Association between cognitive impairment and main metals among oldest old aged 80 years and over in China / 中华预防医学杂志

Objective: To identify the main metals involved in cognitive impairment in the Chinese oldest old, and explore the association between these metal exposures and cognitive impairment. Methods: A cross-sectional study was conducted on 1 568 participants aged 80 years and older from Healthy Aging and Biomarkers Cohort Study (2017 to 2018). Fasting venous blood was collected to measure the levels of nine metals (selenium, lead, cadmium, arsenic, antimony, chromium, manganese, mercury, and nickel). The cognitive function of these participants was evaluated by using the Chinese version of the Mini-Mental State Examination (CMMSE). The random forest (RF) was applied to independently identify the main metals that affected cognitive impairment. The multivariate logistic regression model and restricted cubic splines (RCS) model were used to further verify the association of the main metals with cognitive impairment. Results: The age of 1 568 study subjects was (91.8±7.6) years old, including 912 females (58.2%) and 465 individuals (29.7%) with cognitive function impairment. Based on the RF model (the out-of-bag error rate was 22.9%), the importance ranking of variables was conducted and the feature screening of five times ten-fold cross-validation was carried out. It was found that selenium was the metal that affected cognitive function impairment, and the other eight metals were not included in the model. After adjusting for covariates, the multivariate logistic regression model showed that with every increase of 10 μg/L of blood selenium levels, the risk of cognitive impairment decreased (OR=0.921, 95%CI: 0.889-0.954). Compared with the lowest quartile(Q1) of blood selenium, the ORs (95%CI) of Q3 and Q4 blood selenium were 0.452 (0.304-0.669) and 0.419 (0.281-0.622) respectively. The RCS showed a linear dose-response relationship between blood selenium and cognitive impairment (Pnonlinear>0.05). Conclusion: Blood selenium is negatively associated with cognitive impairment in the Chinese oldest old.

Association of plasma vitamin B12 level with plasma uric acid level among the elderly over 65 years old in 9 longevity areas of China / 中华预防医学杂志

Objective: To investigate the association of plasma vitamin B12 level with plasma uric acid level among the elderly over 65 in 9 longevity areas of China. Methods: The elderly over 65 years old with complete information on plasma vitamin B12 and plasma uric acid from Healthy Aging and Biomarkers Cohort Study (2017 to 2018) were recruited in this study. Information on socio-demographic characteristics, life styles, diet intake, and health status were collected by questionnaire and physical examination; and fasting venous blood was collected to detect the levels of plasma vitamin B12, uric acid and other indicators. Multiple linear regression models were used to analyze the association of plasma vitamin B12 level per interquartile range increase with plasma uric acid level. The association trend of plasma vitamin B12 level with plasma uric acid level was described by restrictive cubic splines fitting multiple linear regression model. Multiple logistic regression models were used to analyze the association of plasma vitamin B12 level stratified by quartiles with hyperuricemia. Results: A total of 2 471 participants were finally included in the study, the age was (84.88±19.76) years old, of which 1 291 (52.25%) were female. The M (Q1, Q3) level of plasma vitamin B12 was 294 (203, 440) pg/ml and the plasma uric acid level was (341.01±90.46) μmol/L. A total of 422 participants (17.08%) were defined with hyperuricemia. The results of multiple linear regression model showed that there was a positive association of plasma vitamin B12 level with plasma uric acid level after adjustment for covariates (P<0.05). An IQR increase in plasma vitamin B12 (237 pg/ml) was associated with a 6.36 (95%CI: 2.00-10.72) μmol/L increase in the plasma uric acid level. The restrictive cubic splines curve showed a positive linear association of log-transformed plasma vitamin B12 with uric acid level (P<0.001). Conclusion: There is a positive association of plasma vitamin B12 level with plasma uric acid level among the elderly over 65 years old in 9 longevity areas of China.

Association of greenness exposure with waist circumference and central obesity in Chinese adults aged 65 years and over / 中华预防医学杂志

Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.

Association of blood lead and blood selenium with serum high-sensitivity C-reactive protein among Chinese adults aged 19 to 79 years / 中华流行病学杂志

Objective: To investigate the association of blood lead and blood selenium with serum high-sensitivity C-reactive protein (hs-CRP) among Chinese adults aged 19 to 79 years. Methods: The participants were enrolled from the first wave of China National Human Biomonitoring (CNHBM) conducted from 2017 to 2018. 10 153 participants aged 19 to 79 years were included in this study. Fasting blood samples were obtained from participants. Lead and selenium in whole blood and hs-CRP in serum were measured. Individuals with hs-CRP levels above 3.0 mg/L were defined as elevated hs-CRP. Generalized linear mixed models and restricted cubic spline models were used to analyze the association of blood lead and blood selenium with elevated hs-CRP. Logistic regression models were used to analyze the multiplicative scale and additive scale interaction between blood lead and blood selenium on elevated hs-CRP. Results: The age of participants was (48.91±15.38) years, of which 5 054 (61.47%) were male. 1 181 (11.29%) participants were defined as elevated hs-CRP. After multivariable adjustment, results from generalized linear models showed that compared with participants with the lowest quartile of blood lead, the OR (95%CI) of elevated hs-CRP for participants with the second, third, and highest quartiles were 1.14 (0.94-1.37), 1.25 (1.04-1.52) and 1.38 (1.13-1.68), respectively. When compared with participants with the lowest quartile of blood selenium, the OR (95%CI) of elevated hs-CRP for participants with the second, third and highest quartiles were 0.86 (0.72-1.04), 0.91 (0.76-1.11), and 0.75 (0.61-0.92), respectively. Results from the interaction analysis showed no significant interaction between lead and selenium on elevated hs-CRP. Conclusion: Blood concentration of lead was positively associated with elevated serum hs-CRP, and blood concentration of selenium was inversely related to elevated hs-CRP, while blood lead and selenium did not present interaction on elevated hs-CRP.

Identification and analysis of 2 Corynebacterium diphtheria strains in Guangdong Province / 中华预防医学杂志

Objective: To identify and analyze two strains of C. diphtheriae in Guangdong Province by combining whole genome sequencing with traditional detection methods. Methods: The C. diphtheriae was isolated from Guangzhou in 2010 and Zhuhai in 2020 respectively. Isolates were identified by API Coryne strips and MALDI-TOF-MS. Genomic DNA was sequenced by using Illumina. The assembly was performed for each strain using CLC software. J Species WS online tool was used for average nucleoside homology identification, then narKGHIJ and tox gene were detected by NCBI online analysis tool BLSATN. MEGA-X was used to build a wgSNP phylogenetic tree. Results: GD-Guangzhou-2010 was Belfanti and GD-Zuhai-2020 was Gravis. ANIb between GD-Guangzhou-2010 and C. belfantii was 99.61%. ANI between GD-Zhuhai-2020 and C. diphtheriae was 97.64%. BLASTN results showed that the nitrate reduction gene narKGHIJ and tox gene of GD-Guangzhou-2010 was negative, while GD-Zhuhai-2020 nitrate reduction gene narKGHIJ was positive. There were two obvious clades in wgSNP phylogenetic tree. The first clades included all Mitis and Gravis types strains as well as GD-Zhuhai-2020. The second clades contained all isolates of C.belfantii, C.diphtheriae subsp. lausannense and GD-guangzhou-2010. Conclusion: Two non-toxic C. diphtheriae strains are successfully isolated and identified. The phylogenetic tree suggests that GD-Guangzhou-2010 and GD-Zhuhai-2020 are located in two different evolutionary branches.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults / 生物医学与环境科学（英文）

Objective@#To evaluate the associations of sarcopenia, handgrip strength and calf circumference with cognitive impairment among Chinese older adults.@*Methods@#Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study. Cognitive impairment was assessed by the Chinese Mini-Mental State Examination. Handgrip strength was calculated from the means of the right and left hand values. Calf circumference was measured at the site of maximum circumference of the non-dominant leg. The formula developed by Ishii was used to define sarcopenia. Multiple logistic regression was performed to evaluate the associations of sarcopenia, handgrip strength, and calf circumference with cognitive impairment.@*Results@#The prevalence of cognitive impairment was 34.36%. The adjusted odds ratio ( @*Conclusion@#Sarcopenia, identified by low handgrip strength and low calf circumference, was positively associated with cognitive impairment.

Analysis of maternal clinical risk factors for different degrees of small for gestational age infant / 上海交通大学学报（医学版）

Objective : To explore the pregestational and gestational risk factors associated with small for gestational age infant (SGA) by dif-ferent degrees. Methods ¡¤ Mothers and single newborns delivered at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from September 2013 to December 2016 were included. Multivariate Logistic regression was used to analyze the correlation between maternal preg-nancy and pre-pregnancy risk factors and the occurrence of SGA by different degrees. Results ¡¤ There were no statistically significant differ-ences in maternal age, number of birth, education level, incidence of preterm birth and fetal sex in SGA. Maternal body mass index (BMI), gesta-tional hypertension and accepting assisted reproduction were significantly correlated with SGA (all P<0.05). The incidence of moderate SGA in mothers with low pre-pregnancy BMI and gestational hypertension were 3.6 and 4.0 times higher than that of the mothers with normal BMI and blood pressure. The incidence of severe SGA in mothers receiving assisted reproduction was 6.4 times higher than that in those who did not. Mild SGA was not associated with the above risk factors. Conclusion ¡¤ Maternal low BMI and hypertension are the risk factors of moderate SGA and accepting assisted reproduction are the risk factors of severe SGA, and the risk factors of SGA by different degrees are not the same.

Effect of breastfeeding on the development of infection-related diseases during hospitalization in late preterm infants in 25 hospitals in Beijing, China / 中国当代儿科杂志

OBJECTIVE@#To investigate the incidence rate of infectious diseases during hospitalization in late preterm infants in Beijing, China, as well as the risk factors for infectious diseases and the effect of breastfeeding on the development of infectious diseases.@*METHODS@#Related data were collected from the late preterm infants who were hospitalized in the neonatal wards of 25 hospitals in Beijing, China, from October 23, 2015 to October 30, 2017. According to the feeding pattern, they were divided into a breastfeeding group and a formula feeding group. The two groups were compared in terms of general status and incidence rate of infectious diseases. A multivariate logistic regression analysis was used to investigate the risk factors for infectious diseases.@*RESULTS@#A total of 1 576 late preterm infants were enrolled, with 153 infants in the breastfeeding group and 1 423 in the formula feeding group. Of all infants, 484 (30.71%) experienced infectious diseases. The breastfeeding group had a significantly lower incidence rate of infectious diseases than the formula feeding group (22.88% vs 31.55%, @*CONCLUSIONS@#Breastfeeding can significantly reduce the incidence of infectious diseases and is a protective factor against infectious diseases in late preterm infants. Breastfeeding should therefore be actively promoted for late preterm infants during hospitalization.

Comparison of postoperative analgesic effect between serratus plane block and thoracic paravertebral block in patients undergoing thoracoscopic surgery / 临床麻醉学杂志

Objective To compare the postoperative analgesic effect between serratus plane block and thoracic paravertebral block in patients undergoing thoracoscopic surgery.Methods Sixty patients undergoing thoracoscopic surgery, 38 males and 22 females, aged 18-65, BMI 18-25 kg/m2, falling into ASA physical status I or II.They were divided into groups S and T by random number table, 30 cases in each group.Two groups of patients were treated with general anesthesia with endobronchial intubation and PCIA after operation.Group S performed Ultrasound-guided serratus plane block and group T performed thoracic paravertebral block, 0.4％ropivacaine 30 ml were used in the two groups.The two groups of patients were observed 30 min after block, and the sensory block plane was measured with acupuncture and recorded.Recording operation time, onset time and duration of the block.Resting and cough VAS score were recorded at 2, 4, 8, 12, 24, and 48 hafter surgery.The first pressing time of the analgesic pump and times of press analgesic pump, the amount of sufentanil used and times the number of cases of useing piperidine were recorded within 48 hafter operation.Block related complications and analgesic related adverse reactions were recorded.Results Compared with group T, the operation time of the block obviously shortening but the duration obviously lengthening (P<0.01).Resting and cough VAS score at 12 hafter surgery significantly was lower (P<0.01).The first pressing time of the analgesic pump obviously lengthening, the number of press analgesic pump and the amount of sufentanil used significantly were reduced (P<0.01) in group S.Conclusion Ultrasound guided SP block and TPVB block can provide good postoperative analgesia for patients undergoing thoracoscopic surgery, but SP block is more durable, with less operation time and complications than TPVB block, and can effectively reduce the opioid demand and incidence of nausea and vomiting after operation.

The inhibitory effects of YZG-330/YZG-331 on central nervous system / 中国药理学通报

Aim To investigate the inhibitory effects of the novel compounds YZG-330 and YZG-331 in central nervous system. Methods The sedative effect was investigated by recording the spontaneous locomotor ac-tivity in mice. The hypnotic effect was evaluated by the latency and duration of the loss of righting reflex ( LORR) in the threshold dosage of sodium pentobarbi-tal treated mice. The two compounds induced the mice that had woken up after a threshold dosage pentobarbi-tal sodium to fall asleep again. The levels of GABA and Glu in brain were measured by HPLC-ECD. Re-sults The results showed that spontaneous locomotor activities decreased in YZG-330 (0.125, 0.5,2 mg·kg-1 ) treated mice and YZG-331 (1.25, 5, 20 mg· kg-1 ) treated mice. YZGs could extend the duration of the loss of righting reflex in threshold dosage of sodium pentobarbital treated mice, and significantly shorten sleep latency. YZGs were able to allow the mice that had woken up after a threshold dosage pentobarbital so-dium to fall asleep again. YZG-331 (40 mg·kg-1 ,i. g. ) could significantly increase GABA level in hypo-thalamus and cerebral cortex. The content of GABA had no significant change after YZG-330 ( 2 mg · kg-1 , ig. ) administration. Conclusions YZG-330 and YZG-331 have potent sedative and hypnotic effects. The efficacy of YZG-330 is stronger than that of YZG-331 , but the mechanism of two compounds sounds different.

Comparison of the effect of dexmedetomidine combined with butorphanol to prevent the adverse effects of carboprost tromethamine druing cesarean delivery / 临床麻醉学杂志

Objective To compare the effect of dexmedetomidine combined with butorphanol to prevent the adverse effects of carboprost tromethamine druing cesarean delivery.Methods Ninety parturients with the risk factor of uterine atony,aged 24-40 years,weighting 55-85 kg,ASA physical status Ⅰ or Ⅱ,undergoing full term cesarean section,were randomly divided into dexmedetomidine combined with butorphanol group (group DB,n=30),butorphanol group (group B,n=30)and control group (group N,n=30).Three groups were intravenously injected corresponding drugs of carboprost tromethamine into uterus.Group DB was given intravenous injection dexmedetomidine 1 μg/kg combined with butorphanol 20 mg/kg.Group B was given butorphanol 20 mg/kg.Group N was given 0.9% sodium chloride solution.MAP,HR,and SpO2were recorded at different times,10 min after go into operation room (T0),10 min after carboprost tromethamine into uterus (T1),end of operation (T2).Ramsay sedation score was recorded at T1.The adverse effects of carboprost tromethamine were recorded.The initial time of lactation after operation was recorded.The initial time of lactation after operation,the height of uterine fundus at 1,3,5 d after operation,the oxyto-cin doses within 72 h after operation were recorded.Results Compared with group N,the MAP and HR of group DB and group B decreased obviously at T1(P<0.05),and group DB was lower than group B obviously at T1(P<0.05).Compared with group N,the scores of Ramsay in group DB and group B were significantly higher (P<0.05),group DB was higher than that of group B(P<0.05). Compared with group N,the incidence of nausea,vomiting,chest tightness,chest pain,hyperten-sion,tachycardia and chills in group B and group DB were significantly lower (P<0.05),and group DB was lower than that of group B (P<0.05).There were no significant differences of the initial time of lactation after operation,height of uterine fundus at 1,3,5 d after operation,the oxytoxin doses within 72 h after operation between the three groups.Conclusion Dexmedetomidine combined with butorphanol can effectively reduce the adverse effects of carboprost tromethamine druing cesarean delivery,the more stable hemodynamics and sedative effect,the effect is better than the sin-gle application of butorphanol,at the same time does not affect lactation,it is safe and effective for clinical use.

Effects of flavonoids from Pyrrosiae folium on pathological changes and inflammatory response of diabetic nephropathy / 中国中药杂志

Diabetic nephropathy (DN) is closely related to immune-mediated inflammatory damage. Pyrrosiae folium is used commonly for the urinary system diseases with a good efficacy, which contains abundant flavonoids (SWHT). This study was performed to investigate the therapeutic effect of SWHT on DN and its effect on inflammatory response. In this study, the main active components of SWHT were identified by high performance liquid chromatography (HPLC). The results showed that SWHT mainly contained mangiferin and isomucoside. Rat model of diabetic nephropathy (DN) was established by feeding high glucose & high fat diet and injecting streptozocin (STZ). Then the rats were randomly divided into control group, DN model group, positive control group, and SWHT groups (50, 100, 200 mg·kg⁻¹, ig). The levels of AGEs and RAGE in serum were measured by ELISA after 12 weeks of drug administration. The serum creatinine, blood urea nitrogen and total protein levels were detected by using test kit. HE staining and transmission electron microscopy were applied to observe the pathological changes and structure of renal tissue. Western blot and ELISA were used to detect the protein expression and content levels of interleukin 6 (IL-6), tumor necrosis factor (TNF-α) and IL-1β in renal tissue. Results showed that SWHT significantly decreased serum AGEs and RAGE levels in DN rats; decreased serum creatinine, blood urea nitrogen and total urinary protein levels, improved renal pathological damages and reduced basement membrane thickening in DN rats. In addition, SWHT down-regulated the protein expression levels of inflammatory mediators IL-6, TNF-α and IL-1β. The research studies indicated that SWHT component had a potential anti-diabetic nephropathy activity, and its improvement effect on pathological damages may be related to reducing inflammation. This provides the basis for the scientific and rational application of P. folium, and also provides active components for further development of Chinese medicine for diabetic nephropathy.

Effects of adipose-derived stem cells and non-methylated CpG-oligodeoxynucleotides on peripheral blood CD4CD25regulatory T cells in young mice with food allergy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effects of adipose-derived stem cells (ADSC) and non-methylated CpG-oligodeoxynucleotides (CpG-ODN) on the expression of peripheral blood CD4CD25regulatory T (Treg) cells in young mice with food allergy, as well as their immune intervention effects.</p><p><b>METHODS</b>A total of 40 female BALB/c mice were randomly divided into control group, allergic group, ADSC treatment group, and CpG-ODN treatment group, with 10 mice in each group. A mouse model of food allergy was established by intraperitoneal injection and intragastric administration of ovalbumin (OVA) for sensitization and challenge. The mice in the control group were treated with normal saline at the same dose; the mice in the ADSC treatment group were given intraperitoneal injection of ADSC (1×10cells for each mouse) before and after OVA challenge, and those in the CpG-ODN treatment group were given intraperitoneal injection of non-methylated CpG-ODN solution (40 μg for each mouse) at 1 hour before challenge by gavage. The allergic symptom scores were determined for each group after model establishment. ELISA was used to measure the serum level of OVA-IgE. Flow cytometry was used to measure the percentage of peripheral blood CD4CD25Treg cells. Hematoxylin and eosin staining was used for the pathological analysis of the jejunum.</p><p><b>RESULTS</b>The allergic group had significantly higher allergic symptom scores and serum level of OVA-IgE than the control group (P<0.05). There were no significant differences in the allergic symptom score and the serum level of OVA-IgE between the ADSC treatment group and the CpG-ODN treatment group (P>0.05), but these two groups had significantly lower allergic symptom scores and serum level of OVA-IgE than the allergic group and significantly higher allergic symptom scores and serum level of OVA-IgE than the control group (P<0.01). The allergic group had a significantly lower percentage of peripheral blood CD4CD25Treg cells than the control group (P<0.05). The ADSC treatment group and the CpG-ODN treatment group had a significantly higher percentage of peripheral blood CD4CD25Treg cells than the allergic group (P<0.05); there were no significant differences between these two groups or between them and the control group (P>0.05). Pathological results showed structural damage and edema in the jejunal villi, a large number of eosinophils, and lymphocyte infiltration in the allergic group, while the ADSC treatment group and the CpG-ODN treatment group had less structural damage and edema in the jejunal villi, a lower number of eosinophils, and less lymphocyte infiltration.</p><p><b>CONCLUSIONS</b>ADSC and non-methylated CpG-ODN have a certain effect in the treatment of food allergy and can increase the percentage of peripheral blood CD4CD25Treg cells and reduce the level of OVA-IgE. They may be associated with the induction of immune tolerance and these two treatment have comparable effects. Detailed mechanisms of action still need further investigation.</p>

Differentiation and analysis on YAN Ming-guang and XU Feng's Najia fa (day-prescription of acupoints) / 中国针灸

The traditional Najiafa (day-prescription of acupoints) can be classified into two schools of YAN Ming-guang and XU Feng. The author studied the YAN Ming-guang and XU Feng Najia fa from the aspects of the academic source, selection of points, existing researches and current application. When compared between the two schools, it is held that Najia fa of YAN Ming-guang school more accords with the law of point selection according to Ziwu Liuzhu Zhenfa (acupuncture based on the midnight-noon and ebb-flow doctrine) in following the original doctrine, selection of points on the base of day-prescription, and time-meridian relation of Sanjiao (triple energizer) and Pericardium meridians. Therefore, it is concluded that the YAN's Najia fa should not be neglected and forgotten. Its inheritage and further study should be carried out so as to enrich the ways of study as well as the prevention and treating methods in clinic.

Effect of high mobility group box protein 1 on the Kupffer cells of rats with severe burn and the role of receptor for advanced glycation end products in the process / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of high mobility group box protein 1 (HMGB1) on the production of pro-inflammatory cytokines by Kupffer cell (KC) of rats with severe burn and the role of receptor for advanced glycation end products (RAGE) in the process.</p><p><b>METHODS</b>Model of 30% TBSA full-thickness burn was reproduced in 32 SD rats through immersing the back in 98°C water for 12 s. KC (32 samples) was isolated from rat liver 24 h after injury and inoculated in 24-well plate in the concentration of 1×10(6) cell per well. (1) Cells were divided into control group (cultured with 1 mL PBS) and HMGB1 group (stimulated with 100 ng/mL HMGB1 in the volume of 1 mL) according to the random number table, with 8 samples in each group. At post culture hour (PCH) 48, the expression of RAGE (denoted as grey value ratio) was detected with Western blotting. (2) Another portion of cells were divided into control group (cultured with 1 mL PBS), HMGB1 group (treated with 100 ng/mL HMGB1 in the volume of 1 mL), HMGB1 + anti-RAGE antibody group (treated with 100 ng/mL HMGB1 in the volume of 1 mL after being pre-incubated with 20 µg/mL anti-RAGE monoclonal antibody in the volume of 1 mL for 2 hours), HMGB1 + recombinant rat RAGE/Fc chimera (rrRAGE/Fc) group (treated with the mixture of 100 ng/mL HMGB1 in the volume of 0.5 mL and 5 µg/mL rrRAGE/Fc in the volume of 0.5 mL which were pre-incubated for 2 hours) according to the random number table, with 8 samples in each group. At PCH 48, the protein levels of TNF-α and IL-1β in supernatant were determined with enzyme-linked immunosorbent assay, while the mRNA expression of TNF-α and IL-1β (denoted as grey value ratio) were determined with Northern blotting. Data were processed with one-way analysis of variance, t test, and LSD test.</p><p><b>RESULTS</b>(1) The expression of RAGE in HMGB1 group (1.036 ± 0.101) was significantly higher than that of control group at PCH 48 (0.191 ± 0.024, t = -23.158, P = 0.000). (2) In HMGB1 group, HMGB1 + anti-RAGE antibody group, and HMGB1 + rrRAGE/Fc group, the contents of TNF-α in supernatant were respectively (10.59 ± 1.39), (9.91 ± 1.68), (11.51 ± 2.27) ng/mL; the contents of IL-1β in supernatant were respectively (2.49 ± 0.33), (2.08 ± 0.32), (2.42 ± 0.42) ng/mL; the mRNA levels of TNF-α in cells were respectively 0.311 ± 0.009, 0.301 ± 0.047, 0.326 ± 0.016; the mRNA levels of IL-1β in cells were respectively 0.237 ± 0.021, 0.244 ± 0.041, 0.245 ± 0.013. There were no statistically significant differences in the above indexes among these three groups (with P values all above 0.05). Their levels were all significantly higher than those of control group [with contents of TNF-α and IL-1β in supernatant respectively (2.69 ± 0.14), (0.43 ± 0.05) ng/mL, and mRNA levels of TNF-α and IL-1β in cells respectively 0.140 ± 0.022, 0.077 ± 0.005, P values all below 0.01].</p><p><b>CONCLUSIONS</b>HMGB1 can induce the production of pro-inflammatory cytokines TNF-α and IL-1β from the KC in rats with severe burn. However, RAGE does not play a predominant role in this process.</p>

Association of depression with glycosylated hemoglobin, lipid metabolism and coping style in patients with type 2 diabetes mellitus / 第二军医大学学报

Objective To investigate the association of depression with glycosylated hemoglobin, lipid metabolism and coping style in patients with type 2 diabetes mellitus (DM). Methods A total of 73 patients with type 2 DM were divided into depression group (n=31) and non-depression group (n = 42) according to the results of Zung Self-Rating Depression Scale. The anxiety statuses were evaluated by Zung Self-Rating Anxiety Scale (SAS). The coping style was assessed by Medical Coping Modes Questionnaire (MCMQ). Moreover, the blood HbAlc, triglycerides (TG), total cholesterol (TO, high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were also compared between the two groups. Results The SAS standard score and MCMQ score of resignation in the depression group were significantly higher than those in the non-depression group (P<0. 01). The MCMQ score of confronce and avoidance, blood HbAlc, TG, TC, HDL-C, and LDL-C were not significantly different between the 2 groups. Conclusion It is suggested that type 2 DM patients with resignation coping style are more liable to have depression.

Unplanned decannulation of tracheotomy tube in massive burn patients: a retrospective case series study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation (UD) in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients.</p><p><b>METHODS</b>A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square (χ(2)) or Fisher's exact test.</p><p><b>RESULTS</b>Patients with UD were often burned with head and neck (67%) and combined with inhalation injury (62%). The majority of them (76%) were transferred patients, occurred early (55%) and were accidental UD (79%). UD events tended to happen in day shift (90%) and to be associated with the medical procedure that was performing by caregivers at besides (79%). Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients' death.</p><p><b>CONCLUSIONS</b>UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.</p>

Role of angiotensin II-angiotensin II type 1 receptor pathway in the production of proinflammatory cytokines in macrophage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the role of angiotensin II (AngII)-angiotensin II type 1 receptor (AT1R) pathway in the production of proinflammatory cytokines in macrophage, and to analyze its mechanisms.</p><p><b>METHODS</b>RAW264.7 macrophages were cultured in vitro in DMEM nutrient medium containing 10% FBS, and then they were divided into control group (ordinary culture for 6 hours without any stimulation), ZD7155 group (pretreated with 38 µmol/L AT1R-specific inhibitor ZD7155 for 1 hour, then cultured with fresh nutrient solution for 6 hours), AngII group (cultured with 0.01 µmol/L AngII for 6 hours), and ZD7155 + AngII group (pretreated with 38 µmol/L AT1R-specific inhibitor ZD7155 for 1 hour, then cultured with 0.01 µmol/L AngII for 6 hours) according to the random number table. Contents of TNF-α and IL-1β in the supernatant were measured by ELISA. Expressions of TNF-α mRNA and IL-1β mRNA were determined by RT-PCR. Activity of NF-κB and AP-1 were examined by electrophoretic mobility shift assay. Data were processed with one-way analysis of variance.</p><p><b>RESULTS</b>Compared with those in AngII group [(119 ± 14), (105 ± 17) pg/mL, respectively], the levels of TNF-α and IL-1β in the supernatant in control group [(24 ± 11), (24 ± 6) pg/mL, with F value respectively 1.62, 8.03, P values all below 0.01], ZD7155 group [(22 ± 11), (25 ± 8) pg/mL, with F value respectively 1.62, 4.52, P values all below 0.01], and ZD7155 + AngII group [(45 ± 13), (62 ± 11) pg/mL, with F value respectively 1.16, 2.29, P < 0.05 or P < 0.01] were all obviously decreased. The expressions of TNF-α mRNA and IL-1β mRNA, and activity of NF-κB and AP-1 showed the similar changes as above: (1) The levels of TNF-α mRNA and IL-1β mRNA in AngII group were all higher than those in control group (with F value respectively 7.59, 3.38, P < 0.05 or P < 0.01), ZD7155 group (with F value respectively 10.66, 2.24, P values all below 0.05), and ZD7155 + AngII group (with F value respectively 5.10, 5.09, P values all below 0.01). (2) Activity of NF-κB and AP-1 was respectively 69 027 ± 2502, 36 752 ± 2055 in AngII group, all higher than those in control group (45 709 ± 1203, 20 325 ± 2695, with F value respectively 4.32, 1.72, P values all below 0.01), ZD7155 group (46 303 ± 1897, 21 951 ± 2517, with F value respectively 1.74, 1.50, P values all below 0.01), and ZD7155 + AngII group (38 271 ± 690, 22 365 ± 3797, with F value respectively 13.13, 3.41, P values all below 0.01).</p><p><b>CONCLUSIONS</b>AngII can mediate activation of transcription factor NF-κB and AP-1 via combination of AT1R, thereby contributing to the production and release of proinflammatory cytokines TNF-α and IL-1β in macrophage.</p>

Role of angiotensin II type 1 receptor in activation of nuclear factor-kappaB and activator protein-1 in lung of mice with acute lung injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the role of angiotensin II type 1 (AT1) receptor in activation of nuclear factor-kappaB (NF-kappaB) and activator protein-1 (AP-1) in lung of mice with LPS-induced acute lung injury (ALI).</p><p><b>METHODS</b>Eighty-eight BABL/c mice were divided into control group (n = 8), LPS group (n = 40), and LPS + AT1 receptor antagonist ZD7155 group (n = 40) according to the random number table. Puncture of trachea was done in all mice. Mice in LPS + ZD7155 group were intraperitoneally injected with 10 mg/kg ZD7155. Mice in LPS and control groups were intraperitoneally injected with normal saline in the same volume as that of ZD7155. Thirty minutes later, 1 mg/mL LPS was dripped into trachea of mice in LPS and LPS + ZD7155 groups (2 mg/kg). Normal saline in the same volume as that of LPS was dripped into trachea of mice in control group. Lung tissue samples of mice in LPS and LPS + ZD7155 groups were harvested at post dripping hour (PDH) 1, 3, 6, 12, and 24. Lung tissue sample of mice in control group was harvested at PDH 24. Expression of AT1 receptor was determined with Western blot. AP-1 and NF-kappaB activity in lung tissue was detected with electrophoretic mobility shift assay. Data were processed with one-way analysis of variance.</p><p><b>RESULTS</b>The relative expression amount of AT1 receptor protein in lung tissue of mice in LPS group at each time point was increased obviously as compared with that of mice in control group (0.69 +/- 0.28, F = 9.356, with P values all below 0.01), and it peaked at PDH 6 (3.44 +/- 0.90), while that of mice in LPS + ZD7155 group was less than that in LPS group at each time point (F = 9.356, with P values all below 0.01). NF-kappaB activity in mice lung was markedly increased in LPS group at each time point as compared with mice in control group (5.47 +/- 0.08, F = 26.443, with P values all below 0.05), and its peak value in LPS group was found at PDH 3 (52.33 +/- 3.25). While NF-kappaB activity in mice of LPS + ZD7155 group was obviously lower than that in LPS group at each time point (F = 26.443, with P values all below 0.05). AP-1 activity in lung was enhanced significantly in LPS group at each time point as compared with that in control group (2.5 +/- 0.4, F = 34.685, with P values all below 0.05), and the activity peaked at PDH 6 (73.3 +/- 9.5) in LPS group. The activity was obviously weaker in mice in LPS + ZD7155 group as compared with that in LPS group at each time point (F = 34.685, with P values all below 0.05).</p><p><b>CONCLUSIONS</b>AT1 receptor contributes to LPS-induced ALI through activating NF-kappaB and AP-1 in lung tissue.</p>

Observation on short and long-term effects of cervical spondylotic radiculopathy treated with abdominal acupuncture plus Long's bone-setting manipulation / 中国针灸

<p><b>OBJECTIVE</b>To compare the short and long-term therapeutic effects on cervical spondylotic radiculopathy (CSR) treated with simple Long's bone-setting manipulation, abdominal acupuncture and abdominal acupuncture plus Long's bone-setting manipulation.</p><p><b>METHODS</b>One hundred and eighty cases of CSR were randomly allocated into abdominal acupuncture plus bone-setting group (combined therapy group), bone-setting group and abdominal acupuncture group, 60 cases in each group. In combined therapy group, the abdominal acupuncture and Long's bone-setting were applied in combination. Abdominal acupuncture was applied to Zhongwan (CV 12), Guanyuan (CV 4), Shiguan (KI 18), Shangqu (KI 17), etc. Long's manipulation, such as bone-setting in head-upward posture and bone-setting in head-lateral posture, was adopted. In bone-setting group and abdominal acupuncture group, Long's bone-setting manipulation and abdominal acupuncture were adopted simply and respectively. The clinical therapeutic effects were compared after 2 courses of treatment (short-term) and 1-month after treatment (long-term) among groups.</p><p><b>RESULTS</b>The short and long-term curative and markedly effective rates in combined therapy group were 80.7% (46/57) and 68.4% (39/57) respectively, which were better than those of 63.64% (35/55), 30.9% (17/55) in bone-setting group and 58.9% (33/56), 50.0% (28/56) in abdominal acupuncture group, separately (all P < 0.05). Moreover, the long-term curative and markedly effective rate in abdominal acupuncture group was superior to that in bone-setting group (P < 0.05).</p><p><b>CONCLUSION</b>Abdominal acupuncture plus Long's bone-setting manipulation has significant efficacy of either short or long-term on CSR, which is superior to the efficacy of either simple abdominal acupuncture or Long's bone-setting manipulation and indicates superimposed effect. Hence, it is one of the better approaches in CSR treatment.</p>