Application of assessment-diagnosis-plan-implementation-evaluation teaching model based on skill competition in the teaching of "basic nursing" skills / 中国实用护理杂志

Objective:To explore the application effect of Assessmen-Diagnosis-Plan-Implementation-Evaluation(ADPIE) teaching model based on skill competition in the teaching of "basic nursing" skills in higher vocational colleges.Methods:This was a quasi experimental study. Convenience sampling method was adopted to select students from two classes of 2021 vocational nursing major of Pingxiang Health Vocational College from February to July 2022 as the research objects, among which 53 nursing students from Class 9 were selected as the experimental group and 55 nursing students from Class 13 were selected as the control group. The experimental group was taught based on the ADPIE teaching mode of skill competition. The control group was taught according to the conventional teaching mode, and the academic record and humanistic care ability of the nursing students in the two groups were compared.Results:The three dimensions of humanistic care ability in experimental group were cognition (70.82 ± 9.20) points, courage (59.58 ± 6.04) points, patience (57.17 ± 5.26) points, total score (187.57 ± 20.50) points. They were higher than those in the control group,which were (67.40 ± 8.83), (55.98 ± 9.03), (54.37 ± 5.96) and (177.75 ± 20.82) points, and there were statistical differences between the groups (t values were 2.61 to 3.42, all P<0.05). In addition, the three dimensions of academic performance: ordinary score (6.10 ± 1.22)points, course score (57.10 ± 6.27) points, objective structured clinical examination (OSCE) score (27.09 ± 2.13)points, total score (90.29 ± 9.69) points, they were also higher than those of the control group (5.06 ± 1.33), (52.73 ± 5.44), (25.35 ± 3.29), and (83.14 ± 10.06), and the differences between groups were statistically significant ( t values were 2.52-3.34, All P<0.05). Conclusions:ADPIE teaching model based on skills competition can improve the course scores and humanistic care ability of nursing students, and the teaching effect is significant.

A qualitative study on self-harm experience of adolescents with mental disorders under environmental function model / 中国实用护理杂志

Objective:To deeply understand the psychological experience of self-harm in adolescent patients with mental disorder under environmental function model, and to provide reference for the formulation of nursing intervention measures for adolescent patients with mental disorder.Methods:Descriptive phenomenology was used to conduct in-depth interviews with 14 adolescent patients with mental disorders in Wuhan Mental Health Center From February to May 2021. The interview data were analyzed by Colaizzi′s seven-step analysis method.Results:There were 4 themes and 12 sub-themes: cognitive bias of self-harming behavior; psychological and emotional complexity: self-denial and self-loathing, pain, despair, satisfaction and comfort, shame, stigma, guilt; the causes of self-harm: family factors, school factors, personality factors and psychiatric symptoms factors; insufficient self-management ability: insufficient emotional management ability, low medication compliance, low self-efficacy.Conclusions:The self-harm behavior of adolescent mental disorder patients is not optimistic, the psychological and emotional burden is heavy, and the self-management ability is insufficient, so the intervention and prevention of self-harm behavior should be further strengthened.

Cloning and functional verification of PhAEP gene, a key enzyme for biosynthesis of heterophyllin A in Pseudostellaria heterophylla / 中国中药杂志

This paper aimed to study the role of asparagine endopeptidase(AEP) gene in the biosynthesis mechanism of cyclic peptide compounds in Pseudostellaria heterophylla. The transcriptome database of P. heterophylla was systematically mined and screened, and an AEP gene, tentatively named PhAEP, was successfully cloned. The heterologous function verification by Nicotiana benthamiana showed that the expression of the gene played a role in the biosynthesis of heterophyllin A in P. heterophylla. Bioinformatics analysis showed that the cDNA of PhAEP was 1 488 bp in length, encoding 495 amino acids with a molecular weight of 54.72 kDa. The phylogenetic tree showed that the amino acid sequence encoded by PhAEP was highly similar to that of Butelase-1 in Clitoria ternatea, reaching 80%. The sequence homology and cyclase active site analysis revealed that the PhAEP enzyme may specifically hydrolyse the C-terminal Asn/Asp(Asx) site of the core peptide in the HA linear precursor peptide of P. heterophylla, thereby participating in the ring formation of the linear precursor peptide. The results of real-time quantitative polymerase chain reaction(RT-qPCR) showed that the expression level of PhAEP was the highest in fruits, followed by in roots, and the lowest in leaves. The heterophyllin A of P. heterophylla was detected in N. benthamiana that co-expressed PrePhHA and PhAEP genes instantaneously. In this study, the PhAEP gene, a key enzyme in the biosynthesis of heterophyllin A in P. heterophylla, has been successfully cloned, which lays a foundation for further analysis of the molecular mechanism of PhAEP enzyme in the biosynthesis of heterophyllin A in P. heterophylla and has important significance for the study of synthetic biology of cyclic peptide compounds in P. heterophylla.

Investigation of influencing factors of stunting in children aged 3‒4 years in Changning District， Shanghai / 上海预防医学

ObjectiveTo analyze the influencing factors of stunting among 3 to 4-year-old children in Changning District， Shanghai， in order to provide a scientific basis for early prevention and intervention for stunting. MethodsRandom cluster sampling was employed to select1 514 children from 16 kindergartens in Changning District， Shanghai as the survey subjects. Basic information such as height， weight， perinatal and infant feeding status， diet and lifestyle， as well as parental information was collected. The detection rate of stunting was calculated， and the influencing factors of stunted growth were analyzed. ResultsThe stunting detection rate of the 1 514 children was 5.4%. In terms of family-related factors， parents of stunted children had lower heights and a lower proportion of accessing growth and developmental knowledge from professional platforms compared to parents of non-stunted children （both P<0.05）. Among individual-related factors， the proportion of premature birth， low birth weight， short birth length， twin or multiple births， low fruit consumption， vitamin D intake， short outdoor playtime， and frequent nighttime waking was higher in the stunting group than in the control group （P<0.05）. Binary logistic multivariate regression analysis showed that shorter parental height （OR=4.35， 95%CI：1.20‒15.84 and OR=3.49， 95%CI：1.43‒8.51）， low birth weight （OR=2.99，95%CI：1.28‒7.05）， multiple or twin pregnancies （OR=3.78，95%CI：1.29‒11.06）， short outdoor playtime during weekends and holidays （OR=2.34，95%CI：1.02‒5.46）， frequent nighttime waking （OR=1.89， 95%CI：1.06‒3.39）， and consuming fewer fruits daily （OR=1.81， 95%CI： 1.01‒3.26） significantly increased the risk of stunting. ConclusionLow parental height， low birth weight， being twins or multiples， limited outdoor playtime during holidays， frequent nighttime waking， and low daily fruit consumption are major risk factors for stunting in infants and children.

Association of serum leptin and the risk of acute exacerbation of chronic obstructive pulmonary disease / 中国医师杂志

Objective:To analyze the association between serum leptin and the risk of acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:The clinical data of 127 COPD patients admitted to the Ninth People′s Hospital of Suzhou from November 2019 to December 2021 were retrospectively analyzed. According to whether acute exacerbation occurred in COPD patients, they were divided into acute exacerbation group (35 cases) and stable group (92 cases). General data of all patients were collected, including gender, age, body mass index (BMI), education level, disease course, smoking history, hypertension, diabetes, pneumonia, asthma and treatment methods. The forced expiratory volume in the first second/forced vital capacity (FEV 1/FVC), partial pressure of carbon dioxide (PCO 2), arterial blood pH and laboratory indicators [serum leptin, tumor necrosis factor (TNF-α) and C-reactive protein (CRP) levels] were detected. Receiver operating characteristic (ROC) curve was used to analyze the value of serum leptin, TNF-α and CRP in predicting acute exacerbation in COPD patients, and non-conditional logistic stepwise regression was used to analyze the risk factors of acute exacerbation in COPD patients. Results:Compared with the stable group, the proportion of patients with BMI<18.5 kg/m 2, complicated with pneumonia and asthma was higher, and the levels of serum leptin, TNF-α and CRP were also higher in acute exacerbation group (all P<0.05); ROC analysis showed that leptin≥3.683 ng/ml, TNF-α≥95.746 pg/ml and CRP≥22.405 mg/L were the best cut-off values of acute exacerbation in COPD patients(all P<0.05). Logistic regression analysis showed that BMI<18.5 kg/m 2, combined pneumonia, combined asthma, leptin≥3.683 ng/ml, TNF-α≥95.746 pg/ml, CRP≥22.405 mg/L were the risk factors for acute exacerbation of COPD patients(all P<0.05). Conclusions:Serum leptin level is elevated in COPD patients, and elevated serum leptin can lead to increased risk of acute exacerbation of COPD. In addition, low BMI, combined pneumonia or asthma, abnormally elevated TNF-α and CRP may be risk factors for acute exacerbation of COPD patients.

Exploration and practice of innovative model of ability-oriented training for general practitioners / 中华医学教育探索杂志

Objective:To explore an innovative model of ability-oriented training for general practitioners and to evaluate its implementation effectiveness.Methods:A total of 49 general practitioners who participated in the training in 2015 were selected as the research objects, and they were trained in a new mode with innovative teaching and training system and comprehensive assessment mode as the main content. The results of theoretical examination and self-assessment scores of post competency were compared before and after the training. SPSS 19.0 was used for t test. Results:The theoretical examination results of the first year of training were higher than those before training [(77.23±0.55) scores vs. (69.14±4.63) scores], with significant differences ( t=12.15, P=0.001); and the results of the second year of training were also higher than those of the first year of training [(83.72±0.45) scores vs. (77.23±0.55) scores], with significant differences ( t=8.12, P=0.001). The self-assessment questionnaire showed that there were significant differences in such five abilities of the students' competency as medical knowledge and clinical skills, autonomous learning, interpersonal communication, teamwork, core values and doctor professionalisms through the comparison of systematic training ( t=2.76, 4.53, 12.09, 2.33, 2.40, all P<0.05). Conclusion:The innovative training model for general practitioners is effective, and the practice of the new model could provide reference for continuously improving the training and education of general practitioners in China.

Utilization of used fungus-growing materials of Gastrodia elata / 中国中药杂志

This study aims to explore the resource utilization of used fungus-growing materials produced in the cultivation of Gastrodia elata. To be specific, based on the production practice, this study investigated the recycling mechanism of used fungus-growing materials of G. elata by Phallus inpudicus. To screen edible fungi with wide adaptability, this study examined the allelopathic effects of Armillaria mellea secretions on P. impudicus and 6 kinds of large edible fungi and the activities of enzymes related to degradation of the used fungus-growing materials of G. elata. The results showed that P. impudicus can effectively degrade cellulose, hemicellulose, and lignin in used fungus-growing materials of G. elata. The cellulase activity of A. mellea was significantly higher than that of P. impudicus, and the activities of lignin peroxidase, polyphenol oxidase, and xylanase of P. impudicus were significantly higher than those of A. mellea, which was the important reason why A. mellea and P. impudicus used different parts and components of the used fungus-growing materials to absorb carbon sources and develop ecological niche differences. The growth of P. impudicus was significantly inhibited on the used fungus-growing materials of G. elata. The secretions of A. mellea had allelopathic effects on P. impudicus and other edible fungi, and the allelopathic effects were related to the concentration of allelopathy substances. The screening result showed that the growth and development of L. edodes and A. auricular were not significantly affected by 30% of A. mellea liquid, indicating that they had high resistance to the allelopathy of A. mellea. The results showed that the activities of extracellular lignin peroxidase, polyphenol oxidase, and xylanase of the two edible fungi were similar to those of P. impudicus, and the cellulase activity was higher than that of P. impudicus. This experiment can be further verified by small-scale production tests.

Construction of protoplast genetic transformation system for Mycena--symbiont of Gastrodia elata / 中国中药杂志

Mycena, a symbiont of Gastrodia elata, promotes seed germination of G. elata and plays a crucial role in the sexual reproduction of G. elata. However, the lack of genetic transformation system of Mycena blocks the research on the interaction mechanism of the two. In order to establish the protoplast transformation system of Mycena, this study analyzed the protoplast enzymatic hydrolysis system, screened the resistance markers and regeneration medium, and explored the transient transformation. After hydrolysis of Mycena hyphae with complexes enzymes for 8 h and centrifugation at 4 000 r·min~(-1), high-concentration and quality protoplast was obtained. The optimum regeneration medium for Mycena was RMV, and the optimum resistance marker was 50 mg·mL~(-1) hygromycin. The pLH-HygB-HuSHXG-GFP-HdSHXG was transformed into the protoplast of Mycena which then expressed GFP. The established protoplast transformation system of Mycena laid a foundation for analyzing the functional genes of Mycena and the molecular mechanism of the symbiosis of Mycena and G. elata.

Resistance of different ecotypes of Gastrodia elata to tuber rot / 中国中药杂志

Tuber rot has become a serious problem in the large-scale cultivation of Gastrodia elata. In this study, we compared the resistance of different ecotypes of G. elata to tuber rot by field experiments on the basis of the investigation of G. elata diseases. The histological observation and transcriptome analysis were conducted to reveal the resistance differences and the underlying mechanisms among different ecotypes. In the field, G. elata f. glauca had the highest incidence of tuber rot, followed by G. elata f. viridis, and G. elata f. elata and G. elata f. glauca×G. elata f. elata showed the lowest incidence. Tuber rot showcased obvious plant source specificity and mainly occurred in the buds and bottom of G. elata plants. After infection, the pathogen spread hyphae in host cortex cells, which can change the endophytic fungal community structure in the cortex and parenchyma of G. elata. G. elata f. glauca had thinner lytic layer and more sugar lumps in the parenchyma than G. elata f. elata. The transcription of genes involved in immune defense, enzyme synthesis, polysaccharide synthesis, carbohydrate transport and metabolism, hydroxylase activity, and aromatic compound synthesis had significant differences between G. elata f. glauca and G. elata f. elata. These findings suggested that the differences in resis-tance to tuber rot among different ecotypes of G. elata may be related to the varied gene expression patterns and secondary metabolites. This study provides basic data for the prevention and control of tuber rot and the improvement of planting technology for G. elata.

Risk factors of acute kidney injury in patients with multiple wasp stings / 中华肾脏病杂志

Objective:To evaluate the risk factors of acute kidney injury (AKI) in patients with multiple wasp stings.Methods:Patients with multiple wasp stings were retrospectively enrolled in Hanzhong Central Hospital from September 2010 to November 2020. Based on whether the patients developed AKI, the patients were divided into AKI group and non-AKI group. The general characteristics and laboratory examinations between the two groups were compared. The logistic regression model was used to analyze the risk factors of AKI.Results:A total of 356 patients with multiple wasp stings were recruited in this study, with 196 males (55.1%). The age was 56.0(45.0, 64.0) years old. There were 59 patients (16.6%) with hypertension and 13 patients (3.6%) with diabetes. There were 51 patients (14.3%) in the AKI group and 305 patients (85.7%) in the non-AKI group. Baseline data and biochemical examinations indicated that the two groups showed significant differences in gender, age, sting sites (systemic or local), sting needles, proportions of gross hematuria, leukocyte count, hemoglobin, creatine kinase, alanine transaminase, aspartate aminotransferase, total bilirubin, proportions of urinary protein, and proportions of urine occult blood (all P<0.05). The multivariate logistic regression analysis results showed that the increasing number of sting needles (every 10 needles increase, OR=1.866, 95% CI 1.289-2.071, P=0.001), gross hematuria ( OR=9.770, 95% CI 2.586-36.910, P=0.001), decreasing hemoglobin (every 1 g/L increase, OR=0.016, 95% CI 0.001-0.355, P=0.009), increasing aspartate aminotransferase (every 100 U/L increase, OR=1.311, 95% CI 1.144-1.502, P<0.001), and increasing total bilirubin (every 10 μmol/L increase, OR=1.200, 95% CI 1.008-1.430, P=0.041) were independent influencing factors of AKI. Conclusions:The increasing number of sting needles, gross hematuria, decreasing hemoglobin, increasing aspartate aminotransferase, and increasing total bilirubin are independent risk factors of AKI in patients with multiple wasp stings.

Buffering effect of positive childhood experiences on mental health risks among adolescents / 中国学校卫生

Objective@#To explore the buffering effect of positive childhood experiences (PCEs) on mental health risks among adolescents before and after COVID-19 epidemic.@*Methods@#In October 2019 (before the outbreak of COVID-19), 1 322 students from grades 4 to 9 were recruited from primary and secondary schools in two counties of Chizhou city, Anhui Province. A questionnaire survey was conducted to collect general demographic information, PCEs, depressive symptoms, anxiety symptoms, self harm behavior, suicidal ideation. Follow up survey was conducted after school re opening (May 2020). Mental health status before and after the COVID-19 epidemic was compared among students with different PCEs by multiple logistic regression analyses.@*Results@#The detection rates of depressive symptoms, anxiety symptoms, self harm behavior and suicidal ideation (22.6%, 16.0%, 40.0%, 29.9%) of the respondents after school re opening were significantly higher compared that before the epidemic (16.5%, 13.5%, 31.1 %, 22.6%). There were no significant differences in the detection rates of depressive symptoms, anxiety symptoms,self harm behavior and suicidal ideation between high PCEs group before and after the epidemic ( Z =-0.05,0.27,0.84,1.84, P >0.05). Multivariate Logistic regression analysis showed that the risk of depressive symptoms and self harm behavior in the low PCEs group after school re opening was 1.39 times higher than that before the epidemic (95% CI= 1.05 -1.84, P <0.05). The risk of non suicidal self injury behavior in the low PCEs group after school re opening was 1.31 times higher than that before the epidemic (95% CI= 1.05 -1.62, P <0.05). There were no significant differences in mental health detection rates in high PCEs group before and after the epidemic ( P >0.05).@*Conclusion@#During the time of COVID-19 epidemic, PCEs is associated with lower rates of depressive symptoms, anxiety symptoms, self harm behavior and suicide ideation in adolescents. The findings suggest that more support and help should be given to adolescents from the perspectives of family, school and peers, so as to reduce the adverse effects of public health emergencies on adolescents mental health.

Cognition analysis of doctor-patient relationship from the perspective of medical students / 中华医学教育探索杂志

Objective:Based on the current medical environment, to learn about cognition status of doctor-patient relationship among medical students and analyze causes of the tension between doctors and patients.Methods:Using the self-designed questionnaire "Clinical Medical Students' Cognition Survey on Occupational Status and Doctor-Patient Relationship", a cross-sectional survey was conducted on 527 medical students from 5-year and 7-year clinical program in Batch 2014 in a medical university in Heilongjiang Province. The survey mainly analyzed the causes of the tension between doctors and patients from the level of medical staff, patients and their families, hospitals and society. SPSS 22.0 was used for descriptive statistics and chi-square test.Results:The results showed that 93.7% of the medical students believed that the current doctor-patient relationship was not harmonious. There were cognitive differences among medical students in different gender ( P=0.029), first contact clinical grade ( P=0.003) and professional identity ( P<0.001). Conclusion:Medical students have a poor evaluation towards the current doctor-patient relationship. In order to construct harmonious doctor-patient relationship in the future, we can try to take measures such as carrying out relevant courses of doctor-patient communication, improving the medical students' communication skills and enhancing their professional identity.

Identification and expression analysis of the DaNAC transcription factor family in Dipsacus asper / 药学学报

italic>NAC transcription factor genes play an important role in regulating plant adversity stress tolerance and secondary metabolism. To explore DaNAC transcription factor participation in the synthesis of asperosaponin Ⅵ in Dipsacus asper, we analyzed the expression of DaNAC genes based on full-length transcriptome data from different tissues (root, stem, leaf, flower, seed) to provide a theoretical foundation for regulating the metabolism of D. asper. RNA-seq data was used to identify open reading frames. Bioinformatic methods were used to identify the conserved domain motifs and construct an evolutionary tree. qRT-PCR was carried out to analyze tissue-specific and adversity-stressed expression. Twenty-nine DaNAC sequences were identified, all of which contain the conserved NAM domain and conserved motif 1 and motif 2 at the N terminal. Five DaNAC genes are closely related to the NAC genes in Arabidopsis thaliana and rice that are involved in adversity stress and are clustered in the Group Ⅰ subfamily. qRT-PCR revealed that DaNAC genes are differentially expressed between tissues. The expression levels were highest in leaves, followed by roots, stems and petioles, and the lowest in flowers and seeds. Compared with normal growth conditions, the expression of four NAC genes was up-regulated by treatment with low temperature (15 ℃). The expression of three genes (34564NAC2, 33883NAC48, 6727NAC14) was up-regulated and one gene (34480NAC22) was down-regulated by 150 μmol·L-1 MeJA. The results illustrate that the expression of NAC genes is induced by adversity stress, which provides a foundation for further study on the role of NAC family members in adversity stress in D. asper.

Content changes of triterpene saponins in crude and sweated Dipsacus asper:an iTRAQ-based analysis / 中国中药杂志

The present study aimed to explore the mechanism of the sweating of Dipsacus asper on content changes of triterpene sa-ponins by detecting the total triterpene saponins and the index component asperosaponin Ⅵ in the crude and sweated D. asper, and analyzing the differentially expressed proteins by isobaric tags for relative and absolute quantification(iTRAQ) combined with LC-MS/MS. After sweating, the content of total triterpene saponins decreased manifestly, while that of asperosaponin Ⅵ increased significantly. As revealed by the iTRAQ-LC-MS/MS analysis, 140 proteins with significant differential expression were figured out, with 50 up-regulated and 90 down-regulated. GO analysis indicated a variety of hydrolases, oxido-reductases, and transferases in the differential proteins. The results of activity test on two differentially expressed oxido-reductases were consistent with those of the iTRAQ-LC-MS/MS analysis. As demonstrated by the analysis of enzymes related to the triterpene saponin biosynthesis pathway, two enzymes(from CYP450 and UGT families, respectively, which are involved in the structural modification of triterpene saponins) were significantly down-regulated after sweating. The findings suggested that sweating of D. asper presumedly regulated triterpene saponins by affecting the expression of downstream CYP450 s and UGTs in the biosynthesis pathway of triterpene saponins of D. asper.

Methyl jasmonate stimulates the synthesis and accumulation of asperosaponin VI in the roots of Dipsacus asper / 药学学报

We investigated the effect of methyl jasmonate (MeJA) on the content of asperosaponin VI and the expression of genes involved in its synthesis. Dipsacus aspero seedlings were treated with MeJA at different concentrations of 50, 100, 150, 200 and 300 μmol·L-1, and leaves and roots were sampled following treatment for 1, 3 and 5 days. The content of asperosaponin VI and superoxide anion in the roots, malondialdehyde (MDA) content in leaves and superoxide dismutase were determined. The results show that 150 μmol·L-1 MeJA significantly increased the accumulation of asperosaponin VI in roots. The content of asperosaponin VI was greatest after treatment for 3 days, and was 2.16 times higher than the control. After MeJA treatment, SOD activity decreased and MDA content increased in leaves. Moreover, superoxide anion content in roots increased. The expression of squalene epoxidase (DaSE1) and geranyl diphosphate synthase (DaGPS), key enzymes in the synthesis of asperosaponin VI, were up-regulated compared with the control group. These results indicate that an optimal concentration of 150 μmol·L-1 MeJA increases the accumulation of asperosaponin VI by up-regulating the expression of key enzymes involved in the synthesis of asperosaponin VI, which facilitates resistance to adversity stress stimulated by MeJA.

Antioxidant mechanism of gastrodin combined with isorhynchophylline in inhibiting MPP~+-induced apoptosis of PC12 cells / 中国中药杂志

Gastrodiae Rhizoma-Uncariae Ramulus cum Uncis is the most frequently used herbal pair in the treatment of Parkinson's disease(PD). Gastrodin and isorhynchophylline are important components of Gastrodiae Rhizoma-Uncariae Ramulus cum Uncis herb pair with anti-Parkinson mechanism. This study aimed to investigate the effect of gastrodin combined with isorhynchophylline on 1-methyl-4-phenylpyridinium(MPP~+)-induced apoptosis of PC12 cells and their antioxidant mechanism. The leakage of lactate dehydrogenase(LDH) from cells to media was analyzed by spectrophotometry. Apoptotic cells were labeled with Annexin V-fluorescein isothiocyanate(FITC) and propidium iodide(PI) and analyzed by flow cytometry. The cell cycle was analyzed using propidium iodide(PI) staining. Lipid peroxidation(LPO) level was analyzed by spectrophotometry. The mRNA expression of caspase-3 was examined by Real-time RT-PCR. The protein expressions of heme oxygenase 1(HO-1) and NADPH: quinoneoxidore-ductase 1(NQO-1) were determined by Western blot. Gastrodin combined with isorhynchophylline reduced the percentage of Annexin V-positive cells and cell cycle arrest in MPP~+-induced PC12 cells. Gastrodin combined with isorhynchophylline down-regulated the mRNA expression of caspase-3, up-regulated the protein expressions of HO-1 and NQO-1, and reduced LPO content in MPP~+-induced PC12 cells. PD98059, LY294002 or LiCl could partially reverse these changes pretreated with gastrodin combined with isorhynchophylline, suggesting that gastrodin combined with isorhynchophylline inhibited MPP~+-induced apoptosis of PC12 cells and oxidative stress through ERK1/2 and PI3 K/GSK-3β signal pathways. Our experiments showed that gastrodin combined with isorhynchophylline could down-re-gulate the mRNA expression of caspase-3 and up-regulate the protein expressions of HO-1 and NQO-1, so as to reduce oxidative stress and inhibit apoptosis.

Effect of Zhenzhu Tiaozhi Capsule on HbA1c in Patient with Type 2 Diabetes Mellitus： A Real-world Study / 中国实验方剂学杂志

Objective:To explore the long-term effect of Zhenzhu Tiaozhi capsule（FTZ） on hemoglobin A1c（HbA1c）in patients with type 2 diabetes mellitus （T2DM） based on real-world data. Method:T2DM patients who were provided with FTZ （FTZ group） and those receiving conventional hypoglycemic drugs （control group） were extracted from the hospital information system （HIS） of the First Affiliated Hospital of Guangdong Pharmaceutical University， followed by propensity score matching （PSM） for balancing the confounding factors between groups. With HbA1c as the efficacy evaluation index， the difference in efficacy between the two groups was compared using <italic>t</italic>-test and <italic>χ</italic>² test. For repeated measurement data of the same patient， the difference in efficacy and the stability of FTZ against HbA1c were analyzed by generalized estimating equation （GEE）. The factors that might affect the efficacy of FTZ against HbA1c were subjected to multivariate linear regression analysis （MLRA）， and the subgroup analyses were then conducted after the stratification of relevant factors. Result:There were 46 patients included in the FTZ group and 1 208 patients in the control group. PSM yielded 42 pairs of samples with balanced covariates between groups. As revealed by one-year observation， ① HbA1c in the FTZ group after treatment was 6.51%±1.09%. No significant difference was observed either in pre- and post-treatment comparison in the FTZ group or in its comparison with the control group. At the same time， the HbA1c compliance rate in the FTZ group was 73.8% after treatment. No significant difference was observed either in pre- and post-treatment comparison in the FTZ group or in its comparison with the control group. ② The GEE results showed that the post-treatment HbA1c levels in the two groups were not significantly different from each other. Moreover， the HbA1c level remained stable over treatment time. ③ MLRA and subgroup analyses results demonstrated that FTZ was more effective in patients with high baseline HbA1c ［<italic>β</italic>=-0.530，95% confidence interval（CI） -0.850～-0.209，<italic>P</italic><0.01］ or those who were complicated with hypertension （<italic>β</italic>=-0.918，95%CI -1.614～-0.222，<italic>P</italic><0.05）. Conclusion:In the real world， FTZ is able to control the blood sugar， and its effect is similar to those of conventional hypoglycemic drugs. Besides， it is capable of stabilizing the blood sugar for a long time.

The clinical application and development of traditional antitumor drugs / 药学学报

Traditional antitumor drugs are cytotoxic chemotherapeutic drugs that can directly kill tumor cells and inhibit the growth and proliferation of tumor cells. Modern chemotherapy for tumors was initiated by use of nitrogen mustard to treat lymphomas in 1946, which was derived from mustard gas. Starting with nitrogen mustard, many kinds of anti-tumor drugs, including alkylating agents, anti-metabolism drugs, anti-tumor antibiotics, and anti-tumor plant drugs, have been successively developed for clinical treatment. Traditional antitumor drugs are the cornerstone of tumor chemotherapy and play important roles in the comprehensive treatment and neoadjuvant therapy of malignant tumors. In recent years, the combination of traditional antitumor drugs with molecular targeted therapy, immunotherapy, and radiotherapy has greatly improved the survival rate of tumor patients. With the deepening understanding of tumor genome as well as tumor initiation and promotion, the concepts of precision medicine and individualized treatment have been proposed and achieved success in clinical practice. In this context, the strategies leading to personalized therapy with traditional anti-tumor drugs also need to be further studied and optimized. This review summarized the recent clinical application and research progress of traditional antitumor drugs.

Exploration and practice of innovative model of ability-oriented training for general practitioners / 中华医学教育探索杂志

Objective:To explore an innovative model of ability-oriented training for general practitioners and to evaluate its implementation effectiveness.Methods:A total of 49 general practitioners who participated in the training in 2015 were selected as the research objects, and they were trained in a new mode with innovative teaching and training system and comprehensive assessment mode as the main content. The results of theoretical examination and self-assessment scores of post competency were compared before and after the training. SPSS 19.0 was used for descriptive analysis and t test of data. Results:The theoretical examination results before training were significantly different from those after the first year of training, and the results of the first year of training were also significantly different from those of the second year of training ( t values were 12.15 and 8.12, respectively), ( P<0.05). The self-assessment questionnaire showed that through systematic training, five aspects of the students' competency such as medical knowledge and clinical skills, autonomous learning, interpersonal communication, teamwork, core values and doctor professionalisms were significantly improved to different degrees ( P<0.05). Conclusion:The innovative training model for general practitioners is effective, and the practice of the new model could provide reference for continuously improving the training and education of general practitioners in China.

Qidong Yixin Oral Liquid Activates Nrf2/HO-1 Signaling Pathway to Alleviate Adriamycin-induced Myocardial Injury in Mice / 中国实验方剂学杂志

<b>Objective::To study the protective effect and mechanism of Qidong Yixin oral liquid on doxorubicin-induced myocardial toxicity in mice. <b>Method::Ninety male ICR mice were randomly divided into normal group, model(DOX) group, DOX+ Qidong Yixin oral liquid group (9.55, 23.88, 47.75 g·kg^-1) and high dose group (47.75 g·kg^-1) with 15 mice in each group. The normal group and model group were given pure water by gavage, and each dose group of Qidong Yixin oral liquid was given different doses of Qidong Yixin oral liquid once a day for 21 days. On the seventh day, normal saline was injected into the abdominal cavity of the normal group and the high dose group of Qidong Yixin oral liquid. Doxorubicin was injected into the abdominal cavity of the other groups (15 mg·kg^-1). After 21 days, the weight and heart weight of mice were weighed and cardiac index was calculated. Serum was taken for the detection of lactate dehydrogenase (LDH), creatine kinase (CK), aspartate aminotransferase (AST). Heart was taken for hematoxylin-eosin (HE) staining, superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), catalase (CAT) in myocardial tissue were detected. The expression of nuclear factor NF-E2 related factor (Nrf2) and heme oxygenase-1 (HO-1) were detected by Western blot. <b>Result::Compared with normal group, adriamycin could significantly reduce the body weight of mice (<italic>P</italic><0.01), increase the activities of LDH, CK and AST in serum(<italic>P</italic><0.01), and decrease the activities of antioxidant enzymes (<italic>P</italic><0.01). Compared with DOX group, high dose Qidong Yixin oral liquid could significantly increase the weight of mice (<italic>P</italic><0.05, <italic>P</italic><0.01), decrease the level of myocardial three enzymes(<italic>P</italic><0.01), increase the activity of antioxidant enzymes(<italic>P</italic><0.05, <italic>P</italic><0.01), and increase the expression of Nrf2 and HO-1(<italic>P</italic><0.01). <b>Conclusion::Qidong Yixin oral liquid has a good protective effect on doxorubicin myocardial toxicity. Its mechanism may be related to activating Nrf2/HO-1 signaling pathway and alleviating oxidative stress injury.