Expert consensus on late stage of critical care management / 中华内科杂志

We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.

Observation on the efficacy of traditional Qigong exercise combined with Tuina manipulations in treating lower cervical disc herniation / 针灸推拿医学（英文版）

Objective:To observe the efficacy of traditional Qigong exercise combined with Tuina(Chinese therapeutic massage)manipulations in treating lower cervical disc herniation(CDH).Methods:A total of 120 CDH patients who met the inclusion criteria were randomly divided into an observation group and a control group,with 60 cases in each group.Patients in both groups were given the same Tuina manipulations.In addition,patients in the observation group practiced traditional Qigong exercise,and those in the control group did conventional neck exercise.After 8 weeks of treatment,the efficacy of the two groups was observed.Follow-up was conducted 3 months after the end of the treatment to record any recurrence.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The improvement in symptom scores was more significant in the observation group than in the control group(P＜0.05).There was inter-group statistical significance in comparing the cross-sectional area and fatty infiltration of certain cervical muscles(P＜0.05).In addition,the recurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion:On the basis of the same Tuina manipulation treatment,the efficacy of traditional Qigong exercise in treating CDH is superior to that of conventional neck exercise,with more significant improvements in pain and quality of life and a lower recurrence rate.

Correlation of illness uncertainty with anxiety and depression in perioperative patients with early gastric cancer / 中华全科医师杂志

Objective:To investigate the correlation of illness uncertainty with anxiety and depression in perioperative patients with early gastric cancer.Methods:A cross-sectional survey was conducted among 107 patients with early gastric cancer who were admitted in Department of Gastroenterology of a Class A tertiary hospital in Beijing from April 2020 to August 2021. The demographic data questionnaire was used for survey, and the psychological status of patients was evaluated with Mishel′s Uncertainties in Illness Scales (MUIS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Spearman correlation analysis was used to explore the correlation of disease uncertainty with anxiety and depression in patients with early gastric cancer.Results:The illness uncertainty in patients with early gastric cancer was at a moderate level (93.2±14.0). The total scores on the SAS and SDS were (46.5±9.7) and (47.7±10.2), respectively. And the incidence rate of anxiety and depression was 34.6% (37/107) and 31.8% (34/107) respectively. The illness uncertainty of patients with early gastric cancer was positively correlated with anxiety and depression ( r=0.40,0.31,all P<0.05). Conclusion:Some patients with early gastric cancer have illness uncertainty, anxiety and depression, and the illness uncertainty is related to anxiety and depression.

Single-copy Loss of Rho Guanine Nucleotide Exchange Factor 10 ( arhgef10) Causes Locomotor Abnormalities in Zebrafish Larvae / 生物医学与环境科学（英文）

OBJECTIVE@#To determine if ARHGEF10 has a haploinsufficient effect and provide evidence to evaluate the severity, if any, during prenatal consultation.@*METHODS@#Zebrafish was used as a model for generating mutant. The pattern of arhgef10 expression in the early stages of zebrafish development was observed using whole-mount in situ hybridization (WISH). CRISPR/Cas9 was applied to generate a zebrafish model with a single-copy or homozygous arhgef10 deletion. Activity and light/dark tests were performed in arhgef10 -/-, arhgef10 +/-, and wild-type zebrafish larvae. ARHGEF10 was knocked down using small interferon RNA (siRNA) in the SH-SY5Y cell line, and cell proliferation and apoptosis were determined using the CCK-8 assay and Annexin V/PI staining, respectively.@*RESULTS@#WISH showed that during zebrafish embryonic development arhgef10 was expressed in the midbrain and hindbrain at 36-72 h post-fertilization (hpf) and in the hemopoietic system at 36-48 hpf. The zebrafish larvae with single-copy and homozygous arhgef10 deletions had lower exercise capacity and poorer responses to environmental changes compared to wild-type zebrafish larvae. Moreover, arhgef10 -/- zebrafish had more severe symptoms than arhgef10 +/- zebrafish. Knockdown of ARHGEF10 in human neuroblastoma cells led to decreased cell proliferation and increased cell apoptosis.@*CONCLUSION@#Based on our findings, ARHGEF10 appeared to have a haploinsufficiency effect.

A scoping review of studies on dietary patterns in patients with heart failure / 中国实用护理杂志

Objective:To analyze the categories, scoring methods and effects of dietary patterns in heart failure patients, systematically.Methods:The databases such as Medline, Embase, and Cochrane were searched to obtain articles on dietary patterns of heart failure patients up to December 31, 2019. Arksey and O′Malley's scoping review method was applied to analyze the articles.Results:A total of 1 500 studies were identified, 21 of them met the inclusion criteria. These studies mainly studied Mediterranean diet(11 articles), Dietary Approaches to Stop Hypertension Diet(7 articles), Palaeolithic diet(1 article), low fat diet(1 article), High-protein Diet(1 article).Conclusions:The Mediterranean and DASH dietary patterns have a positive protective effect on heart failure disease prevention and treatment, but more randomized controlled trials are needed to improve the reliability of the conclusions.

Detection and analysis of syphilis antibody in 80 478 cases of inpatients / 中国基层医药

Objective:To understand the infection and distribution of syphilis in hospitalized patients, thus to provide reference for syphilis prevention and control.Methods:TP-ELISA test was used to examine early syphilis antibody, and adopted the TPPA test to validation syphilis antibody, and TRUST was used to determine the titer of syphilis antibody in 80 478 hospitalized patients from January 2015 to November 2017, then the results were retrospectively analyzed.Results:Among 80 478 inpatients, 1 326 cases were positive by TP-ELISA test(1 223 cases positive, 101 cases weak positive and 2 cases negative by TPPA confirmed). The positive rates of TP-ELISA in different years were 1.62%(445/27 394), 1.72%(490/28 412) and 1.58%(389/24 672), respectively, and the difference was not statistically significant( P>0.05). The positive rates of male and female patients were 2.02%(689/33 985) and 1.37%(635/46 479), and the difference was statistically significant(χ 2=52.91, P=0.00). The positive rates of ≤18 years old, >18-59 years old, >59-79 years old and>79 years old were 0.32%(7/2 161), 1.44%(765/53 001), 2.31%(488/21 163) and 1.50%(62/4 153), respectively.The highest proportion of syphilis patients was in the group of >59-79 years old, and the differences were statistically significant compared with the other groups(χ 2=37.08, 67.05, 10.80, all P<0.01). Among the TP-ELISA positive patients, 54.90%(728/1 326) had TRUST titer negative, 36.50%(484/1 326) had titer less than 1∶8, and the others had 8.44%(112/1 326). Conclusion:The incidence of syphilis was higher in males than in females in 80 478 hospitalized patients.The highest positive rate was found in >59-79 years old group, and the number of elderly cases increased rapidly.Therefore, the effective interventions should be developed to control the transmission of syphilis according to the epidemiological features.

Anxiety and associated factors among medical students returned to school during COVID-19 epidemic situation / 中国学校卫生

Objective@#To investigate anxiety and associated factors among college students returned to school during COVID-19 epidemic, and to provide reference for anxiety relief and school life adaptation to help college students.@*Methods@#A cross-sectional study was conducted among 4 750 students selected from Nanjing Medical University, China Pharmaceutical University, Nanjing University of Chinese Medicine from 2 May to 9 May, 2020. Zung Anxiety Self-rating Scale (SAS) was used to measure anxiety status of students. The self-made questionnaire was used to investigate the related factors.@*Results@#During COVID-19 epidemic situation ,20.0% college students returned to school had mild anxiety, 6.5% had moderate or severe anxiety. College students unable to adapt to campus closed-off management with a higher anxiety detection rate of 52.9%.Students with heavy study burden whose offline study time per day ≥6 hours have a higher anxiety detection rate of 36.0%. Students never exercising had a higher anxiety detection rate of 43.5%. The detection rate of anxiety not participating in online sports and sports activites was 41.6%. 40.7% students were detected of anxiey because of loneliness caused by not being able to meet friends. Multiple logistic regression analysis revealed that the adaptation to the campus closed-off management, satisfaction with the campus disinfection, participation in group activities, the time of offline study per day, the time of online study per day, tension about the exams, regular routine, exercise, participation in online activities were the influencing factors related to anxiety.@*Conclusion@#During COVID-19 epidemic some of college students exhibit anxiety when back to school life, which might be associated with campus management, study burden, exercise and regular routine, school activities and so on. Schools should take measures to relieve students anxiety while epidemic prevention.

Feasibility and safety of minimally invasive cardiac coronary artery bypass grafting surgery for patients with multivessel coronary artery disease: Early outcome and short-mid-term follow up results / 北京大学学报(医学版)

OBJECTIVE@#To explore the feasibility, safety and mid-term outcome of minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) surgery.@*METHODS@#Data of patients who underwent MICS CABG between November 2015 and November 2017 in Peking University Third Hospital were retrospectively analyzed. Results were compared with the patients who underwent off-pump coronary aortic bypass grafting (OPCABG) surgery over the same period. The two groups were matched in propensity score matching method according to age, gender, left ventricular ejection fraction, body mass index, severity of coronary artery disease, smoking, diabetes mellitus, hypertension, hyperlipidemia, renal insufficiency, history of cerebrovascular accident, and history of chronic obstructive pulmonary disease (COPD).@*RESULTS@#There were 85 patients in MICS CABG group, including 68 males (80.0%) and 17 females (20%), with an average age of (63.8±8.7) years; 451 patients were enrolled in OPCABG group, and 85 patients were matched by propensity score as control group (OPCABG group). There was no significant difference in general clinical characteristics (P>0.05). The average grafts of MICS CABG and OPCABG were 2.35±0.83 and 2.48±0.72 respectively (P=0.284). No conversion to thoracotomy in MICS CABG group or cardiopulmonary bypass in neither group occurred. There was no significant difference in the major adverse cardiovascular events (MACCEs, 1.17% vs. 3.52%), reoperation (2.34 vs. 3.52%), new-onset atrial fibrillation rate (4.70% vs. 3.52%) or new-onset renal insufficiency rate (1.17% vs. 0%) between MICS CABG group and OPCABG group (P>0.05). The operation time in MICS CABG group was longer than that in OPCABG group [(282.8±55.8) min vs. (246.8±56.9) min, P < 0.05], while the time of ventilator supporting(16.9 h vs. 29.6 h), hospitalization in ICU [(29.3±20.8) h vs. (51.5±48.3) h] and total hospitalization [(18.3±3.2) d vs. (25.7±4.2) d] in MICS CABG group were shorter than those in OPCABG group (P < 0.05). The total patency rate (A+B levels) of MICS CABG was 96.5% after surgery. There was no significant difference in MACCEs rate between the two groups [1.18%(1/85) vs. 3.61%(3/83), P>0.05] in 1-year follow up.@*CONCLUSION@#The MICS CABG surgery is a safe and feasible procedure with good clinical results in early and mid-term follow-up.

Effects of combination therapy of calcium dobesilate dispersible and monosialotetrahex-osylganlioside sodium on serum inflammatory cytokines IL-6 and MCP-1 in elderly patients with painful diabetic peripheral neuropathy / 中国基层医药

Objective To observe the efficacy of combination therapy of calcium dobesilate dispersible and monosialotetrahexosylganlioside sodium on interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in elderly patients with painful diabetic peripheral neuropathy.Methods From January 2012 to May 2017,in the Second People's Hospital of Lianyungang 70 patients of painful diabetic peripheral neuropathy,aged ≥60 years,were analyzed in this study.They were randomly divided into observation group (35 cases) and control group (35 cases).The observation group was treated with 40mg monosialotetrahexosylganlioside sodium dissolved in 250mL physiological saline,intravenous infusion per day,and oral calcium dobesilate dispersible 0.5g twice a day for two weeks.The control group was treated with methylcobalamin injection 0.5mg per day for two weeks.The clinical treatment effects and levels of IL-6 and MCP-1 were observed and compared between the two groups.Results After two weeks of treatment,the MDNS and MNSI scores of the observation group [(13.09 ± 5.38)points,(2.53 ± 1.19)points] were significantly lower than those of the control group [(18.31 ± 6.13) points,(4.19 ± 1.05) points,t =2.036,2.365,all P ＜ 0.05] and those before treatment [(21.26 ± 4.28) points,(5.40 ± 0.89) points,t =3.251,3.698,all P ＜ 0.05].The VAS-PI scores in the observation group [(6.24 ± 1.25) points,(4.13 ± 1.69) points] were significantly lower than those in the control group[(7.26 ± 1.28) points,(6.34 ± 2.65) points] at the first and second week (t =3.265,5.395,all P ＜ 0.05).The serum levels of inflammatory cytokines IL-6 and MCP-1 in the observation group [(15.16 ±0.88) ng/L,(157.19 ± 11.22) ng,/L] were significantly lower than those in the control group[(17.87 ± 1.19) ng/L,(198.21 ± 12.07)ng/L,t =2.152,1.365,all P ＜0.05]and those before treatment[(20.26 ± 1.05) ng/L,(260.44 ± 13.63) ng,/L,t =1.235,0.965,all P ＜ 0.05].Conclusion Combination of calcium dobesilate and mono-sialotetrahexosyl ganglioside may alleviate the sensory and pain sensations in patients with painful diabetic peripheral neuropathy,possibly by reducing the level of inflammatory cytokines IL-6 and MCP-1.

Standardize nursing terminology in electronic health records / 中国实用护理杂志

With the development of informatization in healthcare system, it is necessary to build the electronic healthcare records. This article reviews the development and meanings of using the standardize nursing terminology in electronic healthcare records, and discusses the challenges and methods of the development of standardized nursing terminology in electronic healthcare records.

Standardize nursing terminology in electronic health records / 中国实用护理杂志

With the development of informatization in healthcare system, it is necessary to build the electronic healthcare records. This article reviews the development and meanings of using the standardize nursing terminology in electronic healthcare records, and discusses the challenges and methods of the development of standardized nursing terminology in electronic healthcare records.

Hemostatic function change during pregnancy of women with placental abruption and its application for predicting postpartum hemorrhage / 临床检验杂志

Objective@#To investigate whether the changes of hemostatic system in pregnant women with placental abruption are different from the pattern of the pregnant women without complications, and the tests of hemostatic function before labor are helpful for prediction and estimation of postpartum hemorrhage. @*Methods@#The pregnant women diagnosed with placental abruption who delivered at Peking University Third Hospital from December 1st, 2013 to December 1st, 2018 were enrolled. The normal pregnant women with matched age and gestational weeks and the women complicated with gestational diabetes mellitus (GDM) were also involved in our study as controls. Their medical records, pregnancy outcomes and all the results of hemostatic tests were completely collected and analysed. @*Results@#A total of 152 pregnant women with placental abruption, 268 normal pregnant women and 101 pregnant women with gestational diabetes mellitus were included. The hemostatic system in uncomplicated women and the women with GDM shared a similar course of changes, during which time PT, APTT and TT dropped, while Fib (fibrinogen), FDP and DD grew with increasing gestational weeks. However, in the women with placental abruption, Fib(g/L) presented downward trend in the second trimester and were significantly lower than the uncomplicated women at the same pregnancy period (4.11±0.17 vs 4.35±0.07, P=0.011). The Fib（g/L） levels in the women at delivery with placental abruption, whether complicated with GDM or not, showed significant difference between the women with and without postpartum hemorrhage (3.41±1.29 vs 4.30±0.94, P=0.001). According to the receiver operating charctistic curve, the area under the curve of Fib was 0.703 (95% confidence interval: 0.596-0.810) with cutoff value of 4.00 g/L and negative predictive value of 0.883. @*Conclusions@#The fibrinogen level in pregnant women with placental abruption did not increase with gestational weeks as it was in uncomplicated women and the women with GDM. Fib level at the time of delivery may contribute to predict the occurrence of postpartum hemorrhage in the women with placental abruption.

Therapeutic Effect of Stretching Therapy Combined with Chinese Herbal Medicine for Primary Dysmenorrhea with Qi Stagnation and Blood Stasis / 广州中医药大学学报

Objective To evaluate the curative effect of stretching therapy combined with oral administration of Chinese herbal medicine Tongjing Powder in treating dysmenorrhea patients with Qi stagnation and blood stasis. Methods Sixty dysmenorrhea patients were randomly divided into two groups, 30 cases in each group. Treatment group was given oral use of Tongjing Powder (mainly composed of Radix Angelicae Sinensis, Rhizoma Chuanxiong, Radix Paeoniae Alba, Rhizoma Cyperi, Aspongopus, Radix Salviae Miltiorrhizae, Pollen Typhae, Faeces Trogopterori, Rhizoma Curcumae, and Semen Persicae) combined with stretching therapy. The control group was given oral use of Tongjing Powder alone. Each group was treated for 3 menstrual cycles. Visual Analogue Scale (VAS) scores of dysmenorhea were observed during the treatment and 3-month follow-up after treatment. Before and after treatment, pulse index (PI), resistance index (RI), the ratio of systolic peak value to the diastolic peak value (A/B) of uterine artery blood flow in the two groups were detected. And the clinical efficacy of the two groups was evaluated after treatment. Results (1) The VAS scores of the two groups after treatment and at the end of the third menstrual cycle after treatment were significantly lower than those before treatment(P<0.05), and the decrease in the treatment group was superior to that in the control group(P < 0.05).(2) After treatment for 3 menstrual cycles, the total effective rate was 96.7％ in the treatment group, which was higher than that in the control group(76.7％). And the difference was statistically significant(P < 0.05). (3) The color Doppler energy (CDE) imaging results showed that PI, RI, A/B of uterine artery blood flow in the two groups were decreased after treatment (P < 0.05 compared with those before treatment) , but the differences between the two groups were insignificantly(P > 0.05). Conclusion Stretching therapy combined with oral administration of Chinese herbal medicine Tongjing Powder exerts certain short-term and long-term effect in treating dysmenorrhea patients with Qi stagnation and blood stasis, with good safety and feasibility.

Comparative Study of Minimally Invasive Directly Bypass Grafting With Bilateral Internal Mammary Artery and Conventional Off-pump Bypass Grafting for Treating Multi-vessel Lesion Coronary Artery Disease / 中国循环杂志

Objective: To assess the early experience and clinical value of left anteriolateral minor thoracotomy minimally invasive directly coronary artery bypass (MIDCAB) for treating multi-vessel lesion coronary artery disease (CAD) with bilateral internal mammary artery (BITA). Methods: Our research included in 2 groups: MIDCABG group, n=38 consecutive patients received left anteriolateral minor thoracotomy MIDCAB with BITA in our hospital from 2015-05 to 2017-01 and Control group, n=236 patients received conventional off-pump coronary artery bypass (OPCAB) by the same surgeon at same period. Peri-operative condition and relevant complications were compared between 2 groups. Results: In MIDCAB group, the success rate for harvesting BIMA was 94.7% (36/38), the mean time for harvesting right internal mammary artery (RIMA) and LIMA were (42.3±10.5) min and (35.2±8.3) min respectively; a total of 78 grafts were made in 38 patients with the mean of (2.05±0.31) graft/patient, no patient was switching to conventional CABG during the operation. Compared with Control group, MIDCAB group had reduced post-operative mechanical ventilation time (8.9±3.8) h vs (23.6±15.9) h, ICU stay time (29.3±20.8) h vs (56.5±38.3) h and hospital stay time (11.3±3.2) d vs (15.7±4.2) d, all P<0.05; while the incidence of peri-operative MACCE including death, myocardial infarction (MI), revascularization, cerebrovascular accident and poor incision healing were similar between 2 groups, P>0.05. No occlusion of anastomotic stoma was found by post-operative coronary angiography in neither group. The patients were followed-up for the average of 3 months, no death, angina or MI occurred. Conclusion: Through left anterolateral small incision, we can successfully get bilateral internal mammary artery and complete beating heart multi branch CABG.

The effects of correcting tape on extensor synergy gait in hemiplegic patients / 中华物理医学与康复杂志

Objective To observe the effect of a walking correcting tape on the kinematics and temporal-spatial indicators of gait after a stroke. Methods Thirty hemiplegic stroke survivors were randomly divided into a control group ( n=15) and a correcting tape group ( n=15) . In addition to their routine rehabilitation program, the control group received 30 minutes of walking training five times a week for 3 weeks with any necessary oral guidance and posture correction. The correcting tape group performed the same walking training assisted by a self-made walking correcting tape. Before and after the treatment, the kinematics and temporal-spatial indicators of both groups were quantified using three-dimensional gait analysis. Results After the treatment, the peak angles of hip and knee flex-ion were significantly higher in the taped group than in the control group and in the taped group before the treatment ( P≤0.05) . After the treatment, the walking speeds, stride frequencies and stride lengths of both groups were signifi-cantly better than before the treatment, but those of the former group were all significantly better than the latter ( P≤0.05 for both) . Conclusions Correcting tape can improve the peak angles of hip and knee flexion of hemiplegic legs and improve the walking capacity of stroke patients.

Mechano growth factor promotes the migration of bone marrow-derived mesenchymal stem cells / 中华物理医学与康复杂志

Objective To study the mechanism by which mechano growth factor (MGF) promotes the migration of mesenchymal stem cells (MSCs).Methods MSCs were isolated from Sprague-Dawley rats and treated with MGF at various concentrations.Western blotting was used to evaluate the expression of RhoA protein and its downstream p-MYPT,as well as p-FAK and t-FAK proteins related to focal adhesion kinase.The aim was to illustrate the effect of MGF in regulating the cytoskeleton of MSCs and the formation of focal adhesion.C3 toxin was used to inhibit RhoA activity and western blotting was used to examine the expression of p-MYPT,and the focal adhesion kinases p-FAK and t-FAK.Transwell assays were used to examine MSCs' migration ability,and immunofluorescence was conducted to examine the formation of F-actin cytoskeleton and focal adhesion.Results MGF can significantly promote the expression of MSCs' RhoA and its downstream protein p-MYPT.The effect is dose-dependent.The expression of RhoA and p-MYPT increased most significantly at 50 μM concentration.The ratio of p-FAK to t-FAK indicates that MGF can activate focal adhesion kinase and promote adhesion.C3 toxin significantly inhibited FAK activation.Transwell assays showed that MGF can significantly promote MSC migration,but pretreatment with C3 toxin inhibited it.The immunofluorescence results show that MGF can promote the rearrangement of MSCs' F-actin cytoskeleton and the formation of focal adhesion.C3 toxin disrupted MSCs cytoskeletons and decreased focal adhesion.Conclusion MGF promotes MSCs' migration through RhoA-and kinase-mediated cytoskeleton rearrangement and the formation of focal adhesion.

Epidemiological characteristics on temporal-spatial distribution of varicella in Guangxi Zhuang Autonomous Region, 2014-2016 / 中华流行病学杂志

Objective To analyze the epidemiological characteristics of temporal-spatial distribution on varicella in Guangxi Zhuang Autonomous Region (Guangxi) during 2014 to 2016.Methods Incidence data on varicella was collected from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS) of the Center for Disease Control and Prevention (CDC)while geographic information data was from the national CDC.ArcGIS 10.2 software was used to analyze global and local spatial auto correlation on spatial clusters.SaTScan v9.1.1 was used to conduct temporal-spatial scan for exploring the areas of temporal-spatial clusters.Results The overall incidence rates of varicella during 2014 to 2016 were 32.48/100 000,43.56/100 000 and 61.56/100 000 respectively.Incidence of varicella showed a positive spatial auto correlation at the county level (the value of Moran's I was between 0.24 to 0.35,P＜0.01),with consistent high morbidity.High-high cluster areas were seen and mainly concentrated in the north-western areas of Guangxi.Result from the temporal-spatial scan showed that temporal cluster of varicella occurred mainly between October and next January while the type I cluster area was mainly distributed in all of the counties in Hechi city and most counties of Baise city,with most counties being covered in the north-western areas of Guangxi,during 2014-2016.When comparing to data from the last two years,two type Ⅱ cluster areas with larger scales were formed in the north-eastern area of Guanyang county and Haicheng county of southem area in Guangxi,in 2016.Conclusions Incidence on Varicella seemed on the rise,and the distribution of cases showed clustered features,both on time and space.Strategies regarding control and prevention on Varicella should focus on high-high clustered areas,namely north-western areas of the province,including surrounding areas during the high onset season.

Relationship between plasma tau protein , p-tau protein and cognitive function in elderly patients with global brain atrophy / 中国神经精神疾病杂志

Objective To investigate the relationship between plasma tau protein, phosphorylated tau protein (p-tau) protein and cognitive function in subjects with generalized brain atrophy. Methods A total of 100 subjects with moderate and severe brain atrophy were divided into two groups according to cognitive function: normal group (n=50 cases) and dementia group (n=50 cases). And their gender, age, educational level, etc. are recorded. The tau protein and p-tau protein content in plasma were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The differences between plasm tau and p-tau protein expression and their relationship with cognitive function were analyzed. Results Plasma tau protein and p-tau protein levels were significantly higher (P<0.05) in the dementia group [(210.92±43.79)pg/mL、(81.15±16.85)pg/mL] than in the normal group[(210.92±43.79)pg/mL、(81.15±16.85)pg/mL]. Plasma tau protein and p-tau protein levels were negatively correlated with the MMSE score (P<0.05) and had no significant correlation with the degree of brain atrophy (P>0.05). Conclusion Cognitive impairment may be associated with elevated tau protein levels in patients with extensive brain atrophy.

Epidemiological characteristics on temporal-spatial distribution of varicella in Guangxi Zhuang Autonomous Region, 2014-2016 / 中华流行病学杂志

Objective To analyze the epidemiological characteristics of temporal-spatial distribution on varicella in Guangxi Zhuang Autonomous Region (Guangxi) during 2014 to 2016.Methods Incidence data on varicella was collected from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS) of the Center for Disease Control and Prevention (CDC)while geographic information data was from the national CDC.ArcGIS 10.2 software was used to analyze global and local spatial auto correlation on spatial clusters.SaTScan v9.1.1 was used to conduct temporal-spatial scan for exploring the areas of temporal-spatial clusters.Results The overall incidence rates of varicella during 2014 to 2016 were 32.48/100 000,43.56/100 000 and 61.56/100 000 respectively.Incidence of varicella showed a positive spatial auto correlation at the county level (the value of Moran's I was between 0.24 to 0.35,P＜0.01),with consistent high morbidity.High-high cluster areas were seen and mainly concentrated in the north-western areas of Guangxi.Result from the temporal-spatial scan showed that temporal cluster of varicella occurred mainly between October and next January while the type I cluster area was mainly distributed in all of the counties in Hechi city and most counties of Baise city,with most counties being covered in the north-western areas of Guangxi,during 2014-2016.When comparing to data from the last two years,two type Ⅱ cluster areas with larger scales were formed in the north-eastern area of Guanyang county and Haicheng county of southem area in Guangxi,in 2016.Conclusions Incidence on Varicella seemed on the rise,and the distribution of cases showed clustered features,both on time and space.Strategies regarding control and prevention on Varicella should focus on high-high clustered areas,namely north-western areas of the province,including surrounding areas during the high onset season.

Clinical factors of post-chemoradiotherapy as valuable indicators for pathological complete response in locally advanced rectal cancer

OBJECTIVES: Pathological complete response has shown a better prognosis for patients with locally advanced rectal cancer after preoperative chemoradiotherapy. However, correlations between post-chemoradiotherapy clinical factors and pathologic complete response are not well confirmed. The aim of the current study was to identify post-chemoradiotherapy clinical factors that could serve as indicators of pathologic complete response in locally advanced rectal cancer. METHODS: This study retrospectively analyzed 544 consecutive patients with locally advanced rectal cancer treated at Sun Yat-sen University Cancer Center from December 2003 to June 2014. All patients received preoperative chemoradiotherapy followed by surgery. Univariate and multivariate regression analyses were performed to identify post-chemoradiotherapy clinical factors that are significant indicators of pathologic complete response. RESULTS: In this study, 126 of 544 patients (23.2%) achieved pathological complete response. In multivariate analyses, increased pathological complete response rate was significantly associated with the following factors: post-chemoradiotherapy clinical T stage 0-2 (odds ratio=2.098, 95% confidence interval=1.023-4.304, p=0.043), post-chemoradiotherapy clinical N stage 0 (odds ratio=2.011, 95% confidence interval=1.264-3.201, p=0.003), interval from completion of preoperative chemoradiotherapy to surgery of >7 weeks (odds ratio=1.795, 95% confidence interval=1.151-2.801, p=0.010) and post-chemoradiotherapy carcinoembryonic antigen ≤2 ng/ml (odds ratio=1.579, 95% confidence interval=1.026-2.432, p=0.038). CONCLUSIONS: Post-chemoradiotherapy clinical T stage 0-2, post-chemoradiotherapy clinical N stage 0, interval from completion of chemoradiotherapy to surgery of >7 weeks and post-chemoradiotherapy carcinoembryonic antigen ≤2 ng/ml were independent clinical indicators for pathological complete response. These findings demonstrate that post-chemoradiotherapy clinical factors could be valuable for post-operative assessment of pathological complete response.