Blood matching incompatibility caused by cold autoantibodies and IgG anti S antibody: a case report / 中国输血杂志

【Objective】 To analyze the serological characteristics of an anemia patient with cold autoantibodies and IgG anti S antibody. 【Methods】 Unexpected antibody screening was performed on screening cells, autologous cells and panel cells with patient serum in saline and anti human globulin card media at room temperature and 37 ℃, respectively. At the same time, the serum that destroying IgM antibodies and acid elution solution were respectively screened for unexpected antibodies in anti human globulin card media. The absorption-elution test was used to treat patients′ red blood cells and serum, and the unexpected antibody identification and cross matching were performed after excluding the interference of cold autoantibodies. 【Results】 Cold autoantibodies and IgG anti S antibody were found in the serum of this patient. 【Conclusion】 When a patient is found to have cold autoantibodies, it is necessary to screen the alloantibody, in order to avoid post transfusion immune reactions due to missed detection of alloantibody.

Characterization of potential bitterness critical quality attributes in Xiaoer Ganmao Oral Liquid based on UHPLC-LTQ-Orbitrap MSn / 药学学报

To identify the bitter compounds of real-world Xiaoer Ganmao Oral Liquid sugar-free intermediates, an integrated strategy has been developed by using ultra-high performance liquid chromatography with linear ion trap-Orbitrap mass spectrometry (UHPLC-LTQ-Orbitrap MSn) method and BitterX database prediction. The chromatographic operating conditions were as follows, chromatographic column: Acquity UPLC BEH C18 (100 mm × 2.1 mm, 1.7 μm), mobile phase: 0.1% formic acid-water solution (A)-acetonitrile (B) with gradient elution. The data were collected in positive and negative ion modes, respectively. The accurate molecular mass and structural information of the target compounds were obtained based on quasi-molecular ions and fragmentation ions provided by high-resolution mass spectrometry. The compounds were identified by combining retention time, reference substances, reports, and other relevant data, and a total of 57 constituents including flavonoids, alkaloids, and phenylpropanoids were finally identified. Further, the BitterX database was used to predict binding probability of compounds to bitter receptors and identify potential bitter critical quality attributes, finally 33 potential bitter compounds, including kukoamine A and linarin, were predicted. This study comprehensively characterized the material basis of Xiaoer Ganmao Oral Liquid sugar-free intermediates, it provides an effective method for bitter compound screening and a reference for further improving the undesirable taste of Xiaoer Ganmao Oral Liquid.

Investigation on therapeutic potential and molecular mechanisms of Kunxian capsule against diabetic kidney disease via reversing the imbalance of "immune-inflammation" network / 药学学报

Drug repositioning provides new clinical indications for existing drugs. The imbalance between body's "immune-inflammation" regulation is one of the important factors in the occurrence and development of diabetic nephropathy (DN). Chinese patent medicine Kunxian capsule is clinically used for treating rheumatoid arthritis with satisfying immune-modulatory and anti-inflammatory actions. Notably, accumulating clinical evidence based on small cohorts had shown that Kunxian capsule may be used to treat DN. But the underlying pharmacological mechanisms remain unclear. Therefore, this study integrated "drug target-disease gene-biological pathway-function module" multi-level associated network analysis, and in vivo and in vitro experiments, to verify the pharmacological effects of Kunxian capsules in DN and to elucidate its molecular mechanisms. The experimental protocol was reviewed by the Laboratory Animal Welfare and Ethics Committee of China Academy of Chinese Medical Sciences, and it complies with the relevant regulations on laboratory animal welfare and ethics. As a result, the network analysis showed that the candidate targets of Kunxian capsule against DN were significantly involved into various functional modules which were related to modulation of immune-inflammation system, basement membrane lesion, abnormal hemorheology, energy metabolism and hormone metabolism, and the number of targets enriched by PI3K/AKT/NF-κB pathway is the largest. In addition, both in vivo and in vitro experiments demonstrated that Kunxian capsule by gavage effectively reduced blood glucose, improved insulin resistance, reduced blood lipid, inhibited renal extracellular matrix protein production and renal inflammation, improved renal function and pathological damages, and inhibited the activity of PI3K/AKT/NF-κB/TNF-α/IL-1β pathway in diabetic nephropathy rats. Collectively, these findings suggest the therapeutic potentials of Kunxian capsule to alleviate DN by regulating the imbalance of immune-inflammation system.

Proteomic characterization of four subtypes of M2 macrophages derived from human THP-1 cells / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Macrophages are widely distributed immune cells that contribute to tissue homeostasis. Human THP-1 cells have been widely used in various macrophage-associated studies, especially those involving pro-inflammatory M1 and anti-inflammatory M2 phenotypes. However, the molecular characterization of four M2 subtypes (M2a, M2b, M2c, and M2d) derived from THP-1 has not been fully investigated. In this study, we systematically analyzed the protein expression profiles of human THP-1-derived macrophages (M0, M1, M2a, M2b, M2c, and M2d) using quantitative proteomics approaches. The commonly and specially regulated proteins of the four M2 subtypes and their potential biological functions were further investigated. The results showed that M2a and M2b, and M2c and M2d have very similar protein expression profiles. These data could serve as an important resource for studies of macrophages using THP-1 cells, and provide a reference to distinguish different M2 subtypes in macrophage-associated diseases for subsequent clinical research.

The health benefits of the active ingredients and whole food components of natural plants through regulating the flora / 生物工程学报

With the cooperation of bacteria and the human body, the nutrients in food are deeply digested, utilized, and shared. In addition, symbiosis is formed between microorganisms and hosts. Such a delicate combination makes the microorganisms form the inherent flora in the human body. They obtain the biological basis for survival, and provide the necessary regulation and support for the host in terms of immunity and nutrition, through their functional metabolism and population signals. At present, most of the researches focus on the isolation and evaluation of the functional components of plants, such as plant polysaccharides, polyphenols, flavonoids, and other active functional components. However, in traditional Chinese medicine, plants are often used with whole food components. To date, studies have found that the dynamics of flora affecting human health are not fixed, nor dependent on the change of a single strain. The ecological competition and metabolic regulation between microorganisms are usually coevolved with the host. The regulatory effect of natural plants for both medicine and food mainly depends on their whole food components. This provides evidence to support the role of whole food components played in promoting the efficacy of traditional Chinese medicine from the perspective of microenvironment. Therefore, the development and utilization of medicinal and edible natural plant activities should be fully understood and evaluated with flora regulation.

Quantification of aristolochic acids and their DNA adducts in mice kidney and liver by HPLC-MS/MS / 中国中药杂志

This study aims to establish a quantitative method of 4 aristolochic acids-DNA adducts in mice kidney and liver based on high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS) for monitoring the content changes of aristolochic acids-DNA adducts. A Shiseido Capcellpak AQ C_(18) column(3 mm×100 mm, 3 μm) was used, with a mixture of 0.2% acetic acid-5 mmol·L~(-1) ammonium acetate as the aqueous phase and methanol as the organic phase for gradient elution. The multiple reaction monitoring(MRM) scanning method under positive mode by electrospray ionization(ESI) was performed for the detection of the aristolochic acids-DNA adducts which formed by combining aristolochic acid Ⅰ/Ⅱ with deoxyadenosine, deoxyguanosine, and deoxycytidine, respectively. Balb/c mice were given Guanmutong extract by gavage, and the relative content of aristolochic acids-DNA adducts in liver and kidney samples were analyzed within 60 days. It was found that the concentration of 4 aristolochic acids-DNA adducts in the kidney was significantly higher than that in the liver, and there were about 15.87 adducts in per 1×10~6 normal deoxynucleosides, which was 4.5-7.5 times than that of the liver. What's more, some adducts can still be detected on the 30 th day after administration. The concentration of the adducts in the liver was highest on the first day after administration, and a second peak appeared during the 7 th to 14 th days. The results indicated that aristolochic acids-DNA adducts are difficult to eliminate in vivo, and it is of great significance to study the mechanism of liver and kidney injury of aristolochic acid.

Parotid CT imaging reporting and data system: A preliminary study / 北京大学学报(医学版)

OBJECTIVE@#To establish a Parotid Imaging Reporting and Data System (PI-RADS) for CT diagnosis of the parotid gland neoplasms and to investigate the clinical applicable value and feasibility of PI-RADS.@*METHODS@#Patients who had been diagnosed with primary parotid gland neoplasms and had received surgical treatments in Peking University School and Hospital of Stomatology during the period of January 2013 to December 2016 were included in this study. The diagnoses were confirmed by the postoperative pathological examinations in all the patients. The CT imaging data of all patients were retrospectively reviewed and analyzed by two readers in consensus. Imaging characteristics related to the parotid neoplasms were extracted and quantified. Based on comprehensive analysis of the imaging characteristics, the probabilities of the benign and malignant neoplasms were evaluated and classified into six grades, PI-RADS 1-6 (PI-RADS 1: normal parotid gland; PI-RADS 2: confidently benign lesions; PI-RADS 3: probably benign lesions without confirmed evidence of malignancy; PI-RADS 4: suspected malignancy without sufficient evidence of malignancy; PI-RADS 5: confidently malignant lesions; PI-RADS 6: lesions with confirmed pathological evidence of malignancy).@*RESULTS@#A total of 897 patients with 1 003 parotid lesions were included. The lesions included 905 benign and 98 malignant lesions. The proportions of the malignancies in PI-RADS 2, PI-RADS 3, PI-RADS 4 and PI-RADS 5 according to the two readers in consensus were 0.4%, 5.7%, 35.5% and 96.7% respectively. The overall Cohen's Kappa test showed medium consistency between the two independent researchers (κ=0.614, P<0.001, 95%CI: 0.569-0.695). Pearson Chi-square test showed that the proportions of malignancies increased with the diagnostic PI-RADS grades (Cochran-Armitage trend test, Z=-15.579, P<0.001). The results of Pearson Chi-square tests showed significant differences between the grades [PI-RADS 2 and 3 (χ²=12.048, P=0.001); PI-RADS 3 and 4 (χ²=75.231, P<0.001); PI-RADS 4 and 5 (χ²=32.266, P<0.001)].@*CONCLUSION@#PI-RADS can be used to evaluate the risk of malignancy and will be helpful to improve the imaging diagnosis and clinical treatment of parotid gland neoplasms.

Determination of 25 characteristic components in Danhe Granules by LC-MS and consistency analysis of preparations / 中草药

Objective: A high performance liquid chromatography coupled to triple quadrupole mass spectrometry method (HPLC- MS/MS) was established to simultaneously determine the content of 25 characteristic components (gallic acid, tanshinol, catechin, chlorogenic acid, caffeic acid, epicatechin, rutin, polydatin, hyperin, astragalin, naringin, hesperidin, rosmarinic acid, resveratrol, salvianolic acid B, quercetin, emodin-8-O-β-D-glucoside, isorhamnetin, emodin, coclaurine, nuciferine, cryptotanshinone, tanshinone I, dehydronuciferine, tanshinone IIA) in Danhe Granules (DG), and the consistency between different batches was investigated. Methods The analysis was conducted on Agilent Rapid Resolution HD C18 column (50 mm × 2.1 mm, 1.8 μm) with the mobile phase of 0.1% formic acid water-0.1% formic acid acetonitrile. The dynamic multi-response detection (dMRM) scanning mode was used in the mass spectrometry. Results: Based on the established HPLC-MS/MS method, the simultaneous quantitative analysis of 25 characteristic components could be completed within 10 min, with the quantitative limits of isorhamnetin, coclaurine, and dehydronuciferine of 0.025 ng/mL; emodin and tanshinone I of 0.050 ng/mL; emodin-8-O-β-D-glucoside of 0.200 ng/ml; gallic acid, chlorogenic acid, caffeic acid, epicatechin, rutin, hyperin, astragalin, resveratrol, quercetin, nuciferine, tanshinone IIA of 0.250 ng/ml; catechin, rosmarinic acid, and cryptotanshinone of 0.500 ng/mL; tanshinol, hesperidin, and salvianolic acid B of 1.000 ng/mL; polydatin of 2.000 ng/mL; naringin of 5.000 ng/mL, respectively. The linear relationships of the 25 constituents within their respective mass concentrations were good, with the average recovery of 85.16%-113.46% and the RSD of 2.01%-8.80%. Furthermore, this method also included the main components named monarch, minister, assistant and guide of herbs in a relatively comprehensive way. The total content of the 25 components was 31.49 mg/g, among which the content of salvianolic acid B (9.44 mg/g) and hesperidin (7.60 mg/g) was the highest, and the content of isorhamnetin (0.79 μg/g) was the lowest. According to boxplot analysis, the content of 25 components in 10 different batches of DG fluctuated (P value) within 75% < P < 125%; and the RSD value of 25 components ranged from 2.58% to 13.10% by statistical analysis. The above results showed that the consistency of the component content among 10 batches of DG was acceptable. Conclusion: The analytical method established in this study is fast and sensitive. Furthermore, the results of this study are reliable and can provide scientific methods and basis for quality control and consistency analysis of DG.

Positive Effects of Qing'e Pill () on Trabecular Microarchitecture and its Mechanical Properties in Osteopenic Ovariectomised Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the impact of Qing'e Pill (, QEP) on the cancellous bone microstructure and its effect on the level of β-catenin in a mouse model of postmenopausal osteoporosis.@*METHODS@#Ninety-six 8-week-old specific pathogen free C57BL/6 mice were randomly divided into 4 groups (24/group): sham, ovariectomised osteoporosis model, oestradiol-treated, and QEP-treated groups. Three months after surgery, the third lumbar vertebra and left femur of the animals were dissected and scanned using micro-computed tomography (micro-CT) to acquire three-dimensional (3D) parameters of their cancellous bone microstructure. The impact of ovariectomy, the effect of oestradiol and QEP intervention on cancellous bone microstructure, and the expression of β-catenin were evaluated.@*RESULTS@#The oestradioland the QEP-treated groups exhibited a significant increase in the bone volume fraction, trabecular number, trabecular thickneßs, bone surface to bone volume ratio (BS/BV), and β-catenin expression compared with those of the model group (P <0.05). In contrast, the structure model index, trabecular separation, and BS/BV were significantly decreased compared with those of the ovariectomised osteoporosis model group (P <0.05). No differences were observed in the above parameters between animals of the QEP- and oestradiol-treated groups.@*CONCLUSIONS@#The increased β-catenin expression may be the mechanism underlying QEP's improvement of the cancellous bone microstructure in ovariectomised mice. Our findings provide a scientific rationale for using QEP as a dietary supplement to prevent bone loss in postmenopausal women.

Computed tomographic features of desmoplastic ameloblastoma of the jaw / 北京大学学报(医学版)

OBJECTIVE@#To retrospectively analyze the clinical and CT imaging features of desmoplastic ameloblastomas (DA) in comparison with other types of ameloblastomas.@*METHODS@#Patients diagnosed with ameloblastoma histopathologically in Peking University School and Hospital of Stomatology from July 2000 to August 2017 were reviewed to analyze the constituent ratios and characteristics of DA. CT imaging features of DA (28 cases) were investigated in comparison with consecutive cases of solid/multicystic and unicystic ameloblastomas. The following imaging perspectives were analyzed: the border, internal structure, three-dimensional shape, tooth, the periodontium, the cortex and the expansion of the tumors. CT values were measured in the region of interest for quantitative analysis.@*RESULTS@#Among the 1 269 cases of ameloblastomas, 50 (3.9%) were DA, which showed predilections for males (74.0%). The average age of DA was about 43.9 years old, which was higher than the other two types. The anterior incisorcanine region (62.0%) and premolar region (30.0%) were most frequently affected. The incidence rate of DA in mandibule was 56.0% (28/50), which was slightly higher than that of maxilla (44.0%). The DA characteristically showed scallop border and honeycomblike or soapbubble internal structure with bone formation on CT. The mean ratios of height to mesiodistal and buccal-lingual to mesio-distal distances were 0.76 and 0.63, which were higher than the other two types. According to the degree of internal bone formation, three subtypes of DA could be observed: densely ossifying type (I), honeycomb/soap bubble type (II) and sparsely ossifying type (III). The means and standard deviations of CT values of DA were significantly higher than those of the other two types, which were (488.8±164.0) HU (type I), (171.7±102.8) HU (type II), (42.1±8.8) HU (type III).@*CONCLUSION@#CT is helpful for diagnosis of DA, which shows as solid tumor with varying degrees of internal ossification.

Protective effect and mechanism of Lactobacillus on cerebral ischemia reperfusion injury in rats

The present study was designed to investigate the protective effects and mechanism of inactivated lactobacillus (ILA) on cerebral ischemia reperfusion injury (CIRI) in rats. In this experiment, 30 male Sprague Dawley rats were randomly divided into control group, IRI groups, and ILA group. A middle cerebral artery occlusion and reperfusion model was prepared. The rats were killed after 24 hours of recovery of blood flow of cerebral ischemia resulting from 60-min occlusion. The cerebral infarction volume and neurological scores were assayed by staining and behavioral observation. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were assayed by biochemical kits. Cell apoptosis was assayed by Tunnel and the Toll-like receptor (TLR)-4, IkB, and A20 were assayed by western blot. The neurobehavioral scores in IRI rats were significantly lower compared to the control group while ILA improved the neurobehavioral scores of the ILA groups. The cerebral infarction volume and neural cell apoptosis of rats in the ILA groups decreased significantly compared with those in the IRI group. In addition, MDA level in the ILA groups decreased whereas SOD activity increased compared to the IRI group. Moreover, ILA also inhibited the expression of TLR-4 and promoted the expression of IkB and A20. ILA inhibited the apoptosis of neural cells, decreased cerebral infarction volume, and reduced oxidative stress through inhibition of TLR-4/NF-kappa B signaling, improving neurobehavioral scores. Thus from the present study it was concluded that ILA has protective effect on CIRI.

Association between ADAMTS14 gene polymorphism and the temporomandibular joint osteoarthritis in Chinese Han females / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association between single nucleotide polymorphisms (SNP) of ADAMTS14 gene rs4747096 and osteoarthritis of the temporomandibular joint in Chinese Han females.@*METHODS@#As a case-control study, a total of 213 Chinese Han females were involved in the present study, which contained 103 temporomandibular joint osteoarthritis patients and 110 healthy people who had no symptoms or signs of temporomandibular joint osteoarthritis as control. Peripheral blood samples were collected from each participant. Genomic DNAs of temporomandibular joint osteoarthritis patients and healthy control were extracted from peripheral venous blood, which were stored in -80 °C refrigerator by using DNA extraction kits. The designed primers were used for polymerase chain reaction (PCR) amplification of specific DNA fragments. Genotype was determined by sequencing the PCR products. The software Chromas 2.22 was used to analyze the genotype. The genotype distributions, allele frequencies and genetic models between the patients and controls were compared. The age distribution was checked by t-test. Genotype and allele frequency were detected by Chi-square test.@*RESULTS@#In the present study, there were no significant differences between the osteoarthritis patients and healthy controls in terms of age. The genotype distribution was in accordance with Hardy-Weinberg equilibrium in the two groups. The genotype frequency of the ADAMTS14 (rs4747096) in the experimental group was 38.8% (AA), 55.4% (AG), and 5.8% (GG), respectively. The genotype frequency in the control group was 40.9% (AA), 43.6% (AG), and 15.5% (GG), respectively. The difference of genotype frequency of the ADAMTS14 (rs4747096) was significant between the experimental group and the control group (P=0.047). There was no significant difference in allele frequency between the two groups (P=0.415). AA and AG genotypes significantly increased the risk of the disease compared with GG in dominant model (OR=1.114, 95% CI: 1.015-1.223, P=0.028).@*CONCLUSION@#A significant correlationship was found between the ADAMTS14 (rs4747096) SNP and the temporomandibular joint osteoarthritis in Chinese Han females. The distribution of rs4747096 may be different between temporomandibular joint osteoarthritis and healthy population.

Application of germ-free animals in the study of pathogenesis of cow mastitis / 中国实验动物学报

Mastitis is one of the high incidence diseases in dairy farm, and the traditional therapies include using of antibiotics which usually have a high recurrent rate. The disease recurrence will reduce the milk production and cause worse result such as breast necrosis. So many cows are obsoleted because of mastitis and that cause a great economic loss to the dairy industry. Nursing mothers also suffering from mastitis and they cannot be treated with antibiotics because the med-icine has a bad influence on the baby' s nervous system. With all of the negative effects, antibiotics cannot be used in the mastitis treatment. Therefore it is extremely urgent to develop a new therapy for mastitis. Probiotics is a viable alternative which can be used in the prevention and treatment of mastitis because of many successful applications. Many previous ex?amples in a variety of disease prevention and treatment using probiotics make this research very interesting. Digestive tract is the main niche where probiotics can play a crucial role in maintaining the host' s health. It has been observed that diges?tive tract is one of the important microbial niche, which have a robust relationship with mastitis. It is the major issue of this research to use probiotic instead of antibiotics in the therapy of mastitis. The healthy intestinal microflora structure is crucial for the cows' health. Probiotics has a potential ability to cure mastitis in dairy cows. In addition it plays an essential role in maintaining the healthy state and mastitis prevention.

Study on the Quality of Life of Nurses from the Perspective of Health / 中国医学伦理学

Objective:To understand the quality of life of nurses and its influencing factors .Methods:Using WHOQOL-BREF scale and self-designed questionnaire , with the method of random , quota sampling , we chose 460 nurses in a county -level city of Shandong province to conduct the survey .Results:The environment field score was the highest (23.23 ±2.60), while the psychological score was the lowest (20.53 ±1.90).Nurses with higher ages scored lower in physiology and psychology .Male nurses ' physiology scores were higher than those of fe-males, but the psychological field scores of male nurses were lower .Those with higher education level scored lower in physiology .Physiological and psychological scores of administrative department nurses were higher .Scores of psychology , environment , and social relations were higher in permanent and high title nurses than those in contract and low (no) title nurses.Conclusion:It should establish the people -oriented nursing ethics culture , improve hu-man resource management .Through the standard post level management , flexible scheduling , we should improve the equal pay system , improve the sense of belonging , professional identity , to enhance quality of life .

Study on the Quality of Life of Nurses from the Perspective of Health / 中国医学伦理学

Objective:To understand the quality of life of nurses and its influencing factors .Methods:Using WHOQOL-BREF scale and self-designed questionnaire , with the method of random , quota sampling , we chose 460 nurses in a county -level city of Shandong province to conduct the survey .Results:The environment field score was the highest (23.23 ±2.60), while the psychological score was the lowest (20.53 ±1.90).Nurses with higher ages scored lower in physiology and psychology .Male nurses ' physiology scores were higher than those of fe-males, but the psychological field scores of male nurses were lower .Those with higher education level scored lower in physiology .Physiological and psychological scores of administrative department nurses were higher .Scores of psychology , environment , and social relations were higher in permanent and high title nurses than those in contract and low (no) title nurses.Conclusion:It should establish the people -oriented nursing ethics culture , improve hu-man resource management .Through the standard post level management , flexible scheduling , we should improve the equal pay system , improve the sense of belonging , professional identity , to enhance quality of life .

Research on the application of holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy / 中国医学装备

Objective:To investigate the effect of holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy. Methods: 80patients with cervical cancer were divided into observation group (40cases) and control group (40cases), and patients of control group received routine nursing modein perioperative period while patients of observation group received holistic nursing mode in the same stage. The complication of the two groups were compared and analyzed, and the satisfaction degree for nursing mode was investigated.Results: Under the intervention of holistic nursing, the number of complication of observation group was significantly lower than that of control group (x2=8.205,P<0.05). And the satisfaction degree for nursing of observation group was significantly higher than that control group(x2=5.000,P<0.05).Conclusion: The holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy can significantly improve the life quality of patients, and reduce the occurrence of complication, and enhance the satisfaction degree of patients for nursing.

Investigation on the Quality of Life about Rural Elderly Population and Its Influencing Factors / 中国医学伦理学

Objective:To understand the quality of life about rural elderly population and its influencing factors.Methods:Using WHOQOL-BREF scale and self-designed questionnaire,a survey about quality of life was conducted among 1074 rural elderly in Shandong Province selected by stratified,random method.T test,variaace analysis and multiple linear regression were used to analyze the influencing factors.Results:The score of environment field was the highest (13.83 ± 1.05),while social relations field was the lowest (8.63± 0.45).Single factor analysis showed that age,education level,economic situation,pension source,chronic disease,pension mode,physical exanination had significant effect on quality of life scores in each dimension (P ＜ 0.05).Marital status only had significant effect on psychological and social relations scores (P ＜ 0.05).Gender and the number of children were not statistically significant on the quality of life score in each dimension (P ＞ 0.05).Multiple regression analysis showed that the influencing factors of quality of life score in each dimension were chronic disease and economic situation.Physical examination only had significant effect on the physiology and psychological score.Pension mode had significant effect on psychological and social relations score.Age influenced physiology health score.Marital status influenced psychology health score.Conclusion:The government should pay attention to the health status of elderly and the psychological status of elderly without spouse;increase the support efforts to the poor rural elderly;strengthen the prevention and treatment of chronic diseases;improve the social support network and social security system.

Risk factor analysis of recurrent acute pancreatitis / 中华消化杂志

Objective To analyze the clinical features and risk factors of recurrent acute pancreatitis (RAP).Methods From September 2012 to September 2014,the clinical data of 411 patients with primary acute pancreatitis (AP) were collected.From March to June 2016,patients were followed up.The clinical features of patients with RAP were analyzed.Univariate and multivariate regression analysis were performed to analyze the risk factors of RAP.Results Among the 411 patients with AP,those caused by biliary disease,hyperlipidemia,alcohol,other known causes and idiopathic AP were 265 cases (64.5％),61 cases (14.8％),19 cases (4.6％),21 cases (5.1％) and 45 cases (10.9％),respectively.In two weeks of AP onset,the recurrent rate of biliary AP in cholecystectomy group was 7.1％ (5/70),which was lower than that of non-cholecystectomy group (30.2％,42/139),and the difference was statistically significant (xz =14.218,P＜0.01).The results of univariate regression analysis suggested that gender,body mass index (BMI),complicated with diabetes,etiology,history of smoking,history of drinking and pancreatic necrosis were correlated with RAP (all P＜0.05).The results of multivariate regression analysis indicated that complicated with diabetes (odd ratios (OR) =3.417,95 ％ confidence interval (CI) 1.979 to 5.900,P＜0.01),hyperlipidemic pancreatitis (OR=2.247,95％CI 1.077 to 4.688,P=0.023),history of smoking (OR=4.023,95％CI 2.377 to 6.809,P＜0.01),complicated with pancreatic necrosis (OR=3.312,95％ CI 1.675 to 6.546,P＜0.01) were independent risk factors of RAP.Conclusions Hypertriglyceridemia,smoking,complicated with pancreatic necrosis and diabetes are independent risk factors of RAP.Patients with biliary AP should receive cholecystectomy as early as possible,which could reduce RAP.

Values of Serum Pepsinogen and Gastrin-17 in Screening Gastric Cancer and Gastric Precancerous Lesion / 胃肠病学

Background:China is an area with high incidence of gastric cancer,studies have shown that serum pepsinogen (PG) and gastrin-17 (G-17)levels can be used for gastric cancer screening. Aims:To investigate the values of serum PG and G-17 levels in screening gastric precancerous lesion and gastric cancer. Methods:A total of 211 patients with gastroduodenal disease diagnosed by endoscopy and biopsy from March 2016 to October 2016 at the First Affiliated Hospital of Soochow University were enrolled,and 67 healthy subjects were served as controls. Serum levels of PGⅠ,PGⅡ,G-17 and Hp-IgG antibodies were determined by ELISA. Results:Compared with control group,PGⅠ level and PGR were significantly decreased in atrophic gastritis group (P < 0. 01);serum PGⅠ level and PGR were significantly decreased, and G-17 level was significantly increased in low grade intraepithelial neoplasia group,high grade intraepithelial neoplasia group and gastric cancer group (P < 0. 01). ROC curve showed that the best cutoff values of PGⅠ,PGR and G-17 for diagnosing gastric cancer and gastric precancerous lesion were 74. 74 ng/ mL (sensitivity 88. 3％,specificity 78. 0％), 6. 59 (sensitivity 87. 0％,specificity 73. 8％),13. 02 pmol/ L (sensitivity 54. 2％,specificity 84. 4％),respectively. PGR and G-17 were the independent predictors of gastric cancer and gastric precancerous lesion. The sensitivity and specificity of combined detection of PGⅠ,PGR and G-17 for diagnosing gastric precancerous lesion and gastric cancer were 89. 9％ and 84. 4％,respectively. Conclusions:Serum PGⅠ,PGR and G-17 may be used as indicators of gastric cancer and gastric precancerous lesion screening. PG combined with G-17 for diagnosing gastric cancer and gastric precancerous lesion is more sensitive and specific than using serum PG or G-17 alone.

Effects of continuous versus intermittent pump feeding on the energy intake in patients with acute stroke: a prospective randomized control trial / 中华临床营养杂志

Objective To investigate the energy intake and complications of continuous and intermittent pump feeding in acute stroke patients and provide a theoretical evidence to support for clinical treatment.Methods From April 2012 to June 2016,69 acute srtoke patients on the nasogastric tube feeding and admitted in the Department of Neurology intensive care unit in Xijing Hospital were enrolled and randomly assigned to have continuous or intermittent pump feeding.The primary endpoint was the efficacy in supplying the desired amount of nutrients by the fifth day and complications(hospital-acquired pneumonia,diarrhea,gastric retention,gastrointestinal bleeding)during the first week.The secondary endpoint was nutritional assessments(albumin,prealbumin,transferrin,hypersensitive c-reactive protein)in the first week.Results Both groups were comparable in acute physiology and chronic health evaluation Ⅱ(13.3±4.7 vs.12.9±4.5),Glasgow coma scale[10(7.2,14)vs.9.5(7.7,12)],National Institute of Health stroke scale[17(15,19)vs.16(13,20)],and Barthel scores[5(0,12.5)vs.10(5,15)](all P>0.05).It was no significantly different in the achievement percentage of the energy determined in the fifth day [93.9％(77.9％,99.8％)in continuous group and 84.8％(75.7％,93.9％)in intermittent group(U=0.144,P>0.05).Intermittent pump feeding significantly reduced the rate of hospital-acquired pneumonia in the first week when compared with continuous pump feeding(58.3％vs.33.3％,X2=4.327,P=0.038),and both groups displayed a moderate number of digestive complications without significant differences,including diarrhea(30.6％vs.27.3％,X2=0.09,P=0.764),gastric retention(2.78％vs.3.03％,X2=0.001,P=1.000),and gastrointestinal bleeding(5.56％vs.9.10％,X2=0.010,P=0.920).No difference could be demonstrated in serum protein markers between two groups in the first week,including prealbumin[0.17(0.13,0.20)g/L vs.0.18(0.15,0.24)g/L,P=0.195),transferrin[1.90(1.52,2.20)g/L vs.1.94(1.65,2.06)g/L,P=0.747),and hypersensitive C-reactive protein[22.5(8.3,50.1)mg/L vs.14.6(6.5,30.5)mg/L,P=0.205].Conclusions Both continuous and intermittent pump feeding can reach the target predictive nutrition(100％of calculated caloric requirements)without statistical differences in the incidences of gastrointestinal complications,and the rate of HAP is lower in intermittent group.Intermittent enteral nutrition can be used as an appropriate method of enteral nutrition support to improve the nutritional status in critically acute stroke patients.