250 patients (500 sides) who underwent head and neck CTA examination were enrolled.The bony parameters and the arterial parameters were measured after MPR.The bony parameters included pedicle diameter (D),isthmus height (T),internal height (H),and the arterial parameters included medial shifting:lateral (L),neutral (N),medial (M);and the degree of riding included below (b),within (w),above (a).The prevalence of narrow pedicles,high-riding vertebral arteries (HRVA) and the subtypes of IAVA in the general population were calculated,and the statistical analysis between narrow pedicles,HRVA,IAVA and C2 vertebral arteries groove (C2 VAG) injury were performed.Results The rate of narrow pedicles and HRVA were 14.40％ (72/500) and 24.60％ (123/500;x2=141.984,P＜0.001).When it came to the simulation of the C2 PSP inserting,the incidence of C2 VAG injuries was 19.40％ (97/500).In narrow pedicle and HRVA patients,the C2 VAG injuries incidence were higher than that of without narrow pedicle and HRVA patients (both P＜0.001).In 58 sides (58/500,11.60 ％),the narrow pedicles and HRVA occurred simultaneously.There were statistical significance differences of narrow pedicles and HRVA and the C2 VAG injuries in different types of IAVA (all P＜0.001),the subtypes of IAVA M-a consisted most common,which account for 55.56％ (40/72),46.34％ (57/123) and 48.45％ (47/97),respectively.Conclusion Most of the C2 VAG injuries happened in narrow pedicles,HRVA or IAVA M-a type patients.MPR can be used to comprehensively evaluate osseous and arterial parameters,which will provide anatomy foundation to the screw placement of C2 pedicles.

Analysis of miR-34a function in brain development and behavior using knockout mouse model / 生理学报

miR-34a is a conserved microRNA highly expressed in the brain. It is thought to play critical roles in regulating many aspects of brain development and function, such as neural stem cell proliferation and differentiation, neuronal migration and apoptosis, fear memory consolidation, etc. However, the assessment of its function was mainly conducted through vector-mediated overexpression and miRNA sponge or antagomir-mediated functional suppression, therefore may suffer from nonspecific off-target effects or incomplete inactivation. We thus analyzed mouse model with a targeted deletion of miR-34a which completely abolishes its expression. To our surprise, loss of miR-34a led to neither an obvious change in brain size, morphology or cortical lamination, nor impaired marker gene expression in major excitatory and inhibitory neuron types in the neocortex. In addition, miR-34a ablation did not affect fear memory formation or consolidation, as well as the anxiety or depression related behavior. However, the performance of mice in rotarod assay was significantly affected, suggesting a defect in motor activity in miR-34a deficient mice. As neocortical parvalbumin (PV) neurons are known for high level miR-34a expression, we also tested the effect of PV-Cre-mediated conditional miR-34a deletion. Similar as germline deletion, PV neuron specific miR-34a deletion did not affect cortical lamination or PV expression in the neocortex. Our studies suggest that, although miR-34a may be involved in regulating certain aspects of brain development or function, such as motor activity, it does not play a significant role in regulating brain morphogenesis, cortical lamination or neocortical neuron subtype specification, and it is also dispensable for fear memory formation, expression and consolidation.

Expression of recombinant h-FGF21 in periplasmic space of Escherichia coli / 药学学报

Fibroblast growth factor 21 (FGF21) is a novel metabolic regulator of glucose and lipid, which is safe, effective and independent on insulin. FGF21 is considered as a prospective anti-diabetic drug. The aim of this study was to express recombinant h-FGF21 in periplasmic space of Escherichia coli. The pET27b plasmid was used to create the expression vectors of h-FGF21 with a PelB secretion signal. The ph-FGF21 (periplasmic expression of h-FGF21) was successfully expressed in the periplasm of E. coli BL21 (DE3), and soluble ph-FGF21 was isolated by disruption of the outer membrane. After twice of ion exchange chromatography, the purity of ph-FGF21 was above 95% in an analysis with a gray analysis software. The molecular weight of ph-FGF21 was about 20 kDa in SDS-PAGE and Western blotting analysis. The activity of ph-FGF21 and ih-FGF21 (intracellular expression of h-FGF21) was observed in vitro in the glucose uptake assay in HepG2 cells. The activity was observed in type 2 diabetic db/db mice after short or long-term treatments. The results suggest that the ph-FGF21 has a consistent activity with ih-FGF21 in vitro and in vivo.

Effect of extended nursing on the quality of life of patients with permanent colostomy / 现代临床护理

Objective To explore the effect of extended care on the quality of life of patients with permanent colostomy . Methods Clinical data of 268 patients with permanent colostomy were retrospectively analyzed. The patients were randomly divided into the experiment group (n=154) and control group (n=114). Two groups of patients after colostomy were given conventional nursing and telephone follow-up and the experiment group also received extended care such as home visits , seminars and fraternity care. Postoperative follow-up was done for 1 month, 3 months, 6 months, 9 months and 1 year. Core quality of life questionnaire (QLQ C30) was used to investigate the patients after 1 year intervention. Result Compared with the control group, patients′physical function, role function, emotional function, cognitive function, social function and health status rating were significantly improved in the experiment group (P<0.05). Conclusion Extended nursing can provide more comprehensive, systematic, professional nursing, improve the mastery of relevant knowledge and the skills and finally improve patients′quality of life.

The synergistic effect of FGF-21 and insulin on regulating glucose metabolism and its mechanism / 药学学报

Previous studies proposed that the synergistic effect of fibroblast growth factor-21 (FGF-21) and insulin may be due to the improvement of insulin sensitivity by FGF-21. However, there is no experimental evidence to support this. This study was designed to elucidate the mechanism of synergistic effect of FGF-21 and insulin in the regulation of glucose metabolism. The synergistic effect of FGF-21 and insulin on regulating glucose metabolism was demonstrated by investigating the glucose absorption rate by insulin resistance HepG2 cell model and the blood glucose chances in type 2 diabetic db/db mice after treatments with different concentrations of FGF-21 or/and insulin; The synergistic metabolism was revealed through detecting GLUT1 and GLUT4 transcription levels in the liver by real-time PCR method. The experimental results showed that FGF-21 and insulin have a synergistic effect on the regulation of glucose metabolism. The results of real-time PCR showed that the effective dose of FGF-21 could up-regulate the transcription level of GLUT1 in a dose-dependent manner, but had no effect on the transcription level of GLUT4. Insulin (4 u) alone could up-regulate the transcription level of GLUT4, yet had no effect on that of GLUT1. Ineffective dose 0.1 mg kg(-1) FGF-21 alone could not change the transcription level of GLUT1 or GLUT4. However, when the ineffective dose 0.1 mg x kg(-1) FGF-21 was used in combination with insulin (4 u) significantly increased the transcription levels of both GLUT1 and GLUT4, the transcription level of GLUT1 was similar to that treated with 5 time concentration of FGF-21 alone; the transcription level of GLUT4 is higher than that treated with insulin (4 u) alone. In summary, in the presence of FGF-21, insulin increases the sensitivity of FGF-21 through enhancing GLUT1 transcription. Vice versa, FGF-21 increases the sensitivity of insulin by stimulating GLUT4 transcription in the presence of insulin. FGF-21 and insulin exert a synergistic effect on glucose metabolism through mutual sensitization.

Effect of FGF-21 on learning and memory ability and antioxidant capacity in brain tissue of D-galactose-induced aging mice / 药学学报

This study aims to investigate the effects of fibroblast growth factor 21 (FGF-21) on learning and memory abilities and antioxidant capacity of D-galactose-induced aging mice. Kunming mice (37.1 +/- 0.62) g were randomly divided into normal control group, model group and FGF-21 high, medium and low dose groups (n = 8). Each group was injected in cervical part subcutaneously with D-galactose 180 mg x kg(-1) x d(-1) once a day for 8 weeks. At the same time, FGF-21-treated mice were administered with FGF-21 by giving subcutaneous injection in cervical part at the daily doses of 5, 2 and 1 mg x kg(-1) x d(-1). The normal control group was given with normal saline by subcutaneous injection in cervical part. At seventh week of the experiment, the learning and memory abilities of mice were determined by water maze and jumping stand tests. At the end of the experiment, the mice were sacrificed and the cells damage of hippocampus was observed by HE staining in each group. Reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and total antioxidant capacity (T-AOC) in the brain of mice were determined. The results showed that different doses of FGF-21 could reduce the time reaching the end (P < 0.01 or P < 0.05) and the number of touching blind side (P < 0.01 or P < 0.05) in the water maze comparing with the model group. It could also prolong the latency time (P < 0.05) and decrease the number of errors (P < 0.01 or P < 0.05) in the step down test. The result of HE staining showed that FGF-21 could significantly reduce brain cell damage in the hippocampus. The ROS and MDA levels of three different doses FGF-21 treatment group reduced significantly than that of the model group [(5.58 +/- 1.07), (7.78 +/- 1.92), (9.03 +/- 1.77) vs (12.75 +/- 2.02) pmol (DCF) x min(-1) x mg(-1), P < 0.01 or P < 0.05], [(2.92 +/- 0.71), (4.21 +/- 0.81), (4.41 +/- 0.97) vs (5.62 +/- 0.63) nmol x mg(-1) (protein), P < 0.01]. Comparing with the model group, the activities of SOD, GPx, CAT and T-AOC of the three different doses FGF-21 treatment groups were also improved in a dose-dependent manner. This study demonstrates that FGF-21 can ameliorate learning and memory abilities of D-galactose induced aging mice, improve the antioxidant abilities in brain tissue and delay brain aging. This finding provides a theoretical support for clinical application of FGF-21 as a novel therapeutics for preventing aging.

Therapeutic effect of fibroblast growth factor 21 on NAFLD in MSG-iR mice and its mechanism / 药学学报

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.