Effect of social support on psychological adaptation in military freshmen: The mediating effect of resilience / 中华医学教育探索杂志

Objective:To investigate the relationship between resilience, perceived social support, and adaptability in military freshmen.Methods:A total of 195 freshmen were randomly selected from a military medical university. The Chinese version of Connor-Davidson Resilience Scale (CD-RISC), the Perceived Social Support Scale (PSSS), and a self-test questionnaire of college students' psychological adaptability were used to investigate their resilience, perceived social support, and adaptability. SPSS 26.0 was used to perform an independent samples t-test and a Pearson correlation analysis to analyze the differences in these scores between freshmen with different demographic characteristics and the correlation between these scores. By using the PROCESS plug-in, a structural equation model was used to analyze the mediating effect of resilience on the relationship between social support and psychological adaptation, which was further tested using the Bootstrap method. Results:The independent samples t-test showed that females had a significantly higher score of other support than males ( t = -2.05, P = 0.041), and student leaders had significantly higher scores of family support and other support, total score of social support, and score in psychological adaptability than other students (all P<0.05). The correlation analysis showed that there were significant positive correlations between the scores of PSSS and its each item, CD-RISC, and self-test of college students' psychological adaptability (all P<0.05). The structural equation model showed that resilience partially mediated the relationship between social support and psychological adaptation, and the Bootstrap method revealed a significant indirect effect (95%CI: 0.102-0.253). Conclusion:Resilience plays a partial mediating role between perceived social support and adaptability in military freshmen. They should be guided to correctly perceive external support and develop strong resilience.

Construction of the post competency model of clinical medicine students in military medical universities / 中华医学教育探索杂志

Objective:To establish a post competency model for clinical medical students in military medical universities to explore the qualities most needed by outstanding graduates.Methods:Through behavioral event interview (BEI) method, the complete interview data of 82 graduates (40 students in excellent group and 42 students in normal group) from a military medical university were obtained. The respondents were asked to recall the three most successful and unsuccessful cases in their past work, and fill in the checklist. The interview data were coded, marked and classified, the interview recording data were analyzed, and the comparison was made between the frequency of competency characteristics and the collection points of excellent graduates.Results:Top 9 competency features with the highest frequency and no difference between the two groups were respectively internal quality (82 students, 100%), clinical medical service capacity (52 students, 63.4%), continuous learning ability (36 students, 43.9%), teamwork ability (38 students, 46.3%), career (66 students, 80.5%), enterprise (46 students, 56.1%), sense of responsibility (42 students, 51.2%), execution (42 students, 51.2%), and coordination of team members (36 students, 44.0%). The proportions of excellent graduates to mention the ability to apply information tools ( χ2=6.80, P=0.009),; master English literature ( χ2=4.42, P=0.036), and be self-disciplined and fame and fortune-weakened ( χ2=6.90, P=0.009) were higher than those of the ordinary ones. Conclusion:This study has scientifically constructed a post competency model for clinical medicine students in military medical universities, including the benchmark competency model (9 characteristics with the highest frequency and non-differentiated between two groups) and the identification competency model (3 characteristics of excellent graduates higher than those of ordinary ones).

The influence of military medical university students' proactive personality on achievement motivation: a conditional process analysis / 中华医学教育探索杂志

Objective:To explore the relationship between proactive personality, resilience and achievement motivation of military cadets, and to explore the mediating role of resilience between proactive personality and achievement motivation, as well as the moderating effect of cadets’leading ability on this mediating role.Methods:In this study, 109 military cadets were measured with proactive personality scale, Connor-Davidson resilience scale (CD-RISC) and achievement motivation scale. SPSS 26.0 was used for descriptive statistical analysis and correlation analysis.Results:①There was a significant correlation among the total scores of proactive personality, resilience and achievement motivation ( Ps<0.01). ②Proactive personality could significantly predict the level of achievement motivation ( a=0.454, P<0.001), and resilience could significantly predict the level of achievement motivation ( b=0.231, P=0.019). ③Resilience significantly mediated the relationship between proactive personality and achievement motivation ( c′=0.3, P=0.003). ④Cadets' leading ability moderated the effect of resilience on achievement motivation (index=0.338, 95% CI: 0.057 to 0.881). The mediating effect of resilience between proactive personality and achievement motivation was significant for cadets' leaders (Effect=0.381, 95% CI: 0.085 to 1.005), but not significant for other students (Effect=0.043, 95% CI: -0.069 to 0.252). Conclusion:The proactive personality of military cadets can affect the level of achievement motivation through psychological resilience, which is also moderated by cadre identity, suggesting that military education should improve the level of achievement motivation in many ways.

Autopsies and placental examinations of perinatal fetal deaths: a clinicopathological analysis of 105 cases / 中华病理学杂志

Objective: To summarize the clinicopathological factors related to perinatal fetal death and to evaluate importance of fetal autopsy and placental pathology. Methods: The clinicopathological data of 105 perinatal fetal deaths in Beijing Haidian Maternal and Child Health Hospital from November 2012 to December 2020 were retrospectively analyzed. Relevant literature was also reviewed. Results: The maternal age of the deceased fetuses ranged from 22 to 43 years with the average (31.35±4.04 years), and the gestational weeks were 28-40+6 weeks. Among them, 101 were singleton cases and 4 twin cases. 103 fetuses died in uterus and 2 died during delivery. Relevant factors analysis of the 105 perinatal fetal deaths showed that 86 cases (81.9%, 86/105) were related to umbilical cord/placental abnormality, 10 cases (9.5%, 10/105) uterine infection, 6 cases (5.7%, 6/105) fetal factors, 1 case was fetal maternal blood transfusion syndrome, 1 case twin blood transfusion syndrome, and 1 case died of complete uterine rupture. Among the 86 cases related to umbilical cord/placental abnormality, the diagnosis was most often based on the gross examination of placenta. The most common cause of death was umbilical cord torsion with thin root, followed by placental abruption, tight umbilical cord winding, vascular rupture and umbilical cord true knot. The morphology of placenta revealed mainly functional changes. Among the 10 cases related to intrauterine infections, the placenta generally showed lobular placental edema. The morphological characteristics of ascending infection were mainly acute chorioamnionitis, and the morphological characteristics of blood-borne infection were mainly acute or chronic villitis, as well as villous interstitial inflammation. Identification of viral inclusions suggested viral etiology, while the final diagnosis was relied on laboratory testing. Among the 6 cases related to fetal abnormality, the diagnostic value of placenta was limited and the diagnosis could be made with fetal autopsy. Conclusion: The causes of perinatal fetal death are complex, diverse, and often the synergistic result of multiple factors. Fetal autopsy and placental pathology are the key technical means to identify the cause of death and deserve more attention and utilization.

Singleton placentas with abnormal shape: a clinicopathological analysis of 130 cases / 中华病理学杂志

Objective: To investigate the pathological characteristics of singleton placenta with abnormal shape and its influence on the outcome of maternal-fetal pregnancy. Methods: The clinicopathological data of singleton placentas with abnormal shape from January 2014 to December 2020 in the Department of Pathology, Haidian Maternal and Children Health Hospital were analyzed retrospectively. Results: There were 130 singleton placentas with abnormal shape in this cohort, including 48 succenturiate placentas, 12 bilobed placentas, 50 marginate placentas, 13 circumvallate placentas, 3 annular placentas, 2 membranous placentas and 2 fenestrated placentas. Gestational age ranged from 29+5 to 40+4 weeks. There were 51 cases of premature rupture of membranes, 11 cases of placenta previa, 5 cases of placental abruption, 15 cases of placental adhesion/implantation and 27 cases of postpartum hemorrhage. There were 46 preterm fetuses,28 fetuses with fetal growth restriction, 22 fetuses with intrauterine distress, and 1 fetus with intrauterine death. Grossly, the placental lobules of succenturiate placentas had apparent size difference, while two lobules of bilobate placenta were more consistent. The chorionic plate size was smaller than the bottom plate of circumvallate placenta, the folded fetal membrane in the rim of placenta was thickened (termed marginate placenta if there was no thickening). The membranous placenta was characterized by a thin, large membrane-like shape. Annular placenta showed characteristic hollow cylinder, ring or horseshoe-shape. Fenestrated placenta was characterized by tissue defects near central area. Microscopically, functional/morphologic changes were the main manifestations of inadequate maternal-fetal perfusion, including villous infarction, distal villous dysplasia and excessive villous maturation. Conclusions: The abnormal shaped singleton placentas showed variable extent of inadequate maternal-fetal perfusion, which may lead to adverse pregnancy outcomes such as premature delivery, fetal growth restriction, intrauterine distress or fetal death.

Prognostic value of serum free triiodothyronine in patients with hepatitis E-related acute liver failure / 中华临床感染病杂志

Objective:To investigate the prognostic value of serum free triiodothyronine (FT3) in patients with hepatitis E-related acute liver failure (HEV-ALF).Methods:Clinical data of 88 patients with HEV-ALF and 86 patients with acute hepatitis E (AHE) were collected from the member hospitals of Chinese Consortium for the Study of Hepatitis E between January 2016 and December 2021; the data of 100 health subjects who underwent health check-up in Suzhou Municipal Hospital were also collected as healthy control (HC) group. Serum FT3 levels were analyzed in all subjects. HEV-ALF patients were divided into survival group ( n=73) and death group ( n=15) according to their 30 day survival. Correlation between serum FT3 level and prognosis of HEV-ALF patients were analyzed by Cox regression and orthogonal partial least squares discriminant analysis (OPLS-DA). The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the predictive value of serum FT3 levels for predicting the prognosis of patients, and its prediction efficacy was compared with conventional Model for End-Stage Liver Disease (MELD), King’s College Hospital criteria (KCH) and Child-Pugh models. Results:The levels of serum FT3 in HEV-ALF patients were significantly lower than those in AHE patients and HC group ( P=0.006 or <0.001). Cox regression analysis showed that international standardized ratio ( HR=17.984, 95% CI 2.804-115.362), hepatic encephalopathy ( HR=12.895, 95% CI 2.386-69.695) and total cholesterol ( HR=2.448, 95% CI 1.108-5.409) were independent risk factors for death in HEV-ALF patients, and serum FT3 level ( HR=0.323, 95% CI 0.119-0.876) was a protective factor. OPLS-DA results showed serum FT3 levels had high predictive value. ROC curve analysis results showed that the area under the curve was 0.828 (95% CI 0.733-0.900, P<0.001), the sensitivity was 80.00%, and the specificity was 78.08%. DCA showed that FT3 has good prediction ability and decision-making level serum FT3 levels in patients with improvement and fluctuation were significantly higher than those in the patients with deterioration ( P<0.05 or <0.01). Conclusion:Serum FT3 levels are closely related to the prognosis of HEV-ALF patients and it may be used as a biomarker for the prognosis of patients with HEV-ALF.

Investigation on the incidence of geriatric syndrome in Beijing area and analysis of influencing factors and its relationship with Barthel ADL score and quality of life / 公共卫生与预防医学

Objective To investigate the incidence and influencing factors of geriatric syndrome (GS) in Beijing area, and to analyze the relationship between GS and Barthel Index (Barthel ADL) score and quality of life. Methods From June 2018 to December 2018, a community-based or door-to-door survey of elderly people >65 years old in some communities in Beijing was conducted. The incidence of GS and its gender distribution, age distribution, and type distribution were investigated. At the same time, GS patients were selected as the observation group, and among people without GS in physical examination, a random sampling method was used to select the control group. The general data, Barthel ADL score, and World Health Organization Quality of Life (WHOQOL-BREF) score were compared between the two groups. The relevant influencing factors of GS and its correlation with the Barthel ADL score and WHOQOL-BREF scores were analyzed. Results Among 500 elderly people in the community investigated in the present study, 97.00% of patients had ≥1 types of GS, 84.80% of patients had ≥2 types, and 70.20% of patients had ≥3 types of GS. High education level (OR=0.329, 95%CI: 0.259-0.418) and retirement pension (OR=0.727, 95%CI: 0.576-0.918) were the protective factors for the occurrence of GS. Hyperlipidemia (OR=3.176, 95%CI: 2.518-4.007), diabetes (OR=2.473, 95%CI: 1.718-3.559), coronary heart disease (OR=2.658, 95%CI:1.649-4.286), hypertension (OR=3.230, 95%CI:2.008-5.197), osteoarthropathy (OR=4.166, 95%CI: 3.008-5.769), cancer (OR=3.008, 95%CI: 1.894-4.778), acute cerebral infarction (OR=3.420, 95%CI: 2.335-5.009), and acute myocardial infarction (OR=2.112, 95%CI: 1.169-3.814) were the risk factors for GS (P<0.05). The Barthel ADL score and WHOQOL-BREF score of the observation group were lower than those of the control group (P<0.05). GS was negatively correlated with Barthel ADL and WHOQOL-BREF scores (P<0.05). Conclusion GS was common in the elderly in Beijing, and its occurrence was related to factors such as education level, retirement pension, hyperlipidemia, diabetes, coronary heart disease, hypertension, osteoarthropathy, cancer, acute cerebral infarction, and acute myocardial infarction. Strengthening the early assessment and management of GS will help improve the daily life and quality of life of the elderly.

Changes of regional saturation of cerebral oxygenation and neuron specific enolase in patients after cardiopulmonary resuscitation / 中华危重病急救医学

Objective:To observe the changes of regional saturation of cerebral oxygenation (rScO 2) and blood neuron specific enolase (NSE) in patients after cardiopulmonary resuscitation (CPR), and to explore its value in evaluating the prognosis of patients' neurological function. Methods:From January 2012 to December 2020, 97 patients with return of spontaneous circulation (ROSC) after cardiac arrest (CA) treated in the intensive care unit (ICU) of the Second Affiliated Hospital of Soochow University were selected. According to the prognosis, the patients were divided into two groups: good neurological function group [Glasgow-Pittsburgh Cerebral Performance Categories (CPC) 1-2, 20 cases] and neurological dysfunction group (CPC classification 3-5, 77 cases). The clinical data of gender, age, the number of patients with defibrillable rhythm, time of ROSC, the number of CA patients outside the hospital, acute physiology and chronic health evaluationⅡ(APACHEⅡ), Glasgow coma scale (GCS), global non-response scale (FOUR), body temperature, mean arterial pressure (MAP), blood lactic acid (Lac) and GCS at discharge, as well as the length of ICU stay, rScO 2 and blood NSE were collected. The differences of rScO 2 and NSE between the two groups were compared; and the receiver operator characteristic curve (ROC curve) was drawn to evaluate the value of rScO 2 and NSE alone or in combination in predicting the prognosis of patients with ROSC after CA. Results:The rScO 2 of good neurological function group was significantly higher than that of neurological dysfunction group at 1, 3, 6, 12, 24 and 48 hours (all P < 0.05). At 24 hours after admission, the rScO 2 on the left and right sides of good neurological function group was significantly higher than that in neurological dysfunction group [left: 0.65 (0.59, 0.76) vs. 0.55 (0.44, 0.67), right: 0.62 (0.61, 0.73) vs. 0.50 (0.30, 0.69), both P < 0.05], and NSE was significantly lower than that in the neurological dysfunction group [ng/L: 21.42 (15.38, 29.69) vs. 45.82 (24.05, 291.26), P < 0.05]. ROC curve analysis showed that both rScO 2 and NSE alone and combined detection had a certain value in predicting the prognosis of neurological function in patients with ROSC after CA, and the area under the ROC curve (AUC) detected by the combination was the largest, which was higher than the AUC predicted by rScO 2 or NSE (0.904 vs. 0.884, 0.792). When the cut-off value of combination was 0.83, the sensitivity and specificity were 75.7% and 100% respectively. Conclusion:Monitoring rScO 2 and NSE can predict the prognosis of neurological function after CPR, especially the combined evaluation of the two indexes, which can greatly improve the accuracy of diagnosis.

Research on evaluation index system of open online courses in military continuing education / 中华医学教育探索杂志

Objective:To establish a suitable quality evaluation index system of open online courses in military continuing education.Methods:A primary index system program was established through literature review and small expert meeting. Delphi method was used to conduct a letter consultation among 50 experts, and the index system was revised according to the experts' advice and they consulted again until a broad agreement was reached.Results:After two rounds of letter consultation, the recognition rate of 43 experts on the naming and connotation of the indexes reached more than 95%, and their opinions basically reached a consensus. The variation coefficients of the index weights were distributed between 0.00 and 0.10, with a high degree of concentration. A quality evaluation index system of open online courses in military continuing education has been established, including 4 first-level indexes: curriculum design, curriculum production, online operation and curriculum effect, 10 second-level indexes, and 25 third-level indexes.Conclusion:The quality evaluation index system could provide a basis for evaluating online course quality scientifically and offer better educational resources and teaching services.

Analysis of study situation of medical students in Shanghai / 中华医学教育探索杂志

Objective:To analyze the study situation of medical students in Shanghai and provide references for the improvement of teaching quality.Methods:With comprehensive questionnaires including simple learning motivation scale, we surveyed 4 054 medical students on campus in four colleges in Shanghai through cluster sampling method about their study situation including study motivations, attitudes, records and their expectations, and compared them in different groups.Results:The intensity of study motivations of the whole medical students in Shanghai was mainly medium, and the percentage was 62.3% (2 525/4 054). Their self-appraised study attitudes were generally more assiduous and medium with the percentages of 41.2% (1 669/4 054) and 36.5% (1 478/4 054). Their study expectation were generally good and excellent, and the percentages were 34.6% (1 401/4 054) and 27.8% (1 126/4 054). Their study records were generally good and qualified, and the percentages were 40.1% (1 625/4 054) and 37.0% (1 502/4 054). There was statistical significance in different groups except the motivations in different genders, and there were significant differences in records among different medical students with different motivations, attitudes and expectations.Conclusion:Medical students in Shanghai generally have moderate level of study motivations, more assiduous attitudes, good records and expectations. The detailed analyses in different groups provide basis for comparison of different teaching levels in colleges and different students' learning situations.

Clinical observation on wheat grain moxibustion for chronic superficial gastritis of spleen-stomach deficiency and cold / 中国针灸

OBJECTIVE@#To compare the clinical effect of wheat grain moxibustion and warming acupuncture on chronic superficial gastritis of spleen-stomach deficiency and cold.@*METHODS@#A total of 200 patients with chronic superficial gastritis of spleen-stomach deficiency and cold were randomly divided into a wheat grain moxibustion group (100 cases, 13 cases dropped off ) and a warming acupuncture group (100 cases, 16 cases dropped off ). The acupoints of Zhongwan (CV 12), Tianshu (ST 25), Qihai (CV 6), Liangqiu (ST 34) and Zusanli (ST 36) were selected in both groups. The patients in the wheat grain moxibustion group were treated with wheat grain moxibustion, and 5 cone were given on every acupoint each time. Moxibustion was performed after acupuncture in the warming acupuncture group, and 3 cone each acupoint. Both groups were treated every other day for 15 times. The scores of clinical symptoms and signs, scores of physical component summary (PCS) and mental component summary (MCS) of quality of life in the two groups were recorded before and after treatment and during follow-up 1 month after treatment, and the clinical effects of the two groups were evaluated after treatment and during follow-up.@*RESULTS@#After treatment and during follow-up, the scores of clinical symptoms and signs of the two groups were lower than before treatment (@*CONCLUSION@#The wheat grain moxibustion can effectively improve the clinical symptoms, signs and quality of life in patients with chronic superficial gastritis of spleen-stomach deficiency and cold, and its long-term effect is better than warming acupuncture.

Establishment of post competency index evaluation system of graduate students specialized in clinical medicine in military medical university / 中华医学教育探索杂志

Objective:To establish a post competency evaluation index system of graduate students specialized in clinical medicine in military medical university, and to further define the military medical training objectives in new era.Methods:Through literature review and small meeting of experts, the initial scheme of structural system was established. Two rounds of expert inquiry were organized using Delphi method, the indexes' names and weights were cleared based on summarizing the experts' opinions.Results:A set of post competency evaluation system consisting of 3 first-level indicators, 9 second-level indicators and 35 third-level indicators was developed. The weights of each indicator were different, for example, among the 3 secondary indicators covered by the first-level indicator "learning effect", the weight of "clinical medical service capacity" was the highest (0.458); among the 4 secondary indicators covered by the first-level indicator "work efficiency", the weight of "innovative scientific research capacity" was the highest (0.321); and among the 6 third-level indicators covered by the secondary index "intrinsic quality", the weight of "career-minded, adhere to medical and national defense industry" was the highest (0.224), etc.Conclusion:The evaluation index system of post competence of clinical medical students of military medical university was scientific and operable, which can provide reference for the selection and assessment of talents in military medical and health field, and guide the direction of the growth of the cadets of the Military Medical University. The interpretation of weight can also clarify the focus of military medical personnel training.

Evaluation of innovation ability training of military medical postgraduates based on Kirkpatrick model / 中华医学教育探索杂志

Objective:To comprehensively evaluate all aspects of innovation ability training of military medical postgraduates based on Kirkpatrick model.Methods:Through scientifically choosing alternative evaluating indexes of four levels (postgraduates' satisfaction with the training in their universities, the intensity of their study motivation, level and distribution characteristics of their innovation abilities, innovation achievements such as published papers) and conducting questionnaire survey and data collection, we comprehensively evaluated the training effects of 804 postgraduates' innovation abilities in a certain military medical university.Results:①The first level (Reaction): The postgraduates were generally satisfied with the innovation ability training of their university (the percentage of students who were "Very Satisfied" plus "Satisfied" was 61.2%), and their satisfaction towards their supervisor (4.18±0.84), which was assessed with likert 5-level method, was greater than that towards the educational management (3.64±0.89) and course teaching (3.59±0.86) in their university. ②The second level (Learning): The study motivation of most of the postgraduates were moderate (57.5%, 463/804). ③The third level (Behavior): The percentage of postgraduates with "average innovation ability" was 64.4% (518/804) and students with "good innovation ability" was 34.3% (276/804). The internal attributes of students' innovation ability were primarily Challenge (78.66±9.84) and Curiosity (76.46±10.38), and Imagination (65.36±11.44) was the lowest. ④The fourth level (Achievement): Most of the papers of postgraduates were published in Chinese core journals (average 0.42±0.83); 46.5% (365/804) of the students appraised the innovation in their research papers as "deficient"; 32.2% (259/804) of the students participated only one research project; and 38.7% (311/804) of the students appraised the academic nature in the research projects they participated as "average".Conclusion:The application of Kirkpatrick model addressed the inconsistency of evaluation indexes of innovation ability training for postgraduates in the university. Specific analyses of the 4 levels provided more information for the innovation ability training for postgraduates in universities, and also deeply demonstrated effect and significance of the training.

Effect of Different Drying Methods on the Chemical Composition of Farfarae Flos / 中国药学杂志

OBJECTIVE: To analyze the effect of different drying methods on the major compounds in Farfarae Flos(FF). METHODS: The content of moisture and tussilagone were determined, and the common peaks in the HPLC fingerprint were calculated and subjected to the principal component analysis. RESULTS: The results showed that the moisture content was the highest when the FF was dried in the shade, and the drying method showed little effect on the content of tussilagone. The results of the principal component analysis showed that the FF dried in the shade was different from those of FF being dried under heat. The relative content of major compounds were the highest for the FF dried in the shade. In addition, the caffeoyl quinic acids and flavonoids were greatly affected after heating, however the heat drying showed little effect on the sesquiterpenoids. Among the different drying temperature, 55 ℃ showed smallest effect on the main components in the FF. CONCLUSION: The components in FF can be protected when drying in the shade, which reveals the scientific basis for the traditional experience of drying. However, in order to facilitate the drying process on a large scale, and minimizing the effect of drying on the compounds in the FF, drying temperature of 55 ℃ is recommended.

Effect of adulteration on quality of Farfarae Flos / 中草药

Objective: For the adulteration phenomenon of Farfarae Flos, the chemical composition of the flower buds and the rachis, rhizome, and the roots were compared, to provide the basis for the quality control of Farfarae Flos. Methods: The content of tussilagone was determined by high performance liquid chromatography (HPLC) according to the Chinese Pharmacopeia. The HPLC based fingerprint was also generated, and the similarity and the relative contents of the common peaks between the flower buds and adulteration parts were calculated. The pearson correlation between the relative content of the major compounds and the flower buds ratio, as well as principal component analysis and clustering analysis were also performed. Results: The content of tussilagone and the peak areas of 13 common peaks in the HPLC fingerprint were significantly higher than those in the rachis, rhizome, and the roots, and positively correlated with the flower buds ratio. The results of the principal component analysis and clustering analysis showed that the flower buds showed distinct separation with those adulteration parts. In addition, the compounds within the caffeoyl quinic acids and flavonoids showed positive correlations with each other, and the correlations were also observed between different kinds of components. Conclusion: The major compounds of Farfarae Flos were mainly present in the flower buds, and the quality of Farfarae Flos will be greatly affected when there are more impurities such as pedicel, taproot and rhizome in the crude drugs. Currently, there is no impurity in the Chinese pharmacopeia for Farfarae Flos, and the limit of the impurities should be added to guarantee the quality of Farfarae Flos.

Effect and mechanism of moxibustion on oxidative stress injury in rats with Parkinson's disease by activating Nrf2/ARE pathway / 中国针灸

OBJECTIVE@#To observe the effect of moxibustion on oxidative stress injury of nigrostriatal system in rats with Parkinson's disease (PD) based on nuclear factor erythroid 2-related factor (Nrf2)/antioxidant response element (ARE) pathway, and to explore its mechanism.@*METHODS@#A total of 48 SD rats were randomized into a blank group, a sham-operation group, a model group and a moxibustion group, 12 rats in each group. Unilateral two-point injection with 6-hydroxydopamine (6-OHDA) was adopted in the model group and the moxibustion group to establish the PD model; the operation manipulation in the sham-operation group was the same as the model group and the moxibustion group, and the same volume of 0.9% sodium chloride solutions was given by unilateral two-point injection. Moxibustion was adopted at "Baihui" (GV 20) and "Sishencong" (EX-HN 1) in the moxibustion group for 20 min, once a day, 6 times a week for 6 weeks. No intervention was given in the other 3 groups. Morphology of right mesencephalon substantia nigra was observed by HE staining, the expression of tyrosine hydroxylase (TH) in right mesencephalon substantia nigra was detected by immunohistochemistry method, the expression of reactive oxygen species (ROS), malondialdehyde (MDA), glutathione (GSH), and glutathione peroxidase (GSH-Px) in corpus striatum was detected by colorimetry method, and the expression of Nrf2 and heme oxygenase-1 (HO-1) proteins was detected by Western blot in the 4 groups.@*RESULTS@#Clear tissue structure and complete dopaminergic neurons of right mesencephalon substantia nigra were observed in the blank group and the sham-operation group; unclear tissue structure, decreased and swelling dopaminergic neurons were observed in the model group; compared with the model group, more neurons were observed and the swelling of cyton was reduced in the moxibustion group. Compared with the sham-operation group, the expression of TH in right mesencephalon substantia nigra was decreased in the model group (<0.01); compared with the model group, the expression of TH in right mesencephalon substantia nigra was increased in the moxibustion group (<0.05). Compared with the sham-operation group, the expression of ROS, MDA was increased (<0.01), the expression of GSH, GSH-Px, Nrf2 and HO-1 was decreased in the model group (<0.01, <0.05); compared with the model group, the expression of ROS, MDA was decreased (<0.05, <0.01), the expression of GSH, GSH-Px, Nrf2 and HO-1 was increased in the moxibustion group (<0.05, <0.01).@*CONCLUSION@#Moxibustion can alleviate oxidative stress injury of nigrostriatal system in rats with Parkinson's disease by activating the Nrf2/ARE pathway, and protect the dopamine neurons.

Quality control and evaluation of Shengmai injection based on anti-oxidant and anti-inflammatory biological effects / 药学实践杂志

Objective To establish a quality evaluation method for Shengmai injection with antioxidant and anti-inflammatory effects as indicators. Methods Using water-soluble vitamin E (Trolox) and N-nitro-L-arginine methyl ester (L-NAME) as control drugs, using trinitrophenyl-hydrazine (DPPH) method and nitric oxide (NO) detection kit, the anti-oxidation effect and the inhibition ability of lipopolysaccharide (LPS)-induced NO release from mononuclear macrophage RAW264.7 were measured. The sample was converted into the corresponding concentration of the control drug to control and evaluate its methodological and biological effects. Results Each batch of samples had good anti-inflammatory and anti-oxidation effects with high precision and good repeatability. There was no significant difference in the anti-inflammation capacity among batches of. Samples 2 and 8 were significant differences from other samples in anti-inflammatory ability. Conclusion The established method can accurately evaluate the anti-oxidant and anti- inflammatory effects of Shengmai injection.

Expression of p-AKT and p-mTOR in pediatric Burkitt lymphoma and their correlation with prognosis / 中华病理学杂志

To evaluate the expression of p-AKT and p-mTOR, the key proteins in PI3K/AKT/mTOR pathway in pediatric Burkitt lymphoma (BL), and to investigate the clinical and prognostic significance. Fifty-eight cases of pediatric BL and thirty cases of reactive hyperplastic lymphadenitis (RH) were collected at Children's Hospital of Fudan University from September 2011 to July 2018. Paraffin sections of tissues were immune stained for p-AKT and p-mTOR, and the expression was assessed and correlated with the clinical features and prognosis. A total of 58 cases were diagnosed and 6 cases lost the follow-up. Of the remaining 52 BL patients including 43 males and 9 females, the median age was 5 years (range: 2 to 14 years). Regarding to the correlation between the two biomarkers, Spearman test showed that p-mTOR was positively associated with the expression of p-AKT (0.759, 0.001). Of all BL patients, the positive rates of p-AKT and p-mTOR were 62.1% (36/58) and 60.3%(35/58) respectively, both significantly higher than control group (0.011, 0.035 respectively). The presence of p-AKT was significantly associated with higher lactate dehydrogenase (LDH≥573 IU/L) level in patients of the disease (0.006), while p-mTOR was increased both in the higher LDH and lower ratio of albumin to globulin (A/G) group (0.006, 0.034 respectively). Expression of p-AKT and p-mTOR did not show any statistical correlation with sex, age, St.jude stage, tumor size, B-symptom present or not, number of extra-nodal sites or international prognostic index (IPI) (0.05). Fifty-two patients had a median follow-up of 40 months (range: 5-87 months). Univariate analysis showed that p-AKT expression was significant in predicting both inferior OS (5-year estimate, 72.7% . 94.7%, (2)=4.123, 0.042) and PFS (5-year estimate, 66.7% . 94.7%, (2)=5.822, 0.016). The 5-year OS rate was 71.0% (22/31) for the p-mTOR positive cohort of patients compared to 95.2% (17/21) for p-mTOR negative group ((2)=4.881, 0.027); however, there was no statistical significance in 5-year PFS rate (0.05). Especially, the 5-year OS and PFS rate of p-AKT/p-mTOR double-positive group were significantly lower than negative control group (including absence of single p-AKT or p-mTOR expression, and absence of both) (OS: 69.0% . 95.7%, (2)=6.285, 0.012; PFS: 65.5% . 91.3%, (2)=5.405, 0.020). The results of multivariate COX proportional risk regression analysis indicated that p-AKT/p-mTOR double-positive, higher LDH and IPI score 3-5 were independent prognostic factors for both OS and PFS, and the bulky tumor (>10 cm) for PFS of pediatric BL. The expression of p-AKT and p-mTOR may be a potential reference for diagnosis and the independent prognostic indicators of pediatric BL.

Correlation between peritoneal thickness and baseline peritoneal solute transport function / 中华肾脏病杂志

Objective:To investigate the relationship between peritoneal thickness and baseline solute transport function in peritoneal dialysis (PD) patients, and analyze the factors affecting the function of peritoneal transport.Methods:Non-diabetic end-stage renal disease (ESRD) patients admitted to the Second Hospital of Longyan City from January 2017 to June 2019 were enrolled in this study. The thickness of the peritoneal membrane was measured by color ultrasound instrument before the peritoneal catheterization. Standard peritoneal equilibration test (PET) was performed after one month of peritoneal dialysis. The ratio of corrected creatine in 4 h dialysate to 2 h serum creatine (D/Pcr) was used as a solute baseline transport index, and according to the D/Pcr evaluation results, the patients were divided into high/high average transfer (H) group (D/Pcr≥0.65) and low/low average transfer (L) group (D/Pcr<0.65). The clinical data, peritoneal thickness and peritoneal dialysis related indicators between the two groups of patients were compared. Binary logistic regression was used to analyze the factors affecting the function of peritoneal transport.Results:The amount of peritoneal ultrafiltration in H group was significantly lower than that in L group, intraperitoneal creatinine clearance (Ccr) and peritoneal thickness were significantly higher than those in L group (both P<0.05). Pearson and Spearman correlation results showed that the thickness of peritoneal membrane positively correlated with D/Pcr ( r=0.673, P<0.05), peritoneal Ccr ( r=0.261, P<0.05), and negatively correlated with ultrafiltration of peritoneal dialysis ( r=-0.365, P<0.05). Partial correlation analysis showed that the peritoneal thickness was positively correlated with the solute transport index D/Pcr ( r=0.539, P<0.05) and the peritoneal Ccr ( r=0.338, P<0.05). Binary logistic regression results showed that peritoneal thickening was a risk factor affecting peritoneal transport function ( OR=1.175, 95% CI 1.009-1.369, P<0.05). Conclusions:There is a positive correlation between the peritoneal membrane thickness and the baseline solute transport index in patients with non-diabetic peritoneal dialysis. Peritoneal thickening is a risk factor affecting peritoneal transport function.

Status of HIV infection and its influencing factors in the MSM population of Haikou city, China, in 2018

Objective: To understand the current status of AIDS epidemic among men who had sex with men (MSM) in Haikou, and to analyze the influencing factors to assess the risk of HIV/AIDS infection in MSM group, and then provide a theoretical basis for MSM population to prevent HIV transmission. Methods: Snowball sampling method was used to find men who had homosexual intercourse in oral sex or anal sex in the past year and conducted a questionnaire survey of them. Blood samples were collected to detect three antibodies against: HIV, syphilis and hepatitis C (HCV). Excel 2007 and SPSS22.0 software were used for statistical description, χ2 test and logistic regression analysis. Results: A total of 408 MSMs were investigated in this study, 27 HIV infections were detected, with a positive rate of 6.6%. Univariate analysis showing there were statistically significant differences in the prevalence of AIDS in ethnic minorities, local residence time, condom use for same-sex anal sex in the past 6 months, people with sexually transmitted diseases in recent one year, syphilis, and gonorrhea (P<0.05). Logistic regression analysis showed that minority nationality and HIV infection sexually transmitted disease in the past year were risk factors for HIV infection, and condom use for same-sex anal sex in the past 6 months, the opposite sex occurred in the last 6 months and high education level are protective factors for HIV infection. Conclusion: The HIV infection rate of the MSM population in Haikou is high. It is necessary to increase the use of condoms in the MSM population. For low-education MSM, it is necessary to strengthen the dissemination and education of AIDS-related knowledge, so as to reduce the spread of AIDS in the MSM population.