Research progress on regulation of N6-adenylate methylation modification in lipid metabolism disorders / 生理学报

Lipid metabolism is a complex physiological process, which is closely related to nutrient regulation, hormone balance and endocrine function. It involves the interactions of multiple factors and signal transduction pathways. Lipid metabolism disorder is one of the main mechanisms to induce a variety of diseases, such as obesity, diabetes, non-alcoholic fatty liver disease, hepatitis, hepatocellular carcinoma and their complications. At present, more and more studies have found that the "dynamic modification" of N6-adenylate methylation (m6A) on RNA represents a new "post-transcriptional" regulation mode. m6A methylation modification can occur in mRNA, tRNA, ncRNA, etc. Its abnormal modification can regulate gene expression changes and alternative splicing events. Many latest references have reported that m6A RNA modification is involved in the epigenetic regulation of lipid metabolism disorder. Based on the major diseases induced by lipid metabolism disorders, we reviewed the regulatory roles of m6A modification in the occurrence and development of those diseases. These overall findings inform further in-depth investigations of the underlying molecular mechanisms regarding the pathogenesis of lipid metabolism disorders from the perspective of epigenetics, and provide reference for health prevention, molecular diagnosis and treatment of related diseases.

Development, and reliability and validity testing of a knowledge needs questionnaire of respiratory rehabilitation training for in-service healthcare workers / 中国康复理论与实践

ObjectiveTo develop a questionnaire on the knowledge needs of respiratory rehabilitation training for in-service healthcare workers, and test its reliability and validity. MethodsA theoretical framework was constructed based on the contents of the respiratory rehabilitation course modules of American Association of Cardiopulmonary Rehabilitation and American Association for Respiratory Care. The first draft of the questionnaire was prepared through literature searches and analyses, semi-structured interviews, and expert group discussions. The reliability and validity of the questionnaire was tested by interviewing 17 respiratory rehabilitation professionals and 16 respiratory rehabilitation experts by correspondence, and investigating 380 cases of in-service healthcare workers engaged in respiratory rehabilitation. ResultsThe knowledge needs questionnaire of respiratory rehabilitation training for in-service healthcare workers included progress in respiratory rehabilitation, physiological basis and diagnosis of chronic lung diseases, individualized assessment and management principles of chronic lung diseases, treatment of chronic lung diseases and guideline-recommended medications, oxygen therapy, exercise assessment and exercise prescription, tobacco addiction and cessation, nutritional assessment and weight management, psychological screening and intervention, self-management and health behavior promotion, and effectiveness assessment of respiratory rehabilitation, totaling eleven dimensions and 52 items. The total Cronbach's α was 0.921, the total folded half reliability was 0.904, the total retest reliability was 0.922, and the Cronbach's α of each dimension ranged from 0.909 to 0.953; the folded half reliabilities ranged from 0.882 to 0.924, and the retest reliabilities ranged from 0.908 to 0.950. The validity of the questionnaire's content was 0.902. In exploratory factor analysis, eleven metric factors were extracted, and their cumulative variance contribution rate was 75.324%. ConclusionThe questionnaire on the knowledge needs of respiratory rehabilitation training for in-service healthcare workers is reliable and valid, and can be used to assess the knowledge needs of healthcare workers participating in in-service training in respiratory rehabilitation.

Efficacy of high-dose dual therapy for Helicobacter pylori infection eradication in servicemen: a randomized controlled trial / 中华内科杂志

Objective: To assess the efficacy and cost-effectiveness of high-dose dual therapy compared with bismuth-containing quadruple therapy for treating Helicobacter pylori(H.pylori) infection in servicemen patients. Methods: A total of 160 H. pylori-infected, treatment-naive servicemen, including 74 men and 86 women, aged from 20 years to 74 years, with a mean (SD) age of 43 (13) years, tested in the First Center of Chinese PLA General Hospital from March 2022 to May 2022 were enrolled in this open-label, randomized controlled clinical trial. Patients were randomly allocated into 2 groups: the 14-day high-dose dual therapy group and the bismuth-containing quadruple therapy group. Eradication rates, adverse events, patient compliance, and drug costs were compared between the two groups. The t-test was used for continuous variables, and the Chi-square test for categorical variables. Results: No significant difference in H. pylori eradication rates were found between high-dose dual therapy and bismuth-containing quadruple therapy by ITT, mITT and PP analysis[ITT:90.0% (95%CI 81.2%-95.6%) vs. 87.5% (95%CI 78.2%-93.8%), χ2=0.25, P=0.617;mITT:93.5% (95%CI 85.5%-97.9%) vs. 93.3% (95%CI 85.1%-97.8%), χ2<0.01, P=1.000; PP: 93.5% (95%CI 85.5%-97.9%) vs. 94.5% (95%CI 86.6%-98.5%), χ2<0.01, P=1.000 ]. The dual therapy group exhibited significantly less overall side effects compared with the quadruple therapy group [21.8% (17/78) vs. 38.5% (30/78), χ2=5.15,P=0.023]. There were no significant differences in the compliance rates between the two groups [98.7%(77/78) vs. 94.9%(74/78), χ2=0.83,P=0.363]. The cost of medications in the dual therapy was 32.0% lower compared with that in the quadruple therapy (472.10 RMB vs. 693.94 RMB). Conclusions: The dual regimen has a favorable effect on the eradication of H. pylori infection in servicemen patients. Based on the ITT analysis, the eradication rate of the dual regimen is grade B (90%, good). Additionally, it exhibited a lower incidence of adverse events, better compliance and significantly reduced cost. The dual regimen is expected to be a new choice for the first-line treatment of H. pylori infection in servicemen but needs further evaluation.

Effect of Dimethyl Fumarate (DMF) on T-cell Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the effect and possible mechanism of dimethyl fumarate (DMF) on T-cell acute lymphoblastic leukemia (T-ALL), and provide experimental and theoretical basis for the clinical treatment of T-ALL.@*METHODS@#Jurkat cells were treated with different concentrations of DMF for 24 hours, and then the proportion and absolute count of Ki67-positive Jurkat cells were analyzed by flow cytometry. Meanwhile, the protein levels of nuclear factor-erythroid 2-related factor 2 (Nrf2) and E3 ubiquitin ligase HACE1 in Jurkat cells treated with DMF for 24 hours were evaluated by Western blot. Nrf2 proteins were co-immunoprecipitated in Jurkat cells, and then HACE1 protein was assessed by Western blot. Plasmids of Flag-Nrf2 and different gradients of Flag-HACE1 were transfected into HEK293T cells, and the levels of Flag-Nrf2 were detected by Western blot after 48 hours.@*RESULTS@#DMF could significantly inhibit the proportion and absolute count of Ki67-positive Jurkat cells, and DMF inhibited the proliferation of Jurkat cells in a dose-dependent manner (r=0.9595, r=0.9054). DMF could significantly up-regulate the protein levels of Nrf2 and E3 ubiquitin ligase HACE1 in Jurkat cells (P<0.01, P<0.01). HACE1 physically interacted with Nrf2 in Jurkat cells. Overexpression of Flag-HACE1 significantly increased the protein level of Flag-Nrf2 in a dose-dependent manner (r=0.9771).@*CONCLUSION@#DMF inhibits the proliferation of T-cell acute lymphoblastic leukemia cell. The mechanism may be that, DMF significantly up-regulates the protein levels of Nrf2 and E3 ubiquitin ligase HACE1, and HACE1 interacts with Nrf2 and positively regulates Nrf2 protein level.

Atractylenolide Ⅰ improves acetaminophen-induced acute liver injury in mice by inhibiting MAPK/NF-κB signaling pathway / 中国中药杂志

This study explored the protective effect of atractylenolide Ⅰ(AO-Ⅰ) against acetaminophen(APAP)-induced acute liver injury(ALI) in mice and its underlying mechanism. C57 BL/6 J mice were randomly divided into a control group, an APAP group(500 mg·kg~(-1)), a low-dose combination group(500 mg·kg~(-1) APAP + 60 mg·kg~(-1) AO-Ⅰ), and a high-dose combination group(500 mg·kg~(-1) APAP + 120 mg·kg~(-1) AO-Ⅰ). ALI was induced by intraperitoneal injection of APAP(500 mg·kg~(-1)). AO-Ⅰ by intragastric administration was performed 2 hours before APAP treatment, and the control group received the same dose of solvent by intragastric administration or intraperitoneal injection. The protective effect of AO-Ⅰ against APAP-induced ALI was evaluated by detecting alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels in the plasma and H&E staining in liver tissues of mice. The malondialdehyde(MDA) and glutathione(GSH) content and catalase(CAT) activity in mouse liver tissues were detected to evaluate the effect of AO-Ⅰ on APAP-induced oxidative stress in the liver. The proteins in the liver p38 mitogen-activated protein kinase(p38 MAPK), c-jun N-terminal kinase(JNK), and nuclear factor kappa-B p65(NF-κB p65) signaling pathways were measured by Western blot, and the liver inflammatory cytokines interleukin-1β(IL-1β) and interleukin-6(IL-6) were detected by real-time PCR. Compared with the APAP group, the combination groups showed reduced APAP-induced ALT level and liver MDA content, potentiated liver CAT activity, and elevated GSH content. Mechanistically, AO-Ⅰ treatment significantly inhibited APAP-up-regulated MAPK phosphorylation and NF-κB p65, and significantly reduced the transcriptional activities of IL-1β and IL-6, downstream targets of NF-κB p65. AO-Ⅰ can improve APAP-induced ALI and the underlying mechanism is related to the inhibition of the MAPK/NF-κB p65 signaling pathway in APAP-challenged mice.

Analysis of changes in mortality of children and adolescents aged 5 to 19 years in China from 2004 to 2018 and policy effects / 中华预防医学杂志

Objective: To analyze the trend of child and adolescent mortality rate in China from 2004 to 2018 and explore the possible policy effects. Methods: This study used the mortality data of child and adolescent aged 5 to 19 years from 2004 to 2018 based on the National Disease Surveillance System. Age-standardized mortality rate was calculated by using the population from the sixth national census. Joinpoint regression was used to analyze the trend of child and adolescent mortality with different features from 2004 to 2018. Results: From 2004 to 2018, the overall mortality rate of children and adolescents in China dropped from 40.02 per 100 000 to 22.00 per 100 000, and the average annual percentage change (AAPC) was -4.28 (95%CI:-5.35,-3.20,P<0.001). The mortality rate dropped rapidly from 2004 to 2006, and the annual percentage change (APC) was -9.20 (95%CI:-15.63,-2.28,P=0.017). The decline rate slowed down between 2006 and 2013, and the APC was -1.56 (95%CI:-2.78,-0.33,P=0.020). The downward trend accelerated from 2013 to 2018, and the APC was -5.99 (95%CI:-7.52,-4.43,P<0.001). The trend of child mortality rate in rural area, females, eastern provinces of China, children aged 10 to 14 years, children aged 15 to 19 years, and injury mortality rate were basically consistent with the overall trend. The child mortality rate in urban area, central provinces of China and the mortality rate of infectious diseases, maternal and infant, and nutritional deficiencies diseases showed a uniform downward trend from 2004 to 2018, with AAPC values about -3.59 (95%CI:-4.38,-2.78,P<0.001), -2.89 (95%CI:-3.24,-2.54,P<0.001) and -6.66 (95%CI:-7.64,-5.68,P<0.001), respectively. Conclusion: The mortality rate of children and adolescents aged 5 to 19 years in China continues to decline from 2004 to 2018, and the decline rate becomes faster after 2011.

Methods for evaluating overweight and obesity among children and adolescents and application in SPSS and SAS / 中华预防医学杂志

Overweight/obesity has become one of the major public health problems among children and adolescents all over the world. The current screening standards for overweight and obesity in children and adolescents are not unified. It is easy to make mistakes and inefficient to evaluate item by item or develop self-written packages. Taking the"Screening standards for overweight and obesity in Chinese school-age children and adolescents"as an example, this study introduced four methods and procedures for evaluating overweight and obesity among children and adolescents from the world and China and described their application methods in combination with specific cases. At the same time, the SPSS and SAS packages were compiled and the specific application steps were explained, so that users could correctly and quickly screen overweight and obesity among children and adolescents, and conduct horizontal comparisons of similar studies across different regions.

Effects of an internet-based blood pressure monitoring and management platform on blood pressure control in a prehypertensive population: an intervention study / 中华健康管理学杂志

Objective:To explore the intervention effects of an Internet-based blood pressure monitoring and management platform in a prehypertensive population.Methods:One hundred and fifty-eight prehypertensive patients who were examined at the Third Xiangya Hospital in Changsha, China, from August to December 2019 were randomly divided into either the experimental or control groups using the random number table method. The experimental group utilized an Internet-based blood pressure monitoring and management platform, whereas the control group utilized regular telephone and SMS health management routines. The intervention duration was 12 months for both groups. Data were analyzed using descriptive analysis, t-tests, chi-square tests, χ 2 tests, and rank-sum tests. Results:Post intervention systolic blood pressure (124.79±9.71 mmHg) (1 mmHg=0.133 kPa) and diastolic blood pressure measurements (77.41±8.21 mmHg) of the participants in the experimental group were significantly lower than those before the intervention (128.29±5.10 mmHg and 79.99±6.01 mmHg, respectively), and significantly lower than those of the control group′s measurements after the intervention (130.00±7.78 mmHg and 80.33±7.90 mmHg, respectively) (all P<0.05). The blood pressure goal attainment rate was significantly higher in the experimental group (23.08%) than that of the control group (8.75%), with statistically significant differences within the experimental group before and after intervention, as well as between the groups post intervention ( P<0.05). Positive lifestyle changes, such as prehypertension knowledge score, active restriction and control of salt and oil intake, reduction of smoking, and exercising weekly, were significantly higher than those in the control group before the intervention (all P<0.05). Conclusion:The use of an Internet-based blood pressure monitoring and management platform can effectively help patients with prehypertension control their blood pressure levels, improve their knowledge about the condition, and improve their lifestyle choices.

Inhibitory effect of microRNA-23b-3p on high glucose-induced autophagy and apoptosis of human lens epithelial cells and its mechanism / 中华实验眼科杂志

Objective:To investigate the regulatory effects of microRNA-23b-3p (miR-23b-3p) on the autophagy and apoptosis of human lens epithelial cells induced by high glucose.Methods:Thirty diabetic cataract (DC) patients as DC group and 30 patients with simple cataract as simple cataract group were enrolled in The First Affiliated Hospital of Xi'an Medical University from September 2019 to October 2020.Conventional phacoemulsification and intraocular lens transplantation were performed in both groups.The anterior capsular tissue was collected during the operation.The expression of miR-23b-3p in the anterior lens capsule was detected by real-time fluorescence quantitative PCR (RT-qPCR). Human lens epithelial cell line HLEB3 cells were cultured in vitro and divided into normal control group and high-glucose group, which were cultured in normal and high-glucose medium, respectively.The targeting relationship between proto-cadherin 17 (PCDH17) and miR-23b-3p was predicted according to the bioinformatics database, and was verified by the dual-luciferase reporter gene experiment.High glucose-cultured HLEB3 cells were divided into miR-23b-3p mimics group, negative control (NC) mimics group, NC-siRNA group, PCDH17-siRNA group, miR-23b-3p mimics+ Vector group, miR-23b-3p mimics+ pcDNA-PCDH17 group, and were transfected with corresponding reagents according to grouping.The expression of miR-23b-3p and PCDH17 mRNA was detected by RT-qPCR.The expressions of a mammalian homolog of yeast Atg6/Vps30 (Beclin-1), microtubule-associated protein 1 light chain 3 (LC3B), c-Jun N-terminal kinases (JNK), phosphorylated (p-) JNK, c-Jun, p-c-Jun, B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) proteins were assayed by Western blot.The apoptosis rate was detected by flow cytometry.The study protocol was approved by the Ethics Committee of The First Affiliated Hospital of Xi'an Medical College (No.LSL2019037). Written informed consent was obtained from each patient. Results:The relative expression of miR-23b-3p in the anterior lens capsule of DC group was 0.35±0.15, which was significantly lower than 1.00±0.09 of simple cataract group ( t=44.627, P<0.01). There were significant differences in the relative expression levels of miR-23b-3p, LC3B Ⅱ/Ⅰ, Beclin-1, Bcl-2 and Bax proteins among normal control group, high glucose group, high glucose+ NC mimics group and high glucose+ miR-23b-3p mimics group ( F=21.325, 28.318, 17.634, 15.482, 22.325, 26.537; all at P<0.01). Compared with normal control group, the apoptosis rate, LC3B Ⅱ/Ⅰ, Beclin-1 and Bax protein expressions in high glucose group were significantly increased, and the Bcl-2 protein expression was significantly decreased (all at P<0.05). Compared with NC mimics group, the apoptosis rate, LC3B Ⅱ/Ⅰ, Beclin-1, and Bax protein expressions were significantly decreased and the Bcl-2 protein expression was significantly increased in miR-23b-3p mimics group (all at P<0.05). The results of bioinformatics and dual-luciferase reporter gene experiments showed that PCDH17 was a target gene of miR-23b-3p, and the relative expression of PCDH17 mRNA in miR-23b-3p mimics group was significantly lower than that in NC mimics group ( P<0.05). Compared with NC-siRNA group, the apoptosis rate, LC3B Ⅱ/Ⅰ, Beclin-1 and Bax protein expressions in PCDH17-siRNA group were significantly decreased, and the Bcl-2 protein expression was significantly increased ( t=9.116, 12.413, 5.349, 3.273, 8.419; all at P<0.01). There were significant differences in the relative expression levels of p-JNK/JNK, p-c-Jun/c-Jun, LC3B Ⅱ/Ⅰ, Beclin-1, Bcl-2 and Bax proteins in NC mimics group, miR-23b-3p mimics group, miR-23b-3p mimics+ Vector group and miR-23b-3p mimics+ pcDNA-PCDH17 group ( F=24.724, 19.319, 23.418, 17.562, 20.263, 15.249; all at P<0.05). Compared with the miR-23b-3p mimics+ Vector group, the expressions of p-JNK/JNK, p-c-Jun/c-Jun, LC3B Ⅱ/Ⅰ, Beclin-1 and Bax were significantly increased, and the expression of Bcl-2 protein was decreased in miR-23b-3p mimics+ pcDNA-PCDH17 group (all at P<0.05). Conclusions:MiR-23b-3p have a protective effect on HLEB3 cells in a high-glucose environment, mainly by targeting PCDH17 to regulate the JNK signaling pathway to inhibit high glucose-induced autophagy and apoptosis.

Characteristic of medication compliance behavior in renal transplantation patients / 中南大学学报(医学版)

OBJECTIVES@#After renal transplantation, patients need to take various immunosuppressant, but the drug compliance is poor. The theory of planned behavior suggests that the past medication behavior and subjective norms of individuals are closely related to medication compliance. This study aims to explore the change of medication compliance behavior and its influenting factors for renal transplantation patients at different stages.@*METHODS@#This study was a prospective longitudinal study. The Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS), Medication Belief Scale, Social Support Scale and Quality of Life Scale were used to dynamically follow up renal transplantation patients at pre-operation and 1-month, 6-month, and 12-month after transplantation.@*RESULTS@#A total of 300 patients completed the whole follow-up. The percentage of patients with good medication compliance was 97.60%, 87.30% and 84.30% at 1-month, 6-month and 12-month after transplantation respectively. The life quality of the patients was decreased at 6 months after the operation, and the patients with better self-reported life quality had poor medication compliance. After adjusting for demographic data, the risk of medication incompliance in patients with poor medication compliance before operation was 37.646 times than those with good compliance. Patients who did not use medication reminders had high risk (odds ratio=2.467) of drug non-adherence. The risk of drug non-adherence in patients with more postoperative misgivings was 1.265 times compared with that in patients with less postoperative misgivings.@*CONCLUSIONS@#The medication compliance decreases with the time of transplantation, but the medication compliance of patients with good self-reported life quality is poor. Medication concerns reduce the compliance behavior. Preoperative medication behavior has a significant predictive effect on postoperative behavior. Medication reminder is a protective factor for promoting compliance. Medical staff should pay more attention to preoperative medication belief, behaviors and reminder of using drug so as to provide precise intervention in the renal transplantation patients.

Cost-effectiveness of Morse Fall Scale assessment in fall prevention care in hospitalized patients / 中南大学学报(医学版)

OBJECTIVES@#To analyze the cost-effectiveness of the Morse Fall Scale by clinical big data for nurses in the prevention of falls in hospitalized patients.@*METHODS@#A total of 59 358 hospitalized patients, who came from the Third Xiangya Hospital of Central South University in 1 year before nurses were trained by the Morse Fall Scale, served as a control, including 26 862 males and 32 496 females. While the 66 203 hospitalized patients served as an observation group in 1 year after nurses were trained by the Morse Fall Scale, including 29 881 males and 36 322 females. The time spent by clinical nurses in the fall-risk assessment and the fall number were recorded in the 2 groups, and the relationship was analyzed between the Morse Fall Scale assessment and the clinical ending along with the labor cost of nursing. The cost-effectiveness was analyzed. In addition, the incidence of fall in the observation group was compared between the falling high-risk patients and the non-high-risk patients.@*RESULTS@#The Morse Fall Scale showed that the incidences of fall in the observation group and the control group were 3.39/100 000 and 3.82/100 000,respectively, there was no significant difference between the 2 groups (@*CONCLUSIONS@#The evaluation of the Morse Fall Scale has a certain effect, but it is limited in the prevention of falls in adult hospitalized patients, and the cost-effectiveness analysis is not good. It is recommended to implement the intervention measures for high-risk patients after the assessment, which may improve the management level and efficiency of fall prevention.

Effect of human umbilical mesenchymal stem cells derived exosomes on autophagy and expression of VEGF of RPE cells under a high-glucose condition / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of human umbilical mesenchymal stem cells(hUMSC)exosomes on the autophagy and expression of vascular endothelial growth factor(VEGF)of ARPE-19 cells under the condition of high glucose.<p>METHODS: Tissue explants adherent culture was adopted to cultivate umbilical cord mesenehymal stem cells. The ultrastmcture of exosomes was observed under transmission electron microscope and the expression of surface specific marker proteins CD63 on exosomes were determined by Western blot. ARPE-19 cells were divided into the control group, high-glucose group and exosomes+high-glucose group. The cells in the exosomes+high-glucose group were pretreated with 75μg/mL exosomes. The ultrastructure of autophagosomes formed in all cells of the three groups was detected under transmission electron microscopy. The viability of ARPE-19 cells was measured by MTT assay. Western blot was applied to detect the expression of autophagy-associated proteins in different groups, including microtubule related protein 1 light chain 3B(LC3B), Beclin-1 and p62. The expression of VEGF in the cell supernatants was examined by ELISA assay. <p>RESULTS: Transmission electron microscopy showed that the shape of hUMSC exosomes was spherical with membranous structure. The diameter of exosomes ranged from 30-100nm. Western blot indicated that the surface marker protein CD63 of exosomes showed positive expression. The number of autophagosomes in high glucose group was more than that in control group, while it was less in exosome+high-glucose group than in high glucose group. Compared with the high-glucose group, the cell proliferation rate of exosomes+high-glucose group was significantly increased(<i>P</i><0.01). In the control group, high-glucose group and exosomes+high-glucose group, the LC3B-Ⅱ/LC3B-Ⅰ ratio in ARPE-19 cells was 0.214±0.019, 0.461±0.067 and 0.332±0.079, respectively; the relative expression of Beclin-1 protein in the cells was 0.186±0.029, 0.615±0.044 and 0.464±0.046, respectively; the relative expression of p62 protein in the cells was 0.771±0.051, 0.364±0.016 and 0.547±0.039, respectively. Compared with the control group and exosomes+high-glucose group, the ratio of LC3B-Ⅱ/LC3B-Ⅰ and the protein expression levels of Beclin-1 were significantly increased in the high-glucose group(all <i>P</i><0.05). Compared with the control group and exosomes+high-glucose group, the protein expression level of p62 were significantly decreased in the high-glucose group(all <i>P</i><0.01). Compared with the high-glucose group, the expression levels of VEGF were significantly decreased in the exosomes+high-glucose group(<i>P</i><0.01). <p>CONCLUSION: High glucose conditions activated autophagy of ARPE-19 cells and promoted the expression of VEGF. hUMSC exosomes could effectively inhibit the autophagy level of ARPE-19 cells and the expression of VEGF in high-glucose environments.

Epidemic status and treatment outcomes of tuberculosis in 2008-2017 in Songjiang District, Shanghai / 上海预防医学

Objective To characterize the epidemic status and treatment outcomes of tuberculosis(TB)from 2008 to 2017 in Songjiang District of Shanghai for the development of TB prevention and control strategies. Methods According to case registration data in the TB management information system, statistical analysis was performed on the epidemic situation, epidemiological characteristics and treatment outcomes of TB cases in Songjiang District from 2008 to 2017. Results There were 5 516 reported cases in 2008-2017 in Songjiang District. The average annual reported incidence was 33.58/100 000, which was declining(χ2 = 6.13, P < 0.05). The incidence was significantly higher in the floating population than that in the household registered population(χ2 = 263.28, P < 0.05). In the cases, gender ratio was 2.17 : 1. More than 70% of the cases were between 15 and 44 years old. The majority of the cases were workers(34.95%), followed by housework or unemployed(16.28%). The proportion of TB case responding to the treatment was 93.38%, which was 93.41% for newly diagnosed cases and 92.86% for previously treated cases. The failure rate in the previously treated smear-positive cases was significantly higher than newly treated smear-positive cases(χ2 = 4.96, P < 0.05). Conclusion TB epidemic in Songjiang District remained at a low level in 2008-2017;however, it is far away from the termination of TB. We should further strengthen the prevention and control of TB, especially in the 15-44 years old workers and unemployed young population.

Correlation of B-type Natriuretic Peptide Level with Hemodynamic Parameters and Inflammatory Cytokines in Patients with Gram-negative Sepsis / 中国医学科学院学报

Objective To study the correlation of B-type natriuretic peptide(BNP)level with hemodynamic parameters and inflammatory cytokines in patients with Gram-negative sepsis,and further determine the main factors for the significant increase of BNP level. Methods The prospective study method was applied,and septic patients infected with Gram-negative bacteria from May 2017 to October 2019 were enrolled.The patients were divided into the BNP<2400 ng/L group and the BNP≥2400 ng/L group by taking the average value of BNP as the dividing point.The independent predictors of BNP≥2400 ng/L were analyzed by Logistic regression.Pearson correlation analysis was used to analyze the correlation between BNP and various indicators. Results A total of 106 patients with Gram-negative sepsis were included,among which 60 cases present with higher serum BNP levels than the average of(2398.45 ± 421.45)ng/L.Thus BNP≥2400 ng/L was considered as a significantly increased BNP level.Multiple logistic regression analysis showed that cardiac index(CI)[odds ratio (

A novel technology to reduce astringency of tea polyphenols extract and its mechanism / 中草药·英文版

Objective: Tea polyphenols are natural extracts used widely throughout the world. However, the severe astringency of tea polyphenols has reduced patient compliance. Based on the analysis of the formation mechanism of astringency, this paper hopes to propose a new method to control the astringency of tea polyphenols and improve patient compliance without changing its effect. Methods: Artificial saliva was used to prepare the tea polyphenols solution with different pH, using β-casein to imitate salivary protein, and preparing 1.2 mg/mL β-casein solution. A fluorescence quenching test was used to study the interaction between tea polyphenols and β-casein, combined with the stability test results of the compound, we can choose the pH with weak binding but good stability as the best pH for masking astringency. The taste-masking tablets were prepared under the best pH conditions, and the Xinnaojian Original Tablets were prepared according to the conventional preparation method. The disintegration time limit and solubility were tested respectively. The astringency of Xinnaojian original tablets and taste-masking tablets was evaluated by visual analogue scale (VAS). Results: The result of the fluorescence quenching test prompted that the combination force was the weakest when the pH was 4.9. Further synchronous fluorescence analysis showed that an increase in pH resulted in a decrease of the binding sites between tea polyphenols and β-casein, and this decrease was closely related to changes in tryptophan residues in β-casein. Both original and taste-masking Xinnaojian Tablets were prepared. Volunteers’ VAS scores illustrated that the astringency improved significantly with the masking tablets (P < 0.05). Conclusion: This pH-adjusting masking treatment had little effect on the recovery of polyphenols from the tablets or the dissolution of the tablets. This study provides a novel and feasible astringency masking technology for tea polyphenols and its preparation.

Effect of FOCUS-PDCA procedure on improving self-care ability of patients undergoing colostomy for rectal câncer / Efeito do procedimento FOCUS-PDCA na melhoria da capacidade de autocuidado de pacientes submetidos a colostomia por câncer retal / Efecto del procedimiento FOCUS-PDCA en la mejora de la capacidad de autocuidado de los pacientes sometidos a colostomía por cáncer de recto

ABSTRACT Objective: To investigate the effect of the FOCUS-PDCA procedure on the self-care ability of patients undergoing colostomy for rectal cancer. Method: A nonrandomized controlled trial of 160 patients with rectal cancer undergoing colostomy. The control group received routine nursing intervention, and the observation group received the FOCUS-PDCA procedure. The self-care ability of the two groups was investigated 1 week and 1 month after surgery, and a comparative analysis was made between the groups. Results: One week after surgery, the self-care ability of rectal cancer patients with colostomy increased from 39.09 points before implementation of the FOCUS-PDCA procedure to 60.15 points after implementation; an increase of 21.06%. One month after surgery, the self-care ability increased from 61.50 points to 83.13 points after implementation of the FOCUS-PDCA procedure; an increase of 21.63%. Conclusion: Application of the FOCUS-PDCA procedure improved the self-care ability of rectal cancer patients undergoing colostomy, improved their physical and mental health, reduced colostomy complications, and improved their quality of life. The results suggest that it is worth applying FOCUS-PDCA more widely.

RESUMO Objetivo: Investigar o efeito do procedimento FOCUS-PDCA na habilidade de autocuidado de pacientes submetidos a colostomia por câncer retal. Método: Um ensaio clínico não randomizado com 160 pacientes com câncer retal submetidos a colostomia. O grupo controle recebeu intervenção de enfermagem de rotina, e o grupo observação recebeu o procedimento FOCUS-PDCA. A capacidade de autocuidado dos dois grupos foi investigada por 1 semana e 1 mês após a cirurgia, e foi feita uma análise comparativa entre os grupos. Resultados: Em uma semana após a cirurgia a capacidade de autocuidado de pacientes com câncer retal com colostomia aumentou de 39,09 pontos antes da implementação do procedimento FOCUS-PDCA para 60,15 pontos após a implementação; um aumento de 21,06%. Em um mês após a cirurgia, a capacidade de autocuidado aumentou de 61,50 pontos para 83,13 pontos após a implantação do procedimento FOCUS-PDCA; um aumento de 21,63%. Conclusão: A aplicação do procedimento FOCUS-PDCA melhorou a capacidade de autocuidado de pacientes com câncer retal submetidos a colostomia, melhorou sua saúde física e mental, reduziu as complicações da colostomia e melhorou sua qualidade de vida. Os resultados sugerem que vale a pena aplicar o FOCUS-PDCA de forma mais ampla.

RESUMEN Objetivo: Investigar el efecto del procedimiento FOCUS-PDCA sobre la capacidad de autocuidado de pacientes sometidos a colostomia por cáncer de recto. Método: Un ensayo controlado no aleatorizado de 160 pacientes con cáncer de recto sometidos a colostomia. El grupo de control recibió una intervención de enfermería de rutina y el grupo de observación recibió el procedimiento FOCUS-PDCA. La capacidad de autocuidado de los dos grupos se investigó 1 semana y 1 mes después de la cirugía, y se realizó un análisis comparativo entre los grupos. Resultados: En una semana después de la cirugía la capacidad de autocuidado de los pacientes con cáncer de recto con colostomía aumentó de 39,09 puntos antes de la implementación del procedimiento FOCUS-PDCA a 60,15 puntos después de la implementación; un aumento del 21,06%. En un mes después de la cirugía, la capacidad de autocuidado aumentó de 61,50 puntos a 83,13 puntos después de la implementación del procedimiento FOCUS-PDCA; un aumento del 21,63%. Conclusión: La aplicación del procedimiento FOCUS-PDCA mejoró la capacidad de autocuidado de los pacientes con cáncer de recto sometidos a colostomía, mejoró su salud física y mental, redujo las complicaciones de la colostomía y mejoró su calidad de vida. Los resultados sugieren que vale la pena aplicar FOCUS-PDCA de manera más amplia.

Nursing care of a patient with multiple renal transplantation with high sensitization and severe obstructive sleep apnea hypopnea syndrome / 中国实用护理杂志

Objective:To summarize the nursing experience of a patient with multiple renal transplants with high sensitization and severe obstructive sleep apnea hypopnea syndrome.Methods:A phased care intervention was implemented through multidisciplinary joint treatment.Results:The transplanted renal function of the patient recovered well, the concentration of immunopreparations was stable, and the patient was cured and discharged after 30 days of hospitalizationConclusion:Preoperative accurate antibody screening and effective desensitization therapy are the prerequisites for successful operation. Postoperative sleep apnea, rejection and observation and nursing of immunosuppressive drugs are implemented. Personalized rehabilitation guidance and psychological care are implemented throughout the whole process. Strengthening missions and attaching importance to continuous care have effectively protected patients' safety.

Microecology research: a new target for the prevention of asthma / 中华医学杂志(英文版)

The incidence and prevalence of asthma have increased remarkably in recent years. There are lots of factors contributing to the occurrence and development of asthma. With the improvement of sequencing technology, it has been found that the microbiome plays an important role in the formation of asthma in early life. The roles of the microbial environment and human microbiome in the occurrence and development of asthma have attracted more and more attention. The environmental microbiome influences the occurrence of asthma by shaping the human microbiome. The specific mechanism may be related to the immune regulation of Toll-like receptors and T cells (special Tregs). Intestinal microbiome is formed and changed by regulating diet and lifestyle in early life, which may affect the development and maturation of the pulmonary immune system through the intestinal-pulmonary axis. It is well-recognized that both environmental microbiomes and human microbiomes can influence the onset of asthma. This review aims to summarize the recent advances in the research of microbiome, its relationship with asthma, and the possible mechanism of the microbiome in the occurrence and development of asthma. The research of the microbial environment and human microbiome may provide a new target for the prevention of asthma in children who have high-risk factors to allergy. However, further study of "when and how" to regulate microbiome is still needed.

Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function / 中国实验方剂学杂志

Diarrhea-predominant irritable bowel syndrome (IBS-D) is one of the common functional gastrointestinal diseases in clinical practice, its pathogenesis is diverse. Because of its sudden and lingering intractable symptoms, it seriously affects patients' work and life. IBS-D patients suffer from repeated illnesses, which often affect their lives with mental symptoms such as anxiety and depression. Anxiety and depression can also affect visceral sensation, increase intestinal sensitivity, aggravated by interaction between physical symptoms and mental symptoms. The main pathogenesis of IBS-D such as visceral hypersensitivity, gastrointestinal motility disorders, intestinal infections, and psychosocial factors are all related to brain-gut interaction disorders. Patients with IBS-D are prone to brain-gut interaction disorders due to long-term chronic mental stress. Brain-gut interaction is the main mode of regulation of gastrointestinal function in the brain-gut axis. Traditional Chinese medicine （TCM） believes that the main syndrome type of IBS-D patients is liver stagnation and spleen deficiency, while liver stagnation will be unsatisfactory, and the secretion and content of various neurotransmitters in the brain are closely related to emotions. Tongxie Yaofang is a commonly basic prescription used for the clinical treatment of IBS-D liver stagnation and spleen deficiency syndrome. It has the functions of softening the liver and replenishing the spleen, removing dampness and stopping diarrhea, and has a significant clinical effect. At present, many animal experiments and clinical studies have explored the mechanism of Tongxie Yaofang in treating IBS-D and its effect on brain-gut interaction function and brain-gut peptide content, but the main liver drainage and brain-gut interaction have not been linked. The author took the correlation between liver liver govers regulating and brain-gut interaction as the starting point, explored the mechanism of Tongxie Yaofang in treating IBS-D based on brain-gut interaction disorder, and explained the correlation between the three. Based on the research literature of Tongxie Yaofang in the past 5 years and the interaction between Tongxie Yaofang and brain-gut interaction, the author explored the effect of Tongxie Yaofang in treating IBS-D by affecting the brain-gut axis and brain-gut peptides.

Nursing standard of internet-based rehabilitation for patients with coronavirus disease 2019 / 中南大学学报(医学版)

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with COVID-19 may have respiratory dysfunction, physical dysfunction, and psychological dysfunction. Rehabilitation and long-term follow-up management are particularly important for these patients. Traditional face-to-face rehabilitation possesses high risk of infection, low coverage, time-consuming and laborious. While online rehabilitation nursing mode will be more feasible by using mobile internet technology. Based on literature review and focus group discussion, we standardize the internet-based nursing assessment, plan formulation, implementation, and effectiveness evaluation on discharged patients with COVID-19.We hope it can give guidance for nurses to provide better care for patients.