Roles and functions of rural health midwives in Cordillera Administrative Region: A qualitative pilot study

Background@#Midwives have been frontline health professionals at the grassroots level, especially in rural communities. Their role was expanded from maternal and child healthcare providers to primary healthcare services providers. Despite their expanded functions, there have been limited studies investigating the professional practice of midwifery in the Philippines in a rural setting.@*Objective@#This study aimed to investigate the professional practice of midwives in selected rural areas in the Cordillera Administrative Region, Philippines.@*Methods@#This research is a qualitative pilot study using a semi-structured interview guide to collect the data. Key informant interviews were conducted through mobile phone calls convenient for the participants from September to October 2021. Data were analyzed through qualitative content analysis.@*Results@#A total of seven rural health midwives participated in this study. From the data analysis, six themes emerged related to the professional functions of rural Filipino midwives: 1) antenatal and postnatal care, 2) basic emergency obstetrical and newborn care, 3) health education and counseling, 4) treating common children and adult infections, 5) health promotion, and 6) beyond midwifery role.@*Conclusion@#Rural midwives play a role in providing several primary healthcare services mandated by the government and the profession. They also offer health services beyond their scope as midwives because of geographical difficulties and logistic issues. The findings inform the policymaker to review and amend the expanded roles of practicing midwives so that they will be empowered in providing quality and legal healthcare services. The study results will also be important in preparing midwives for rural midwifery practice.

Role of 3-methyladenine in uric acid-induced apoptosis of renal tubular epithelial cells / 中华肾脏病杂志

Objective:To investigate the effect of autophagy inhibitor 3-methyladenine (3-MA) on uric acid (UA)-induced apoptosis of renal tubular epithelial cells.Methods:(1) Totally 24 SD rats were randomly divided into 4 groups: control group, treatment with 3-MA group, hyperuricemic nephropathy (HN) group, and HN+3-MA group, with 6 rats in each group. According to the body weight of the rats, adenine (100 mg/kg) and potassium oxonate (1 500 mg/kg) were mixed with distilled water to make a suspension, and the rats were given intragastrically once daily for consecutive 21 days to establish HN rat model. The control group and the 3-MA treatment group were fed an equivalent amount of distilled water. At the same time, the 3-MA treatment group and the HN+3-MA group were intraperitoneally injected with 3-MA (15 mg/kg), and the control group and HN group were intraperitoneally injected with an equal volume of saline once daily for 21 consecutive days. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) was used to observe renal cell apoptosis. Western blotting was used to detect the expression levels of cleaved caspase-3 and Bax, and immunofluorescence staining was used to detect the expression and localization of cleaved caspase-3 in renal tissue. (2) Human renal tubular epithelial cells (HK-2) were stimulated with UA (800 μmol/L), and cells were administrated with different concentrations of 3-MA or Beclin-1 small interfering RNA (siRNA). The apoptosis of renal tubular epithelial cells was detected by Western blotting and immunofluorescence staining.Results:Compared with the normal rats, the apoptosis of renal tubular epithelial cells in the HN group was significantly increased ( P<0.01), and the expression levels of cleaved caspase-3 and Bax were significantly up-regulated (both P<0.05). Compared with the HN group, the apoptosis of renal tubular epithelial cells in the HN+3-MA group was significantly decreased ( P<0.01). In addition, high level of uric acid could significantly increase the levels of apoptosis associated proteins in HK-2 cells (all P<0.05), and using different concentrations of 3-MA or transfecting with Beclin-1 siRNA could significantly reduce the expression of cleaved caspase-3 and Bax (all P<0.05). Conclusion:Autophagy plays an important role in uric acid-induced apoptosis of renal tubular epithelial cells. Inhibiting the excessive activation of autophagy may be a new strategy to prevent the progression of HN.

Effect of electroacupuncture on laparoscope postoperative shivering in patients undergoing general anesthesia / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on laparoscope postoperative shivering in patients undergoing general anesthesia and explore its effect mechanism.@*METHODS@#A total of 80 patients with elective laparoscopic resection of intestinal tumor under general anesthesia were randomly divided into an EA group and a tramadol group, 40 cases in each group. Thirty min prior to the end of the operation, in the EA group, EA was exerted at Neimadian and Zusanli (ST 36), with disperse-dense wave, 2 Hz/100 Hz in frequency, 1 mA in intensity, and lasting 30 min. In the tramadol group, tramadol hydrochloride injection was dropped intravenously, 1 mg/kg. The conditions of shivering, dizziness, nausea, vomiting and agitation were observed in the post-anesthesia care unit (PACU). Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed before treatment (T0), at the moment of extubation (T1), in 3 min of extubation (T2) and 1 h after operation (T3). Using ELISA, at T0 and T3, the expression levels of interleukin 6 (IL-6) and 5-hydroxytryptamine (5-HT) in plasma were detected separately. Choking and agitation were recorded during extubation.@*RESULTS@#① In the EA group, the incidence of shivering, dizziness, nausea, vomiting and agitation in the PACU was lower than that in the tramadol group (P<0.05). ②Compared with T0, HR, SBP and DBP were increased at T1 and T2 in the tramadol group (P<0.05). HR, SBP and DBP in the EA group were lower than the tramadol group at T1 and T2 (P<0.05). ③Compared with T0, the expression levels of IL-6 and 5-HT in plasma were increased at T3 in the tramadol group (P<0.05). The expression levels of IL-6 and 5-HT in the EA group were lower than the tramadol group at T3 (P<0.05). ④The incidence of choking and agitation during exudation in the EA group was lower than that in the tramadol group (P<0.05).@*CONCLUSION@#Electroacupuncture can reduce the incidence of laparoscopic postoperative shivering under general anesthesia. The potential mechanism mays related to the modulation of the expression levels of IL-6 and 5-HT caused by surgical trauma.

Routine blood test, C-reactive protein and blood culture for predicting necrotizing enterocolitis in preterm infants with late-onset sepsis / 中华围产医学杂志

Objective:To explore the value of blood routine indexes, C-reactive protein(CRP), and blood culture in predicting the occurrence of neonatal necrotizing enterocolitis (NEC) secondary to late-onset sepsis (LOS) in preterm infants.Methods:This study retrospectively enrolled 80 premature infants with LOS admitted to the First Hospital Affiliated to Army Medical University from January 1, 2015 to January 1, 2020. Based on whether complicated by NEC or not, all the subjects were assigned into the NEC group ( n=11) and non-NEC group ( n=69). Laboratory data for perinatal conditions, complete blood cell count, CRP, and blood culture in the early stage of LOS were recorded, and the decreased value of the hemoglobin concentration before and at early stage of LOS was calculated. Mann-Whitney U test, Chi-square test or Fisher exact probability method was used to compare the differences in perinatal conditions, blood routine, CRP and blood culture results between different groups. Binomial stepwise logistic regression analysis and the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and their predictive value for NEC secondary to LOS, respectively. Results:(1) There was no significant difference in gestational age, birth weight or other perinatal factors between the NEC group and non-NEC group (all P>0.05). (2) Mean platelet volume (MPV), CRP, and the hemoglobin decreased value in NEC group were greater than those in non-NEC group [11.7 fl (10.9-12.6 fl) vs 10.7 fl (10.3-11.6 fl), Z=－2.773; 33.3 mg/L (21.3-92.9 mg/L) vs 13.5 mg/L (4.7-27.3 mg/L), Z=－2.662; 25.0 g/L (18.0 -36.0 g/L) vs 13.0 g/L (1.0-19.0 g/L), Z=－3.803; all P<0.01]. (3) Binomial stepwise logistic regression analysis suggested that higher MPV at early stage of LOS ( OR=3.213, 95% CI: 1.104-9.354, P=0.032) and the decreased hemoglobin ( OR=1.153, 95% CI: 1.057-1.257, P=0.001) were independent risk factors for NEC secondary to LOS in preterm infants. (4) The cut-off values of MPV combined with the decreased value of hemoglobin for predicting NEC in premature infants with LOS were 11.2 fl and 14.0 g/L, respectively, with a sensitivity of 1.00 and specificity of 0.71. Conclusions:MPV combined with the decreased value of hemoglobin may help to predict NEC in the early stage of LOS for preterm infants.

Role of histone deacetylase 6 in epithelial-mesenchymal transition of renal tubular epithelial cells and activation of renal interstitial fibroblasts / 中华肾脏病杂志

Objective:To investigate the role and mechanism of (histone deacetylase 6, HDAC6) in the epithelial-mesenchymal transition (EMT) of renal tubular epithelial cells and the activation of renal interstitial fibroblasts.Methods:Human renal tubular epithelial cells (HK-2) and rat renal interstitial fibroblast (NRK-49F) were cultured in vitro, and divided into 4 groups: control group, Tubastatin A (TA) group (treated with 10 μmol/L HDAC6 inhibitor TA for 36 h), transforming growth factor-β1 (TGF-β1) group (10 ng/ml TGF-β1 for 36 h), and TGF-β1+TA group (treated with 10 ng/ml TGF-β1 and 10 μmol/L TA for 36 h). The expression levels of fibronectin, α-smooth muscle actin (α-SMA), collagen I, E-cadherin, HDAC6, acetyl histone H3, histone H3, acetyl α-tubulin, α-tubulin, TGF-β receptor (TGF-βR) 1, p-Smad3, Smad3, connective tissue growth factor (CTGF), epidermal growth factor receptor (EGFR) and p-EGFR in HK-2 and NRK-49F cell samples were detected by Western blotting, and quantitative analysis was performed according to gray level. Results:(1) In HK-2 cells stimulated by TGF-β1, TA decreased the expression of fibronectin, α-SMA, collagen I, and increased the expression of epithelial cell marker E-cadherin. Meanwhile, TA decreased the expression of HDAC6 and increased the expression levels of acetyl histone H3 and acetyl α-tubulin (all P<0.05). (2) Compared with the TGF-β1 group, the expressions of TGF-βR1, p-Smad3, CTGF and p-EGFR in TGF-β1+TA group were decreased (all P<0.05), while the total protein levels of Smad3 and EGFR were not significantly different (both P>0.05). (3) In NRK-49F cells stimulated by TGF-β1, TA decreased the expressions of fibronectin, α-SMA, collagen I, TGF-βR1 and p-Smad3 (all P<0.05). Conclusions:Blockade of HDAC6 by TA may inhibit the EMT of renal tubular epithelial cells and the activation of renal interstitial fibroblasts via regulating multiple signaling pathways including TGF-β/Smad3, CTGF and EGFR.

Progress of research on effect and mechanism of Scutellariae Radix on preventing liver diseases / 中国中药杂志

Scutellariae Radix is a kind of traditional Chinese medicine, which has the functions of heat-clearing and damp-drying, purging fire and detoxifying, hemostasis and miscarriage prevention. Modern pharmacological studies show that Scutellariae Radix has various effects, such as anti-oxidation, anti-inflammatory, liver protection and antiviral microorganisms. By searching the documents in the past ten years, the author has found that Scutellariae Radix and its active components play an important role in protecting the liver. It can prevent and cure liver injuries caused by different reasons, including acute or chronic hepatitis, liver fibrosis and liver cancer. Among all kinds(chemical, immunological, alcoholic, nonalcoholic, viral, ischemia-reperfusion, etc.) of acute or chronic hepatitis, most studies are on CCl_4 induced chemical liver injury. Scutellariae Radix and its active components can significantly reduce the serum transaminase level in hepatitis animals, and reduce the degree of liver pathological damage. The mechanisms include antioxidant stress, anti-inflammatory, anti-apoptosis, inhibition of immunity, anti-virus and regulation of lipid metabolism, etc. Scutellariae Radix and its active components can significantly inhibit the activation of hepatic stellate cells and reduce extracellular matrix, and its anti-fibrosis mechanism involves antioxidation, anti-inflammatory, inducing apoptosis of hepatic stellate cells and so on. Whether in vivo or in vitro, Scutellariae Radix and its active components show a good anti-hepatocarcinoma effect, especially on hepatocarcinoma. Its prevention and treatment mechanisms for hepatocarcinoma mainly include blocking cancer cell cycle, inhibiting cancer cell metastasis, promoting cancer cell apoptosis and inducing autophagy. It can be seen that Scutellariae Radix has multiple functions and mechanisms in liver protection, and has a great development potential. Therefore, this paper reviews the prevention and treatment effects and mechanism of Scutellariae Radix and its components on different liver diseases, in order to provide reference for in-depth study, development and clinical application in the prevention and treatment of liver disease.

Prediction of Pathological Subtypes of Lung Adenocarcinoma with Pure Ground Glass Nodules by Deep Learning Model / 中国医学科学院学报

To make a preliminary pathological classification of lung adenocarcinoma with pure ground glass nodules(pGGN)on CT by using a deep learning model. CT images and pathological data of 219 patients(240 lesions in total)with pGGN on CT and pathologically confirmed adenocarcinoma were collected.According to pathological subtypes,the lesions were divided into non-invasive lung adenocarcinoma group(which included atypical adenomatous hyperplasia and adenocarcinoma in situ and micro-invasive adenocarcinoma)and invasive lung adenocarcinoma group.First,the lesions were outlined and labeled by two young radiologists,and then the labeled data were randomly divided into two datasets:the training set(80%)and the test set(20%).The prediction Results of deep learning were compared with those of two experienced radiologists by using the test dataset. The deep learning model achieved high performance in predicting the pathological types(non-invasive and invasive)of pGGN lung adenocarcinoma.The accuracy rate in pGGN diagnosis was 0.8330(95% =0.7016-0.9157)for of deep learning model,0.5000(95% =0.3639-0.6361)for expert 1,0.5625(95% =0.4227-0.6931)for expert 2,and 0.5417(95% =0.4029-0.6743)for both two experts.Thus,the accuracy of the deep learning model was significantly higher than those of the experienced radiologists(=0.002).The intra-observer agreements were good(Kappa values:0.939 and 0.799,respectively).The inter-observer agreement was general(Kappa value:0.667)(=0.000). The deep learning model showed better performance in predicting the pathological types of pGGN lung adenocarcinoma compared with experienced radiologists.

Analysis of clinical significance of gonadotropin-releasing hormone and its receptor in breast cancer utilizing TCGA database / 中华内分泌外科杂志

Objective:To investigate the clinical significance of gonadotropin-releasing hormone (GnRH) and its receptor (GnRHR) expression in breast cancer.Methods:GnRH and GnRHR expression data in The Cancer Genomes Atlas (TCGA) database and its clinical information were downloaded. Statistically assessed was performed for relationship with clinicopathological factors and prognosis.Results:The expression of GnRH in breast cancer tissues was lower than that in normal breast tissue (0.42 vs 1.27, P=0.000) , and it was correlated with age ( P=0.046) , race ( P=0.000) , lymphnode status ( P=0.003) , ER ( P=0.000) , PR ( P=0.000) , and HER2 ( P=0.000) . The GnRH expression was higher in patients whose age ≤55 years, black or African American, lymphnode negative, ER negative, PR negative, and HER2 negative. Survival analysis suggested that the Overall Survival (OS) in GnRH high expression group was better than in low expression group ( P=0.018) . The expression of GnRHR in breast cancer tissues was similar to normal breast tissue (0.08 vs 0.07, P=0.778) , and it was correlated with age ( P=0.031) , race ( P=0.000) , ER ( P=0.000) , PR ( P=0.000) , and HER2 ( P=0.030) . The GnRHR expression was higher in patients whose age >55 years, white, ER positive, PR positive, and HER2 negative. There was no significant difference in OS between GnRHR high expression group and low expression group ( P=0.719) . Subgroup analysis showed that OS in GnRHR high expression group was better than in low expression group ( P=0.028) in the triple negative breast cancer subgroup, while GnRHR was not associated with OS in the non-triple negative subgroup ( P=0.976) . Conclusion:The expressions of GnRH and GnRHR are correlated with some clinicopathological parameters of breast cancer, and the prognosis of oreast cancer (especially triple negative breast cancer) . The GnRH and GnRHR signaling pathways maybe have tumor suppressor activity.

Epidemiological characteristics of 107 pediatric partients with COVID-19 during the initial phase of the outbreak / 中国学校卫生

Objective@#To describe the epidemiological characteristics and clinical manifestations of the 2019 coronavirus disease (COVID-19) in pediatric patients, and to provide data support and decision-making basis for the prevention and control of COVID-19.@*Methods@#Cases of children aged 0-17 years reported by provincial health commissions in Anhui, Shandong, Zhejiang and Henan provinces were collected to analyze their spatial, temporal, and demographic distribution.@*Results@#By 24:00 on February 6, 2020, a total of 107 pediatric patients had been reported in the four provinces, accounting for 3.8% (107/2 808) of the total cases reported in the four provinces during the same period. Anhui, Shandong, Zhejiang and Henan provinces had 25, 25, 28 and 29 cases, respectively. Cases ranged in age from 5 days after birth to 17 years, with a median age of 8 years. Boys accounted for 58.9%. Totally 38 cases had a history of sojourn in Wuhan or Hubei, 63 cases had a history of exposure to confirmed cases, and 6 cases with unknown exposure history. A group of 52 family clustering were found in 107 cases. All cases presented mild symptoms, no serious and no death.@*Conclusion@#Children were also susceptible to the COVID-19. Before February 2, the index pediatric cases were mainly the first generation cases, and after February 3, these pediatric cases were mainly the secondary-generation cases and those who had close contact with confirmed cases. The monitoring of children with secondgeneration cases and close contact with COVID-19 cases were valued.

Activation of aldehyde dehydrogenase 2 attenuates myocardial injury in diabetic rats by regulating two-pore potassium channel TASK-1 / 中南大学学报(医学版)

To investigate the effect of activating aldehyde dehydrogenase 2 (ALDH2) on TASK-1 two-pore potassium channel in myocardial injury of diabetic rats.
 Methods: Diabetic rats were induced by intraperitoneal injection of streptozotocin (55 mg/kg). The diabetic rats were divided into 4 groups: normal group, diabetes at 4th week (DM4W) group, diabetes at 8th week (DM8W) group, and diabetes at 8th week+low concentration of ethanol intervention (DM8W+EtOH) group. The cardiac function of rats was determined by cardiac ultrasonography. The content of hydroxyproline was detected by ELISA. The appearance of myocardial morphous and positive material were observed by HE and PAS staining. The protein expression of TASK-1 was detected by Western blot. Whole-cell patch clamp technique was used to record the action potential duration at 30% and 90% repolarization (APD30, APD90) and two-pore potassium channel TASK-1 current in rat ventricular myocytes. Meanwhile, according to the sensitive electrophysiological characteristics of the potassium channel to acid and base, whether it is two-port potassium channel TASK-1current can be determined.
 Results: Compared with the N group, end-diastole left ventricular diameter (LVIDd), end-systolic left ventricular diameter (LVIDs), hydroxyproline content, TASK-1 protein expression increased, APD30 and APD90 extend, left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF), and TASK-1 current decreased (all P<0.01) in the DM4W group and the DM8W group. HE staining showed that myocardial cell and fiber arrangement disorder, myocyte hypertrophy, myocardial widened and PAS staining reveals that positive material increased in the DM4W group and the DM8W group. Compared with the DM4W group, these changs are more obvious in DM8W rats (P<0.01 or P<0.05). Compared with the DM8W group, in the DM8W+EtOH group, the left ventricular function was restored, the hydroxyproline content and expression of TASK-1 protein were decreased, the TASK-1 current was increased, and APD30 and APD90 were shortened (all P<0.01). HE staining showed that myocardial cell injury was ameliorate and PAS staining showed decreased deposition of positive substances in the DM8W+EtOH group.
 Conclusion: Activation of aldehyde dehydrogenase 2 by low concentration of ethanol can reduce myocardial injury and fibrosis caused by diabetes, and its mechanism may be related to the changes of the two-por potassium channel TASK-1.

Sleep quality in preschool children in three provinces along the middle and lower reaches of the Yangtze River / 中国学校卫生

Objective@#To analyze the detection rate of sleep problems such as sleep delay and deficiency in preschool children in the middle and lower reaches of the Yangtze River in China,and to provide the reference for the standard of sleeping mode among preschool students.@*Methods@#From October to November 2017, a questionnaire survey was conducted among 27 200 preschool children in 11 cities in Hubei, Anhui and Jiangsu provinces in the middle and lower reaches of the Yangtze River in China. Epidemiology of sleep delays, deficiencies and sleep patterns in preschool children was described.@*Results@#The detection rate of sleep problems in preschool children in the middle and lower reaches of the Yangtze River was 15.3%. Taking the length of sleep and bedtime as the main analysis points, it was found that the average sleeping time point of each age group was 21:31, and the detection rate of bedtime delay was 86.5%. The average length of sleep was (10.60±1.12) hours. The detection rate of sleep deprivation in preschool children was 15.7%. Sleep delay was positively correlated with girls, age increase and parents’ higher educational level (P<0.05), and negatively correlated with living in the city, non-only child and bedroom without TV (P<0.01) .The detection rate of sleep deprivation was positively correlated with children of high age group (4yearold group：OR=1.32，95%CI=1.19-1.46；5-year-old group：OR=2.10，95%CI=1.91-2.32；6-year-old group：OR=2.47，95%CI=2.20-2.77)(P<0.01), and negatively correlated with no TV in bedroom (OR=0.91，95%CI=0.84-0.98) and no light in sleep (OR=0.87，95%CI=0.78-0.97)(P<0.05).@*Conclusion@#Preschool children sleep delay and sleep deprivation and other sleep problems are more prominent, affected by family environment and other factors.

Antibacterial and anti-biofilm activity of the lipid extract from Mantidis ootheca on Pseudomonas aeruginosa / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The aim of this study is to assess the antibacterial and anti-biofilm properties of the lipid extract from Mantidis ootheca against the gentamycin resistant Pseudomonas aeruginosa. The chemical composition of the lipid extract and its relative proportion were determined using the technique of gas chromatography coupled with mass spectrometry (GC-MS). Antibacterial susceptibility tests were performed using a disc diffusion assay and the minimum inhibition concentration (MIC) was determined by way of the agar dilution method. The anti-biofilm test was carried out with crystal violet staining and scanning electron microscopy (SEM). There were 16 compounds detected, and the most abundant components were sesquiterpenoids, monoterpenes, and trace aromatic compounds. The MIC for P. aeruginosa was 4 mg/ml and the eradication effect on preformed biofilms was established and compared with a ciprofloxacin control. The results of our study indicated that a lipid extract from M. ootheca could be used as a topical and antibacterial agent with anti-biofilm activity in the future.

Mitochondrial aldehyde dehydrogenase 2 protects against high glucose-induced injury in neonatal rat cardiomyocytes by regulating CaN-NFAT3 signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate whether CaN-NFAT3 pathway mediates the protective effects of aldehyde dehydrogenase (ALDH) 2 in high glucose-treated neonatal rat ventricular myocytes.@*METHODS@#The ventricular myocytes were isolated from the heart of neonatal (within 3 days) SD rats by enzyme digestion and cultured in the presence of 5-Brdu. After reaching confluence, the cultured ventricular myocytes were identified using immunofluorescence assay for -SA protein. The cells were then cultured in either normal (5 mmol/L) or high glucose (30 mmol/L) medium in the presence of ALDH2 agonist Alda-1, ALDH 2 inhibitor Daidzin, or Alda-1 and NFAT3 inhibitor (11R-VIVIT). Fluorescent probe and ELISA were used to detect intracellular Ca concentration and CaN content, respectively; ALDH2, CaN and NFAT3 protein expressions in the cells were detected using Western blotting.@*RESULTS@#Compared with cells cultured in normal glucose, the cells exposed to high glucose showed a significantly decreased expression of ALDH2 protein ( < 0.05) and increased expressions of CaN ( < 0.05) and NFAT3 proteins with also increased intracellular CaN and Ca concentrations ( < 0.01). Alda-1 treatment significantly lowered Ca concentration ( < 0.05), intracellular CaN content ( < 0.01), and CaN and NFAT3 protein expressions ( < 0.05), and increased ALDH2 protein expression ( < 0.05) in high glucose- exposed cells; Daidzin treatment significantly increased Ca concentration ( < 0.01) and intracellular CaN content ( < 0.05) in the exposed cells. Compared with Alda-1 alone, treatment of the high glucose-exposed cells with both Alda-1 and 11R-VIVIT did not produce significant changes in the expression of ALDH2 protein (>0.05) but significantly reduced the expression of NFAT3 protein ( < 0.05).@*CONCLUSIONS@#Mitochondrial ALDH2 protects neonatal rat cardiomyocytes against high glucose-induced injury possibly by negatively regulating Ca-CaN-NFAT3 signaling pathway.

Effects of irbesartan on Notch1 signaling pathway in diabetic rats with myocardial injury / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects and mechanisms of irbesartan on myocardial injury in diabetic rats, and to analyze the changes of Notch1 signaling pathway in it.@*METHODS@#Thirty rats were randomly divided into four groups:normal control group (CON, =6), high calorie group (HC, =6) and diabetes mellitus group (DM, =9), irbesartan + diabetes group (Ir + DM, =9). After modeling 8 weeks later, the body weight ratio and left ventricular weight index were measured and the serum levels of triglyceride (TG) and total cholesterol (TC) were measured by automatic biochemical analyzer. The changes of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in myocardium of rats were determined by the kit and the expressions of B-cell lymphoma-2 (Bcl-2) and Bcl-2 assaciated X protein (Bax) protein in myocardium were detected by immunohistochemistry. The expressions of Notch1, Hes-1 and jagged-1 in myocardium of rats were detected by Western blot.@*RESULTS@#Compared with CON group, the levels of heart weight/body weight (H/B), left ventricular weight index(LVWI) and fasting blood glucose(FBG) in HC group were not significantly changed, while the levels of blood lipids, MDA and Bax were increased significantly, and the expressions of SOD, Bcl-2 and Notch1, Hes-1 and Jagged-1 were decreased. Compared with HC group, the levels of H/B, LVWI, FBG, MDA and Bax in DM group were increased significantly, and the levels of SOD, Bcl-2 and Notch1, Hes-1 and Jagged-1 were decreased. The expression of H/B, LVWI, Notch1, Hes-1 and Jagged-1 in Ir+DM group were increased, but there was no significant difference between the other indexes. The H/B and LVWI in Ir + DM group were significantly lower than those in DM group, the levels of blood lipid and blood glucose did not change significantly, but the incidence of oxidative stress and apoptosis was reduced. While Notch1, Hes-1, Jagged -1 protein expressions were increased.@*CONCLUSIONS@#Diabetes can induce myocardial injury, and irbesartan has myocardial protective effects through activation of Notch1.

Changes of two-pore K+ channel TASK-1 in diabetic myocardial injury in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes of the two- pore K channel TASK-1 in diabetic rats with myocardial injury.</p><p><b>METHODS</b>Thirty-six SD rats were divided into normal group (N), diabetes at 4 weeks (DM 4W) group, and diabetes at 8 weeks (DM 8W) group. The cardiac functions of the rats were determined using cardiac ultrasonography, and the body weight and heart weight of the rats at different time points were measured to calculate the heart/body weight ratio (HW/BW). Myocardial fibrosis in the rats was assessed using Masson's staining. The protein expression of TASK-1 in the myocardium was detected using Western blotting. Whole- cell patch clamp technique was used to record the action potential duration (APD) and twopore domain potassium channel TASK- 1 current in acutely isolated rat ventricular myocytes. meanwhile, The inhibition of TASK-1 current was observed by the TASK-1 specific inhibitor ML-365.</p><p><b>RESULTS</b>Compared with the normal group, the diabetic rats showed significantly increased HW/BW ( < 0.05), end- diastole left ventricular diameter (LVIDd), end- systolic left ventricular diameter (LVIDs), and TASK-1 protein expression, with obviously decreased left ventricular diameter shortening rate (FS) and ejection fraction (EF) ( < 0.01). Masson staining showed that in diabetic rats, the collagen fibers were thickened, interwoven into a network with uneven arrangement and increased deposition. Compared with DM 4W group, the rats in DM 8W group exhibited progressive increases in LVIDd, LVIDs, HW/BW, and TASK-1 expression ( < 0.01 or 0.05); FS and EF were further decreased ( < 0.01). Masson staining showed worsened morphological changes of the myocardium with increased deposition. Compared with that in the normal group, the current of TASK- 1 in diabetic rats at 8 weeks was significantly reduced ( < 0.01) and the duration of action potential was extended ( < 0.05). The TASK-1 current was successfully inhibited by ML-365.</p><p><b>CONCLUSIONS</b>Diabetes can induce myocardial fibrosis and aggravate myocardial injury possibly in relation to changes in the protein expression and current of the two-port potassium channel TASK-1.</p>

Effect of low-dose ethanol consumption on expression of nuclear factor-κB in diabetic rats with myocardial injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of low-dose ethanol on the expression of nuclear factor-κB (NF-κB) in diabetic rats with myocardial injury.</p><p><b>METHODS</b>Rat models of diabetes were established by an intraperitoneal injection of 55 mg/kg streptozotocin (STZ). After successful modeling, the rats were given 2.5% ethanol (daily dose of 20 mg/kg) for 1 week, followed by 5% ethanol (daily dose of 39.45 mg/kg) for another 7 weeks. Normal rats without STZ injection and diabetic rats without ethanol treatment serve as the normal control and diabetic model groups, respectively. The ventricular function of the rats was determined using echocardiography. The plasma levels of interleukin-1 (IL-1) and IL-4 were detected in the rats, and the expressions of 4-HNE, NF-κB and IKK proteins in the left anterior myocardium was evaluated using immunohistochemistry or Western blotting; the ultrastructural changes of the myocardium were observed using transmission electron microscopy.</p><p><b>RESULTS</b>Compared with the normal control group, the diabetic rats showed significantly lowered systolic and diastolic functions of the left ventricle, increased plasma level of IL-1 and myocardial 4-HNE expression ( < 0.01), decreased plasma level of plasma IL-4 ( < 0.01), and increased myocardial expressions of NF-κB and IKK proteins ( < 0.01). Transmission electron microscopy revealed myofibrillar rupture, incomplete myofibrillar structure and mitochondrial damage in the cardiac myocytes in the diabetic rats. Compared with the diabetic rats, the rats with low-dose ethanol treatment exhibited improved systolic and diastolic functions of the left ventricle, milder myocardial myofibrillar and mitochondrial damages, and significantly lowered plasma IL-1 level and myocardial expressions of 4-HNE, NF-κB and IKK ( < 0.01), and increased plasma IL-4 level ( < 0.01).</p><p><b>CONCLUSIONS</b>NF-κB expression is increased in the myocardium of diabetic rats with myocardial injury, and low-dose ethanol consumption lowers myocardial expression of NF-κB in diabetic rats, suggesting the involvement of NF-κB signaling pathway in the protective effect of low-dose ethanol against myocardial injury in diabetes mellitus.</p>

Transarterial Infusion Chemotherapy With and Without Embolisation in Hepatocellular Carcinoma Patients: A Systematic Review and Meta-Analysis

<p><b>INTRODUCTION</b>The purpose of this meta-analysis was to compare the efficacy of transarterial chemoembolisation (TACE) and iodised oil infusion chemotherapy without embolisation (TAI) in patients with hepatocellular carcinoma.</p><p><b>MATERIALS AND METHODS</b>We searched for randomised controlled trials, retrospective cohort studies, and two-arm prospective studies that compared the clinical outcomes in patients who received TACE and TAI treatment. Database search was performed through 14 December 2016. Rates of survival and therapy response were compared using odds ratios (OR) with 95% confidence intervals (CI).</p><p><b>RESULTS</b>Survival rates and therapy response rates were similar between patients who received TACE and TAI treatments (pooled OR: 1.278; 95% CI, 0.783 to 2.086,= 0.327; and pooled OR: 1.502; 95% CI, 0.930 to 2.426,= 0.096, respectively).</p><p><b>CONCLUSION</b>Our results suggest that treatment intensification by adding embolisation did not increase overall survival and therapy response over TAI in patients with hepatocellular carcinoma.</p>

Clinical Observation of Xiaozhen Zhiyang Spray in the Treatment of EGFRI-associated Rash / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of Xiaozhen zhiyang spray in the treatment of EGFRI-asso-ciated rash. METHODS:A total of 60 malignant tumor patients suffering from rash induced by EGFRI were divided into trial group (40 cases)and control group(20 cases)according to the patient's willingness. Control group didn't received any therapy for rash. Trial group received Xiaozhen zhiyang spray for several times a day according to the degree of rash as 1-2 times/d for first degree, 2-3 times/d for second degree,3-5 times/d for third degree,and the treatment course lasted for 2 weeks. Rash degree and improve-ment,itching degree and improvement,daily life quality index(DLQI)score before and after treatment as well as the occurrence of ADR were compared between 2 groups. RESULTS:before treatment,there was no statistical significance in rash and itching de-gree,or DLQI score between 2 groups(P>0.05). After treatment,rash and itching degree of trial group were improved significant-ly compared to before treatment and control group,with statistical significance(P0.05). No obvious ADR was found in trial group. CONCLUSIONS:Xiaozhen zhiyang spray can effectively relieve EGFRI-associated rash and itching as well as improve the quality of life for patients.

Expression and its clinical significance of G-protein coupled receptor 49 in pancreatic carcinoma / 中华消化杂志

Objective To investigate the clinical significance and biological role of G-protein coupled receptor 49(GPR49) expression in pancreatic carcinoma.Methods GPR49 expression in tumor and adjacent normal tissues of 77 patients with pancreatic cancer was compared by tissue microarray and immunohistochemistry.And then, the GPR49 expression levels in the tumor tissues of patients with different pathological grades and clinical stages were analyzed.GPR49 positive pancreatic cancer cell line CFPAC-1 was taken as cellular model.CFPAC-1 cells were stimulated with roof plate-specific spondin(RSPO)1, the ligand of GPR49, in vitro.The effect of RSPO1 on CFPAC-1 cells proliferation was evaluated with cell counting.The effect of RSPO1 on the expression of membrane molecular CD44 in CFPAC-1 cells was detected by flow cytometry.CFPAC-1 cells incubated with RSPO1 were subcutaneously implanted into nude mice.And then, the time of tumor formation and tumor size were observed.T test and single factor analysis of variance were performed for statistical analysis.Results GPR49 was widely expressed in all 77 pancreatic cancer tissues.By immunohistochemistry, the score of GPR49 expression in pancreatic cancer tissues was 9.0±2.4, which was higher than that of adjacent normal tissues (5.7±2.4), and the difference was statistically significant (t=8.995, P0.05).The results of experiments in vitro indicated that RSPO1 could promote CFPAC-1 cells proliferation and up-regulate CD44 expression in CFPAC-1 cells.Experiments in vivo demonstrated that after 30 days the tumor volume of mice implanted with RSPO1-pretreated CFPAC-1 cells was (606.0±188.0) mm3, which was larger than that of PBS-pretreated group ((364.2±83.7) mm3), and the difference was statistically significant (t=2.616, P=0.031).Conclusion GPR49 is widely expressed in pancreatic cancer cells and RSPO1/GPR49 pathway has play a role in promoting the proliferation of pancreatic cancer cells, which might be a potential target for interfering pancreatic cancer.

Analysis on the Liabilities of Urban Public Hospitals in Jiangxi / 中国卫生经济

Objective:To understand the liability situation of urban public hospitals in Jiangxi.Methods:Qualitative and quantitative analysis,descriptive analysis and comparative analysis were used to analyze the causes and changes of urban public hospitals' debt increase.Results:To meet the increasing demand for health diagnosis and services,debt infrastructure and the purchase of equipment coupled with inadequate financial investment were performed in public hospitals,which resulted in the sustainably increasing of liabilities level in urban public hospitals.Conclusion:Governments at all levels should increase the capital expenditure of hospital construction and equipment investment,strictly control the public hospital debt behavior,the implementation of the reform of public hospitals canceled drug addition,establishing the characteristics of the medical industry personnel salary system and other measures to resolve the synchronous speed of public hospital debt and prompt public hospital debt risk control in the reasonable scope.