Liver cell therapies: cellular sources and grafting strategies / 医学前沿

The liver has a complex cellular composition and a remarkable regenerative capacity. The primary cell types in the liver are two parenchymal cell populations, hepatocytes and cholangiocytes, that perform most of the functions of the liver and that are helped through interactions with non-parenchymal cell types comprising stellate cells, endothelia and various hemopoietic cell populations. The regulation of the cells in the liver is mediated by an insoluble complex of proteins and carbohydrates, the extracellular matrix, working synergistically with soluble paracrine and systemic signals. In recent years, with the rapid development of genetic sequencing technologies, research on the liver's cellular composition and its regulatory mechanisms during various conditions has been extensively explored. Meanwhile breakthroughs in strategies for cell transplantation are enabling a future in which there can be a rescue of patients with end-stage liver diseases, offering potential solutions to the chronic shortage of livers and alternatives to liver transplantation. This review will focus on the cellular mechanisms of liver homeostasis and how to select ideal sources of cells to be transplanted to achieve liver regeneration and repair. Recent advances are summarized for promoting the treatment of end-stage liver diseases by forms of cell transplantation that now include grafting strategies.

Research progress on sugar substitutes and human health / 环境与职业医学

Sugar reduction and restriction have become one of the most urgent health demands as the number of obese people increases globally. Sugar substitutes (mainly classified into sugar alcohols, natural sweeteners, and artificial sweeteners) have been widely used in food processing as alternatives to sugar for their low energy and high sweetness. Thus, the classification, metabolism pathways, advantages, applications, and human health effects of sugar substitutes, their effects on human health were introduced, and the relationships between sugar substitutes and obesity, diabetes, intestinal microbes, hypertension, and all-cause mortality were emphatically summarized in this paper. Generally, long-term high intake of sugar substitutes is associated with adverse health outcomes such as elevated blood pressure, higher risks of diabetes, cancer, and increased all-cause mortality. Meanwhile, sugar alcohols and natural sweeteners are more likely to associate with beneficial effects on human gut microbial diversity, while artificial sweeteners associate with imbalance of gut microbiota based on available evidence. Current published research focuses on single sugar substitute exposure with varied health effects, while nearly half of commercial sugar substitute products contain two or more sugar substitutes. The effects of exposure to multiple sugar substitutes on human health are not clear yet, so further strengthening the relevant epidemiological and molecular mechanism research is necessary.

Comparative study on pathological characteristics of four different antigen-induced rheumatoid arthritis mouse models / 药学学报

Rheumatoid arthritis (RA) is an autoimmune disease driven by antigens and mediated by T cells. Collagen II (CII) and fibrinogen (Fib) are the two main antigens in the pathogenesis of RA. The antigen produced after citrulline modification (Cit) is also one of the inducements to induce the body to produce a pathogenic anti-citrulline protein antibody (ACPA). To provide a reference for RA-related research, this study intends to establish an RA animal model by using CII, Cit-CII, Fib, and Cit-Fib antigens, emulsification with complete Freund's adjuvant and immunization with DBA/1 mice, respectively, to compare the pathological characteristics of RA models induced by different antigens from the aspects of pathology, imaging and serum biochemistry. Animal welfare and experimental process are in accordance with the regulations of the Experimental Animal Ethics Committee of the China Academy of Chinese Medical Sciences. The results showed that the CII, Cit-CII, and Cit-Fib induced mice all had symptoms such as joint redness and swelling, and toe deformation and the clinical score and incidence rate were higher than those of the normal group. The CII group had the most serious lesions, with a incidence rate of 100%, and the Cit-CII and Cit-Fib groups had mild symptoms, with a incidence rate of 25% and 37.5%, respectively; pathological and imaging examination results showed that the joints of mice in CII-induced group showed severe synovial inflammation, cartilage and bone destruction, while those in Cit-CII and Cit-Fib group showed only slight inflammatory infiltration, joint cavity stenosis and bone destruction; the results of serum antibody detection showed that CII, Cit-CII and Cit-Fib groups all produced high levels of anti-cyclic citrullinated peptide (CCP) antibodies, among which, Cit-Fib group > Cit-CII group > CII group > Fib group, and both Cit-CII and Cit-Fib groups produced high levels of citrullinated epitope-specific antibodies, while the total IgG level was the highest in CII group; serum ELISA and RT-PCR analysis of joint tissue showed that the expression of pro-inflammatory factors and bone destruction-related molecules increased most significantly in the CII-induced group, followed by Cit-Fib and Cit-CII. The above results showed that among the four different antigens, the symptoms and conditions of arthritis in RA mice induced by CII were the most serious, and IgG instead of anti-CCP antibody was its typical immunological feature, and CII could be the first choice for the model of RA mice; Cit-Fib has certain immunogenicity, can partially induce the symptoms and conditions of RA arthritis in mice, and produce high-level anti-CCP antibody and anti-Cit-Fib antibody, which is more suitable for the study of citrulline-related RA; although Cit-CII has certain immunogenicity, the incidence, and severity of RA arthritis induced by Cit-CII in mice are low.

New Advances, Challenges and Opportunities in Forensic Applications of Microbiomics / 法医学杂志

The succession of microbiota is closely associated with several essential factors, including race, sex, health condition, lifestyle, postmortem interval, etc., and it has great potential application value in forensic medicine. This paper summarizes recent studies on the forensic applications of the microbiome, including individual identification, geographical feature identification, origin identification of the tissue or body fluid, and postmortem interval estimation, and introduces the current machine learning algorithms for microbiology research based on next-generation sequencing data. In addition, the current problems facing forensic microbiomics such as the extraction and preservation of samples, construction of standardization and database, ethical review and practical applicability are discussed. Future multi-omics studies are expected to explore micro ecosystems from a comprehensive and dynamic perspective, to promote the development of forensic microbiomics application.

Effectiveness of precise prevention and control strategies of dynamic zero COVID-19 in Ningbo, Zhejiang province / 中华流行病学杂志

Objective: To evaluate effectiveness of the precise prevention and control strategies of dynamic zero COVID-19 in Ningbo, Zhejiang province. Methods: Based on the incidence data of COVID-19 and case epidemiological survey report in Ningbo in December 2021, the incidence curve of COVID-19 was generated and a dynamics model was developed to estimate the case number of under different intervention measures. The basic reproduction number (R0) and real-time reproduction number (Rt) were calculated to evaluate intervention effect. Results: A total of 74 cases of COVID-19 had been confirmed in Ningbo as of 17 December, 2021. The R0 was estimated to be 4.3. With the strengthening of prevention and control measures, the Rt showed a gradual downward trend, dropping to below 1.0 on December 11 and 0.4 on December 14. The model fitting results showed that the actual case number was close to the estimated case number (76 cases) when the effectiveness of intervention was 90%. The number of cases decreased by 98.4% compared with that if no intervention was taken. Conclusion: The precise prevention and control strategies of dynamic zero COVID-19 have obvious effect, which can facilitate the rapid control of COVID-19 epidemic in Ningbo.

Segmentation of core infarct in acute ischemic stroke in diffusion weighted imaging using cascaded VB-Net / 中华放射学杂志

Objective:To explore the detection and segmentation of ischemic core infarct volume of the acute stroke in diffusion weighted imaging (DWI) images using cascaded VB-Net.Methods:MRI data of 1 500 patients (2 456 lesions) with acute ischemic stroke in Henan Provincial People′s Hospital from December 2016 to December 2018 were retrospectively analyzed. Firstly, manual segmentation of ischemic core was performed on DWI images (b=1 000 s/mm 2), and then all data were divided into training set, validation set and independent test set by 8∶1∶1. Then, the cascaded VB-Net was constructed, and the core infarct was automatically detected and segmented in the test set. Interclass correlation coefficient (ICC) was used to evaluate the consistency of volume size measured by manual segmentation and cascaded VB-Net. The patients were divided into large ischemic core lesion group (ischemic core volume ≥10 ml) and small ischemic core lesion group (ischemic core volume<10 ml), and the Dice coefficient difference between the two groups was compared using Mann-Whitney U test. Results:In independent test set, cascaded model had the detection rate of 94.6% (243/257) with Dice coefficient of 0.76 (0.68, 0.84). The agreement of cacade VB-Net segmented [4.19(1.21,14.13)ml] and manual segmented ischemic core infarct volume [4.08(1.19,17.92)ml] was high (ICC=0.97, P<0.001). There was no significant difference in Dice coefficient between large and small lesion groups [0.76 (0.69, 0.85), 0.76 (0.67, 0.84), Z=-0.44, P=0.657]. Conclusions:The cascaded VB-Net model provided a tool to realize automatic detection, segmentation, and calculation of ischemic core infarct volume. It has good segmentation accuracy and high consistency with manual segmentation, which can provide an auxiliary decision-making tool for the selection of treatment plans.

Effect of Jianpi Huogu Formula on function damage of vascular endothelial cells induced by glucocorticoid / 中国中药杂志

This study aimed to observe the intervention effect of Jianpi Huogu Formula(JPHGF) on the functional damage of vascular endothelial cells caused by glucocorticoid, and explore its action mechanism from the PI3 K/Akt and mitogen activated protein kinase(MAPK) signaling pathways. The extracted thoracic aorta ring of normal SD rats were intervened first with vascularendothelial growth factor(VEGF, 20 μg·L-1) and/or sodium succinate(MPS, 0. 04 g·L-1) in vitro and then with JPHGF(8, 16, and 32 μg·L-1) for five mcontinuous ethylpdays, rednisolofollowed nebythe statistics of the number, length, and area of microvessels budding fromvascular rings. In addition, the human umbilical vein endothelial cells(HUVECs) induced by VEGF(20 μg·L-1) were added with MPS(0. 04 g·L-1) and then with JPHGF(8, 16, and 32 μg·L-1) for observing the migration, invasion, and luminal formation abilities of HUVECs in the migration, invasion and luminal formation experiments. The protein expression levels of PI3 K, p-Akt, p-JN K, and p-ERK in HUVECs were assayed by Western blot. The results showed that JPHGF dose-dependently improved the num-ber,length, and area of microvessels in MPS-induced rat thoracic aortic ring, reversed the migration, invasion and lumen formation abiliti es of HUVECs reduced by MPS, and up-regulated the protein expression levels of PI3 K, p-Akt, and p-JNK in HUVECs. All thesehave suggested that JPHGF exerts the protective effect against hormone-induced damage to the angiogenesis of vascular endothelial cells by activating the PI3 K/Akt and MAPK signaling pathways, which has provided reference for exploring the mechanism of JPHGF in treating s teroid-induced avascular necrosis of femoral head(SANFH) and also the experimental evidence for enriching the scientific connotationof spleen-invigorating and blood-activating therapy.

Epidemiological and etiological characteristics of hand, foot and mouth disease among children aged 5 years and younger in Ningbo (2016 to 2019) / 北京大学学报(医学版)

OBJECTIVE@#To describe the epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) among children aged 5 years and younger in Ningbo after the access of entero-virus-A71 vaccine (2016 to 2019).@*METHODS@#A retrospective cohort study were performed in children aged 5 years and younger in Ningbo from 2016 to 2019. Data for incidence of HFMD was collected from the National Notifiable Disease Surveillance Reporting System and the Electronic Medical Records (EMRs) System, while the demographic information was derived from the Immunization Information System. Speci-mens were detected by real-time fluorescence quantitative PCR and the Wilson method was used to estimate the incidence rate and 95% confidence interval.@*RESULTS@#From 2016 to 2019, a total of 1 044 800 residential children were observed in this population-based cohort. In the study, 102 471 cases of HFMD were diagnosed in 2 651 081 person-years, revealing an overall incidence density of 3 865.25/100 000 person-years. There was no significant decline in the number of the cases after the vaccine was available. The number of the patients of hand foot mouth disease during the four years was 93 421, of whom 84 875 (90.85%) had only one incident record, while 8 946 (9.15%) had 2 or more cases in this period; there were 69 771 (66.06%) patients who only needed to see a doctor once for each disease, 19.92% of the patients needed to be treated twice, and 14 801 (14.02%) patients needed to go to the hospital or clinic three times or more. The incidence of HFMD showed obvious seasonality and periodicity, which mainly concentrated in April to July each year, and the epidemic cycle was 2 years; most of the cases were 1 to 3-year old children, with more cases in male. The incidence density varied across the region, with the highest density observed in Ninghai (4 524.76/100 000 person-years), followed by Xiangshan (3 984.22/100 000 person-years). In 3 748 library-conformed cases, 2 834(75.61%) were detected positive, among which enterovirus-A71, Cox-A16 and other enteroviruses accounted for 9.03%, 31.55% and 59.42%, respectively. During the study period, the cumulative coverage of enterovirus-A71 vaccine increased year by year, with the proportion of enterovirus-A71 and severe cases both gradually decreasing.@*CONCLUSION@#The current status of hand, foot and mouth disease in Ningbo is still serious. Children under 3-year old (especially male children aged 1 year) were the key population for prevention and control. Vaccination might lead to changes in major pathogenic virus type, of which more attention should be paid to the potential impact on disease surveillance, prevention and control.

Epidemiological study of infantile epilepsy incidence density among infants under 36 months of age in Ningbo City from 2015 to 2019 / 北京大学学报(医学版)

OBJECTIVE@#To describe the distribution and trend of infantile epilepsy among infants under 36 months in Ningbo, Zhejiang Province.@*METHODS@#Using the birth cohort design, we retrospectively collected the local born infants in Ningbo national health information platform from 2015 to 2019, and took the first visit of epilepsy in the electronic medical record of the platform as the new case. The incidence density and 95% confidence interval (CI) of epilepsy were estimated by Poisson distribution.@*RESULTS@#From 2015 to 2019, a total of 294 900 children were born in Ningbo, with male accounting for 51.92%. The total person-years of observation were 595 300, while the median follow-up person-years was 2.31 [interquartile range (IQR): 1.90]. There were 575 new onset epilepsy patients during the whole observation period. The total number of visits was 2 599, with an average of 4.52. The total incidence density was 96.59/100 000 person-years (95%CI: 88.85-104.82). The median age of onset was 13 months (IQR: 15), 0-12 months old infants had the highest incidence density (102.18/100 000 person-years), 25-36 months old infants had the lowest incidence density (89.68/100 000 person-years), and the difference was not statistically significant (P>0.05). The incidence density of male was 97.58/100 000 person-years, female was 95.53/100 000 person-years, and the difference was not statistically significant (P>0.05). Fenghua was the highest (130.54/100 000 person-years, 95%CI: 94.47-175.83) and Ninghai was the lowest (66.44/100 000 person-years, 95%CI: 47.02-91. 19), with significant difference (P < 0.05). There was no significant difference in the incidence density in different birth years (P>0.05). There was significant difference in the incidence density between 0-12 months old infants in different calendar years (Ptrend < 0.05). In this age group, the incidence density was the lowest in 2015 (69.41/100 000 person-years, 95%CI: 41.79-108.39), and the highest in 2019 (225.61/100 000 person-years, 95%CI: 186.10-271.03). There was no significant difference in the incidence density between 13-24 and 25-36 months old infants in different calendar years (P>0.05).@*CONCLUSION@#The incidence density of epilepsy in 0-36 months old infants in Ningbo City from 2015 to 2019 was low as a whole, and there was no difference in age group, gender, and year of birth. The incidence density of 0-12 months old infants increased with the year.

Research Progress on Pathological Fibrosis of Sinoatrial Node / 法医学杂志

Human heart rhythm is mainly regulated and controlled by the sinoatrial node. Fibrosis plays an important regulating role in adjusting the structural and functional integrity of the sinoatrial node pacemaker complex. In physiological state, the fibrosis degree of sinoatrial node is negatively correlated with heart rate, positively correlated with age and heart size, and can maintain a relatively stable heart rate. Pathological fibrosis of sinoatrial node can induce various types of arrhythmias which can result in sudden death. Determination of the mechanisms related to sinoatrial node pathological fibrosis could provide a target for clinical treatment of sinoatrial node fibrosis and diagnosis basis for forensic pathologists. This paper reviews the main mechanism of sinoatrial node pathological fibrosis, including abnormal activation of cardiac fibroblast cells in sinoatrial node, hyperplasia of epicardial adipose tissue, calcium clock disorder, artery stenosis, etc., introduces the test methods, diagnostic criteria as well as its role in sudden cardiac death and discusses the potential application, to provide reference for relevant research and application.

Advance on pharmacokinetics study of traditional Chinese medicine injections in recent ten years / 中国中药杂志

Traditional Chinese medicine(TCM) injections boast a definite efficacy and have been widely used in clinic. However, the problems in medication safety have been attracted increasing attention. Pharmacokinetics is of significance to guiding TCM injection administration regimen design and improving safety and effectiveness in clinical use. In recent years, with the improvement of ideas, technology and methods of TCM studies, the pharmacokinetic studies of TCM injections have been broadly performed, with a notable progress. This paper reviewed the advance in pharmacokinetics studies of TCM injections in recent ten years, which mainly focused on pre-clinical concentration-time course, distribution, metabolism and excretion in vivo based on analysis techniques, pharmacokinetic interactions of constitutes, impact of pathological state, pharmacokinetic interactions between TCM injection and chemical drugs, and clinical pharmacokinetics studies of TCM injections, in the expectation of providing reference for studies on quality control, product development and rational clinical use of TCM injections.

New Opportunities and Challenges for Forensic Medicine in the Era of Artificial Intelligence Technology / 法医学杂志

Traditional forensic identification relies on forensic experts to manually extract information and provide identification opinions based on medicine, biology and other fields of knowledge combined with personal work experience, which is not only time-consuming and require great effort, but also affected by subjective factors that are difficult to overcome. In the era of big data, the booming development of artificial intelligence brings new ideas to forensic medicine. In recent years, forensic researchers at home and abroad have conducted many studies based on artificial intelligence technology, such as face recognition, age and gender identification, DNA analysis, postmortem interval estimation, injury and cause of death identification, showing the feasibility and advantages of using artificial intelligence technology to solve forensic identification problems. As a new means of technology that has adapted to the development of the times, artificial intelligence has brought new vitality to forensic medicine, but at the same time also some new challenges. How to deal with these challenges scientifically and form a new mode of 'artificial intelligence plus forensic medicine' with artificial intelligence and forensic medicine developing collaboratively is a new direction for the development of forensic medicine in the era of big data.

Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19 / 中华创伤杂志(英文版)

Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

Detection of Ancestry Information of Urumqi Mongolians Based on the AIM-InDels Loci Multiplex System / 法医学杂志

Objective To explore the genetic background and structure of Urumqi Mongolians, the previously developed 39-AIM-InDels panel for ancestry inference was utilized in the present study. Methods The blood samples of 145 unrelated healthy Urumqi Mongolian individuals were collected and genotyped. The compositions of ancestry information of Urumqi Mongolians were studied with 17 different populations from three continents （East Asia, Europe and Africa） as reference populations. Then, multiple population genetics and bioinformatics analysis methods were applied, the Fst and DA values between matched populations were compared and analyzed, PCA analysis was performed and a phylogenetic tree was constructed. The proportions of ancestry information components of Urumqi Mongolians were analyzed with Structure software, etc. Results The ancestry information components of Urumqi Mongolian group in different intercontinental populations accounted for 89%, 7%, and 3% of East Asian, European, and African populations, respectively. Compared with other intercontinental populations, Urumqi Mongolian group and East Asian populations have lower Fst and DA values, and they were in the same cluster in PCA analysis as well. In a phylogenetic tree, the Urumqi Mongolian group was in the same branch as East Asian populations. Conclusion Urumqi Mongolian group had relatively close genetic relationships with East Asian populations, and the proportion of its East Asian ancestry was about 89%.

Evaluation of health working environment by ICU nurses based on empowerment management model: a cross-sectional research / 中国实用护理杂志

Objective@#To investigate the current status of ICU nurses′ evaluation of clinical health work environment and its influence factor under the foundation of empowerment management model.@*Methods@#This study included 162 ICU nurses from Renmin Hospital of Wuhan University. The Chinese version of the Essentials of Magnetism II was used to evaluate the healthy working environment and another two 0–10 single-item scales was used to evaluate job satisfaction and quality of care.@*Results@#The total score of nurses on the healthy working environment was (183.75±1.56), and score of each dimensions were included medical relationship(2.83±0.43), support for training(2.88±0.05), autonomy of nursing work (2.98±0.03), nursing practical control(2.93±0.03), adequate nursing staff(2.83±0.33), colleagues′ clinical competence(3.37±0.04), nursing manager support(3.50±0.04), cultural values(3.48±0.04), the satisfaction of nursing work(8.12±0.14) and the quality of care evaluation(8.66±0.12) were higher. There were significant statistical difference in the evaluation of nurses′ healthy working environment on age, working years, education and level of authorization. The degree showed low level negative correlation degree and healthy working environment (r=-0.299, P=0.000), the level of authorization showed low level correlation degree and healthy working environment (r=0.236, P=0.003). The independent variable could explain 97.9% of the variation of the dependent variable, among which nursing manager support and cultural values and adequate nursing staff had a high explanatory power for the evaluation of healthy working environment.@*Conclusions@#ICU nurses have a higher evaluation of the healthy working environment. Nursing managers should be concerned about more support to different levels of nurses, pay attention to the needs of training, promote the harmonious development of doctor-nurse relationship, improve healthy working environment focuses on the process of nursing manager support and cultural values and adequate nursing staff,so to create a magnetic professional environment that will satisfy the nurses are helpful to improve the quality of care.

Relationship between Alzheimer's disease and non-verbal listening comprehension obstacle / 中华老年医学杂志

Objective To study the relationship between Alzheimer's disease(AD)and nonverbal listening comprehension obstacle,and to observe the different specific performance of AD patients in the non-verbal listening comprehension tests involving music and non-verbal semantics,in order to identify the yalue of these tests in the differential diagnosis of AD.Methods The internalized 104 subjects meeting inclusion and exclusion criteria were divided into 4 groups of normal group(n =24),a-MCI group(amnesia-mild cognitive impairment,n =30),mild-AD group (n =27) and moderate AD group (n =23).All subjects received a series of central non-verbal listening comprehension tests which were scored and evaluated,including categorizing and naming according to the sound which involved the non-verbal semantic aspect,judging the emotion and rhythm according to the melody which involved the music aspect.Then the scores were analyzed.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA) were used for assessing the degrees of cognitive impairment.Results All test scores had a positive moderate to high correlations with MMSE and MoCA(all r＞0.4,P＜0.01),in which sound classification and nomination had better positive correlations than other tests.The statistically significant differences were found in all tests among the four groups(all P＜0.05).There was a significant difference in sound nomination between a-MCI group and normal group(P＜ 0.05).There were significant differences in sound classification,nomination and judging melody rhythm between mild AD group and normal group or a-MCI group (both P ＜0.05).There were significant differences in all tests between moderate AD group and normal group or a-MCI group (both P ＜ 0.05).The sound classification tests,especially sound nomination tests,had better diagnostic value than the rhythm and emotion judgment tests for identifying AD.Conclusions Patients with AD,even with a-MCI,can develop the non-verbal listening comprehension obstacle,which is aggravated along with the exacerbation of cognitive impairment.AD patient's semantic aspect-involving non-verbal listening ability degeneration is faster than involving the music aspect.Non-verbal listening comprehension tests involving non-verbal semantic aspect,especially sound nomination tests,have better diagnostic values.

Research advances in augmented renal clearance in critically ill children / 中国当代儿科杂志

In recent years, the concept of "augmented renal clearance" (ARC) has been proposed in the field of critical illness and is defined as enhanced renal clearance of drugs. ARC is considered when the creatinine clearance rate exceeds 130 mL/(min·1.73 m). An increasing number of evidence has shown that ARC is commonly seen in critically ill adults and children. In critically ill children, low drug concentration due to ARC may lead to treatment failure. Unfortunately, ARC is often neglected due to the lack of reliable tools to assess renal function in critically ill children. Therefore, with reference to the articles on ARC in critically ill children, this article reviews the concept of ARC, the pathogenesis of ARC, the influencing factors for ARC, the identification tools for ARC, and the influence of ARC on pharmacokinetics/pharmacodynamics of antibacterial agents and clinical outcome, in order to provide a reference for clinical medication.

Vertebral Artery Dissection Probably Caused by Massage: A Case Report / 中国医学科学杂志(英文版)

MASSAGE has been recommended to more people as an adjunct to health care. We illustrate a case of vertebral artery dissection (VAD) probably caused by massage that almost resulted in the patient's death. The patient experienced sudden cardiac arrest and paralysis. After treatment with anticoagulation and antiplatelet, he finally discharged without any sequelae.

Effects of high glucose induced primary cardiomyocytes injury on necroptosis and the related mechanism / 中国应用生理学杂志

OBJECTIVE@#To observe whether necroptosis was happened in high glucose (HG) - induced primary cardiomyocytes injury and to investigate the likely mechanism.@*METHODS@#The primary cultured cardiomyocytes were divided into 4 groups (n=9): control group (the cardiomyocytes were incubated with 5.5 mmol/L glucose for 48 h), HG group (the cardiomyocytes were incubated with 30 mmol/L glucose for 48 h), HG + necrostatin-1 (Nec-1) group (the cardiomyocytes was co-incubated with necroptosis inhibitor Nec-1 at 100 μmol/L and HG for 48 h) and hypertonic pressure group (HPG, the cardiomyocytes was co-incubated with 5.5 mmol/L glucose and 24.5 mmol/L mannitol for 48 h). Cell viability was measured by MTT method, reactive oxygen species (ROS) generation was measured by DHE staining. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) were tested by ELISA method. The mRNA and protein expressions of necroptosis related genes receptor interacting serine/threonine protein kinase 1 (RIP1), RIP3, mixed lineage kinase domain-like protein (MLKL) were tested by quantitative real-time PCR and Western blot.@*RESULTS@#The results showed HG intervention decreased cardiomyocytes viability, increased ROS generation, up-regulated the levels of TNF-α, IL-6 and IL-1β, increased RIP1, RIP3, MLKL expressions at mRNA and protein levels. Nec-1 treatment attenuated HG-induced increased cardiomyocytes viability, reduced ROS generation, down-regulated the levels of TNF-α, IL-6 and IL-1β, decreased RIP1, RIP3, MLKL expressions at mRNA and protein levels.@*CONCLUSION@#Necroptosis was happened in high glucose-induced primary cardiomyocytes injury. Inhibition of necroptosis can reduce high glucose-induced cardiomyocytes damage, may be related to inhibition of oxidative stress and depression of inflammative factors releasing.

Apprenticeship system of American NCCAOM Certification of acupuncture and oriental medicine / 中国针灸

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is the only national institution for the accreditation of clinical practice of acupuncture and Oriental (Chinese) Medicine in the United States. Its qualification certificate or examination certificate is a mandatory document for 47 states and Washington, D.C. to issue the practice license. According to the latest information of the NCCAOM official website, this paper introduced the preceptor qualifications of the apprenticeship, studying hours, quality control, and the evaluation at the end of apprenticeship. The paper also discussed the enlightening and referential effects of the American system to apprenticeship policy in China.