Safety and efficacy of the early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF) / 中华内科杂志

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.

Enhancing cancer chemo-immunotherapy by biomimetic nanogel with tumor targeting capacity and rapid drug-releasing in tumor microenvironment

In the development of chemo-immunotherapy, many efforts have been focusing on designing suitable carriers to realize the co-delivery of chemotherapeutic and immunotherapeutic with different physicochemical properties and mechanisms of action. Besides, rapid drug release at the tumor site with minimal drug degradation is also essential to facilitate the antitumor effect in a short time. Here, we reported a cancer cell membrane-coated pH-responsive nanogel (NG@M) to co-deliver chemotherapeutic paclitaxel (PTX) and immunotherapeutic agent interleukin-2 (IL-2) under mild conditions for combinational treatment of triple-negative breast cancer. In the designed nanogels, the synthetic copolymer PDEA-co-HP-β-cyclodextrin-co-Pluronic F127 and charge reversible polymer dimethylmaleic anhydride-modified polyethyleneimine endowed nanogels with excellent drug-loading capacity and rapid responsive drug-releasing behavior under acidic tumor microenvironment. Benefited from tumor homologous targeting capacity, NG@M exhibited 4.59-fold higher accumulation at the homologous tumor site than heterologous cancer cell membrane-coated NG. Rapidly released PTX and IL-2 enhanced the maturation of dendritic cells and quickly activated the antitumor immune response in situ, followed by prompted infiltration of immune effector cells. By the combined chemo-immunotherapy, enhanced antitumor effect and efficient pulmonary metastasis inhibition were achieved with a prolonged median survival rate (39 days).

First report of invasive Pomacea snails in Shandong Province / 中国血吸虫病防治杂志

Objective To characterize the species of invasive Pomacea snails that were discovered for the first time in Shandong Province. Methods Pomacea snails samples were collected in the field of Jining City, Shandong Province on October 2021 for morphological identification. Pomacea snails were randomly sampled and genomic DNA was extracted from foot muscle tissues of Pomacea snails for multiplex PCR amplification. The PCR amplification product was sequenced. Then, the sequence was aligned and a phylogenetic tree was created using the software MegAlign 7.1.0. In addition, Angiostongylus cantonensis infection was detected in Pomacea snails with the lung microscopy. Results A total of 104 living Pomacea snails were collected, and all were characterized as Pomacea spp. based on morphological features. Of 12 randomly selected adult Pomacea snails, multiplex PCR assay and sequencing identified eleven snails as P. canaliculata and one as P. maculata. No A. cantonensis infection was detected in 104 Pomacea snails. Conclusion This is the first report of invasive Pomacea snails in Shandong Province, where P. canaliculata and P. maculata are found.

Clinical features of Wilson's disease: An analysis of 83 cases / 临床肝胆病杂志

Objective To summarize the clinical features of patients with Wilson's disease (WD). Methods A retrospective analysis was performed for the clinical data of 83 patients with WD who were admitted to The Third Hospital of Hebei Medical University from April 2013 to August 2021, including clinical manifestations, Imaging examinations, laboratory examinations, liver histopathological examinations, and ATP7B gene testing results. The patients were divided into groups based on different clinical types. A one-way analysis of variance was used for comparison between groups. Results The youngest age was 3 years for the 83 patients with WD, among whom 39 (46.99%) had an age of ≤18 years, with a mean age of 21.16±14.87 years for all 83 patients. Of all patients, 63.86% had liver-type WD, 31 patients (37.35%) had developed liver cirrhosis at the time of consultation, and 5 patients (6.2%) attended the hospital due to acute or acute-on-chronic liver failure. Of all patients, 62(74.69%) were positive for corneal K-F ring, and the positive rate of K-F ring was 66.04% in the patients with liver-type WD. Among the 83 patients, 79(95.18%) had a reduction in blood ceruloplasmin, and 73(87.95%) had an increase in 24-hour urine copper. The liver histopathological results of 25 patients showed varying degrees of inflammation, fibrosis, steatosis, and copper particle deposition in liver tissue. The ATP7B gene testing results of 25 patients showed that c.2333G > T/p.R778L of exon 8 was the most common mutation site. Conclusion Most patients with WD have the manifestation of liver diseases, and the examinations of corneal K-F ring, serum ceruloplasmin, and 24-h urine copper have their own limitations. Liver pathology and ATP7B gene testing can be performed when it is unable to make a confirmed diagnosis.

Clinical and pathological features of children with glycogen storage disease: An analysis of 10 cases / 临床肝胆病杂志

Objective To investigate the clinical and pathological features of children with glycogen storage disease (GSD). Methods A retrospective analysis was performed for ten children with GSD who were admitted to the Third Hospital of Hebei Medical University and The Fifth Medical Center of Chinese PLA General Hospital from January 2002 to January 2022, based on medical history, liver biochemistry, and liver biopsy, and population characteristics, clinical manifestations, biochemical parameters, and liver histopathological characteristics were compared and analyzed. Results All ten children had developmental retardation and a short stature, with the manifestations of abnormal liver function, mild weakness, poor appetite, yellow urine, and yellow eyes, and four children had hepatosplenomegaly. Among the ten children, six had the clinical manifestations of hypoglycemia, and one had bilateral gastrocnemius hypertrophy and positive Gower sign. Two children had positive CMV IgG. Liver histopathological manifestations included diffuse enlargement of hepatocytes, light cytoplasm, and small nucleus in the middle like plant cells, with or without fibrous tissue proliferation. Conclusion Most patients with GSD have developmental retardation and abnormal aminotransferases, and liver pathological examination shows specific pathological features.

Enzymatic preparation of manno-oligosaccharides from locust bean gum and palm kernel cake, and investigations into its prebiotic activity

BACKGROUND: Manno-oligosaccharides (MOS) is known as a kind of prebiotics. Mannanase plays a key role for the degradation of mannan to produce MOS. In this study, the mannanases of glycoside hydrolase (GH) families 5 Man5HJ14 and GH26 ManAJB13 were employed to prepare MOS from locust bean gum (LBG) and palm kernel cake (PKC). The prebiotic activity and utilization of MOS were assessed in vitro using the probiotic Lactobacillus plantarum strain. RESULTS: Galactomannan from LBG was converted to MOS ranging in size from mannose up to mannoheptose by Man5HJ14 and ManAJB13. Mannoheptose was got from the hydrolysates produced by Man5HJ14, which mannohexaose was obtained from LBG hydrolyzed by ManAJB13. However, the same components of MOS ranging in size from mannose up to mannotetrose were observed between PKC hydrolyzed by the mannanases mentioned above. MOS stability was not affected by high-temperature and high-pressure condition at their natural pH. Based on in vitro growth study, all MOS from LBG and PKC was effective in promoting the growth of L. plantarum CICC 24202, with the strain preferring to use mannose to mannotriose, rather than above mannotetrose. CONCLUSIONS: The effect of mannanases and mannan difference on MOS composition was studied. All of MOS hydrolysates showed the stability in adversity condition and prebiotic activity of L. plantarum, which would have potential application in the biotechnological applications.

Effect of general anesthesia combined with epidural anesthesia on tissue perfusion and intestinal barrier in elderly colorectal cancer patients undergoing radical resection / 中华老年医学杂志

Objective:To investigate the effect of the combined general and epidural anesthesia on tissue perfusion and intestinal barrier in elderly patients undergoing radical resection of colorectal cancer.Methods:A total of 118 elderly patients with colorectal cancer admitted to our hospital from January 2018 to September 2019 were randomly divided into two groups: a single general anesthesia(control, n=59)and combined general and epidural anesthesia(observation, n=59). Two groups underwent radical resection of colorectal cancer.The perioperative parameters were compared between the two groups, including tissue perfusion[central venous-to-arterial carbon dioxide difference(Pcv-aCO 2), oxygen delivery index(DO 2I), oxygen consumption index(VO 2I), difference between central venous and arterial lactate(Dcv-aLac), oxygen extraction rate(O 2ER), central venous oxygen saturation(ScvO 2)], and intestinal barrier[diamine oxidase(DAO), D-lactic acid(D-Lac)]. Results:Compared with the control group, the ScvO 2 during T2-T4 periods was increased in the observation group, and the VO 2I, Dcv-aLac and Pcv-aCO 2 during T1-T4 periods were reduced in observation group( P<0.05). The DO 2I during T1-T4 periods was slightly higher in the observation group than in the control group, and the O 2ER was slightly lower in the observation group than in the control group, but the differences were not statistically significant, ( P>0.05). In the both two groups, the D-Lac and DAO levels showed a gradual upward trend during T1-T5 periods and a gradual downward trend during T5-T6 periods.The D-Lac and DAO levels during T2-T6 periods were lower in observation group than in the control group( P<0.05)[during abdominal exploration(T1); invitrolesion(T2); before abdominal closure(T3); after surgery(T4); postoperative day 1(T5); postoperative day 3(T6)]. Conclusions:General anesthesia combined with epidural anesthesia in elderly colorectal cancer patients undergoing radical resection can stabilize perioperative tissue perfusion, decrease intestinal barrier injury and increase anesthetic effect.

Carrier-free nanoparticles based on self-assembly of active ingredients from Chinese medicine / 药学学报

Traditional Chinese medicine has a long history, unique system and perfect technology, which has been used to prevent or treat a variety of diseases in the form of compound medicine. Recently, some of the active ingredients from Chinese medicine were found to have self-assembly properties, mainly through non-covalent interactions, including π-π stacking, electrostatic interaction, hydrogen bond and coordination interactions, etc. Carrier-free nanoparticles based on self-assembly of active ingredients from Chinese medicine could not only improve the solubility of insoluble active ingredients, but also the bioavailability. As nanocarriers, the natural active ingredients could exert synergistic therapeutic effects. The strategy of self-assembly without carrier is safer and almost non-toxic compared to the commonly used nanocarriers. In addition, some ingredients from Chinese medicine could coordinate with metal ions to form stable nanoparticles, which could be applied to photothermal therapy. In this paper, we summarized and analyzed the recent achievements of carrier-free nanoparticles based on self-assembly of active ingredients from Chinese medicine, and briefly outlined the future development of this kind of nanomedicine.

Surveillance of Enterobius vermicularis infections among children in Shandong Province from 2016 to 2020 / 中国血吸虫病防治杂志

Objective To investigate the prevalence and changing trend of Enterobius vermicularis infections among children in Shandong Province, so as to provide the scientific evidence for the adjustment and development of the enterobiasis control strategy. Methods Soil-borne nematodiasis surveillance sites were assigned in 51 counties (districts, cities) in Shandong Province from 2016 to 2020, and the E. vermicularis infections were detected using a modified Kato-Katz technique and the cellophane tape method among children at ages of 3 to 9 years living in these surveillance sites. The epidemiological profiles of E. vermicularis-infected children were descriptively analyzed. Results A total of 5 060 children at ages of 3 to 9 years were detected in 51 soil-borne nematodiasis surveillance sites in Shandong Province from 2016 to 2020, and the overall prevalence of E. vermicularis infections was 2.23%. The annual prevalence of E. vermicularis infections was 3.99% (26/651), 1.70% (14/824), 0.96% (8/837), 2.90% (45/1 552) and 1.67% (20/1 196) from 2016 to 2020, respectively, with a significant difference detected among years ( χ2 = 21.455, P < 0.01). The prevalence of E. vermicularis infections was 1.25% (15/1 198), 1.85% (14/755), 3.18% (84/2 640) and 0 (0/467) among children from central, eastern, southern and northern Shandong Province (χ2 = 27.326, P < 0.01). In addition, there was no significant difference in the prevalence of E. vermicularis infections between male (1.98%, 56/2 831) and female children (2.56%, 57/2 229) (χ2 = 1.916, P > 0.05); however, there was age-specific prevalence of E. vermicularis infections among children (χ2 = 16.448, P < 0.05), with the greatest prevalence detected among children at ages of 6 years (3.18%, 25/786), and the lowest prevalence seen among children at ages of 3 years (0.75%, 6/800). Conclusions The prevalence of E. vermicularis infections remained at a medium level among children at ages of 3 to 9 years in Shandong Province from 2016 to 2020, with region-specific prevalence found across the province. An integrated strategy is required for enterobiasis control.

Nanomedicine for acute respiratory distress syndrome: The latest application, targeting strategy, and rational design

Acute respiratory distress syndrome (ARDS) is characterized by the severe inflammation and destruction of the lung air-blood barrier, leading to irreversible and substantial respiratory function damage. Patients with coronavirus disease 2019 (COVID-19) have been encountered with a high risk of ARDS, underscoring the urgency for exploiting effective therapy. However, proper medications for ARDS are still lacking due to poor pharmacokinetics, non-specific side effects, inability to surmount pulmonary barrier, and inadequate management of heterogeneity. The increased lung permeability in the pathological environment of ARDS may contribute to nanoparticle-mediated passive targeting delivery. Nanomedicine has demonstrated unique advantages in solving the dilemma of ARDS drug therapy, which can address the shortcomings and limitations of traditional anti-inflammatory or antioxidant drug treatment. Through passive, active, or physicochemical targeting, nanocarriers can interact with lung epithelium/endothelium and inflammatory cells to reverse abnormal changes and restore homeostasis of the pulmonary environment, thereby showing good therapeutic activity and reduced toxicity. This article reviews the latest applications of nanomedicine in pre-clinical ARDS therapy, highlights the strategies for targeted treatment of lung inflammation, presents the innovative drug delivery systems, and provides inspiration for strengthening the therapeutic effect of nanomedicine-based treatment.

Analysis of drug - resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province in 2015 and 2016 / 中国血吸虫病防治杂志

ObjectiveTo investigate the drug-resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province. MethodsFrom 2015 to 2016, blood samples were collected from imported P. falciparum malaria patients returning from Equatorial Guinea to Shandong Province, and genome DNA of the malaria parasite was extracted. The drug-resistant Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum were amplified using a PCR assay, followed by DNA sequencing, and the sequences were aligned. Results The target fragments of all 5 drug-resistant genes of P. falciparum were successfully amplified and sequenced. There were 72.8%, 18.6%, and 8.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfcrt gene, respectively, and all mutant haplotypes were CVIET (the underline indicates the mutation site). There were 20.0%, 61.4% and 18.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfmdr1 gene, respectively, and the mutant haplotypes mainly included YF and NF (the underlines indicate the mutation sites). There were 1.4%, 98.6%, and 0 of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhfr gene, respectively, and AIRNI was the predominant mutant haplotype (the underline indicates the mutation site). There were 1.4%, 94.3%, and 4.3% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhps gene, respectively, and SGKAA was the predominant mutant haplotype (the underline indicates the mutation site). The complete drug-resistant IRNGE genotype consisted of 8.6% of the Pfdhfr and Pfdhps genes, and the K13 gene A578S mutation occurred in 1.4% of the parasite samples. Conclusions There are mutations in the Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum imported from Equatorial Guinea to Shandong Province, with a low frequency in the Pfcrt gene mutation and a high frequency in the Pfmdr1, Pfdhfr, and Pfdhps gene mutations, and the K13 gene A578S mutation is detected in the parasite samples.

Effect of Shen-Fu Injection () on Hemodynamics in Early Volume Resuscitation Treated Septic Shock Patients / 中国结合医学杂志

OBJECTIVE@#To investigate the hemodynamic effect of Shen-Fu Injection (, SFI) in early volume resuscitation treated septic shock patients by monitoring pulse indicator continuous cardiac output (PICCO).@*METHODS@#All septic shock patients admitted in the Intensive Care Unit of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1st, 2014 to December 31th, 2015, were reviewed, and totally 65 were enrolled in this study. They were assigned to SFI group (33 cases) and control group (32 cases). All 65 patients underwent conventional treatment mainly including volume resuscitation, antibiotics and vasoactive drugs therapy. The patients of the SFI group received additional 100 mL of SFI intravenously every 12 h. In all 65 patients, the PICCO arterial catheter and vein catheter were implanted within 1 h after the diagnosis of septic shock. In the course of early volume resuscitation, hemodynamic data of patients were recorded by PICCO monitor at 0, 12, and 24 h after the catheter implantation.@*RESULTS@#The hemodynamic indices of the two groups showed no significant differences at the beginning of 0 h (P>0.05). At 12 and 24 h, the hemodynamic indices of SFI group were significantly improved in comparison with the control group (P0.05).@*CONCLUSION@#SFI significantly improved hemodynamic indices such as CI, GEDI, MAP and HR in early volume resuscitation treated septic shock patients.

Optimal dose of dexmedetomidine to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery / 中华麻醉学杂志

Objective@#To determine the optimal dose of dexmedetomidine required to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery.@*Methods@#A total of 135 patients, aged 18-60 yr, weighing 52-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective gynecological laparoscopic surgery, were divided into 3 groups (n=45 each) using a random number table method: control group (group C), dexmedetomidine 1 μg/kg group (group D1) and dexmedetomidine 2 μg/kg group (group D2). Immediately after anesthesia induction, dexmedetomidine 0.4 μg·kg-1·h-1 was injected intravenously until 30 min before the end of surgery in all the patients.When the patient was fully awake at the end of surgery, the tracheal tube was removed, and patients were sent to postanesthesia care unit and received patient-controlled intravenous analgesia (PCIA). The PCIA solution contained sufentanil 1.2 μg/kg and dezocine 20 mg in 100 ml of 0.9% normal saline.The PCIA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Dexmedetomidine 1 and 2 μg/kg were added to PCIA solution in group D1 and group D2, respectively.The occurrence of nausea and vomiting was recorded in postanesthesia care unit stay period (P1) and in 0-12 h (P2), 12-24 h (P3), 24-36 h (P4) and 36-48 h (P5) periods after patients returned to the ward.Ramsay sedation score was recorded at 12, 24, 36 and 48 h after patients returned to the ward.When visual analogue scale score >3, patients were told to press PCIA.Patients were followed up for 48 h after surgery, and patients′ satisfaction, pressing times of PCIA and occurrence of pruritus, respiratory depression, bradycardia and dizziness were recorded.@*Results@#Compared with group C, the incidence of nausea was significantly decreased in P2 period, and the pressing times of PCIA were reduced in P2, 3 period in D1 and D2 groups (P<0.05). There was no significant difference in Ramsay sedation score at each time point, patients′ satisfaction and incidence of bradycardia among the three groups (P>0.05). No patients developed pruritus, respiratory depression or dizziness in the three groups.@*Conclusion@#The optimal dose of dexmedetomidine required to prevent nausea and vomiting is 1 μg/kg when used for postoperative analgesia after gynecological laparoscopic surgery.

Optimal dose of dexmedetomidine to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery / 中华麻醉学杂志

Objective To determine the optimal dose of dexmedetomidine required to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery.Methods A total of 135 patients,aged 18-60 yr,weighing 52-80 kg,of American Society of Anesthesiologists physical status I or Ⅱ,scheduled for elective gynecological laparoscopic surgery,were divided into 3 groups (n=45 each) using a random number table method:control group (group C),dexmedetomidine 1 μg/kg group (group D1) and dexmedetomidine 2 μg/kg group (group D2).Immediately after anesthesia induction,dexmedetomidine 0.4 μg · kg-1 · h-1 was injected intravenously until 30 min before the end of surgery in all the patients.When the patient was fully awake at the end of surgery,the tracheal tube was removed,and patients were sent to postanesthesia care unit and received patient-controlled intravenous analgesia (PCIA).The PCIA solution contained sufentanil 1.2 μg/kg and dezocine 20 mg in 100 ml of 0.9％ normal saline.The PCIA pump was set up with a 0.5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h.Dexmedetomidine 1 and 2 μg/kg were added to PCIA solution in group D1 and group D2,respectively.The occurrence of nausea and vomiting was recorded in postanesthesia care unit stay period (P1) and in 0-12 h (P2),12-24 h (P3),24-36 h (P4) and 36-48 h (P5) periods after patients returned to the ward.Ramsay sedation score was recorded at 12,24,36 and 48 h after patients returned to the ward.When visual analogue scale score ＞3,patients were told to press PCIA.Patients were followed up for 48 h after surgery,and patients' satisfaction,pressing times of PCIA and occurrence of pruritus,respiratory depression,bradycardia and dizziness were recorded.Results Compared with group C,the incidence of nausea was significantly decreased in P2 period,and the pressing times of PCIA were reduced in P2,3 period in D1 and D2 groups (P＜0.05).There was no significant difference in Ramsay sedation score at each time point,patients' satisfaction and incidence of bradycardia among the three groups (P＞0.05).No patients developed pruritus,respiratory depression or dizziness in the three groups.Conclusion The optimal dose of dexmedetomidine required to prevent nausea and vomiting is 1 μg/kg when used for postoperative analgesia after gynecological laparoscopic surgery.

Epidemiological analysis of malaria in Shandong Province in 2017 / 中国血吸虫病防治杂志

Objective To understand the malaria epidemiological characteristics of Shandong Province in 2017, so as to provide the evidences for formulating targeted prevention and control strategy and measures. Methods The data of malaria cases of Shandong Province in 2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological characteristics of malaria situation and the diagnosis and treatment of malaria cases were analyzed. Results There were 209 malaria cases reported in 2017, all of them were imported cases, and 205 cases (98.09%) were imported from African countries. Among them, 155 cases (74.16%) were falciparum malaria cases. Totally 16 cities had cases reported in 2017, and 154 cases (73.68%) were reported in 6 cities (Yantai, Jining, Weihai, Dezhou, Qingdao, and Tai’an). The malaria cases distributed in 17 cities, and there were 110 cases distributed in 4 cities, namely Yantai, Tai’an, Weihai, and Qingdao, which accounted for 56.41% of the total cases in Shandong Province. Both the median time from onset to seeing a doctor and the median time from seeing a doctor to being diagnosed were one day. Totally 12.92% of the cases went to visit a doctor 7 days later after they had symptoms and 10.53% of the cases were diagnosed 7 days later after the first visit to a doctor. Conclusions At present, the prevention and control of the imported malaria is the focus of malaria control in Shandong Province. According to the central tendency of the malaria situation, the health education and propaganda among the high risk groups and the training on the diagnosis and treatment among medical workers should be strengthened, so as to prevent the risk of reappearance of local cases in the past malaria endemic regions, and to ensure the goal of malaria elimination been achieved on schedule.

Epidemiological analysis of malaria in Shandong Province in 2017 / 中国血吸虫病防治杂志

Objective To understand the malaria epidemiological characteristics of Shandong Province in 2017, so as to provide the evidences for formulating targeted prevention and control strategy and measures. Methods The data of malaria cases of Shandong Province in 2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological characteristics of malaria situation and the diagnosis and treatment of malaria cases were analyzed. Results There were 209 malaria cases reported in 2017, all of them were imported cases, and 205 cases (98.09%) were imported from African countries. Among them, 155 cases (74.16%) were falciparum malaria cases. Totally 16 cities had cases reported in 2017, and 154 cases (73.68%) were reported in 6 cities (Yantai, Jining, Weihai, Dezhou, Qingdao, and Tai’an). The malaria cases distributed in 17 cities, and there were 110 cases distributed in 4 cities, namely Yantai, Tai’an, Weihai, and Qingdao, which accounted for 56.41% of the total cases in Shandong Province. Both the median time from onset to seeing a doctor and the median time from seeing a doctor to being diagnosed were one day. Totally 12.92% of the cases went to visit a doctor 7 days later after they had symptoms and 10.53% of the cases were diagnosed 7 days later after the first visit to a doctor. Conclusions At present, the prevention and control of the imported malaria is the focus of malaria control in Shandong Province. According to the central tendency of the malaria situation, the health education and propaganda among the high risk groups and the training on the diagnosis and treatment among medical workers should be strengthened, so as to prevent the risk of reappearance of local cases in the past malaria endemic regions, and to ensure the goal of malaria elimination been achieved on schedule.

Application Progress of Rehabilitation Therapy in Rheumatoid Arthritis(review) / 中国康复理论与实践

Rheumatoid arthritis (RA) is a chronic inflammatory joint dysfunction by inflammation driven autoimmune disease, with joint swelling,pain and stiffness,resulting in severe disability,while increasing the risk of suffering from extra ar-ticular disease.Rehabilitative therapy,as an auxiliary intervention beyond drug therapy,plays an important role in RA treatment, which includes physical therapy, kinesitherapy and occupational therapy. Physical therapies are effective on improving the symptom of RA and alleviating inflammation. Kinesitherapy could reduce inflammatory reaction, im-prove the joint function,reduce the risk of cardiovascular disease,and improve the mental health.Occupational therapy may help them adapt the living and working status,and improve the quality of life.

Application of multidisciplinary team in improving the cleanliness of ob-ject surface frequently touched by doctors and nurses / 中国感染控制杂志

Objective To improve the cleanliness of object surface frequently touched by doctors and nurses through collaboration of multidisciplinary team(MDT). Methods In the fourth quarter of 2015,a baseline survey was performed by healthcare-associated infection(HAI)management professionals in a hospital(baseline survey stage),in the first quarter of 2016,HAI management office combined with medical affairs office and nursing de-partment to carry out collaboration of MDT intervention(intervention stage). The second,third,and fourth quar-ters of 2016 were evaluation stages for efficacy of implementation of intervention measures,cleanliness of frequently touched object surface at different stages was compared.Results In the baseline survey,the qualified rates of fluo-rescent labeling in doctor group and nurse group were 44.25% and 61.61% respectively,after MDT joint interven-tion,the qualified rates of fluorescence labeling in doctor group and nurse group increased to 89.83% and 87.50%respectively,difference was statistically significant(both P<0.05). The incidence of HAI in baseline survey stage was 1.22%,at stage three of post-intervention,incidence of HAI was 1.02%,difference was statistically signifi-cant(P<0.05).Conclusion MDT can effectively integrate hospital management resources,make medical affairs office and nursing department give full play to their respective function,and effectively enhance the cleanliness of frequently touched object surface during medical care.

Inhibitory effects of Genistein on hyperoxia-induced retinal neovascularization / 中华实验眼科杂志

Objective To investigate the effect of Genistein,a tyrosinase inhibitor,on retinal neovascularization in mice.Methods Thirty-six 7-day-old C57BL/6J mice were randomly assigned into hyperoxiainduced group,Genistein group,DMSO group and normal control group.The mice in the hyperoxia-induced group,Genistein group and DMSO group were fed in a static chamber with the oxygen volume fraction (75±2)％ for 5 days and then sent back to natural environment for 5 days to establish retinal neovascular models,and 1 μl Genistein diluted by 5％ dimethyl sulfoxide (DMSO) (400 mg/L) and 1 μl DMSO were intravitreally injected in the 12-dayold mice of Genistein group and DMSO group,respectively.The mice in the normal control group were bred in natural environment.The fluorescence angiography was carried out in 17-day-old mice (2 mice in each group) to prepare the whole retinal flatmounts,and the morphology of retinal vessels was observed under the fluorescence microscope.The other mice in various groups were sacrificed and the retinas were collected.The expressions of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in mRNA and protein levels were detected by realtime fluorescence quantitative PCR and Western blot,respectively.The use and care of the mice complied with regulations for the management of laboratory animals.Results Retinal vessels were normal in the mice of normal control group.In the mice of the hyperoxia-induced group and DMSO group,retinal vessels were tortuous,and neovacularization and non-perfusion areas were visible.In the Genistein group,retinal vessels were clearly visible,but non-perfusion areas were exhibited.The relative expression levels of VEGF mRNA in retinas were 0.64±0.25,0.37±0.23,0.03±0.02 and 0.04±0.02,and the relative expression levels of bFGF mRNA in retinas were 21.40±3.07,17.22±2.63,0.52±0.25 and 0.67±0.23,in the hyperoxia-induced group,DMSO group,Genistein group and normal control group,and the expressions of VEGF and bFGF in mRNA level in the hyperoxia-induced group and DMSO group were significantly higher than those in the Genistein group and normal control group (all at P＜0.05).The protein expression levels of VEGF and bFGF were 1.01 ±0.05 and 0.97±0.06 in the hyperoxia-induced group,1.06±0.07 and 1.03±0.08 in the DMSO group,0.73±0.05 and 0.76±0.07 in the Genistein group,0.52±0.05 and 0.56± 0.05 in the normal control group.The expressions of VEGF and bFGF in protein level in the hyperoxia-induced group and DMSO group were significantly higher than those in the Genistein group and normal control group (all at P＜0.05).Conclusions Genistein can inhibit hyperoxia-induced retinal neovascularization may be by downregulating the expressions of VEGF and bFGF in retinas.

Study on the effect of optimizing the three-level network working mechanism of hospital acquired infection management / 中华医院管理杂志

The hospital took such measures as composing a hospital acquire infection committee, staffing office posts, and building a three-level network of hospital acquired infection management based on clinical departments'teams to improve the management. Full-time staff were appointed to launch monitoring of such infection, and work with clinical staff to supervise, while risk self-appraisal was used to identify risk exposure of such infection. By means of hospital acquired infection management committee, coordination meetings, infection control saloon and WeChat groups, effective communication is realized. Priority improvement programs made sustained quality improvement on risk exposures. All these measures furthered capacity of the hospital and clinical departments in infection control to the end of minimal hospital acquired infection.