Changes in peripapillary choroidal thickness within one year of the first episode of acute primary angle closure glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the changes in peripapillary choroidal thickness(pCT)within 1a of the first episode of acute primary angle closure glaucoma(APACG).METHODS: A prospective cohort study. A total of 31 patients with APACG who admitted to the ophthalmology department of Shijiazhuang People's Hospital from October 2015 to September 2019 were selected, with 31 eyes in attack group, 31 fellow eyes in preclinical group and 30 cases(30 eyes)in control group. pCT of the three groups was measured respectively at the attack period, 1wk, 1, 3, 6mo and 1a after surgery.RESULTS: The pCT of the attack group was thicker than that in the attack period when at 1wk after surgery, and continued to become thinner within the following 1a(P<0.05). The pCT of the attack group was thicker than that of the other two groups during the attack period and at 1wk after surgery, while it became thinner at 1a(P<0.05). In the attack group, the average pCT was positively correlated with the duration of intraocular hypertension and negatively correlated with the anterior chamber depth(P<0.05).CONCLUSION: For patients with first episode of APACG, pCT was diffusely thickened during attack and at 1wk after surgery. The pCT returned to normal at 1mo, while it became thinner at 1a. Furthermore, the average pCT was positively correlated with the duration of intraocular hypertension, and the choroidal thickness may play an important role in the attack of APACG.

Expression, purification and characterization of a novel bis (hydroxyethyl) terephthalate hydrolase from Hydrogenobacter thermophilus / 生物工程学报

PET (polyethylene terephthalate) is one of the most important petrochemicals that is widely used in mineral water bottles, food and beverage packaging and textile industry. Because of its stability under environmental conditions, the massive amount of PET wastes caused serious environmental pollution. The use of enzymes to depolymerize PET wastes and upcycling is one of the important directions for plastics pollution control, among which the key is the depolymerization efficiency of PET by PET hydrolase. BHET (bis(hydroxyethyl) terephthalate) is the main intermediate of PET hydrolysis, its accumulation can hinder the degradation efficiency of PET hydrolase significantly, and the synergistic use of PET hydrolase and BHET hydrolase can improve the PET hydrolysis efficiency. In this study, a dienolactone hydrolase from Hydrogenobacter thermophilus which can degrade BHET (HtBHETase) was identified. After heterologous expression in Escherichia coli and purification, the enzymatic properties of HtBHETase were studied. HtBHETase shows higher catalytic activity towards esters with short carbon chains such as p-nitrophenol acetate. The optimal pH and temperature of the reaction with BHET were 5.0 and 55 ℃, respectively. HtBHETase exhibited excellent thermostability, and retained over 80% residual activity after treatment at 80 ℃ for 1 hour. These results indicate that HtBHETase has potential in biological PET depolymerization, which may facilitate the enzymatic degradation of PET.

Intrathecal delivery of nusinersen using the Ommaya reservoir in a spinal muscular atrophy type 2 patient: a case report / 中华神经科杂志

Ommaya reservoir implantation is generally used in the treatment of hydrocephalus and intraventricular drug administration. Ommaya reservoir implantation in the subarachnoid space of the spinal cord for the intrathecal drug administration has not been carried out in China, and only several reports can be retrieved from PubMed. About 60%-90% of untreated patients with spinal muscular atrophy type 2 (SMA2) who survive to adulthood often have complex scoliosis and joint deformities. Nusinersen is an effective drug for the treatment of SMA2. And the route of administration is intrathecal injection, which is difficult for patients with severe scoliosis. This article summarizes the process of Ommaya reservoir implantation and postoperative drug administration in a patient with complex scoliosis type SMA2, which provides a new method for clinical treatment of this disease.

Contrast-enhanced ultrasound features of carotid plaque and its relationship with peripheral blood leukocytes in patients with type 2 diabetes mellitus / 中华超声影像学杂志

Objective:To explore the features of atherosclerotic plaque in patients with type 2 diabetes mellitus by contrast-enhanced ultrasound (CEUS), and to analyze the correlation between the features and leukocyte count in peripheral blood.Methods:A total of 30 type 2 diabetic patients with carotid atherosclerotic plaque treated in Tangdu Hospital of Air Force Military Medical University who underwent CEUS from March 2018 to September 2021 were included as the diabetes group. Thirty-two non-diabetic patients with carotid atherosclerotic plaque who were matched for age and sex during the same period served as the control group. The optimized plaques were performed by CEUS to obtain parameters including peak (P), time to peak (TP), sharpness (S) and area under the curve (AUC) of time-intensity gamma fitting curve (FC curve). The differential count of leukocytes in peripheral blood was detected by the automatic hematology analyzer. Spearman rank correlation and multiple linear regression were used to analyze the correlation between CEUS parameters of plaque and the differential leukocyte count in peripheral blood.Results:①The peripheral blood leukocyte count, monocyte count and monocyte proportion in the diabetes group were higher than those in the control group (all P<0.05). ②P and AUC in the diabetes group were higher than those in the control group (all P<0.05). ③There was linear relationship( B=75.440, P<0.001) and positive correlation ( rs=0.929) between P and peripheral blood monocyte count in the diabetes group. Conclusions:The neovascularization density and perfusion in carotid plaques in patients with type 2 diabetes mellitus are increased, which may be related to the increase of leukocytes in circulation, especially monocytes.

Active components of Descurainia sophia improve lung permeability in rats with allergic asthma by regulating airway inflammation and epithelial damage / 中国中药杂志

The present study investigated the effect of active components of Descurainia sophia on allergic asthma and explored the underlying mechanism. SD male rats were randomly divided into a normal group(NC), a model group(M), a D. sophia decoction group(DS), a D. sophia fatty oil group(FO), a D. sophia flavonoid glycoside group(FG), a D. sophia oligosaccharide group(Oli), and a positive drug dexamethasone group(Y). The allergic asthma model was induced in rats by intraperitoneal injection of ovalbumin(OVA) and aluminum hydroxide gel adjuvant(sensitization) and atomization of OVA solution(excitation). After modeling, asthma-related indicators, tracheal phenol red excretion, inflammatory cell levels in the peripheral blood, lung permeability index(LPI), and oxygenation index(OI) of rats were detected. The pathological changes of lung tissues were observed by HE staining. Enzyme-linked immunosorbent assay(ELISA) was used to detect the content of inflammatory factors immunoglobulin E(IgE), interleukin-4(IL-4), and interferon-γ(IFN-γ) in the bronchoalveolar lavage fluid(BALF) and the content of endothelin-1(ET-1) and angiotensin-converting enzyme(ACE) in lung tissue homogenate. The serum content of nitric oxide(NO) was detected by colorimetry. Western blot was employed to determine the protein expression of Toll-like receptor 4(TLR4), nuclear factor κB-p65(NF-κB-p65), phosphorylated NF-κB-p65(p-NF-κB-p65), myosin light chain kinase(MLCK), vascular endothelial cadherin(VE cadherin), connexin 43, and claudin 5, and the mechanism of active components of D. sophia on allergic asthma was explored. As revealed by the results, the M group showed extensive infiltration of inflammatory cells around the bronchus of the lung tissues of the allergic asthma rats, thickened bronchial wall, severely deformed alveolar structure, increased number of wheezes, the content of IgE, IL-4, ET-1, and ACE, inflammatory cells, and LPI, and reduced latency of asthma, tracheal phenol red excretion, IFN-γ, NO content, and OI. After the intervention of the active components of D. sophia, the DS, FO, FG, Oli, and Y groups showed improved asthma-related indicators, tracheal phenol red excretion, and lung tissue lesions in allergic asthma rats, and the effects in the FO and Oli groups were superior. The content of inflammatory factors in BALF was recovered in the DS, FO, and Y groups and the FG and Oli groups. The number of inflammatory cells in rats was reduced in the DS and FO groups, and the FG, Oli, and Y groups to varying degrees, and the effect in the FO group was superior. DS, FO, Oli, and Y reduced ET-1, ACE, and LPI and increased NO and OI. FG recovered NO, ET-1, ACE, LPI, and OI to improve lung epithelial damage and permeability. Further investigation of inflammation-related TLR4/NF-κB pathways, MLCK, and related skeleton protein levels showed that TLR4, NF-κB-p65, p-NF-κB-p65, and MLCK levels were increased, and VE cadherin, connexin 43, and claudin 5 were reduced in the M group. DS, FO, FG, Oli, and Y could reduce the protein expression related to the TLR4 pathway to varying degrees, and regulate the protein expression of MLCK, VE cadherin, connexin 43, and claudin 5. It is inferred that the active components of D. sophia improve lung permeability in rats with allergic asthma presumedly by regulating the TLR4/NF-κB signaling pathway to improve airway inflammation, mediating MLCK and connexin, and regulating epithelial damage.

A four-component combination derived from Huang-Qin Decoction significantly enhances anticancer activity of irinotecan / 中国天然药物

Huang-Qin Decoction (HQD) is a classic prescription for diarrhea in Chinese medicine treatment. Recent studies have demonstrated that HQD and its modified formulation PHY906 could ameliorate irinotecan (CPT-11) induced gastrointestinal (GI) toxicity and enhance its anticancer therapeutic efficacy. Nevertheless, which constituents in HQD are effective is still unclear so far. The study aims to screen out the key bioactive components combination from HQD that could enhance the anticancer effect of CPT-11. First, the potential bioactive constituents were obtained through system pharmacology strategy. Then the bioactivity of each constituent was investigated synthetically from the aspects of NCM460 cell migration, TNF-α release of THP-1-derived macrophage and MTT assay in HCT116 cell. The contribution of each constituent in HQD was evaluated using the bioactive index E

Proposal of Living Evidence-based Guideline for Combination of Traditional Chinese and Western Medicine for Treatment of COVID-19 / 中国中药杂志

In order to standardize the clinical diagnosis and treatment decision-making with traditional Chinese medicine for pa-tients of coronavirus disease 2019(COVID-19) and put the latest clinical study evidence into clinical practice, the international trust-worthy traditional Chinese medicine recommendations( TCM Recs) working group started the compilation of Living Evidence-based Guideline for Combination of Traditional Chinese and Western Medicine for Treatment of COVID-19 on the basis of the standards and re-quirements of WHO handbook, GRADE and RIGHT. This proposal mainly introduces the formulation methods and processes of the living guidelines in details, such as the composition of the working group, the collection and identification of clinical issues and out-comes, the production of the living systematic review and the consensus of recommendations. The guidelines will continue to monitor the clinical study evidences of TCM in the prevention and treatment of COVID-19, and conduct regular evidence updating, retrieval and screening. When there is new study evidence, the steering committee will evaluate the possibility of the evidence to change clinical practice or previous recommendations, so as to decide whether the recommendations for the guidelines shall be implemented or upda-ted. The main criteria considered in the guideline updating are as follows:(1) There are new high-quality randomized controlled trial(RCT) evidences for TCM uninvolved in the previous edition of the guidelines;(2) as for the TCM involved in the guidelines, living sys-tematic review shows that new evidence may change the direction or strength of the existing recommendations. The specific implementation of the living evidence-based guidelines will take this proposal as the study basis and framework, in order to ensure the standardization of the formulation process and methods. This will be the first exploration of the methodology for living guidelines in the field of TCM.

Recreational Physical Activity and Functional Rehabilitation for Adult with Disability Based on ICF: A Scoping Review / 中国康复理论与实践

Objective:To analyze the categories and its relations of recreational physical activities and rehabilitation exercise for adult with disabilities based on the theory and method of International Classification of Functioning, Disability and Health (ICF). Methods:An evidence-based scoping review had been implemented. We had developed the framework and coding approaches for recreational physical activities, rehabilitation exercise and functional improvement for the adults with disabilities based on evidence-based literature review. The literature related to recreational physical activities and rehabilitation exercise of adult with disabilities was searched by subject retrieval method. The retrieval database in Chinese included CNKI and Wanfang database, and the retrieval database in English included PubMed and Web of Science. The retrieval time was from establishment to July 31, 2020. The authors, countries, published time, published journals, research objectives, object of the study and their ages, data collection tool, and the key findings were extracted. Results:A total of 2476 literatures were returned, and 18 of them were enrolled, which were published in 14 countries, and most were published in journals on topics related to medicine, public health, exercise and people with disabilities. They were mainly published from 2010 to 2020, and mainly used questionnaire survey, measurement and interviewing method. There were three typical recreational physical activities: physical fitness activities, skills activities and sports activities, mainly including Taiji Quan, wheelchair basketball, leisure outdoor activities, community recreational sports activities and rehabilitation exercises, etc. According to the framework of ICF, recreational physical activities promote functional rehabilitation for adults with disabilities, including physical functions (b1 mental function; b4 cardiovascular, blood, the function of the immune system and respiratory system; b5 digestion, metabolism and function of the endocrine system; and b7 nerve musculoskeletal function related to movement), and activities and participation (d1 study and application of knowledge; d2 the general tasks and requirements; d4 activity; d5 self-care; d7 interpersonal communication and interpersonal relationship; and d9 community, social and civic life). The evidences showed benefits of improvement in the fields of body mass index, body index, athletic ability, balance ability, and cognitive function. There were more gains at individual levels, including support, coping with stress, self-concept development, life satisfaction, happiness, exercise self-efficacy, health perception, etc. The environmental and personal factors had effects on the performance of activity and participation in recreational physical activities, including e1 products and technologies, e4 attitude, e3 support and interpersonal relationships, e5 service system and policy, as well as attitudes and support of family members and colleagues, interpersonal relationships, social support, transportation, equipment and facilities, and policies. Conclusion:Rehabilitation exercise is an important part of health-related services. We scoped the recreational physical activities and its functional effects for adults with disabilities. The categories and structure of recreational physical activities and rehabilitation exercises were constructed based on ICF. Aligning rehabilitation exercises and relevant factors to ICF, the recreational activities and rehabilitation exercises had been reviewed and discussed and several recommendations for further studies had been drawn.

Oxygen impact on genome structure and chemistry / 药学学报

Oxygen is an essential element for life, which is mostly consumed at mitochondria for energy metabolism. For the genome inside nucleus, oxygen conducts structural regulations and chemical modifications through multiple pathways, where reactive oxygen species (ROS) serve as important messenger molecules. The highly activated ROS have the ability to produce different kinds of DNA lesions, while ferrous ions provide supports in many forms. Under the combinatorial action of oxygen and iron, almost all the genomic biochemical processes, such as replication, transcription and DNA damage repair are affected. Moreover, the variation of environmental oxygen concentration, particularly hypoxia that presents in many major diseases and critical physiological stages, provokes the responds at the genomic level. While the factors that lead to these genomic alterations are potential drug targets and deserve systematic investigations, herein, we collect the existing knowledge in the effects of ROS, ferrous ion and cell hypoxia on genome, along with brief discussions of the related drug molecules.

Isochlorogenic acid (ICGA): natural medicine with potentials in pharmaceutical developments / 中国天然药物

Natural products have attracted a great deal of attention as significant resources in traditional Chinese medicine (TCM) and in chemical medicine, as well as in cosmetic ingredients, nutraceuticals and food products. Isochlorogenic acid (ICGA), which has medicinal value, has been discovered in various plants. As a widespread natural medicine, ICGA should be the subject of further research and development. However, there have been no systematic analyses of ICGA. According to our investigation, ICGA was initially isolated from green coffee extracts by Barnes et al. in 1950. To date, it has been discovered in a variety of tea, vegetables, medicinal diet and TCM materials. ICGA is used as a chemical marker for the quality control of these TCM materials. The metabolic process of ICGA has been studied in detail, conforming to be linear dynamics. Thus, the clear pharmacokinetics of ICGA offers a solid foundation for its research and development. ICGA has multiple biological and pharmacological effects, and studies have mainly focused on its antioxidant, anti-inflammatory, antimicrobial, hypoglycemic, neuroprotective, and cardiovascular protective effects, and hepatoprotective properties. The mechanisms underlying these effects are summarized in this review to provide scientific support and inspiration for the future research and development of ICGA and ICGA-rich natural products.

Effect and Mechanism of Amide Alkaloids of Lycii Cortex on Improving Lipid Metabolism in HepG2 Cells / 中国药学杂志

OBJECTIVE: To investigate the effect of two amide alkaloid derivatives (LCAA and LCAB) from Lycii Cortex on lipid metabolism in HepG2 cells and explore their possible mechanisms. METHODS: The lipid accumulation model of HepG2 cells induced by sodium oleate was established. The cells were pretreated with different concentrations of LCAA and LCAB, and the lipid accumulation was observed by oil red O staining. The content of TC in HepG2 cells was measured by oxidizing enzyme method, and the content of TG in HepG2 cells was measured by GPO-PAP method. The expression of lipid metabolism related proteins, such as SIRT1, FOXO1, AMPK and phospho-AMPK (p-AMPK), was detected by Western blot. The mRNA expression of AMPK, SIRT1, ACC2, COXII and COXIII were detected by RT-qPCR. RESULTS: Both LCAA and LCAB could significantly decrease the lipid accumulation in HepG2 cells induced by sodium oleate (200 μmol•L-1) (P<0.01) and the TC and TG levels (P<0.05 or P<0.01). At the same time, the sodium oleate-induced high expression of p-AMPK protein, the low expression of SIRT1, FOXO1 (P<0.01), and the low expression of AMPK, SIRT1, ACC2, COXII and COXIII mRNA (P<0 05 or P<0 01) were all improved by LCAA and LCAB. CONCLUSION: Both LCAA and LCAB can significantly improve lipid metabolism in HepG2 cells, and regulate lipid metabolism by regulating lipid metabolism-related proteins p-AMPK, SIRT1, FOXO1 and mitochondrial oxidation-related factors COXII and COXIII.

Study on identification of different producing areas of Gastrodia elata using multivariable selection and two-dimensional correlation spectroscopy of near infrared spectroscopy / 中国中药杂志

The efficacy and quality of Gastrodia elata from different producing areas are significant difference. The identification of producing area is helpful for the scientific and reasonable usage of medicinal material. Application near infrared spectroscopy( NIR) together with variance spectra,principal component analysis( PCA),interval partial least squares( i PLS) and genetic algorithm( GA),the characteristic spectra of G. elata from inside and outside of Yunnan province( except Zhaotong) and Zhaotong were extracted,and the pattern recognition models of i PLS-DA and GA-SVM were built,and the suitability of the models were also validated. The results showed that the prediction accuracy of i PLS-DA model was 96. 15%,the values of R2,RMSECV and RMSEP were 0. 893,0. 224 and0. 321,respectively. The prediction accuracy of GA-SVM model was 100% and RMSECV was 0. 719 4. Both methods could identify G. elata from different producing area preferably. Further,two-dimensional spectroscopy analysis was conducted for the characteristic spectra extracted by i PLS and GA. The results showed that the differential spectra of G. elata from outside and inside Yunnan were mainly located in the absorption areas of the stretch,bending and double frequency of C-H,C-N,O-H and N-H bonds of polysaccharides,aromatic hydrocarbon,amides and starch. The differential spectra of G. elata from outside Yunnan and Zhaotong were mainly located in the absorption areas of the stretch,bending and double frequency of C-H,O-H and N-H bonds of vegetable protein,aromatic hydrocarbon,polysaccharides,and alcohols. The differential spectra of G. elata from inside Yunnan and Zhaotong were mainly located in the absorption areas of the stretch,bending,transformation and double frequency of CHO,N-H,C-H,O-H and HOH bonds of lignin,aromatic hydrocarbon,alcohols,polysaccharides and aliphatics. Effective recognition of different producing areas and exploration the difference of component of G. elata could be conducted through NIR combined with multivariable selection and two-dimensional spectroscopy,which provided the basis for the reasonable development and efficient utilization of G. elata.

Effects of Hand Robot-assisted Training Based on Motor Imagery on Upper Limb Function of Stroke Patients / 中国康复理论与实践

Objective To investigate the effect of hand robot-assisted training based on motor imagery on upper limb function of stroke patients.Methods From November, 2016 to May, 2018, 55 hemiplegic patients with upper limb dysfunction were randomly assigned to control group (n = 25) and experimental group (n = 30). The control group received routine hand motor training, while the experimental group received hand robot-assisted training, for four weeks. They were assessed with simplified Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT) and Modified Barthel Index (MBI) before treatment (t0), one week of treatment (t1), immediately after treatment (t2) and 2 months after treatment (t3).Results The score of WMFT improved in the experimental group at t1 (P ＜ 0.05), with no significant difference between groups (Z =-0.901, P＞ 0.05). The scores of FMA, WMFT and MBI improved in both groups at t2 and t3 (P ＜ 0.05), and the scores of FMA and MBI improved more in the experimental group than in the control group (Z＞-2.073, t＞ 2.034, P ＜ 0.05).Conclusion Hand robot-assisted training based on motor imagery can promote recovery of upper limb function in stroke patients more effective than routine hand function training.

Adverse Outcome of Cesarean Scar Pregnancy Managed Expectantly / 中山大学学报(医学科学版)

@#：【Objective】Toprovidefurtherevidenceoftheassociationbetweencesareanscarpregnancy（CSP）and placentaincreta，andtoinvestigatetheriskofexpectantmanagementofCSP.【Methods】Aretrospectivereviewof3women diagnosedwithCSP，whoweremanagedexpectantly，wasperformedintheThirdAffiliatedHospitalofSUNYat-sen UniversityfromJanuary2014toDecember2018.Theirclinicalcharacteristics，sonographicmanifestationandpoorout⁃ comeswereanalyzed.【Results】These3casesofCSPhad1~2previouslowersegmentcesareansectionsandtheirclinical symptomsincludedrecurrenthemorrhage，grosshematuriaandsevereabdominalpain.Amongthe3cases，thegestational ageatdiagnosisofCSPwas6+2weeks，7weeksand7+4weeks，respectively；thesonographicCSPtypewastypeⅠ，type ⅡandtypeⅢ，respectively；thegestationalageatthefirstdiagnosisofplacentaincretawas24+4weeks，12+2weeksand 13+1weeks，respectively；andall3caseswerediagnosedasplacentapercretabyultrasoundatthesecondtrimester.These 3casesofCSPwereterminatedatthesecondtrimesterwithoutlivebornneonatesbecauseofseverehemorrhage，colt tamponadeofbladderanduterinerupture；andallwereconfirmedasplacentapercretaduringsurgerywiththetotalblood lossofmorethan2500mLandwithoutmaternaldeath，andonegotapathologicaldiagnosisofplacentapercretaafter subtotal hysterectomy.【Conclusion】Placenta percreta should be noticed during the expectant management of CSP becauseof the close association between CSP and placenta increta. Natural history of CSP is usually associated with adverseoutcome，andthereforeexpectantmanagementofCSPshouldbecarefullychosen

Clinical characteristics of human cytomegalovirus and polyomavirus infection after allogeneic hematopoietic stem cell transplantation / 中国感染控制杂志

Objective To explore clinical characteristics of human cytomegalovirus (HCMV) and polyomavirus (BKV and JCV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Clinical data of 53 patients with hematologic malignancies who underwent allo-HSCT from June 2016 to December 2017 were collected.HCMV, BKV and JCV loads in patients' peripheral blood and urine were monitored once a week from day 1 to day 100 after transplantation.Incidence, occurrence time, clinical manifestations, and risk factors of viral infection were analyzed.Results A total of 51 patients had viral infection, infection rate was 96.23％.HCMV, BKV, and JCV infection rates were 54.72％ (29/53), 77.36％ (41/53), and 28.30％ (15/53) respectively.Incidences of pulmonary infection, acute graft-versus-host disease (aGVHD), and hemorrhagic cystitis (HC) were 54.72％, 58.49％, and 20.75％respectively.Analysis on risk factors showed that aGVHD (OR, 24.61[95％ CI, 2.30-46.24]), pretreatment with total body irradiation (TBI) (OR, 33.39[95％ CI, 1.57-79.13]), and use of antithymocyte globulin (ATG) (OR, 24.77[95％ CI, 1.16-52.58]) were independent risk factors affecting HCMV.Human leukocyte antigen (HLA) coincidence (OR, 0.003[95％ CI, 0.00-0.10]) could reduce the risk of HCMV viruria;pretreatment with TBI (OR, 15.10[95％ CI, 1.14-39.27]) was an independent risk factor for BKV viruria, compatible blood group of donor and recipient (OR, 0.07[95％ CI, 0.01-0.64]) could reduce the risk of BKV viruria.Conclusion HCMV and polyomavirus infection in blood and urine of recipient should be monitored as soon as possible after transplantation, so as to prevent and reduce complications in time.

Effectiveness and Safety of Oral Midazolam Combined Nitrous Oxide Sedation in Treating Children with Dental Fear / 中国医学科学院学报

Objective To evaluate the safety and effectiveness of oral midazolam sedation combined nitrous oxide sedation for reducing dental fear in children.Methods Totally 77 children with a Frankl's Behavior Rating Scale score of 1 were included in this study,among whom 41 received a total of 78 person-times of oral midazolam sedation (0.50-0.75 mg·kg ) (midazolam group) and 36 children were treated with the combination of 0.4 mg/kg oral midazolam with 30%-40% nitrous oxide (totally 73 person-times)(combination group). At each visit,heart rate,arterial oxygen saturation,and treatments were recorded. The behaviors of children during the treatment were assessed by Frankl's Behavior Rating Scale,the completion of treatment was assessed by Houpt Scale,and the sedation status was assessed by Ramsay Scale. Telephone follow-up was performed to record the side effects 24 hours after treatment. Results The vital signs were stable among all the 77 subjects,with a Ramsay score of 2 or 3. In the midazolam group, the behaviors were cooperative in 52 person-times (66.7%) and not cooperative in 26 person-times (33.3%);the planned treatments were completed in 62 person-times (79.5%) and partially completed in 16 person-times(20.5%). In the combination group,the behaviors were cooperative in 56 person-times (76.7%) and not cooperative in 17 person-times (23.3%);64 person-times (87.7%) completed the planned treatments and 9 person-times (12.3%) partially completed the treatments. The success rates of sedation (χ =1.87,P= 0.17) and treatment (χ =1.83,P= 0.18) were not significantly different between these two groups. The median Frankl scale score was significantly higher in the combination group [3 (3,4)] than in the midazolam group [3 (2,4)] (Z=2.647,P=0.008]. The median score of Houpt scale in the combination group [5(4,6)] was also significantly higher than in midazolam group [5(3,5)] (Z=2.236,P=0.026]. In midazolam group,there were 7 person-times of dysphoria,3 person-times of diplopia,and 2 person-times of hiccough among 78 person-times;in the combination group,there were 5 person-times of dysphoria,5 person-times of diplopia,1 person-time of hiccough,and 2 person-times of vomit among 73 person-times of treatment. Thus,there was no significant difference in the incidence of side effects (15.4% vs.17.8%,χ =0.160,P=0.689). Logistic regression analysis showed that the success rate of treatment was not associated with sex (OR=1.704,P=0.174),dose (OR=1.289,P=0.516),and treatment types (OR=0.555,P=0.143). Children over 3 years old had a significantly high success rate than those under 3 years old (OR=3.372,P=0.011). Conclusions Oral midazolam is safe and effective for reducing dental fear in children. The combination of oral midazolam with 30%-40% nitrous oxide can improve the behaviors of children during the dental treatment,especially in children over 3 years old.

Recent advances of phage display techniques for drug discovery / 药学学报

Phage display technology utilizes filamentous phage display proteins and polypeptides to extract a desired polypeptide or protein from a large number of variants. The antibody fragments screened and obtained by phage display library technology play an important role in disease diagnosis and treatment. This article briefly introduces the principles of phage display technology, summarizes the development of monoclonal antibodies, the development of antigenic microbial vaccines, and the application of peptide drugs. This review highlights the importance of phage display technology in the diagnosis and treatment of various human diseases such as cancer and autoimmune diseases etc.

Color Doppler two-dimensional ultrasound combined with real-time ultrasonic shear wave elastography in breast cancer diagnosis / 国际生物医学工程杂志

Objective To evaluate the value of color Doppler two-dimensional ultrasound combined with real-time ultrasonic shear wave elastography (SWE) in the early diagnosis of breast cancer.Methods A total of 110 suspected breast tumor patients from October 2015 to April 2017 were selected as subjects.Comprehensive detailed examinations on the patients were conducted by routine two-dimensional ultrasound,color Doppler and SWE,and the lesion location,size,boundary,capsule,internal echo,blood flow,elastic value and other related data were recorded.The BI-RADS classification was conducted based on these data.Pathological diagnosis was used as the gold standard to compare the diagnostic effects of color Doppler two-dimensional ultrasound and the combination of color Doppler two-dimensional ultrasound and SWE.Results Of the 110 patients,78 were malignant and 32 were benign.The sensitivity of color Doppler two-dimensional ultrasound for breast cancer diagnosis was 83.3％,the specificity was 81.2％,and the accuracy was 82.7％.The sensitivity of color Doppler two-dimensional ultrasound combined with SWE for breast cancer diagnosis was 88.5％,the specificity was 90.6％,and the accuracy was 94.5％.Conclusion Color Doppler two-dimensional ultrasound combined with SWE can complement each other and improve the qualitative and quantitative diagnosis of early breast cancer.

Effect of triglyceride level on acute kidney injury complicating acute pancreatitis / 上海预防医学

[Objective] To explore whether the triglyceride level is associated with incidence of acute kidney injury in patients with acute pancreatitis. [Methods] From Jan 2015 to March 2017, 184 patients with acute pancreatitis were selected and divided in to 3 groups based on different triglyceride levels: ideal triglyceride group (n = 89) , mild high triglyceride group (n = 53) and severe high triglyceride group (n =42). The incidence of acute kidney injury and its severity were compared between the three groups.[Results]The incidence of acute kidney injury in severe high triglyceride group was 33.3％, significantly higher than that in ideal triglyceride group (12.3％). The surgical treatment (16.7％ vs 4.5％) , average hospitalization days (20 days vs 14 days) and systemic inflammatory response syndrome score (3.0 vs2.3) in severe high triglyceride group were higher than those in ideal triglyceride group, and all differences between the two groups were significant. After adjusting for factors such as age, sex, body mass index and other confounders, the risk of acute kidney injury occurring in severe high triglyceride group was 2.35 times that in ideal triglyceride group (95％CI: 1.32-4.29). [Conclusion] High triglyceride level proves to be associated with high risk of acute kidney injury in patients with acute pancreatitis.

Further Discussion on the Problems and Countermeasures of Single Disease Payment Reform / 中国卫生经济

Through the investigation of the single disease policy and the local actual situation in many regions of the country, it analyzed the practical problems faced by Chinese medical institutions in the implementation of single disease payment policy. The necessity and urgency of the national unified single disease payment policy were put forward, and the system of standard quota payment for single disease standard was preferred, supporting patients to pay extra fees for differential medical services, standardize the accounting policy of single disease payment.