Protective Effect of Total Lignans of Arctii Fructus on Retina in Rat Model of Type 2 Diabetes Mellitus / 中国实验方剂学杂志

ObjectiveTo investigate the protective effect of total lignans of Arctii Fructus on the retinal tissue in the rat model of type 2 diabetes mellitus. MethodWistar rats were randomized into normal， model， solvent， Shuangdan Mingmu Capsules （618 mg·kg-1）， and low-， medium-， and high-dose （100， 200， 400 mg·kg-1， respectively） total lignans of Arctii Fructus groups， with 16 rats in each group. The rat model was established by streptozotocin （STZ） combined with a high-fat diet and administrated with corresponding drugs by gavage once a day for 14 weeks. At the 14th week， blood was sampled for the collection of serum from the abdominal aorta after anesthesia， and bilateral eyeballs were collected and frozen. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes of the retinal tissue in rats. The pathological changes of retinal vascular network in rats were observed by retinal vascular tissue digestion and mounting The levels of vascular endothelial growth factor （VEGF）， tumor necrosis factor-α （TNF-α）， and intercellular adhesion molecule-1 （ICAM-1） in the serum were determined by the ELISA kit. ResultCompared with the normal group， the solvent group showed pathological changes in the retinal tissue， reduced retinal ganglion cells （P<0.01）， and retinal thinning （P<0.01）， decreased E/P value in retinal blood vessels （P<0.01）， and elevated serum levels of VEGF， TNF-α， and ICAM-1 （P<0.01）. Compared with the model group， the total lignans of Arctii Fructus increased the retinal ganglion cells （P<0.01）， thickened the retina （P<0.01）， and lowered the serum levels of VEGF， TNF-α， and ICAM-1 （P<0.05， P<0.01）. ConclusionTotal lignans of Arctii Fructus may lower the VEGF， TNF-α， and ICAM-1 levels to protect the retina.

Initial analysis of the environmental factors on the prognosis of patients with chronic obstructive pulmonary disease / 公共卫生与预防医学

Objective To analyze the effect of different environments risks on the prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 231 patients diagnosed with COPD who visited Mianyang Hospital of Traditional Chinese Medicine from April 2018 to January 2021 were selected as the study subjects and divided into two groups according to whether the residence was changed after discharge, that is, Mianyang Environmental Living Suzhou Environmental Living Group. The follow-up time was 2019 December to September 2021. The contents include relative humidity, temperature, PM2.5, PM10, air quality index, exposure to household smoking environment, and open windows for ventilation. The regional environment was mainly measured three times, namely October to February (expressed as cold period), June to August (expressed as warm period), March to May and September to October (expressed as suitable period). The family environment was followed up every 2 months by means of questionnaires and interviews, and detailed records were recorded. After the follow-up, the COPD Assessment Test (CAT) and Modified Dyspnea Rating Score (mMRC) were analyzed. Concentration-response curves were used to analyze the influence of living environment exposure on the prognosis of COPD patients. The generalized additive model with semi-Poisson distribution as the connection function was used to study the influence of univariate and multifactor environmental factors on COPD. Results The air quality index of Mianyang was higher than that of Suzhou during the cold period, while that of Mianyang was lower than that of Suzhou during the suitable period. Meanwhile, the average relative humidity of Suzhou was higher than that of Mianyang during the warm period. The comparison of CAT and mMRC scores of COPD patients in the two regions in different quarters showed that the CAT and mMRC scores of COPD patients in Mianyang City were lower than those in Suzhou City during the cold period, and the difference between groups was statistically significant (P2.5 (warm period), PM10 (warm period) and NO2 (suitable period) increased by 10μg/m3, 8μg/m3, 12μg/m3 and CO (suitable period) increased by 0.3mg/m3 respectively caused COPD function The scores of indicators CAT and mMRC increased. After adjusting for other pollutants, PM2.5, CO were still related to the prognosis of COPD. Concentration-response curve results showed that the risk of increasing CAT score decreased with increasing daily windowing time; conversely, the risk of increasing CAT score was increasing with increasing environmental exposure to smoking. Conclusion Pollutant exposure and living environment factors have a significant impact on the prognosis of COPD, and improving the environment is of great significance for the recovery of COPD pulmonary function.

Diagnostic value of a combined serology-based model for minimal hepatic encephalopathy in patients with compensated cirrhosis / 中华检验医学杂志

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Role of succinate dehydrogenase in hypoxic postconditioning-induced reduction of hypoxia-reoxygenation injury in myocardial cells of rats and the relationship with mito-K ATP / 中华麻醉学杂志

Objective:To evaluate the role of succinate dehydrogenase (SDH) in hypoxic postconditioning (HPC)-induced reduction of hypoxia-reoxygenation (H/R) injury in myocardial cells of rats and the relationship with mitochondrial ATP-sensitive potassium channels (mito-K ATP). Methods:Myocardial cells isolated from adult male Sprague-Dawley rats were cultured for 48 h and then divided into 7 groups ( n=24 each) using a random number table method: blank control group (Nor group), H/R group, SDHA-siRNA adenovirus+ H/R group (siRNA+ H/R group), HPC group, SDHA-siRNA adenovirus+ HPC group (siRNA+ HPC group), 5-HD+ HPC group, and SDHA-siRNA adenovirus+ 5-HD+ HPC group (siRNA+ 5-HD+ HPC group). Nor group was continuously cultured for 195 min under normoxic conditions. The H/R injury model was prepared by exposing the cells to hypoxia for 45 min in 5% CO 2 + 1% O 2 + 94% N 2, followed by reoxygenation for 150 min. The HPC method involved three cycles of 5 min reoxygenation/5 min hypoxia at the end of 45 min ischemia before 120 min reoxygenation. The mito-K ATP blocker 5-HD administration method involved adding 5-HD at a final concentration of 100 μmol/L at 30 min of hypoxia. The myocardial cells in each siRNA group were successfully transfected with SDHA-siRNA adenovirus to silence SDHA expression. The cell viability, calcium ion level, SDH activity, ATP content, degree of mitochondrial permeability transition pore (mPTP) opening, and mitochondrial membrane potential (MMP) were measured at the end of reoxygenation. Results:Compared with Nor group, the cell viability, ATP content and MMP were significantly decreased, and the degree of mPTP opening, level of calcium ion and activity of SDH were increased in H/R group ( P<0.05). Compared with H/R group, the cell viability, ATP content and MMP were significantly increased, and the degree of mPTP opening, calcium ion level and SDH activity were decreased in siRNA+ H/R group and HPC group ( P<0.05). Compared with HPC group, the cell viability, ATP content and MMP were significantly decreased, and the degree of mPTP opening, calcium ion level and SDH activity were increased in 5-HD+ HPC group ( P<0.05), and the cell viability, ATP content and MMP were significantly increased, and the degree of mPTP opening, calcium ion level and SDH activity were decreased in siRNA+ HPC group ( P<0.05). Compared with siRNA+ HPC group, the cell viability, ATP content and MMP were significantly decreased, the opening degree of mPTP and calcium ion level were increased ( P<0.05), and no significant change was found in the SDH activity in siRNA+ 5-HD+ HPC group ( P>0.05). Compared with 5-HD+ HPC group, the SDH activity was significantly decreased, and no significant change was found in the other parameters in siRNA+ 5-HD+ HPC group ( P>0.05). Conclusions:HPC alleviates H/R injury probably by reducing SDH activity and opening mito-K ATP in myocardial cells of rats.

Application of the teaching model based on case teaching and clinical practice in the top-up teaching of Clinical Nutrition Nursing / 中华医学教育探索杂志

Objective:To explore the application of clinical case analysis and practice-oriented teaching mode in the top-up teaching of Clinical Nutrition Nursing. Methods:Traditional teaching methods were adopted to the top-up nursing students of Shanghai University of Traditional Chinese Medicine in Batch 2018 (Class A). The top-up nursing students of Shanghai University of Traditional Chinese Medicine in Batch 2019 (Class B) adopted the teaching method of focusing on process teaching and combining clinical case teaching, case analysis report and practice. At the end of teaching, the teaching effect was evaluated through course assessment and questionnaire survey. SPSS 18.0 was used for t test. Results:Students' self-evaluation showed that the evaluation of teaching effect in Class B was higher than that in Class A with significant differences ( P<0.05). The scores of Class A were (83.34±4.27) points, and those of Class B were (85.07±4.22), with significant differences ( P<0.05). Conclusion:The teaching model based on clinical case analysis and practice has achieved good teaching effect on the teaching of Clinical Nutrition Nursing, which is worthy of promotion in the teaching of nursing major.

A prospective multicenter and real-world study on the diagnostic value of combination of number connection test-B and line tracing test in mild hepatic encephalopathy / 中华消化杂志

Objective:To investigate the diagnostic value of independent and combined subtests of the psychometric hepatic encephalopathy score (PHES) in mild hepatic encephalopathy(MHE) of patients with liver cirrhosis, so as to optimize the PHES.Methods:This was a prospective, multicenter and real-world study which was sponsored by the National Clinical Research Center of Infectious Diseases and the Portal Hypertension Consortium. Twenty-six hospitals from 13 provinces, autonomous regions and municipalities countrywide participated in this study, induding Tianjin Third Central Hospital, the Fourth People′s Hospital of Qinghai Province, the Second Affiliated Hospital of Baotou Medical College, the Third People′s Hospital of Taiyuan, the Fifth Medical Center of PLA General Hospital and so on. From October 2021 to February 2022, outpatients and hospitalized patients with liver cirrhosis and no obvious hepatic encephalopathy were consecutively enrolled. All patients received 5 PHES subjects in the same order: number connection test(NCT)-A, NCT-B, digit symbol test(DST), line tracing test(LTT) and serial dotting test(SDT), and the scores were calculated. The total score of PHES <-4 was taken as the cut-off value for diagnosing MHE. Compare the differences in each subtest between MHE group and non-MHE group. Receiver operating characteristic curve(ROC) and area under the curve(AUC) was performed to assess the diagnostic value of independent and combined subtests in MHE. Mann-Whitney U test and DeLong test were used for statistical analysis. Results:A total of 581 patients with liver cirrhosis were enrolled, 457 were diagnosed as MHE, and the incidence of MHE was 78.7%. The results of NCT-A, NCT-B, SDT, LTT, DST of MHE group were 60.00 s(47.01 s, 88.00 s), 90.45 s(69.32 s, 125.35 s), 74.00 s(57.65 s, 96.60 s), 74.72(60.00, 98.61) and 27.00(20.00, 36.00), respectively. Compared those of non-MHE group(34.00 s(29.15 s, 44.48 s), 50.00 s(40.98 s, 60.77 s), 50.00 s(41.07 s, 63.03 s), 46.23(38.55, 59.42) and 42.00(34.00, 50.75)), the differences were statistically significant( Z=12.37, 12.98, 9.83, 11.56, 10.66; all P<0.001). The AUC(95% confidence interval(95% CI)) of subtests of PHES NCT-B, NCT-A, LTT, DST and SDT alone in MHE diagnosis were 0.880(0.849 to 0.910), 0.862(0.828 to 0.896), 0.838(0.799 to 0.877), 0.812(0.772 to 0.851) and 0.788(0.743 to 0.832), respectively. The combination of 2 PHES subtests significantly increased the diagnostic efficacy. Among them the diagnostic efficacy of the combination of NCT-B and LTT was the best, the AUC(95% CI) was 0.924(0.902 to 0.947), the specificity was 91.9% and the sensitivity was 79.2%, which was better than a single PHES subtest (NCT-A, NCT-B, SDT, LTT and DST) and the combination of NCT-A and DST(AUC was 0.879, 95% CI0.847 to 0.910) which was recommended by guidelines on the management of hepatic encephalopathy in cirrhosis, the differences were statistically significant ( Z=3.78, 3.83, 5.57, 5.51, 5.38, 2.93; all P<0.01). Furthermore, compared between the combination of NCT-B and LTT and the combination of 3 subests of PHES, only the diagnostic efficacy of combination of NCT-B, LTT and SDT (AUC was 0.936, 95% CI 0.916 to 0.956) was better than that of the combination of NCT-B and LTT, the difference was statistically significant( Z=2.32, P=0.020). Conclusion:Based on the diagnostic efficacy and clinical feasibility of PHES subtests and their combinations, the combination of NCT-B and LTT is recommended for the diagnosis of MHE.

Role of reactive oxygen species in hypoxia postconditioning-induced activation of Nrf2/ARE signaling pathway in rat cardiomyocytes / 中华麻醉学杂志

Objective:To evaluate the role of reactive oxygen species (ROS) in hypoxia postconditioning-induced activation of nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway in rat cardiomyocytes.Methods:Primary cardiomyocytes of adult rats were isolated and cultured and divided into 4 groups ( n=20 each) using a random number table method: normal group (group N), hypoxia-reoxygenation group (group HR), hypoxia postconditioning group (group HPO) and hypoxia postconditioning plus an ROS scavenger N-(2-Amidinopropionyl)-glycine (MPG) group (group HPO+ MPG). Cells were exposed to hypoxia for 45 min followed by 60 min reoxygenation to develop the cardiomyocyte hypoxia-reoxygenation injury model.In HPO group, cells were subjected to 3 cycles of 5-min hypoxia/5-min reoxygenation after 45 min hypoxia, followed by reoxygenation for 60 min.In HPO+ MPG group, MPG (final concentration 2 mmol/L) was added at 35 min of hypoxia, cells were subjected to hypoxia for 10 min, and the other treatments were similar to those previously described in group HPO.At the end of reoxygenation, the intracellular calcium level and Nrf2 activity were measured, the ultrastructure of cardiomyocytes was observed, and the Flameng score of mitochondria was assessed, and the expression of Nrf2, NAD(P)H quinine oxidoreductase 1 (NQO1), superoxide dismutase 1 (SOD1) and heme oxygenase-1 (HO-1) protein and mRNA was detected using real-time polymerase chain reaction and Western blot. Results:Compared with group N, the intracellular free Ca 2+ level, Nrf2 activity and Flameng score were significantly increased, and the expression of Nrf2, NQO1, SOD1 and HO-1 protein and mRNA was down-regulated in group HR ( P<0.05). Compared with group HR, the intracellular free Ca 2+ level and Flameng score were significantly decreased, the Nrf2 activity was increased, and the expression of Nrf2, NQO1, SOD1 and HO-1 protein and mRNA was up-regulated in group HPO ( P<0.05). Compared with group HPO, the intracellular free Ca 2+ level and Flameng score were significantly increased, the Nrf2 activity was decreased, and the expression of Nrf2, NQO1, SOD1 and HO-1 protein and mRNA was down-regulated in group HPO+ MPG ( P<0.05). Conclusions:The mechanism by which hypoxia postconditioning activates the Nrf2/ARE signaling pathway in rat cardiomyocytes may be related to ROS.

Mitochondrial mechanism of diabetic mellitus-caused abolition of cardioprotection induced by ischemia postconditioning in rats: succinate dehydrogenase / 中华麻醉学杂志

Objective:To evaluate the relationship between the mitochondrial mechanism of diabetic mellitus-caused abolition of cardioprotection induced by ischemia postconditioning (IPO) and succinate dehydrogenase (SDH) in rats.Methods:Thirty-six SPF male non-diabetic Sprague-Dawley rats, aged 16-20 weeks, weighing about 300 g, were divided into 3 groups ( n=12 each) using a random number table method: sham operation group (ND+ Sham group), ischemia-reperfusion (I/R) group (ND+ I/R group) and IPO group (ND+ IPO group). Seventy-two rats with diabetes mellitus were divided into 6 groups ( n=12 each) using a random number table method: sham operation group (DM+ Sham group), I/R group (DM+ I/R group), DM+ IPO group, sham operation+ dimethyl malonate group (group DM+ Sham+ Dme), I/R+ dimethyl malonate group (group DM+ I/R + Dme) and IPO+ dimethyl malonate group (group DM+ IPO+ Dme). The model of cardiopulmonary bypass (CPB) was established, and the model of total I/R injury was induced by ligating the ascending aorta for 30 min followed by 60 min of reperfusion.The animals underwent 3 cycles of 30-s reperfusion followed by 30-s ischemia starting from the onset of reperfusion in each IPO group.In each Dme group, dimethyl malonate was infused through the tail vein at a rate of 4 mg· kg -1·min -1 for 40 min starting from the beginning of CPB.At the end of reperfusion, the myocardial tissues were taken for measurement of mitochondrial respiratory control ratio (RCR) (by the Lufthansa electrode method), mitochondrial membrane potential (MMP) (by the JC-1 method) and the opening of mitochondrial permeability transition pore (mPTP) (by absorptiometry) and for determination of the activity of reactive oxygen species (ROS) (with the fluorescent probe), succinate dehydrogenase (SDH) (using spectrophotometric method) and the contents of succinic acid and fumarate. Results:Compared with ND+ Sham group, the activities of SDH and ROS, opening of mPTP and content of fumarate were significantly increased, and MMP, RCR and succinic acid content were decreased in ND+ I/R ( P<0.05). Compared with group ND+ I/R, the activities of SDH and ROS, opening of mPTP and content of fumarate were significantly decreased, and MMP, RCR and succinic acid content were increased in ND+ IPO ( P<0.05). Compared with group DM+ Sham, the activities of SDH and ROS, opening of mPTP and content of fumarate were significantly increased, and MMP, RCR and succinic acid content were decreased in group DM+ I/R ( P<0.05). Compared with group DM+ I/R, no significant change was found in the parameters mentioned above in group DM+ IPO ( P>0.05). Compared with group DM+ IPO, the activities of SDH and ROS, opening of mPTP and content of fumarate were significantly decreased, and MMP, RCR and succinic acid content were increased in group DM+ IPO+ Dme ( P<0.05). Compared with group DM+ I/R+ Dme, the activities of SDH and ROS, opening of mPTP and content of fumarate were significantly decreased, and MMP, RCR and succinic acid content were increased in group DM+ IPO+ Dme ( P<0.05). Conclusion:The mitochondrial mechanism of diabetic mellitus-caused abolition of cardioprotection induced by IPO may be related to the enhancement of SDH activity in rats.

Developmental eye movement assessment in Chinese children with developmental dyslexia / 中华实验眼科杂志

Objective:To analyze the relationship between the developmental eye movement (DEM) test results and the vocabulary size in Chinese children with developmental dyslexia.Methods:A cross-sectional study was conducted.A total of 1 243 fifth grade students from 10 primary schools were enrolled from September to December 2019 in Tianjin, among which there were 664 males and 579 females, with the average age of (10.68+ 0.53) years old.The Chinese vocabulary test and intelligence test were carried out.Eighty-five dyslexic children with subaverage vocabulary size were selected as the experimental group and 54 normal children were selected as the control group.The DEM test was conducted in the two groups, and the vertical time, the horizontal adjustment time, the ratio of horizontal to vertical time and the total number of errors were recorded and analyzed.The differences in positive rate of dyslexia, various DEM test indicators between different genders and different groups were analyzed.The correlations between vocabulary size and vertical time, horizontal adjustment time, the ratio of horizontal to vertical time and the total number of errors were analyzed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of School of Optometry, Tianjin Vocational Institute (No.ysgxyll001). Written informed consent was obtained from the guardian of each subject.Results:The total positive rate of dyslexia was 6.83%(85/1 243), and the positive rate of 9.33%(62/664) in boys was higher than 3.97%(23/579) in girls, with a significant difference between them( χ2=13.974, P<0.001). There were no statistically significant differences in age, vocabulary size, vertical time, horizontal adjustment time, and the ratio of horizontal to vertical time between different genders in the control group (all at P>0.05). The vocabulary size of girls in the experimental group was larger than that of boys, showing a statistically significant difference ( t=-2.259, P=0.027). There was no significant difference in age, vertical time, horizontal adjustment time, and the ratio of horizontal to vertical time (all at P>0.05). The vertical time and horizontal adjustment time of the experimental group were longer than those of the control group, and the differences were statistically significant ( t=-4.848, -4.297; both at P<0.001). There was no statistically significant difference in the ratio of horizontal to vertical time between the two groups ( t=0.126, P=0.900). The total number of errors was 0(0, 1) in the experimental group, which was higher than the control group 0(0, 0), with a significant difference between them ( H=1.979, P=0.001). The vocabulary size of students in the two groups was negatively correlated with the vertical time, horizontal adjustment time and the total number of errors ( r=-0.397, P<0.001; r=-0.355, P<0.001; r s=-0.180, P=0.034), and was not obviously correlated with the ratio of horizontal to vertical time ( r=0.038, P=0.656). Conclusions:The DEM test scores of Chinese children with developmental dyslexia are higher than those of normal children, and there is no difference between different genders.The lower the scores of vocabulary size test, the higher the scores of DEM test.

Application research of ISBAR communication mode based on nursing priorities in nursing rounds / 中国实用护理杂志

Objective:To study the clinical value of the ISBAR communication model based on nursing priorities in nursing ward rounds.Methods:Using a quasi-experiment method, 104 patients who received secondary and tertiary care from April to June 2020 were set as the control group, and 122 patients who received secondary and tertiary care from July to September 2020 were set up as the experimental group, with non-randomized method. The experimental group used the ISBAR communication model based on nursing priorities for nursing ward rounds, and the control group used the traditional method for nursing ward rounds. The abilities of bedside nurses collecting the patients′condition, the bedside nurses′ condition observation and the nurses′ critical thinking were compared between the two groups, and the patients' nursing quality and satisfaction were also compared.Results:The scores of the bedside nurses′ knowledge of the patients′ condition were 81.14±3.09 in the test group and 75.90±2.84 in the control group, with statistically significant difference ( t value was -12.88, P<0.01). The scores of the bedside nurses′ ability in observing patients′ condition were 140.50 (137.00, 144.50) in the experimental group and 135.50 (128.75, 139.00) in the control group, with statistically significant difference ( Z value was -3.399, P<0.01). The scores of the Critical Thinking Disposition Inventory Chinese-version (CTDI-CV) were 309.82±36.33 in the experimental group and 286.86±33.54 in the control group, with statistically significant difference ( t value was -2.177, P<0.05). The scores of patient care quality evaluation were 62.50 (60.00, 64.00) in the experimental group and 59.00 (55.00, 61.50) in the control group, with statistically significant difference ( Z value was -6.47, P<0.01). The patient discharge satisfaction score of the experimental group was 53.00 (48.75, 55.00), and that of the control group was 51.00 (44.00, 54.00), with statistically significant difference ( Z value was -3.56, P<0.01). Conclusions:The application of ISBAR communication model based on nursing priorities in nursing ward rounds had a significant promotion effect on the improvement of nurses' abilities of collecting the patients′ condition, observing patients′ condition, and critical thinking, and can effectively improve nursing care quality and patients′ satisfaction.

Development of Self Training Device for Lung Function Compliance Guided by Meridians / 中国医疗器械杂志

OBJECTIVE@#To develop a self deep breathing training device which can improve lung function compliance and blood oxygen saturation.@*METHODS@#The device consists of four parts:flow tube, measuring cylinder, mobile phone holder and meridian guidance audio-visual synthesis training software. The flow tube measures the flow rate of inhaled gas, the metering cylinder measures the total amount of inhaled gas, and the mobile phone rack is equipped with a mobile phone storing the meridian guidance audio-visual synthesis training software.@*RESULTS@#The device is reasonable in structure and flexible in operation, which can meet the requirements of self deep inspiration training under the guidance of training module.@*CONCLUSIONS@#Deep inspiration training under the guidance of guidance training module can form "deep and slow" abdominal breathing, and then improve lung function.

HBV infection in window period among repeated blood donors: Residual risk assessment and trend analysis / 中国输血杂志

【Objective】 To investigate the status of blood safety and the effectiveness of preventive measures. 【Methods】 The data of Fengxian Blood Bank from 2018 to 2020 were extracted from Shanghai blood collection and supply information system. HBsAg sero-conversion samples of repeated blood donors were confirmed, and HBV serologic supplemental test were performed to obtain the number of new infections during the blood donation interval. The incidence and residual risk of HBV infection were evaluated by the sero-conversion model in donation intervals for repeated donors, and residual risk trend between the study period of 2002 to 2005, 2007 to 2011, 2011 to 2013 and 2018 to 2020 was compared. 【Results】 During 2018~2020, nine new HBV infections occurred among repeated donors during blood donation interval, with an incidence rate of 2.71 per 10 000. The residual risk of window period HBV transmission by transfusion could be reduced by 58.33% using HBsAg test plus NAT (HBsAg test 1∶30 637 vs HBsAg test plus NAT 1∶73 529). The residual risk of HBV transmission was decreasing when stratifying by periods, especially one order of magnitude dropped in 2018~2020 as in comparison of 2002 to 2005. 【Conclusion】 The residual risk of HBV transmission by transfusion showed a decrease trend. Although NAT could greatly reduce the risk, comprehensive preventive measures are needed to further reduce the risk.

Posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis: Prediction of functional prognosis of patients based on spinopelvic parameters / 中国组织工程研究

BACKGROUND: Surgery is a common way to treat degenerative lumbar spondylolisthesis, but some patients have poor postoperative health and quality of life. The relationship between preoperative spine pelvic parameters and postoperative healthy quality of life is not clear. OBJECTIVE: To investigate the preoperative predictors of postoperative poor improvement in healthy life quality for patients with degenerative lumbar spondylolisthesis based on spinopelvic parameters. METHODS: A retrospective analysis was performed on 186 patients with degenerative lumbar spondylolisthesis who met the criteria and underwent posterior lumbar interbody fusion surgery from June 2014 to September 2017, including 87 males and 99 females. (1) All patients were examined by the whole spine X-ray films in a standing position and sagittal spinopelvic parameters were measured, including pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, L4 slope, L5 slope, and sagittal vertical axis. (2) At the last postoperative follow-up, SF-36 was used to evaluate the healthy life quality of the patients, and the patients were divided into good group and poor group according to this score. The basic data and spinopelvic parameters of the two groups were compared and the preoperative predictors of poor quality of life were analyzed by Logistic regression and receiver operating characteristic curve analysis. RESULTS AND CONCLUSION: (1) All cases were followed up for 20 to 26 months, with an average of 24 months. (2) There were 127 cases in the good group and 59 cases in the poor group, with poor improvement in quality of life accounting for 32%. Group comparison revealed that sacral slope, lumbar lordosis, pelvic tilt, and sagittal vertical axis were larger in the poor group than in the good group (P 0.05). (3) Logistic regression analysis identified three preoperative predictors: pelvic incidence (P 52.18°, pelvic tilt > 25.23°, and sagittal vertical axis > 3.84 cm were risk factors for poor improvement in quality of life in postoperative patients, and the AUC value of pelvic tilt (0.944) was the largest. Sufficient attention should be paid to patients with preoperative risk factors.

Omics analysis of angiotensin converting enzyme 2 inhibitory mutation-related inflammatory response and intervention drugs and its significance on corona virus disease 2019 / 中华传染病杂志

Objective:To analyze the inflammatory mechanism and potential intervention drugs related to angiotensin converting enzyme 2 (ACE2) inhibitory mutations in order to provide reference for the treatment of corona virus disease 2019 (COVID-19).Methods:The data of lung adenocarcinoma with ACE2 mutations were screened from the cancer genome atlas (TCGA) database. The data were analyzed by R program language edgeR package and cluster Profiler package, gene ontology (GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Using String online analysis website for protein-protein interaction (PPI) network analysis, screening out the core genes, and finally using the Epigenomic Precision Medicine Prediction Platform (EpiMed) for multi-group association analysis of key genes, and drug candidates prediction.Results:A total of 1 005 differential genes were obtained, of which 91 were up-regulated and 914 down-regulated. A total of 71 GO were enriched, including 45 items related to biological processes, 16 items related to cell components, and 10 items related to molecular function. A total of 13 KEGG pathways were enriched, mainly in inflammatory pathways, various viral infectious diseases, transcriptional regulation, drug metabolism and protein digestion and absorption pathways. The differentially expressed genes were introduced into String online analysis website for PPI network analysis, a total of 252 proteins were obtained, and 10 core genes were H2A clustered histone 16(HIST1H2AL), H3 clustered histone 2 (HIST1H3B), H3 clustered histone 7 (HIST1H3F), H3 clustered histone 11 (HIST1H3I), H3 clustered histone 3 (HIST1H3C), H2B clustered histone 3 (HIST1H2BB), H2B clustered histone 6 (HIST1H2BI), H4 clustered histone 2 (HIST1H4B), H1-4 linker histone (HIST1H1E), H2A clustered histone 4 (HIST1H2AB). Interferon-α, resveratrol, celecoxib, heartleaf houttuynia herb, weeping forsythia capsule, dexamethasone, Chinese pulsatilla root, tumor necrosis factor-α inhibitors, liquorice root and famciclovir might be drugs for the treatment of ACE2 mutation-related inflammation.Conclusions:Inflammation associated with ACE2 inhibitory mutations is similar to the pathogenesis of COVID-19, which could lead to disease by promoting the activation of inflammatory pathways such as mitogen-activated protein kinase (MAPK), the Janus kinase signal transducer and activator of transcription (JAK/STAT), mammalian target of rapamycin (mTOR). Celecoxib, interferon and resveratrol may have the potential therapeutic effects on COVID-19.

Interpretation of Optometric Clinical Practice Guideline Care of the Patient with Learning Related Vision Problems / 中华实验眼科杂志

Learning is a complex process that is accomplished through the interaction of multiple senses, in which vision plays an important role.Abnormalities of vision problems probably having an adverse effect on learning are referred to as learning-related vision problems.In 2008, the American Optometric Association (AOA) approved and revised the Optometric Clinical Practice Guideline Care of the Patient with Learning Related Vision Problems, which provides appropriate evaluation methods, diagnosis and treatment strategies for patients with learning related vision problems to reduce the risk of visual problems interfering with learning process.This guideline provides a comprehensive description of the definition, epidemiology, evaluation and clinical diagnosis and treatment of learning related vision problems.In foreign countvies, optometrists are the main members who provide assistance to patients with learning problems.They form a multidisciplinary comprehensive managing team with health care practitioners and special education professionals.The optometrists are mainly responsible for handling visual factors that affect learning.However, many domestic optometrists are still not familiar with learning related vision problems, and they do not yet understand clinical practice guidelines well.Although the guideline was revised in 2008, it is still in use.Therefore, the interpretation of the guideline has certain reference significance in the study of children's visual science in China.The main content of the Optometric Clinical Practice Guideline Care of the Patient with Learning Related Vision Problems was introduced and elucidated to get a deeper understanding of learning related vision problems and improve the diagnosis and treatment skills of optometrists, so as to better serve patients.

Opportunities and challenges for the development of the old-age care model of medical and nursing combination in Chinese medical institutions / 国际中医中药杂志

With the aggravation of aging and the increasing demand of the elderly for pension and medical services,the old-age model of medical care combined with nursing emerges as the times required.Traditional Chinese medicine medical institutions have the advantages and opportunities in the process of developing integrated medical and nursing services,such as the treatment and prevention of chronic diseases,the increasing demand of the elderly for integrated medical and nursing institutions,and the strong support of the state for integrated medical and nursing institutions.However,they are also facing challenges and difficulties such as imperfect team,weak market competition and low payment ability.Through the analysis of opportunities and challenges for TCM medical institutions,this paper provides corresponding counter measures and suggestions for their development.

Effect of hypothalamic nerve growth factor precursor on field potential of paraventrucular nucleus during rat cardiopulmonary bypass / 临床麻醉学杂志

Objective To evaluate the effect of cardiopulmonary bypass (CPB) on the expression of hypothalamic nerve growth factor precursor (proNGF) and the influence of hypothalamic proNGF on the sympathetic output of paraventrucular nucleus. Methods Forty-two male SD rats, aged 3-4 months, weighing 350-500 g, were divided into control group, CPB group and ischemia reperfusion (IR) group. At the end of CPB for 110 min, hypothalamus and dorsal root ganglion (DRG) were taken to measure the levels of proNGF mRNA and hypothalamic proNGF protein. Mini pipe was put into bilateral paraventrucular nucleus (PVN) and human recombination proNGF protein was injected into PVN for 7 d before the local field potentials (LFP) of RVLM was recoreded. Human recombination proNGF protein was administrated into lateral ventricle, the prior-administration-LFP of PVN and post-administration-LFP were recorded and compared. At the end of the experiment, hypothalamus was taken to measure the levels of glutamate and gammer amino butyric acid (GABA). Results Hypothalamic proNGF protein in CPB group and IR group was higher than that in the control group (P ＜ 0.05); NGF mRNA of hypothalamus and DRG in CPB and IR group were higher than those of control group (P ＜ 0.05). In PVN and RVLM, after the administration of proNGF protein, the power of delta band significantly decreased and other bands increased (P ＜ 0.05). The hypothalamic GABA level decreased (P ＜ 0.05) with no change of hypothalamic glutamate after proNGF was injected into lateral ventricle. Conclusion CPB increases the expression of proNGF in the hypothalamus contributing to the changes of hypothalamic sympathetic output.

Practice of PDCA Method in the New Specialties Accreditation of Drug Clinical Trial Institution / 中国药房

OBJECTIVE:To explore the effects of PDCA method in the new specialties accreditation of drug clinical trial institution. METHODS:PDCA method was used for drug clinical trial institution office and 9 newly applied majors in our hospital. Total score of each major were compared before and after intervention,in order to make the newly applied major meet the standard of specialties accreditation of drug clinical trial. RESULTS:After conducting PDCA related training,establishing new specialties accreditation work group,formulating work goals and plans,9 new majors of our hospital were all approved by CFDA for new specialties accreditation;after intervention total score of each accreditation item for newly applied major were all higher than before intervention,with statistical significance(P<0.05),improved by more than 45.57%. CONCLUSIONS:It is feasible to adopt PDCA method in the preparation of new specialty accreditation of drug clinical trials. It is of significance to guarantee scientific and reliable drug clinical trial results and protect the rights and interests of the subjects.

Effect of electroacupuncture on learning and memory in rats with cerebral ischemia-reperfusion and its mechanism / 中华行为医学与脑科学杂志

Objective To explore the effect and possible mechanism of electroacupuncture on learning and memory impairment in rats with cerebral ischemia reperfusion.Methods 90 SD rats used for stepdown test were divided into normal control group,simple cerebral ischemia reperfusion of 7 d,14 d,30 d,60 d group (I/R) and cerebral ischemia reperfusion of 7 d,14 d,30 d,60 d and electroacupuncture intervention group (I/R+EA),through simple random sampling method (10 rats in each group);70 SD rats used for molecular biology experiments were randomly divided into normal control group,simple cerebral ischemia and reperfusion of 3 h,6 h,12 h group (I/R) and cerebral ischemia reperfusion of 3 h,6 h,12 h and electroacupuncture intervention group (I/R+EA),n=10.Use suture method to make model of cerebral ischemia reperfusion in rats.Take the rats' "baihui" acupoint and "shuigou" acupoint to acupuncture.The final strength was 5 mA and the duration was 30 minutes.Step down test was used to observe the restoration of learning and memory in rats.Western blot was used to detect the expression of procaspase-3,procaspase-12,PARP and ICAD in rat cerebral cortex and striatum.Immunofluorescence histochemical method was used to detect the number of GRP94 positive cells.Results The results of the platform showed that the learning and memory abilities of the rats were obviously improved after electroacupuncture treatment.Electric shock incubation period of rats in electroacupuncture of 7 d and 14 d group was (90.60± 17.01) and (128.80±8.85) respectively.It was significantly higher than that of cerebral ischemia reperfusion of 7 d group(51.20±5.09) and 14 d group(105.00± 10.39).The number of mistakes in single foot jump of rats in electroacupuncture of 7 d and 14 d group was (3.90±0.99) and (2.70±0.67) respectively.It was significantly lower than that of 7 d group (9.20± 1.61) and 14 d group (6.10± 0.99).Through SPSS13.0 statistical software one-way ANOVA,the difference was statistically significant (P＜ 0.05).Western blot results showed that the expression of procaspase-3,procaspase-12,PARP protein precursor and ICAD protein,upregulation increased after electroacupuncture(P＜0.05).The results of immunofluorescence histochemistry showed that the number of positive cells of GRP94 protein was significantly decreased after 3 h,6 h and 12 h after electroacupuncture intervention compared with the corresponding I/R group.Conclusion Electroacupuncture can effectively improve the learning and memory ability of rats with ischemia-reperfusion,which may be related to the apoptosis of cerebral cells after cerebral ischemia reperfusion injury by blocking the apoptosis pathway mediated by endoplasmic reticulum and inflammatory factors.

Acute kidney injury in Xinjiang: a cross-sectional survey / 中华肾脏病杂志

Objective To evaluate the etiology,epidemiological characteristics,clinical diagnosis,and outcomes of hospitalized patients with AKI in Xinjiang,analyzing the risk factors of their clinical prognosis.Methods A multicenter retrospective survey was conducted,investigating adult patients admitted to four hospitals in Xinjiang in January and July 2013.Patients with AKI were screened out based on KDIGO's inclusion and exclusion criteria.Clinical variables of patients with AKI including demographics,clinical data,laboratory tests,treatment measures and prognosis were collected.Results Among 32,157 adult hospitalized patients,there were 722 AKI patients.Excluding those with incomplete data,719 patients were enrolled in this study.The detection rate of AKI was 2.25％ (722 of 32,157) by KDIGO criteria.The main cause for AKI was pre-renal injury,led mainly by cardiac output,low blood volume,and the use of nephrotoxic drugs.The non-recognition rate of AKI was 72.4％ (407/557).Multivariate binary logistic regression analysis showed that AKI stage,peripheral vasodilation and renal parenchyma were protective factors of the omission diagnosis.In the short-term prognostic analysis,the overall mortality rate was 12.8％(92/719).Among the 323 patients with AKI who survived discharge,43.7％(141) had renal function recovery;40.2％(130) did not fully recover their renal function but ceased maintenance dialysis;16.4％ (53) were still on dialysis at discharge.Multivariate Cox regression model suggested that DIC,shock and department of obstetrics were independent risk factors for death during hospitalization of AKI.In addition,the risk of death for AKI from department of obstetrics and gynecology patients was higher than that of other departments.Conclusions The most common reason for AKI in hospitalized patients in Xinjiang was pre-renal injury.The main risk factors were low cardiac output and low blood volume.The omission diagnosis of AKI was serious;AKI stage,peripheral vasodilation and renal parenchymal injury however were its protective factors.Poor-DIC,shock,hospitalization in obstetrics were independent risk factors for death in patients with AKI.