Pharmacoeconomic evaluation of trastuzumab biosimilars versus original drug in the treatment of recurrent/metastatic HER-2 positive breast cancer / 中国药房

OBJECTIVE To evaluate the cost-effectiveness of trastuzumab biosimilars （Hanquyou） versus original drug （Hesaiting） in the treatment of recurrent/metastatic human epidermal growth factor receptor-2 （HER-2） positive breast cancer. METHODS A partitional survival model was constructed based on the NCT03084237 trial data. The simulation period was 3 weeks， and the simulation time was 10 years. Using costs and quality-adjusted life year （QALY） as the output indicator， the cost- utility analysis method was used to evaluate the cost-effectiveness of the two schemes mentioned above. Univariate and probabilistic sensitivity analyses were performed to verify the robustness of the basic analysis. RESULTS The costs of the trastuzumab biosimilars group and original drug group were 111 516.72 yuan and 111 122.30 yuan respectively， with health utility values of 1.52 QALYs and 1.36 QALYs， and ICER of 2 465.12 yuan/QALY， which were less than 3 times China’s per capita gross domestic product （GDP） in 2023 as the threshold for willingness-to-pay （WTP） （268 200 yuan/QALY）. Univariate sensitivity analysis showed that the cost of the trastuzumab biosimilars and original drug had a great impact on the ICER. The probabilistic sensitivity analysis showed that the probability of trastuzumab biosimilars being cost-effective was 100% at WTP threshold of 14 902 yuan/QALY. CONCLUSIONS When WTP threshold is 3 times China’s GDP in 2023 （268 200 yuan/QALY）， compared with original drug， trastuzumab biosimilars have good cost-effectiveness in the treatment of recurrent/metastatic HER-2 positive breast cancer.

Clinical Observation on Therapeutic Effect of Huatan Jieyu Anshen Decoction Combined with Abdominal Vibration Tuina Manipulations on Chronic Insomnia in the Elderly / 广州中医药大学学报

Objective To investigate the therapeutic effect of Huatan Jieyu Anshen Decoction(mainly with the actions of resolving phlegm,relieving depression and calming mind)combined with abdominal vibration tuina manipulations on chronic insomnia in the elderly.Methods Ninety-four cases of elderly patients with chronic insomnia of phlegm-heat harassing the interior type were randomly divided into the observation group and the control group,with 47 cases in each group.The control group was given Huatan Jieyu Anshen Decoction orally,while the observation group was given oral use of Huatan Jieyu Anshen Decoction combined with abdominal vibration tuina manipulations.The course of treatment for the two groups lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)score,Athens Insomnia Scale(AIS)score,Fatigue Scale-14(FS-14)score,World Health Organization Quality-of-Life Brief Scale(WHOQOL-BREF)score,and the serum levels of melatonin(MT),dopamine(DA),and cortisol(CORT).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 97.88%(46/47),while that of the control group was 87.23%(41/47),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the scores of primary and secondary TCM symptoms in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores of primary and secondary TCM symptoms in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the PSQI scores,AIS scores,and FS-14 scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the WHOQOL-BREF scores were significantly increased compared with those before treatment(P＜0.05).The decrease of the PSQI scores,AIS scores and FS-14 scores as well as the increase of the WHOQOL-BREF scores in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the serum MT level of both groups was significantly higher than that before treatment(P＜0.05),and the serum DA and CORT levels were significantly lower than those before treatment(P＜0.05).The increase in serum MT level and the decrease in serum DA and CORT levels of the observation group were significantly superior to those of the control group(P＜0.01).Conclusion The combined therapy of Huatan Jieyu Anshen Decoction combined with vibration tuina manipulations can achieve satisfactory efficacy in the elderly patients with chronic insomnia of phlegm-heat harassing the interior syndrome.The therapy is effective on regulating the central nervous system of the patients,improving the quality of the sleep,and promoting the relief of fatigue and the enhancement of the quality of life,which has great significance to the enhancement of the overall therapeutic efficacy of insomnia.

Evaluation on the stability of positioning precision of the leaves of accelerator MLC under different gantry angles / 中国医学装备

Objective:To evaluate the stability of the positioning precisions of the leaves of accelerator multi-leaf collimator(MLC)at different gantry angles,so as to determine whether the positioning precision of leaf is affected by the gantry angle.Methods:The HD 120 MLC of American Varian Edge medical linear accelerator at our hospital was selected,and the Varian Eclipse radiotherapy planning system was used to design test cases.One test plan included 5 dynamic subfields(named PMLCE)was designed,which ray amount was 100MU,and small machine head was kept at 0°position,and the numbers of the positions of corresponding leaves of each control point were respectively-20,-15,-10,-5,0,5,10 and 12 that were 8 in total,and the dose rate was set at 500MU/min.In test,all leaves slid as uniform velocity from one extreme position to the opposite extreme position,and the movement distance of leaves between the adjacent control points was 5 cm.The PMLCE test plan was executed on the EDGE linear accelerator by using the IEC1217 coordinate system,and each test was conducted at eight different gantry angles(0°,45°,90°,135°,180°,225°,270° and 315°),and a total of 8 treatment log files of accelerator were obtained.A program was written by using Matlab2016a(MathWorks,USA)software to read the log files of accelerator,and extract out leaf position data,and calculate the deviation between the actual position and planned position of all leaves,and record a total of 960 data of positioning deviations of 120 leaves at 8 leaves positions which included in each file.The above acquisition scheme of data was performed per three days for 10 times,and then the average value was obtained.There were the data of positioning deviations of a total of 8 groups of HD 120 MLC at different gantry angles.The above 8 groups of data were analyzed as statistical method.Results:Under various angles,the range of the percentage of"leaf positioning deviations≤10 μm"was between 45.7%and 58.3%,and that of"leaf positioning deviations≤30 μm"was between 95.6%and 99.2%.When the gantry angle was at 0° and 180°,the leaf positioning accuracy was relatively higher,and the percentages of"leaf positioning deviations≤10 μm"were respectively 58.3%and 57.9%.The maximum positioning error of the HD 120 MLC did not exceed 43.3 μm.The results of the one-way ANOVA showed that there were significant differences in the average positioning precisions between 0° and each one of 45°,90°,135°,225°,270° and 315°,and between 90° and 180°,and between 135° and 180°,and between 180° and each one of 225°,270° and 315° under the gantry angles were respectively 0°,45°,90°,135°,180°,225°,270° and 315°,and under the observation values of the positioning precision of 8 leaf positions(F=4.32,F=5.67,F=3.98,F=3.85,F=6.14,F=2.87,F=4.89,F=4.56,F=4.12,F=5.01,F=6.77,P<0.05).There were no significant differences in the positioning precision among other gantry angles.Conclusion:The positioning precisions of HD 120 MLC leaf under different gantry angles can be kept at higher level,but the influences of gantry angles on the positioning precision of leaf indeed existed.Therefore,doctors and physicists should fully consider these factors under the design stage of treatment plan,so as to optimize the dose distribution and enhance the treatment outcomes.

Exploring of Transformation Rule of Saponins in Polygalae Radix Before and After Processing Based on Simulated Processing Technology / 中国实验方剂学杂志

ObjectiveTo investigate the transformation mechanism and content variation of saponins from Polygalae Radix before and after being boiled with licorice juice and water. MethodSimulated licorice juice boiled products and simulated water boiled products of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ were prepared by simulated processing technology， and analyzed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap/MS）. Then the contents of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin in Polygalae Radix， licorice-boiled Polygalae Radix and water-boiled Polygalae Radix were determined by UPLC-triple quadrupole tandem mass spectrometry（UPLC-QQQ-MS/MS）. ResultDuring the boiling process with licorice juice and water， onjisaponin B could be hydrolyzed to produce 4-methoxycinnamic acid， desacylsenegin Ⅲ， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin Z could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin TF， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin F could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin G， polygalasaponin ⅩⅩⅧ and tenuifolin， and polygalasaponin ⅩⅩⅧ was hydrolyzed to produce tenuifolin. After being boiled with licorice juice or water， the content of onjisaponin B decreased significantly（P<0.05， P<0.01）， but the contents of onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin increased significantly（P<0.05， P<0.01） in Polygalae Radix. Compared with the water-boiled products， the contents of onjisaponin Z and tenuifolin increased significantly（P<0.05， P<0.01）， and the change of tenuifolin content was the most significant in the licorice-boiled products.However， there was no significant difference in the content of onjisaponin B， onjisaponin F and polygalasaponin ⅩⅩⅧ between the water-boiled products and the licorice-boiled products. ConclusionBeing boiled with licorice juice or water can hydrolyze onjisaponin B， onjisaponin Z， onjisaponin F and polygalasaponin ⅩⅩⅧ， and generate secondary glycosides and aglycones（organic acids） through deglycosylation， which leads to obvious changes in the contents of onjisaponins after Polygalae Radix being processed.It is inferred that licorice juice can promote the hydrolysis of some onjisaponins in Polygalae Radix to onjisaponin Z and tenuifolin.This study provides an experimental basis for revealing processing mechanism of Polygalae Radix.

Regulation of Yes associated protein in diabetic nephropathy mice by Yishen Huashi Granule / 中国药理学通报

Aim To explore the protective effect of Yishen Huashi Granule (YSHS) on streptozotocin (STZ) - indueed diabetes nephropathy (DN) in mice and its possible mechanism. Methods The STZ induced DN mice model was established, which was randomly divided into model group, YSHS group and YAP inhibitor Vertepofin group, and the eontrol group was also established. The intervention was started eight weeks after the successful modeling with the course of four weeks. Urine protein concentration before and after intervention in each group as well as serum creatinine (Scr) and blood urea nitrogen (Bun) levels after intervention were measured. After the treatment, the mice were sacrificed, and the pathological changes of glomeruli were observed by light microscope HE staining. The protein expression of YAP, p-YAP S127 and CTGF were detected by Western blot, and the mRNA expressions of YAP, CTGF and podocyte functional proteins nephrin, podophyxin and WT1 were detected by RT-PCR. Results The biochemical indexes of YSHS group were better than those of model group, and HE staining showed that the pathological injury of glomeruli was improved. In the model group the protein expression of YAP, p-YAP (S127) and CTGF as well as the mRNA expression of YAP and CTGF increased, while the mRNA expression of nephrin, podocalyxin and WT1 decreased. After YSHS treatment, the protein expression of YAP, p-YAP S127, CTGF and the mRNA expression of YAP and CTGF decreased, while the mRNA expression of nephrin, podocalyxin and WT1 increased. Conclusions YSHS can reduce urinary protein, protect renal function and alleviate glomerular pathological injury in DN mice. Its possible mechanism may be related to the down-regulation of YAP in renal tissue, the reduction of CTGF expression level and the up-regulation of podocyte protein mRNA expression.

Investigation and study of the professional identity and its correlation with mentoring function and professional competency among clinical medicine postgraduates / 中华医学教育探索杂志

Objective:To investigate the current status of professional identity among the clinical medical postgraduates and its correlation with mentoring function and professional competency, so as to provide reference for optimizing the training mode of clinical medicine postgraduates.Methods:A questionnaire survey was conducted among 217 academic and professional full-time postgraduates from Batch 2016 to 2018 majoring in clinical medicine in Peking University Health Science Center in 2019. The contents included four aspects: basic information, preliminary questionnaire of professional identity, mentoring function scale and professional competency. SPSS 26.0 was used for t test, one-way ANOVA, Kruskal-Wallis H test, and Pearson correlation analysis to analyze the status of professional identity and its correlation with professional competency and mentoring function. Results:Both professional and academic clinical medicine postgraduates had high scores of the overall level and four factors, and there was no statistical significance in the scores between the two groups ( P >0.05). There were significant differences in the overall level, behavior and appropriateness of professional identity among different grades of professional postgraduates ( P<0.05). Correlation study showed that the professional identity was significantly positively correlated with the total score of professional competency and mentoring function ( P<0.001). Further interview survey showed that the role of supervisor and employment prospects also played an important role in the elevation of professional identity. Conclusion:The overall degree of professional identity of academic and professional postgraduates is good and closely related to professional competency and mentoring function and for professional postgraduates, the overall level of professional identity of senior students is better. It is suggested that besides focusing on their professional competency, it is necessary to further optimize the employment policy of academic postgraduates and the training of tutors for professional postgraduates.

Research on the competence of hospital pharmacists in pharmaceutical care based on factor analysis and fuzzy comprehensive evaluation / 中国药房

OBJECTIVE To provi de reference for scholars to carry out the research on the competency of pharmacists in pharmaceutical care and the human resource management of hospital pharmaceutical personnel. METHODS The questionnaire was designed with Pharmacist Pharmaceutical Service Competency Evaluation Standard （Trial）as the competency evaluation indexes. The convenient sampling method was used to investigate the pharmaceutical technicians from two third-class grade A hospitals in Harbin. Exploratory factor analysis was used to judge whether each dimension and item of competency index system needed to be adjusted；the final weight of each evaluation index was calculated by analytic hierarchy process ；fuzzy comprehensive evaluation method was used to evaluate the competency of pharmacists in pharmaceutical care. RESULTS Totally 152 questionnaires were collected and 142 valid questionnaires were collected ，with an effective recovery rate of 93.42％. In this study ，women accounted for 76.8％，those aged 40 and below accounted for 60.6％，those with bachelor ’s degree and above accounted for 84.5％，those with intermediate professional title accounted for 45.1％，and those with 10 years of work or below accounted for 60.6％. Four common factors were extracted in exploratory factor analysis ，and the cumulative variance contribution rate was 78.841％，which were named knowledge and skills ，motivation，personal literacy and professional ethics. The average score of the pharmacist ’s pharmaceutical care competency was （5.884±0.810），and the development of various dimensions of competency was not balance ； honesty and trustworthiness ，conscientiousness and responsibility and dedication scored higher ，while the scores of statistical knowledge，foreign language knowledge and drug treatment evaluation ability were lower. According to the evaluation method of fuzzy comprehensive evaluation ，the final comprehensive evaluation result was “consistent”. CONCLUSIONS The evaluation indexes of pharmacist competency have good reliability and validity in the competency evaluation of pharmacists in medical institutions. At the same time ，the basic knowledge of 32 hospital pharmacists and their ability to participate in clinical rational drug use need to be further improved.

Prospective effect of dietary intake of fat on menarche among girls / 中国学校卫生

Objective@#To explore the prospective effect of dietary intake of total fat and fatty acids on menarcheal timing among girls,and to provide a theoretical basis for preventing the early puberty development of Chinese children.@*Methods@#Using the data from 1997-2015 China Health and Nutrition Survey (CHNS), 1 240 girls aged 6-13 with menarche information, baseline dietary survey data and at least one follow up assessment were selected. Cox regression analysis was performed to examine the prospective effect of dietary intake of total fat and fatty acids before menarche on age at menarche.@*Results@#The mean baseline age of the participants was (8.3±1.8). After adjustment for year of birth, residence, household income, dietary energy intake and body mass index Z score at baseline, girls in the highest quartile of intake of total fat and polyunsaturated fatty acid (PUFA) had a 30% and 34% higher probability of experiencing menarche at an earlier age than those in the lowest quartile [ HR(HR 95%CI )=1.30 (1.01~1.68)，1.34(1.05~1.70)]. After adjusting for the confounders, there were no correlations between the intake of saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) and the onset of menarche [ HR(HR 95%CI )=1.24(0.98~1.58),1.25(0.97~ 1.62 )]( P >0.05).@*Conclusion@#Higher dietary intake of total fat and PUFA before menarche may lead to earlier age at menarche and no correlation between intake of SFA and MUFA before menarche with age at menarche is found among Chinese girls.

CT Characteristics of Consolidation Type of Pulmonary Cryptococcosis in Immunocompetent Patients / 中国医学科学院学报

Objective To analyze the CT characteristics of consolidation type of pulmonary cryptococcosis in immunocompetent patients,and thus improve the diagnosis of this disease. Methods A total of 20 cases with consolidation-type pulmonary cryptococcosis confirmed by pathological examinations were studied.Each patient underwent breath-hold multislice spiral CT,and 10 patients underwent contrast enhanced CT.The data including lesion number,lesion distribution,lesion density,performance of enhanced CT scan,accompanying signs,and prognosis were analyzed. Results The occurrence rates of single and multiple lesions were 80.0%(n=16)and 20.0%(n=4),respectively.In all the 16 multiple-lesion patients,the occurrence rate of unilateral lobar distribution was 56.0%(n=9).The 76 measurable lesions mainly presented subpleural distribution(71.1%,n=54)and lower pulmonary distribution(75.0%,n=57).A total of 39 lesions were detected in the 10 patients received contrast enhanced CT,in which 31 lesions(79.5%)showed homogeneous enhancement,34 lesions(87.2%)showed moderate enhancement,and all the lesions manifested angiogram sign.Consolidation lesions were accompanied by many CT signs,of which air bronchogram sign had the occurrence rate of 63.2%(n=48),including types Ⅲ(n =37)and Ⅳ(n=11).Other signs included halo signs(43/76,56.6%),vacuoles or cavities(9/76,11.8%),pleural thickening(14/20,70.0%),and pleural effusion(2/20,10.0%).After treatment,the lesions of 7 patients were basically absorbed and eventually existed in the form of fibrosis. Conclusions The lesions in the immunocompetent patients with consolidation type of pulmonary cryptococcosis usually occur in the lower lobe and close to the pleura,mainly presenting unilateral distribution.The CT angiogram signs,proximal air bronchogram signs,and halo signs are the main features of this disease,which contribute to the diagnosis.

Exploration of Active Ingredients and Anti-breast Cancer Mechanism of Glycyrrhizae Radix Et Rhizome and Aurantii Fructus Based on Network Pharmacology / 中国实验方剂学杂志

Objective::To explore the potential active ingredients and possible anti-breast cancer mechanism of Glycyrrhizae Radix et Rhizome and Aurantii Fructus based on the method of network pharmacology. Method::The main potential targets of Glycyrrhizae Radix et Rhizome and Aurantii Fructus on breast cancer were summarized by comparing the Glycyrrhizae Radix et Rhizome-Aurantii Fructus active ingredients screened from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and breast cancer targets searched in Therapeutic Target Database (TTD). Cytoscape 3.7.1 software was used to establish a Glycyrrhizae Radix et Rhizome-Aurantii Fructus active ingredients-target-disease network and perform topology analysis based on the network. Result::According to related conditions of drug-like (DL) and oral bioavailability (OB), the network of Glycyrrhizae Radix et Rhizome-Aurantii Fructus active ingredients-breast cancer target was obtained, covering a total of 133 nodes, 116 chemical components and 17 breast cancer drug targets, 109 active components of Glycyrrhizae Radix et Rhizome interacting with breast cancer drug target, 6 active ingredients of Aurantii Fructus interacting with breast cancer drug targets, and 1 common active ingredient of Aurantii Fructus and Glycyrrhizae Radix et Rhizome interacting with breast cancer targets. There were 400 breast cancer target-interaction target pairs in the network diagram. Conclusion::The anti-breast cancer effect of Glycyrrhizae Radix et Rhizome and Aurantii Fructus is based on the overall pharmacodynamic effect of multi-component, multi-pathway and multi-target, the investigation of its potential anti-breast cancer mechanism provides theoretical basis for further experimental research.

Transcriptional Profile Alteration of Peripheral Blood in Chronic Hypoxia / 中国医学科学杂志(英文版)

Objective Many physiological and pathological conditions, including cyanotic congenital heart diseases (CCHD), are accompanied by chronic hypoxia, which might interfere with the transcription process. However, the transcriptome profile in peripheral blood under hypoxia is still unidentified. The present work aimed to explore the transcriptional profile alteration of peripheral blood in chronic hypoxia. Methods The present study used a chronic hypoxia rat model to simulate the hypoxic state of CCHD patients. Two groups of Sprague-Dawley rats (n=6 per group) were either exposed to hypoxia (10% O2) or normoxia (21% O2) for 3 weeks. Body weight was measured weekly. Peripheral blood was collected and total RNA was extracted for RNA-Seq at the end of the hypoxia treatment. After quality assessment, the library was sequenced by the Illumina Hiseq platform. The differentially expressed genes were screened (false discovery rate<0.05 and fold change>2). The functional annotation analysis and cluster analysis of differentially expressed genes were performed based on the adjusted P-value (padj<0.05). Results Compared with the control group, the body weight of the rats in the hypoxia group was significantly lowered (P<0.01). RNA-Seq results showed that the transcriptome patterns of the two groups had significant differences. In total, 872 genes were identified as differentially expressed. Among all, 803 genes were down-regulated, while only 69 genes were up-regulated in the hypoxia group. The functional enrichment analysis of the 872 genes showed that multiple biological processes involved, such as porphyrin-containing compound metabolic process, hemoglobin complex and oxygen transporter activity. Conclusions Our study demonstrated the transcriptional profile alteration in peripheral blood of chronic hypoxia rat model. This study provided basic data and directions to further understand the physiological and pathological changes in patients with CCHD.

The clinical research of biofeedback electrical stimulation plus PFMT in the treatment of stress urinary incontinence after total hysterectomy / 中国医师杂志

Objective To explore the clinical efficacy of biofeedback electrical stimulation plus pelvic floor muscle training (PFMT) in the treatment of stress urinary incontinence (SUI) after total hysterectomy.Methods The research objects who underwent total hysterectomy and complicated SUI were selected from January 2014 to December 2017 in our hospital.They were randomly divided into two groups:the study group (n =55) received biofeedback electrical stimulation plus PFMT treatment,while the control group (n=55) received PFMT treatment only.To record and compare the efficacy related indicators of the two groups.Results The indexes and scores of 3/6 months in the two groups were significantly improvedafter treatment.After 3 months the treatment,the study group had less leakage of urine [(4.3 ± 1.2)g vs (5.7 ± 1.9) g],better recovery of muscle strength of Ⅰ/Ⅱ muscle fibers [(3.5 ± 0.9) grade vs (2.8 ± 1.1) grade &(3.7 ± 0.6) grade vs (3.2 ± 1.2) grade],and better score of international consultation on incontinence questionnaire-short form (ICI-Q-SF) questionnaire [(2.7 ± 1.4) vs (4.5 ± 2.2)] compared with the control group,with statistically significant difference (P ≤ 0.05).After 6 months treatment,compared with the contiol group,the study group had less leakage of urine pad test [(1.4 ± 0.7) g vs (2.6 ± 1.1) g],better recovery of muscle strength of type Ⅰ/Ⅱ muscle fiber [(4.2 ±0.8) grade vs (3.5 ± 1.1)grade & (4.7 ±0.5) grade vs (4.0 ±0.9)grade],and better ICI-Q-SF score [(2.7 ± 1.4) vs (4.5 ±2.2)] (P ≤0.05).Conclusions Compared with using the PFMT alone,biofeedback electrical stimulation plus PFMT treatment had less leakage,better pelvic floor muscle strength and better subjective symptoms.

Pathogens and clinical features of preterm infants with sepsis / 中国当代儿科杂志

OBJECTIVE@#To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants.@*METHODS@#A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis).@*RESULTS@#There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05).@*CONCLUSIONS@#Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.

Therapeutic Effects of Transthoracic Pulmonary Artery Denervation in a Rat Model of Pulmonary Arterial Hypertension / 中国循环杂志

Objectives:The aim of this study was to observe whether transthoracic pulmonary artery denervation (TPADN) could reduce the pulmonary arterial pressure and attenuate pulmonary vascular remodeling in rats with pulmonary arterial hypertension induced by monocrotaline. Methods:Twenty-four healthy male SD rats were randomly divided into control group, sham operation group and operation group (n=8 per group). Rats in sham operation group and operation group received single subcutaneous injection of monocrotaline (MCT, 60 mg/kg). After four weeks, the mean pulmonary arterial pressure (mPAP) and other hemodynamic parameters were measured with the right heart catheter in rats of these two groups. Then, operation group received the surgery of TPADN, which included thoracotomy in left 2-3 rib, exposing pulmonary artery, and removing the near connective tissue of the pulmonary artery trunk. After two weeks of operation, the mPAP and other hemodynamic parameters were measured again by the right heart catheter. The microstructure changes of the heart and pulmonary vessels was observed by immunohistochemistry and immunofluorescence. Meanwhile, RV cardiomyocyte cross-sectional area (CSA) and the right hearthy pertrophy index (RVHI= RV/[LV+S]) were used to evaluate the degree of right ventricular hypertrophy. Results:After four weeks of injection of MCT, the mPAP was significantly higher in the operation group and the sham operation group than in control group (P＜0.01). Two weeks after the surgery of TPADN, the mPAP was significantly reduced in the operation group than compared in the sham group(P＜0.01). Meanwhile, the percentage of medial thickness to outer diameter of the small pulmonary arterioles, right ventricular myocardial cell cross-sectional area and RVHI were also significantly decreased in the operation group compared to sham operation group(all P＜0.01). Conclusions:Our results show that TPADN could reduce the mean pulmonary arterial pressure and attenuate the hypertrophy of medial thickness of small pulmonary arterioles and of right ventricle in PAH rats induced by monocrotaline.

Effect of early application of recombinant human erythropoietin on white matter development in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of early application of recombinant human erythropoietin (rhEPO) on white matter development in preterm infants using fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging (DTI).</p><p><b>METHODS</b>A total of 81 preterm infants with gestational age ≤32 weeks, birth weight <1 500 g, and hospitalization within 24 hours after birth were randomly divided into rhEPO group (42 infants) and control group (39 infants). The infants in the rhEPO group were administered rhEPO, while those in the control group were given the same volume of normal saline. The preterm infants of both groups took examinations of head magnetic resonance imaging, diffusion-weighted imaging, and DTI at the corrected gestational age of 35-37 weeks. FA was calculated for the regions of interest in both groups.</p><p><b>RESULTS</b>There was no significant difference in the incidence of intracranial hemorrhage, periventricular leukomalacia, focal cerebral white matter damage (CWMD), and extensive CWMD between rhEPO and control groups (P>0.05). Compared with the control group, the rhEPO group showed higher FA values at the posterior limb of the internal capsule, the splenium of the corpus callosum, frontal white matter, and occipital white matter (P<0.05). There was no significant difference in FA values at the parietal white matter, thalamus, lenticular nucleus, and caudate nucleus between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>Early application of rhEPO has a neuroprotective effect on white matter development in preterm infants.</p>

Effects of social isolation on the cognition and expression of 5-HT2C receptor and ADAR1 in BALB/c mice / 中华行为医学与脑科学杂志

ObjectiveTo explore the effects of social isolation on the cognition and expression of 5-HT2C receptor(5-HT2CR) and adenosine deaminase that act on RNA 1(ADAR1) in BALB/c mice.MethodsThe healthy BALB/c mice were isolated for 2,4,and 8 weeks individually since postnatal 21 days respectively to set up isolation mice model,the same age mice without isolation were regarded as control group.The new object location and the new object recognition tests were used to measure the spatial and non-spatial cognitive function,and western blot was used to measure the protein expression of 5-HT2CR and ADAR1.ResultsThe new object location test showed that the spatial discrimination index (DI) of BALB/c mice isolated for 2 weeks was decreased significantly compared with the control group(control group was (0.075±0.340),isolation group was (-0.653±0.308),P<0.05),and no obvious difference was found for the group isolated for 4 and 8 weeks.The new object recognition test showed that the non-spatial DI of BALB/c mice isolated for 2 and 4 weeks were decreased significantly compared with the control group(control 2 weeks group was (0.088±0.210),isolation 2 weeks group was (-0.945±0.194),P<0.05;control 4 weeks group was (0.105±0.267),isolation 4 weeks group was (-0.506±0.215),P<0.05),and no obvious difference was found for the group isolated for 8 weeks.Compared with the control group the expression of 5-HT2CR and ADAR1 in the hippocampus were decreased significantly for the group isolated for 2 weeks.(5-HT2CR:control group was (1.025±0.144),isolation group was (0.891±0.026),P<0.05.ADAR1: control group was (0.839±0.120),isolation group was (0.629±0.094),P<0.05).ConclusionsTwo week social isolation results in the decrease of spatial and non-spatial cognitive function in BALB/c mice,in the meanwhile,social isolation stress results in the obvious decrease of 5-HT2C receptor and ADAR1 protein expression in the hippocampus of BALB/c mice.

The establishment and implementation of the role of specialist stroke nurse / 中华护理杂志

To better coordinate the construction of stroke center in one tertiary hospital,a specialist stroke nurse was hired,whose working scope included participation in rapid treatment of acute stroke patients,health education,stroke programme coordination,stroke quality surveillance,healthcare staff training and so on.Through the establishment of stroke center involving participation of the specialist stroke nurse,rules and regulations of the stroke center were improved while median Door-to-Needle time of intravenous thrombolysis was shortened from 98min in 2009～2010 to 58min in 2015～2016 and the percentage of zero quality defect medical records was improved from 10.8％ to 81.1％(P＜0.001).The involvement of specialist stroke nurse in coordination of stroke center is a new model for health quality improvement and provides some experience for specialized nurse role development and implementation.There is also a need for standardized training,professional certification and long-term management of specialist stroke nurse.

Protective effect of salidroside on contrast-induced nephropathy in comparison with N-acetylcysteine and its underlying mechanism / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the prevention effect of salidroside on contrast-induced-nephropathy (CIN) and its underlying mechanism.</p><p><b>METHODS</b>A total of 24 Wistar rats were randomly divided into 4 groups with 6 in each group. Rats were firstly administrated with normal saline (control and model groups), N-acetylcysteine (NAC, NAC group) and salidroside (salidroside group) for 7 days before model establishment in each group, respectively. Histopathological analysis was performed by periodic acid-Schiff (PAS) staining. Oxidative stress related parameters including superoxide dismutase (SOD) and methane dicarboxylic aldehyde (MDA), nitric oxide (NO), angiotensin II (Ang II), 8-hydroxy-2'-deoxyguanosine (8-OHdG), mRNA and protein levels of endothelial nitric oxide synthase (eNOS), and nitric oxide synthase (NOS) activity were measured.</p><p><b>RESULTS</b>Compared with the control group, the levels of MDA, Ang II and 8-OHdG were all significantly increased and levels of SOD, NO, and eNOS mRNA and protein were decreased significantly in the model group (P<0.05). Meanwhile, the NOS activity was also significantly decreased in the model group (P<0.05). In addition, the levels of these parameters were all improved in the NAC (P<0.05) and salidroside groups and no significant different was found between these two groups (P>0.05).</p><p><b>CONCLUSION</b>Salidroside can be the potential substitute of NAC to prevent CIN. The underlying mechanism may be associated with oxidative stress damage caused by contrast agents.</p>

Pioglitazone administration combined with bone marrow mesenchymal stem cells transplantation improved the heart function of rats with myocardial infarction / 中国组织工程研究

BACKGROUND:Our previous work has demonstrated that bone marrow mesenchymal stem cels (BMSCs) transplantation can improve the heart function of rats with myocardial infarction. However, the overal efficacy is not satisfactory. OBJECTIVE: To adopt pioglitazone as a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist combined with BMSCs transplantation therapy, thereby further improving cardiac function of rats with myocardial infarction as wel as investigating the relevant mechanisms. METHODS:Twenty Sprague-Dawley rats with myocardial infarction were induced by the left anterior descending coronary artery ligation. The animals were randomized into two groups: BMSCs and BMSCs+pioglitazone. Two weeks later, al the animals received the injection of BMSCs labeled with PKH26 in PBS into the local infarct zone, and then pioglitazone (3 mg/kg/d) was given by the oral gavage for 2 weeks in the BMSCs+pioglitazone group after the cel transplantation. After 2 weeks of cel transplantation, cardiac functions were evaluated by echocardiography. The expressions of PPAR-γ, Connexin 43 and molecules in TGF-β1/SMAD signaling pathway were examined in different areas of the left ventricle from each harvested heart using immunofluorescent staining, western blot assay and qRT-PCR. RESULTS AND CONCLUSION:There were no differences in the baseline parameters of cardiac function between the two groups. At 2 weeks after cel transplantation, the left ventricular internal diameter at end-diastole, left ventricular internal diameter at end-systole and left ventricular ejection fraction were significantly improved in the BMSCs+ pioglitazone group; the expressions of PPAR-γ and Connexin 43 were distinctly increased in different zones of the left ventricle; the levels of TGF-β1, SMAD2 and SMAD3 were obviously attenuated in the infarct zone and border zone. The above-mentioned findings suggest that pioglitazone, a PPAR-γ agonist, can enhance BMSCs potential in improvingthe heart function after myocardial infarction, and PPAR-γ may elevate the expression of Connexin 43via the blockade of the TGF-β1/SMAD signaling pathway in the procedure.

Study of national natural science foundation investment of traditional Chinese medicine R & D in common illnesses / 国际中医中药杂志

Objective Study the National Natural Science Foundation investment of traditional Chinese Medicine R&D investment in common illnesses to understand the total investment as well as researching areas, agency and disease. Methods Filtered research data of common illnesses from National Natural Science Foundation website database with keywords. Quantitative analysis was made with the obtained data. Results National Natural Science Foundation of China invested a total of more than 50 million RMB in common illness R&D, of which nearly 400 million RMB was invested to traditional Chinese medicine. Cancer R&D investment was the highest, bone diseases R&D investment was less than 0.1% of the total investment. Conclusion Total investment in common illness increased year by year, but the investment in traditional Chinese medicine ratio was still low.