Incidence of chronic obstructive pulmonary disease and risk factors in the Suzhou cohort / 中华流行病学杂志

Objective: To understand the incidence of chronic obstructive pulmonary disease (COPD) in the Suzhou cohort, and explore the risk factors for the development of COPD in Suzhou, and provide a scientific basis for COPD prevention. Methods: This study was based on the China Kadoorie Biobank project in Wuzhong District, Suzhou. After excluding individuals with airflow obstruction and self-reported chronic bronchitis, emphysema, or pulmonary heart disease at baseline, 45 484 individuals were finally included in the analysis. Cox proportional risk models were used to analyze risk factors of COPD and calculate hazard ratios and 95% confidence interval (CI) in the Suzhou cohort. The effect modifications of smoking on the association between other risk factors and COPD were evaluated. Results: Complete follow-up was available through December 31, 2017. Participants were followed up for a median of 11.12 years, and 524 individuals were diagnosed with COPD during the follow-up period; the incidence was 105.54 per 100 000 person-years. Multivariate Cox proportional risk regression models showed that age (HR=3.78, 95%CI:3.32-4.30), former smoking (HR=2.00, 95%CI:1.24-3.22), current smoking (<10 cigarettes/day, HR=2.14, 95%CI:1.36-3.35;≥10 cigarettes/day, HR=2.69, 95%CI:1.60-4.54), history of respiratory disease (HR=2.08, 95%CI:1.33-3.26), daily sleep duration ≥10 hours (HR=1.41, 95%CI:1.02-1.95) were associated with increased risk of COPD. However, education level of primary school and above (primary or junior high school, HR=0.65, 95%CI:0.52-0.81; high school and above, HR=0.54, 95%CI:0.33-0.87), consuming fresh fruit daily (HR=0.59, 95%CI:0.42-0.83) and consuming spicy food weekly (HR=0.71, 95%CI:0.53-0.94) were associated with reduced risk of COPD. Conclusions: The incidence of COPD is low in Suzhou. Older age, smoking, history of respiratory disease, and long sleep duration were risk factors for the development of COPD in the Suzhou cohort.

Preparation and polarization activity research of astragalus polysaccharide-superparamagnetic iron oxide nanocomposite / 药学学报

Size and surface modification are the two key factors affecting the effect of macrophages polarization induced by superparamagnetic iron oxide nanoparticles (SPIONs). The smaller the particle size, the better the polarization effect of SPIONs. Besides, the reasonable SPIONs surface modification method can also be used to enhance the polarization effect. In this study, SPIONs was prepared by solvothermal method and optimized by Box-Benhnken center combination design and response surface method. Furthermore, astragalus polysaccharide-superparamagnetic iron oxide nanocomplex (APS-SPIONs) was successfully constructed by EDC/NHS esterification method. The structure of APS-SPIONs was confirmed by dynamic light scatter and infrared spectrometer, and the contents of iron and polysaccharide were characterized by spectrophotometry. The effect of APS-SPIONs on inducing mouse macrophages RAW264.7 polarization was investigated by flow cytometry. The RAW264.7 macrophages-HepG2 human hepatoma cancer cells Transwell co-culture system was established to investigate APS-SPIONs improve anti-tumor function of macrophages in vitro, and the proliferation activity of APS-SPIONs on RAW264.7 detected by cell counting kit-8 (CCK-8) method. The results showed that the average particle size and zeta potential of APS-SPIONs were (82.93 ± 1.47) nm and (-24.00 ± 0.47) mV. Polysaccharide and Fe content were 8.69% and 7.04%, respectively. APS-SPIONs effectively induced the polarization of RAW264.7 into M1 type in vitro, improving the anti-tumor ability of macrophages in a co-culture system, without effecting the proliferation of macrophages. Our study provides a drug development strategy and preliminary research results to educate macrophages and reshape the tumor immune microenvironment to achieve tumor-killing effects.

The efficacy and safety of intravenous sucrose iron therapy for recurrent iron deficiency anemia / 中华血液学杂志

Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.

Effect of Dahuang Xiezhuo Prescription on Renal Tubular Function in Patients with IgA Nephropathy Complicated with Hyperuricemia / 中国实验方剂学杂志

ObjectiveTo observe the effect of Dahuang Xiezhuo prescription on the clinical symptoms， blood uric acid， and renal tubular function of patients with immunoglobulin A （IgA） nephropathy in stages 1-2 of chronic kidney disease （CKD） complicated with hyperuricemia （HUA）. MethodSixty patients with IgA nephropathy in stages 1-2 of CKD complicated with HUA of spleen and kidney deficiency and combined turbidity and blood stasis syndromes were randomly divided into an observation group and a control group， with 30 cases in each group. The patients in the control group received basic treatment， i.e.， losartan potassium tablets 50-100 mg/time， once per day， and sodium bicarbonate tablets 0.5 g/time， three times per day by oral administration， combined with low-salt， low-fat， and low-purine diet. The patients in the observation group received Dahuang Xiezhuo prescription on the basis of basic treatment， one dose per day， twice a day in the morning and evening with warm water. Both groups were treated for two months. The total scores of traditional Chinese medicine（TCM）syndrome， blood pressure， 24 h urinary protein （24 h UTP）， blood urea nitrogen （BUN）， serum creatinine （SCr） ［glomerular filtration rate （eGFR） was calculated by CKD-epidemiology collaboration （CKD-EPI） formula］， serum uric acid （SUA）， and renal tubular function indexes ［urinary α1-microglobulin （α1-MG）， urinary β2-microglobulin （β2-MG）， urinary kidney injury molecule-1 （KIM-1）， and neutrophil gelatinase-associated lipocalin （NGAL）］ of the two groups before treatment and two months after treatment were recorded. The clinical efficacy of the two groups was evaluated two months after treatment. ResultAfter 2 months of treatment，the total effective rate in the observation group was 81.48%（22/27），higher than 50.00%（14/28） in the control group（χ2 =6.661，P<0.05）. The total scores of TCM syndrome， 24 h UTP， and SUA in the observation group and the observation group were lower than those before treatment （P<0.05）， and compared with the control group after treatment， the observation group decreased more significantly （P<0.05）. After treatment， the blood pressure in the observation group and the observation group was lower than that before treatment （P<0.05）， and there was no significant difference in blood pressure between the two groups after treatment. After treatment， the levels of urinary α1-MG， β2-MG， KIM-1， and NGAL in the two groups were lower than those before treatment （P<0.05）， and the observation group was lower than the control group after treatment （P<0.05）. There were no significant inter-group and intra-group differences in BUN， SCr， and eGFR levels before and after treatment. There were no obvious abnormalities in blood routine， liver function， and electrolytes before and after treatment in the two groups， and no adverse reactions such as allergies occurred. ConclusionDahuang Xiezhuo prescription can effectively improve the clinical symptoms of IgA nephropathy with HUA （CKD1-2） patients with spleen and kidney deficiency and combined turbidity and blood stasis syndromes， reduce blood uric acid level， alleviate renal tubular injury， and protect the kidney. The curative effect is better than that of basic treatment.

GAO Shu-zhong's clinical experience in "seeking yin from yang needling method" based on "qi street" and "four seas" theories / 中国针灸

The paper introduces professor GAO Shu-zhong's understanding on "seeking yin from yang needling method" and its clinical application on the basis of "qi street" and "four seas" theories. Through professor GAO's clinical practice for years, he integrates and extendes the theories of "seeking yin from yang", "qi street" and "four seas" in Huangdi Neijing (The Yellow Emperor's Inner Classic). In this specific acupuncture method, in reference with the theories of "qi street" and "four seas", acupuncture is exerted on yang part of body, e.g. the back and lumber region to treat the diseases of yin parts, e.g. the chest and abdomen, which is differentiated as yin-yang imbalance in pathogenesis. In order to fully explain the clinical curative effect of "seeking yin from yang needling method", the common diseases in clinic, e.g. the disorders of heart, spleen and stomach systems, as well as the gynecology are taken as examples in the paper.

Research progress of injectable in situ hydrogel embolic agents / 药学学报

Embolotherapy is a common method for clinical intervention in the treatment of diseases including aneurysms, arteriovenous malformations and solid tumors, and embolic agents are a decisive factor affecting the effect of embolization. Although various embolic agents like coils, microspheres, and Onyx have been used clinically, there are still some treatment limitations: such as weak blood vessel penetration, easy to aggregate, poor mechanical properties, adhesion to catheters, and the need for toxic solvents (e.g. dimethyl sulfoxide). In recent years, a number of studies have found that in situ hydrogels have good application prospects in the field of vascular embolization. When low viscosity precursor solution is injected into the targeted blood vessel via microcatheters, it will undergo a sol-gel transition through physical and/or chemical cross-linking to form hydrogel to block blood flow. In addition, these in situ hydrogels can load drugs by pore embedding, electrostatic interaction, chemical bonding, etc., and have excellent sustained-release properties. This review summarizes the research progress of injectable in situ hydrogel vascular embolic agents in the past ten years, with a view to provide references for the development of new embolic agents in the future.

Manual therapy combined with posterior percutaneous endoscopic cervical decompression for the treatment of cervical spondylotic radiculopathy / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy and safety of manual therapy combined with posterior percutaneous endoscopic cervical decompression(PECD) in the treatment of intractable cervical spondylotic radiculopathy.@*METHODS@#From May 2016 to May 2018, 23 CSR patients who responded poorly to conservative treatment for at least 6 weeks underwent the combination management. Firstly, the patients received the posterior percutaneous endoscopic cervical decompression routine care for the following 4 weeks and manual therapy for another 4 weeks. A total of 23 patients were followed up, including 14 males and 9 females, the age ranged from 29 to 78 years old with an average of (50.30±12.28) years, the course of disease was 3 to 24 months with an average of (9.74±5.76) months. The lesion segment involved C4,5 in 4 cases, C5,6 in 13 cases, C6,7 in 6 cases. The visual analogue scale (VAS), neck disability index (NDI), changes of cervical physiological curvature and interbody stability, adverse events were observed before and after operation. The follow-up time points were before operation, 1 day after operation and 1, 3 and 6 months after operation.@*RESULTS@#All patients successfully completed the operation and manual treatment for 4 to 8 times. Among the 29 cases, 23 patients were followed up for more than 6 months. There was no spinal cord and nerve root injury during the treatment and follow-up. Operation time was from 80 to 120 min with a median of 90 min;intraoperative blood loss was from 35 to 80 ml with a median of 50 ml. NDI, VAS of neck, shoulder and arm each period after operation were significantly lower than those before PECD(P<0.05), while there were no significant improvement in cervical physiological curvature and target segment intervertebral space height(P>0.05);there was no significant change in interbody stability (P>0.05). After received the manual therapy, NDI significantly decreased (P<0.05), however, there was no significant difference in VAS of neck, shoulder and arm, physiological curvature of cervical spine and intervertebral space height of target segment compared with that before manual treatment (P>0.05);there was no significant change in interbody stability (P>0.05).@*CONCLUSION@#Manual therapy combined with PECD in the treatment of intractable cervical spondylotic radiculopathy can not only quickly improve the symptoms, but also alleviate the residual symptoms after PECD safely and effectively, and can not cause obvious signs of accelerated instability of cervical adjacent segments in the short term.

Clinical pathological characteristics and prognosis of 468 thymoma patients / 中国胸心血管外科临床杂志

@#Objective    To assess the correlation of WHO pathological classification and Masaoka stage of thymomas with its prognosis. Methods    A total of 468 patients with thymomas who received surgeries during 2009-2019 in Huashan Hospital, Fudan University, were collected. There were 234 males and 234 females with an average age of 21-83 (49.6±18.7) years. A total of 132 patients underwent video-assisted thoracic surgery (VATS) and 336 patients underwent thymectomy with median sternal incision. The follow-up time was 5.7±2.8 years. The clinical data of the patients were analyzed. Results    The amount of intraoperative bleeding was 178.3±133.5 mL in the median sternal incision group, and 164.8±184.1 mL in the VATS group (P=0.537). The operative time was 3.3±0.7 h in the median sternal incision group and 3.4±1.2 h in the VATS group (P=0.376). Postoperative active bleeding, phrenic nerve injury and chylothorax complications occurred in 8 patients, 9 patients and 1 patient in the VATS group, respectively, and 37 patients, 31 patients and 7 patients in the median sternal incision group, respectively. There was no statistical difference between the two groups (P=0.102, 0.402, 0.320). The 5-year cumulative progression free survival (PFS) rates of patients with WHO type A, AB, B1, B2, B3 and C thymomas were 100.0%, 100.0%, 95.7%, 81.4%, 67.5% and 50.0%, respectively (P<0.001). The 5-year PFS rates of patients with Masaoka stageⅠ-Ⅳ thymomas were 96.1%, 89.2%, 68.6% and 19.3%,  respectively (P<0.001). The 5-year PFS rate was 87.3% in patients with myasthenia gravis (MG) and 78.2% in patients without MG (P<0.001). The 5-year PFS rates of patients with different surgeries were 82.4% and 83.8%, respectively (P=0.904). Conclusion    WHO pathological classification and Masaoka stage have significant clinical prognosis suggestive effect. Thymoma patients combined with MG have better prognosis, which suggests early diagnosis and treatment of thymoma are important.

Advances in the management of cataract surgery in patients with diabetes / 国际眼科杂志(Guoji Yanke Zazhi)

@#With the growing population of diabetes patients on a global scale, the management of diabetic cataract has been attached more attention. Diabetic patients are often associated with fundus lesions, requiring early diagnosis and treatment for cataract duo to early onset and rapid progression of this disease compared to non-diabetics. Patients with diabetes also have an increased risk of developing postoperative corneal edema, diabetic macular edema and posterior capsular opacification <i>etc.,</i> making cataract surgery technically challenging. Before surgery, patients should have good glycemic control and no evidence of ocular infection. An optimal operation timing and individualized treatment should be adopted to prevent vision-threatening complications and improve visual outcomes. This article provides an overview of diabetic cataract and related complications.

The near-infrared dye IR-61 restores erectile function in a streptozotocin-induced diabetes model via mitochondrial protection / 亚洲男科学杂志(英文版)

This study aimed to evaluate the therapeutic effect of IR-61, a novel mitochondrial heptamethine cyanine dye with antioxidant effects, on diabetes mellitus-induced erectile dysfunction (DMED). Eight-week-old male Sprague-Dawley rats were intraperitoneally injected with streptozotocin (STZ) to induce type 1 diabetes. Eight weeks after STZ injection, all rats were divided into three groups: the control group, DM group, and DM + IR-61 group. In the DM + IR-61 group, the rats were administered IR-61 (1.6 mg kg

Glucose metabolism: A link between traumatic brain injury and Alzheimer's disease / 中华创伤杂志(英文版)

Traumatic brain injury (TBI), a growing public health problem, is a leading cause of death and disability worldwide, although its prevention measures and clinical cares are substantially improved. Increasing evidence shows that TBI may increase the risk of mood disorders and neurodegenerative diseases, including Alzheimer's disease (AD). However, the complex relationship between TBI and AD remains elusive. Metabolic dysfunction has been the common pathology in both TBI and AD. On the one hand, TBI perturbs the glucose metabolism of the brain, and causes energy crisis and subsequent hyperglycolysis. On the other hand, glucose deprivation promotes amyloidogenesis via β-site APP cleaving enzyme-1 dependent mechanism, and triggers tau pathology and synaptic function. Recent findings suggest that TBI might facilitate Alzheimer's pathogenesis by altering metabolism, which provides clues to metabolic link between TBI and AD. In this review, we will explore how TBI-induced metabolic changes contribute to the development of AD.

Comparison of intermittent fasting diet and continuous energy-restricted diet on weight loss and metabolic profile in overweight people / 中华临床营养杂志

Objective To compare the weight loss and metabolic profile between a continuous energyrestricted diet and intermittent fasting diet in order to present an optimal nutritional weight reduction method for obese people in China. Methods Sixty overweight or obese adults were selected and divided into two groups as the continuous energy-restricted diet group and the intermittent fasting diet group. Height, weight, waist circumference, body mass index (BMI), body fat, change of visceral fatarea, fasting glucose (FPG), triglyceride (TG), total cholesterol ( TC), high density cholesterol ( HDL), low density cholesterol (LDL), glutamic pyruvicaminotransferase ( AST), signglutamic pyruvic transaminase ( ALT), gammaglutamyltranspeptidase (GGT), alkalinephosphatase (ALP), fasting insulin level (FINS) and HOMA-IR were assessed at baseline and 8 weeks after weight loss methods carried. Results Both continuous energy-restricted diet and intermittent fasting diet resulted improvement on body shape indexes and a significant decrease in weight, waist circumference, BMI, body fat, visceral fat area and skeletal muscle (P<0. 01) at 8 weeks. Both groups experienced improvements in biochemical outcomes and metabolic indicators at 8 weeks. A significant reduction in TC, AST, ALT, GGT, ALP, FINS and HOMA-IR (P<0. 01 or P<0. 05) were observed in continuous energy-restricted diet group. And a significant decline in TC, LDL, HDL, AST, ALT, GGT, ALP, FINS and HOMA-IR were observed in intermittent fasting diet group (P <0. 01 or P < 0. 05). HDL was found significantly reduced in intermittent fasting diet group as compared with continuous energy-restricted diet group (P<0. 01) at 8 weeks, however, there were no difference in weight loss, waist circumference, BMI, body fat, visceral fat area and other metabolic indicators at 8 weeks (P>0. 05). Conclusion Both intermittent fasting diet and continuous energy-restricted diet have a similar effect on weight loss and metabolic indexes like blood glucose, HOMA-IR and blood lipid, but intermittent fasting diet can more significantly decrease HDL level.

Effect of rivaroxaban on the injury during endotoxin-induced damage to human umbilical vein endothelial cells / 中华危重病急救医学

Objective To evaluate the effect and mechanism of rivaroxaban, an inhibitor of coagulation factor Ⅹa (FⅩa), on endotoxin-induced injury to human umbilical vein endothelial cells (HUVEC). Methods When cultured HUVEC grow to 80% fusion, they were divided into four groups according to the random number method: blank control group (DMEM medium), lipopolysaccharide (LPS) group (cells were challenged by 100 μg/L LPS for 16 hours), FⅩa+LPS group (cells were challenged by LPS for 16 hours after they were cultured with 100 nmol/L FⅩa for 24 hours), and FⅩa+RIV+LPS group (cells were challenged by LPS for 16 hours after they were cultured with 100 nmol/L FXa and 1 μmol/L rivaroxaban for 24 hours). After each group of cells were challenged with LPS, the cell activity was detected by the cell proliferation and toxicity kit (CCK-8); the cell migration ability was detected by cell scratch experiments;the abilities of cells migration were measured by scratch-wound-healing assay; the apoptosis of cells were evaluated using flow cytometry; the endothelial barrier of cells was assessed by Transwell and Evans blue; the levels of tumor necrosis factor-α(TNF-α), interleukin (IL-1β, IL-6) were detected by the enzyme linked immunosorbent assay (ELISA); the expressions of nuclear factor-κB (NF-κB) and mitogen activated protein kinase (MAPK) signaling pathway were detected by Western Blot. Results Compared with blank control group, the cell viability in LPS group was significantly decreased, and the migration ability, number of apoptotic cells, and barrier permeability of endothelial cells was significantly increased, the levels of TNF-α, IL-1β and IL-6 were significantly increased, and the expressions of phosphorylation of c-Jun N-terminal kinase (p-JNK), phosphorylation of p38MAPK (p-p38MAPK), phosphorylation of transforming growth factor kinase 1 (p-TAK1) and phosphorylation of NF-κBp65 (p-NF-κBp65) were significantly increased. It indicated that LPS could stimulate the inflammatory response of vascular endothelial cells, and had a significant impact on cell activity, apoptosis and function. There was no significant difference in above indexes between FⅩa+LPS group and LPS group, except for the level of IL-6 being higher in FⅩa+LPS group. Compared with FⅩa+LPS group, in FⅩa+RIV+LPS group, the cell activity was significantly increased (A value: 0.42±0.02 vs. 0.33±0.02), and migration ability was significantly decreased (folds: 1.78±0.17 vs. 2.24±0.20), the number of apoptotic cells was significantly decreased [(11.30±0.70)% vs. (21.03±0.19)%], and permeability of monolayers endothelial cells was significantly decreased [(149±12)% vs. (253±15)%], the levels of inflammatory cytokines were significantly decreased [IL-1β(ng/L): 163.2±20.7 vs. 477.8±20.2, IL-6 (ng/L): 69.3±0.5 vs. 238.0±24.1, TNF-α(ng/L): 117.0±13.1 vs. 196.2±4.5], the expressions of p-TAK1 and p-NF-κBp65 were significantly decreased (p-TAK1/TAK1: 0.74±0.09 vs. 1.85±0.15, p-NF-κBp65/NF-κBp65: 1.15±0.17 vs. 2.36±0.20), with statistically significant differences (all P <0.05). There was no significant difference in the p-JNK, p-p38MAPK expressions between FⅩa+RIV+LPS group and FⅩa+LPS group (p-JNK/JNK: 1.64±0.12 vs. 1.65±0.15, p-p38MAPK/p38MAPK: 2.31±0.32 vs. 2.35±0.20, both P > 0.05). Conclusion Rivaroxaban can effectively relieve the inflammatory response of HUVEC stimulated by LPS, which may be related to the inhibition of NF-κB signaling pathway activation rather than MAPK signaling pathway.

Fecal microbiota transplantation from growing pigs with different feed efficiency to pseudo-germ-free mice can result in reappearance of the original phenotype / 中国实验动物学报

Objective The aim of this experiment was to explore the effect and mechanism of intestinal microbiota on shaping the growth performance by fecal microbiota transplantation from pigs to pseudo-germ-free mice. Methods Thirty-six barrows with a similar initial body weight of 30 kg were raised for 42 days(ad libitum)within individual metabolic cages. Feed intake and body weight of each pig were recorded every week to calculate the feed conversion rate and average daily gain. At the end of the experiment,feed conversion ratio and average daily gain were integrated to divide the pigs into 3 groups, namely, high growth performance(HP), moderate growth performance(MP)and low growth performance(LP)groups. Feces were collected to calculate the total intestinal nutrient digestibility and prepare for fecal microbiota transplantation to pseudo-germ-free mice, which were induced with several antibiotics for four weeks. Fecal microbiome structure was assayed by profiling V3-V4 region of the 16S rRNA gene. Results Fecal microbiota transplantation from pigs to pseudo-germ-free mice resulted in reappearance of the original phenotype. Compared with the LP pigs, the microbial species richness and microbial diversity in feces were higher in the HP pigs. The HP pigs had improved digestibility of gross energy(P =0.01)and higher abundance of Methanobrevibacter. Enterococcus and Akkermansia were also more abundant in the recipient pseudo-germ-free mice from the HP pigs which may be correlated with a high energy utilization. Conclusions Fecal microbiota transplantation from pigs to mice results in reappearance of the original phenotype and microbial species richness,microbial diversity,and their growth ability. Different nutritional metabolism is shown among pigs with different feed efficiency and the HP pigs have improved energy utilization(P=0.01). At the same time, the bacteria correlated with high energy utilization are more abundant in feces of HP pigs than in LP pigs.

Effects of Integrated Case Payment on Medical Expenditure and Readmission of Inpatients with Chronic Obstructive Pulmonary Disease: A Nonrandomized, Comparative Study in Xi County, China / 华中科技大学学报（医学）（英德文版）

In the past few decades,Chinese government attempted to reduce the economic burden of chronic diseases and lower family fmancial risk of patients by establishing a nationwide coverage of Social Health Insurance system.However,the payment mode of Social Health Insurance varies across Chinese healthcare settings,and the effectiveness of each mode differs.This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD),a complex,multicomponent,chronic condition.A nonrandomized,comparative method was used in this study.Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County.The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A,clinical pathway B and clinical pathway C).Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days.A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis.The results showed that case payment,comprising price-cap case payment (β=2382.988,P＜0.001) and fixed-reimbursement case payment (β=2613.564,P＜0.001),and clinical pathway C (β=1996.467,P＜0.001) were risk factors of per capita total medical expenses.Clinical pathway A (β=1443.409,P＜0.001) and clinical pathway B (β=-1583.791,P＜0.001) were protective factors.The interactive effects of case payment with hospital level (β=0.710,P＜0.001) lowered the readmission rate within 30 days.Meanwhile,clinical pathways A (β=18.949,P＜0.001),B (β=-19.752,P＜0.001) and C (β=-1.882,P＜0.1) were associated with the rate increase.The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent.However,this payment mode increased the per capita total medical expense.Further,policy-makers should set reasonable reimbursement standards of case payment,unify the type of case payment,and strengthen the supervision of the reform to enhance its function on medical cost control.

Effects of Integrated Case Payment on Medical Expenditure and Readmission of Inpatients with Chronic Obstructive Pulmonary Disease: A Nonrandomized, Comparative Study in Xi County, China / 华中科技大学学报（医学）（英德文版）

In the past few decades,Chinese government attempted to reduce the economic burden of chronic diseases and lower family fmancial risk of patients by establishing a nationwide coverage of Social Health Insurance system.However,the payment mode of Social Health Insurance varies across Chinese healthcare settings,and the effectiveness of each mode differs.This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD),a complex,multicomponent,chronic condition.A nonrandomized,comparative method was used in this study.Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County.The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A,clinical pathway B and clinical pathway C).Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days.A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis.The results showed that case payment,comprising price-cap case payment (β=2382.988,P＜0.001) and fixed-reimbursement case payment (β=2613.564,P＜0.001),and clinical pathway C (β=1996.467,P＜0.001) were risk factors of per capita total medical expenses.Clinical pathway A (β=1443.409,P＜0.001) and clinical pathway B (β=-1583.791,P＜0.001) were protective factors.The interactive effects of case payment with hospital level (β=0.710,P＜0.001) lowered the readmission rate within 30 days.Meanwhile,clinical pathways A (β=18.949,P＜0.001),B (β=-19.752,P＜0.001) and C (β=-1.882,P＜0.1) were associated with the rate increase.The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent.However,this payment mode increased the per capita total medical expense.Further,policy-makers should set reasonable reimbursement standards of case payment,unify the type of case payment,and strengthen the supervision of the reform to enhance its function on medical cost control.

Effects of bletilla striata polysaccharideon on expression of vascular endothelial growth factor in rat ovaries and malondialdehyde in rat serum and endometrial morphology during perimenopause period / 局解手术学杂志

Objective To investigate the effect of the bletilla striata polysaccharide on the expression of ovarian vascular endothelial growth factor(VEGF) and serum malondialdehyde(MDA)and endometrial morphology in rat during perimenopause period.Methods The animal model of perimenopause rats was established by unforced aging.A total of 40 female SD rats(12~14 months old)were randomly divid-ed into four groups:Chinese medicine low(0.5 g/kg),medium(1 g/kg),high(2 g/kg) dosage group and the elder model group.The rats were given with corresponding drugs for 8 weeks.The content changes of ovarian VEGF protein was detected by western blot;serum MDA con-tent was detected by thiobarbituric acid;the morphology of endometrium in rats was observed by HE staining.Results Eight weeks later, compared with the elder model group,the VEGF protein expression in Chinese medicine low,medium,high dosage group increased,the serum MDA content in Chinese medicine low,medium,high,dosage group reduced,the differences were statistically significant( P<0.01),with dose dependence.Endometrial thickening and glandular increasing with the increase of dose.Conclusion Bletilla striata polysaccharide can upregulate the expression of VEGF protein,and down regulate the level of serum MDA,which improves the uterine function so as to delay the process of perimenopause in rats.

Significance of leukocyte subtypes and thyroid function tests in differential diagnosis of thyrotoxicosis / 吉林大学学报(医学版)

Objective:To explore the differences of leukocyte subtypes and thyroid function of the patients with different thyrotoxicosis diseases,and to clarify the practical significance of leukocyte subtypes and thyroid function tests in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Methods:A total of 33 patients with Graves disease thyrotoxicosis and 30 patients with destructive thyrotoxicosis confirmed by clinical and laboratory examination were selected; the levels of neutrophils (Ne),lymphocyte (Ly),basophils (Ba), eosinophil (Eo)and mononuclear cells (Mo),serum free thyroxine (FT4),three free iodine thyroid former glycine (FT3),and thyroid stimulating hormone (TSH)of the patients in two groups were analyzed and the receiver operator characteristic curve (ROC)was used to evaluate the values of the indicators with statastical significance in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Results:The levels of serum Eo,FT4 and FT3,and the modified data Eo/Mo,Eo × FT3 / Mo of the patients in Graves disease thyrotoxicosis group were significantly higher than those in destructive thyrotoxicosis group (P <0.05);the levels of TSH and Mo of the patients were lower than those in destructive thyrotoxicosis group (P < 0.05).The ROC curve analysis results showed that the sensitivities and specificities of Eo,Eo/Mo,Eo×FT3/Mo in the differential diagnosis of two diseases were good, and the best diagnostic boundaries were 1.54, 0.34, and 3.94. Conclusion:Eo,Mo,TSH,FT3,FT4,Eo/Mo,and EoxFT3/Mo could be regarded as the basis in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis ,and the practical significances of Eo,Eo/Mo,and Eo×FT3 /Mo in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyotoxicosis are bigger.

Implementation and evaluation of perioperative delirium prevention scheme for elderly patients with hip fracture / 中华护理杂志

Objective To summarize common nursing problems of postoperative delirium in elderly patients with hip fracture,to formulate perioperative management scheme,and to implement proactive nursing intervention.Methods Multidisciplinary cooperative team was established,2014 clinical practice guidelines for preventing postoperative delirium in elderly patients from American Geriatrics Society was referenced.Through oxygen therapy and respiratory function training preoperatively,perfusion balance and temperature control and restricted blood transfusion intraoperatively,multimodal analgesia and comprehensive management of sleep postoperatively,professional,systematic perioperative delirium coping strategies were implemented to reduce the incidence of postoperative delirium in elderly patients with hip fracture.Results The incidence of postoperative delirium was 16.36％(9/55) and 30.91％ (17/55) for the experimental group and the control group,the duration of delirium was (3.37±1.21) d and (4.53± 1.87) d,the incidence of postoperative hypoxemia was 9.09％(5/55) and 14.55％(8/55),and the daily total sleep time was(5.18±0.53)h and(3.56±0.69)h.Conclusion Perioperative delirium management scheme involved various nursing coping strategies and quality continuous improvement projects,shortened the first time of ambulation and average days of hospitalization,and reduced the incidence of postoperative delirium.

Implementation and evaluation of perioperative delirium prevention scheme for elderly patients with hip fracture / 中华护理杂志

Objective To summarize common nursing problems of postoperative delirium in elderly patients with hip fracture,to formulate perioperative management scheme,and to implement proactive nursing intervention.Methods Multidisciplinary cooperative team was established,2014 clinical practice guidelines for preventing postoperative delirium in elderly patients from American Geriatrics Society was referenced.Through oxygen therapy and respiratory function training preoperatively,perfusion balance and temperature control and restricted blood transfusion intraoperatively,multimodal analgesia and comprehensive management of sleep postoperatively,professional,systematic perioperative delirium coping strategies were implemented to reduce the incidence of postoperative delirium in elderly patients with hip fracture.Results The incidence of postoperative delirium was 16.36％(9/55) and 30.91％ (17/55) for the experimental group and the control group,the duration of delirium was (3.37±1.21) d and (4.53± 1.87) d,the incidence of postoperative hypoxemia was 9.09％(5/55) and 14.55％(8/55),and the daily total sleep time was(5.18±0.53)h and(3.56±0.69)h.Conclusion Perioperative delirium management scheme involved various nursing coping strategies and quality continuous improvement projects,shortened the first time of ambulation and average days of hospitalization,and reduced the incidence of postoperative delirium.