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Objective To investigate the effect of Liangxue Jiedu decoction on intestinal flora in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods The patients who were hospitalized and diagnosed with HBV-ACLF in Beijing Ditan Hospital from October 2018 to October 2019 were enrolled, and healthy individuals were enrolled as HP group. High-throughput sequencing was used to screen for the differences in bacterial diversity and species between HBV-ACLF patients and healthy individuals, and differentially expressed bacteria between the two groups were screened out at the phylum and genus levels. With the help of in vitro simulated fermentation experiment, fecal samples were collected from the patients with HBV-ACLF and were then cultured in the medium containing different concentrations of Liangxue Jiedu decoction (0, 10%, 50%, and 100%) for 24 hours, and the changes in intestinal flora were analyzed and compared between the HBV-ACLF treatment group, the HBV-ACLF non-treatment group, and the HP group at the genus level. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. Results A total of 10 HBV-ACLF patients were enrolled, with 5 in the HBV-ACLF treatment group and 5 in the HBV-ACLF non-treatment group, and there were 15 individuals in the HP group. Compared with the HP group, the HBV-ACLF non-treatment group had significant reductions in the diversity and abundance of intestinal flora. At the phylum level, Bacteroidetes and Firmicutes were mainly observed in the samples of the HP group, while the HBV-ACLF non-treatment group had a significant reduction in Bacteroidetes and significant increases in Fusobacteria , Proteobacteria , and Fibrobacteres. At the genus level, compared with the HP group, the HBV-ACLF non-treatment group had significant reductions in Ruminococcus, Blautia , and Eubacterium and significant increases in Parabacteroides, Lactobacillus, Fusobacterium , and Streptococcus . The in vitro fermentation experiment showed that compared with the HBV-ACLF non-treatment group, the HBV-ACLF treatment group had significant increases in Ruminococcus, Lachnospira, Bacteroides , and Genusgenus and significant reductions in Fusobacterium and Proteobacteria (all P < 0.05). Conclusion Liangxue Jiedu decoction can regulate intestinal flora disturbance, restore the diversity of intestinal flora, increase dominant bacteria, and reduce pathogenic bacteria, which may be one of its important mechanisms of action in the treatment of HBV-ACLF.
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Objective@#Refine and understand the characteristics of different types of bystanders, in order to maximize the exploitation and utilization of bystanders as potential resources for anti bullying, so as to provide more targeted guidance for the formulation of intervention programs.@*Methods@#In this study, 1 279 students from two middle schools in Beijing and Anhui Province and two high schools in Guangdong Province and Guangxi Zhuang Autonomous Region were administered with Participation Role Questionnaire (PRQ) and Peer Nomination Questionnaire.@*Results@#There was a significant difference between male and female in the role of onlooker( χ 2=96.92, P <0.01). Female students were more likely to play the role of defender and outsider, while male students were more likely to play the role of reinforcer( χ 2=31.87, P =0.01). And there were significant differences in the distribution of bystander roles in different grades. The chi square test results were( χ 2=456.26, P <0.01).@*Conclusion@#The bystander plays an important role in the occurrence of bullying incidents. It is an important direction of school bullying intervention programs to promote the positive transformation from passive bystander to active bystander.
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Objective:To explore the long-term preservation value and repair effect of normothermic machine perfusion (NMP) on clinically discarded kidneys.Methods:A case of clinical discarded donor kidney was collected, and NMP was carried out in vitro for 9 hours with recovered blood. The dynamic changes of renal appearance, blood gas and biochemistry analysis of perfusate and renal pathology were recorded. Results:In the second to fifth hour of NMP, the appearance of renal was pink and ex vivo normothermic perfusion assessment score (EVNP) was grade Ⅰ. While, the sixth hour and beyond of NMP, the appearance of kidney turned to dark red and EVNP was grade Ⅲ. The renal perfusion blood flow maintained above 150 ml/min in the first 6 hours and decreased significantly after that, and at the end, was only 50 ml/min. During the whole process of perfusion, urine output was maintained at about 100 ml/h. PO 2 remained above 100 mmHg in the first 5 hours of perfusion and from the 6th hour, was lower than 80 mmHg and continued to decline, and was close to 0 at the end of perfusion. The results showed that although the K + concentration changes in blood and urine in the first 5 hours of NMP had a good consistency, the lactic acid level had been rising. In addition, there was no significant change in the histopathology at the fourth hour of perfusion compared with that before zero-point puncture, and the fibrinous thrombus in glomeruli was improved compared with that before perfusion. However, at the sixth hour after perfusion and before the end of perfusion, the pathological changes of renal tissue were significantly worse. There were a large of thrombosis in glomerular blood vessels, renal tubular atrophy and acute tubular necrosis. Conclusions:NMP can realize the evaluation of extended criteria donors before transplantation, and it proves the feasibility and repair potential of NMP in kidney to a certain extent. At the same time, NMP also provides a new way to expand the source of donor kidney and to pre-treat organ in vitro.
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ObjectiveTo analyze the genetic characteristics of the hemagglutinin （H） gene of measles virus （MeV） in Shanghai， 2001‒2018. MethodsNasopharyngeal swab specimens were collected from suspected measles cases reported in Shanghai from 2001 to 2018， and the isolation of measles virus was conducted with Vero/hSLAM cell line. RT-PCR amplification and sequencing were conducted after RNA extraction to analyze the genetic characteristics of the complete H gene. ResultsIn total， 5 665 nasopharyngeal swab samples were collected by suspected measles case surveillance from 2001 to 2018， and 1 394 measles virus strains were isolated. The homology of nucleotide acid and amino acid among 349 representative measles virus isolates was 87.4%‒100.0% and 85.1%‒100.0%， respectively. The homology of nucleotide acid and amino acid between representative measles virus isolates and China vaccine strain （S191） was 85.7%‒100.0% and 84.1%‒100.0%， respectively. All the sub-genotype H1a MeV isolates had an amino acid substitution （Ser240Asn）， which removed a predicted N-linked glycosylation site. ConclusionMost of the MeV isolates are sub-genotype H1a analyzed based on H gene， which are identical to those of the N gene. The predicted amino acid sequences of the H protein are relatively conserved at most of the functionally significant amino acid positions.
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Objective:To investigate the effect of growth hormone replacement therapy(GHRT) on glucose and lipid metabolism in patients with hypopituitarism.Methods:Clinical data of patients with hypopituitarism who received GHRT in Department of Endocrine and Metabolic Diseases, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2016 to February 2020 were retrospectively analyzed. The patients were divided into normal glucose regulation(NGR) group and impaired glucose regulation(IGR) group according to their glucose metabolism status before GHRT. The changes of the characteristics of glucose metabolism before and after GHRT were analyzed.Results:A total of 30 patients aged(23.0±5.2) years were included, 23 patients in NGR group and 7 patients in IGR group. After 12 months of GHRT, there were no significant changes in fasting plasma glucose(FPG), 2-hour postprandial plasma glucose(2hPG), and insulin sensitivity index(ISI) in both groups(all P>0.05), while homeostasis model assessment insulin resistance(HOMA-IR) in IGR group was significantly decreased compared with that before GHRT( P<0.05). None of the patients in NGR group progressed to IGR or diabetes mellitus, and none of the 7 patients in the IGR group progressed to diabetes mellitus, while 4 of them recovered from impaired glucose tolerance(IGT) to NGR. Triglyceride, total cholesterol, and low density lipoprotein-cholesterol levels were all significantly decreased in two groups(all P<0.05). Multivariate linear regression analysis showed that the increase of body mass index was an independent risk factor for the increase of FPG and 2hPG( P<0.05). Conclusion:12-month GHRT significantly improved their blood lipid profiles in patients with hypopituitarism without adversely affecting glucose homeostasis.
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The enterobacterial common antigen (ECA) is a polysaccharide composed of polysaccharide repeats that are located in the outer membrane of almost all Enterobacteriaceae bacteria and has diverse biological functions. ECA is synthesized by the synergistic action of multiple genes that are present in clusters on the genome of Enterobacteriaceae bacteria, forming the ECA antigen gene cluster, an important virulence factor that plays a role in host invasion and survival of Enterobacteriaceae in vivo. ECA also plays an important role in the maintenance of the bacterial outer membrane permeability barrier, flagella gene expression, swarming motility, and bile salts resistance. In addition, ECALPS, anchored in the core region of bacterial lipopolysaccharide, is an important surface antigen for bacteria, stimulating high levels of antibody production in the host and could be a target for vaccine research. This review summarizes ECA purification, genes involved in ECA biosynthesis, its immunological characteristics, biological functions and clinical applications.
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Antigens, Bacterial/genetics , Enterobacteriaceae/genetics , Lipopolysaccharides , PolysaccharidesABSTRACT
ObjectiveTo investigate the effect of anti-liver fibrosis Chinese patent drugs on renal hypofunction associated with alcoholic liver disease (ALD). MethodsA retrospective analysis was performed for 592 patients with ALD who were admitted to Beijing Ditan Hospital, Capital Medical University, from August 1, 2008 to March 1, 2016, and according to whether they were treated with Fuzheng Huayu capsules, Anluo Huaxian pills, or Fufang Biejia Ruangan tablets for ≥180 cumulative defined daily doses, they were divided into Chinese medicine group and control group. After propensity score matching at a ratio of 1∶1, two groups were obtained with 187 patients in each group. Related data were recorded, including medical history, drinking amount, routine blood test results, liver and renal function, coagulation, and abdominal imaging findings. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to compare the cumulative incidence rate of renal hypofunction between two groups. ResultsThere were no significant differences between the two groups in age, drinking amount, proportion of patients with hypertension or diabetes, baseline aspartate aminotransferase, estimated glomerular filtration rate, uric acid, and prothrombin time, and the patients were followed up for 36 months (range 23-54 months). Uric acid (hazard ratio ［HR］=1.003, 95% confidence interval ［CI］: 1001-1.005, P=0.001), prothrombin time (HR=1.103, 95%CI: 1.034-1.177, P=0.003), and red cell volume distribution width (HR=1.024, 95%CI: 1.011-1.038, P＜0.001) were independent risk factors for renal hypofunction in patients with ALD, and anti-liver fibrosis Chinese patent drug was an independent protective factor against renal hypofunction (HR=0.170, 95%CI: 0.053-0552, P=0.003). The Chinese medicine group had a significantly lower incidence rate of renal hypofunction than the control group (166% vs 32.1%, χ2=10.263, P=0.001). The subgroup analysis of the patients in the Chinese medicine group showed that Chinese medicine treatment for ＞24 months had the best effect (HR=0.210, 95%CI: 0.084-0.525, P=0.001). Compared with the control group, the Chinese medicine group had a significantly longer time to the onset of renal hypofunction (36 months vs 24 months, Z=-2.652, P=0.008). ConclusionAnti-liver fibrosis Chinese patent drugs can reduce the incidence rate and delay the onset of renal hypofunction in patients with ALD.
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OBJECTIVE：To study “Qi-invigorating”effect and its possible mechanism of total saponins of Astragalus membranaceus on rats with Qi-deficiency ，and to provide reference for elucidating the material basis of “Qi-invigorating”effect of A. membranaceus . METHODS ：Forty male Wistar rats were randomly divided into normal group ，model group ，positive control group [Buzhong yiqi pills ，4.5 g/（kg·d）]，A. membranaceus total saponins high-dose and low-dose groups [ 252，28 g/（kg·d），by the amount of total saponins] according to body weight ，with 8 rats in each group. Except for normal group ，the model of Qi-deficiency was made in other groups by the method of “diet disorder+fatigue ”. At the same time ，administration groups were given relevant medicine intragastrically ，and normal group and model group were given constant volume of water，once a day ，for consecutive 21 days. After last administration ，the general situation of rats was observed ；the body weight ，spleen index and thymus index of rats were detected ；weight-bearing swimming time was recorded ；the levels of spleen T lymphocyte subsets CD 3 and CD 4，the levels of ATP and ADP in liver tissue ，serum levels of ALB ，RBC and HBG in blood as well as the serum levels of SOD，MDA，lactate，LDH，CK，IL-2，IL-12 and TNF-α were all detected. RESULTS：Compared with normal group ，body weight，thymus index ，spleen index ，weight-bearing swimming time ，the level of spleen T lymphocyte subsets CD 3，ATP，ADP， ALB，IL-2 and IL- 12 were decreased or shortened significantly in model group （P＜0.05 or P＜0.01）. The levels of MDA ， lactate，CK and TNF-α were increased significantly （P＜ 0.05）. Compared with model group ，body weight ，spleen index，weight-bearing swimming time ，the level of spleen T lymphocyte subsets CD 3 and the levels of ATP ，ADP，ALB， RBC and IL- 2 were increased significantly or prolonged（P＜0.05）；while the levels of MDA ，lactate，CK and TNF-α were decreased significantly in A. membranaceus total saponins high-dose group（P＜0.05 or P＜0.01）.Weight-bearing swimming time ，the levels of ATP ，ADP and IL- 2 in A. membranaceus total saponins low-dose group were increased significantly or prolonged （P＜0.05 or P＜0.01），while the levels of MDA ，lactate，CK and TNF-α were decreased significantly （P＜0.05 or P＜0.01）. Compared with positive control group ，spleen index ，spleen T lymphocyte subsets CD 3，weight-bearing swimming time and ATP level of A. membranaceus total saponins high-dose group were increased significantly or prolonged （P＜0.05 or P＜0.01），while MDA levels of A. membranaceus total saponins high-dose and low-dose groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：A. membranaceus total saponins can reduce the body ’s accumulation of blood lactic acid ，the activity of CK ，the level of lipid peroxide and regulate immunity to tonify Qi ，delay fatigue and improve exercise ability.
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OBJECTIVE：To establish a method for th e content determination of 7 kinds of triterpenoids in Poria cocos ，and to compare the differences of the above components in P. cocos from different habitats ，so as to provide reference for the quality control of P. cocos . METHODS ：Using 36 batches of P. cocos from different habitats as samples ，HPLC method was used for content determination of dehydrotomorphic acid ， polyporhinic acid C ， 3-epidehydrotomorphic acid ， 3-O-acetyl-16 α-hydroxy-hydrogenolysaccharic acid ，dehydrotomorphic acid ，pachymic acid and dehydrotrametenolic acid. The column was performed on Thermo Acclaim 120 C18 with mobile phase consisted of acetonitrile-phosphoric acid water （gradient elution ）at the flow rate of 1 mL/min. The detection wavelength was set at 210 nm. The column temperature was 30 ℃，and the injection volume was 20 μL. SPSS 21.0 statistical software was used for cluster analysis of 36 batches of P. cocos from different habitats. RESULTS ： The linearity of 7 triterpenoids was good in the range of their mass concentration （all r≥0.999 0）；average recoveries were 96.74％-104.04％（RSD＝0.54％-1.55％，n＝6）. RSDs of precision ，and reproducibility stability （24 h）tests were all lower than 3.0％（n＝6）. RSD of durability test was lower than 5.0％（n＝2）. There were some differences in the single content of 7 indicator components among samples from different habitats ，but the total content difference was not obvious （the total content of most samples was in the range of 1.3-1.9 mg/g）. After cluster analysis ，36 batches of sample were clustered into 5 categories，i.e. S 27 was clustered into class Ⅰ；S30 and S 34 were clustered into class Ⅱ；S2，S8 and S 9 were clustered into class Ⅲ；S10，S11，S12 and S 14 were clustered into class Ⅳ；and the remaining 26 batches of samples were clustered into class Ⅴ. CONCLUSIONS ：The method is simple ，and has good precision ，repeatability and durability. It can be used for the simultaneous determination of above 7 components in P. cocos . There has no significant difference in the quality of P. cocos from different habitats. The content of P. cocos in most producing areas is uniform in content and stable in quality ，only a few of them are different. Δ 基金项目 ：国家重点研发计划中医药现代化研究重点专项
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OBJECTIVE：Compare the difference of total protein content of Poria cocos from different producing areas. METHODs：Using bovine serum albumin （BSA） as control ，0.4 mol/L sodium hydroxide solution as exctraction solution ， Coomassie brilliant blue G- 250 as chromogenic reagent ，visible spectrophotometry at 595 nm was used to determine the contents of total protein of P. cocos ；cluster analysis was used to classify 34 batches（S1-S34）of P. cocos from different producing areas. RESULTS：The linear range of BSA was 1.45-17.40 μ g/mL （r＝0.999 6）. RSDs of precision ，stability （20 min） and reproducibility tests were all lower than 3％；recoveries were 100.14％-104.26％（RSD＝1.43％，n＝9）. The contents of total protein in 34 batches of P. cocos from different producing areas were 0.388 4％-1.129 7％. The results of cluster analysis showed that among 34 batches of P. cocos ，the total protein content of P. cocos produced in Yingshan county of Hubei province （S2，S3） was higher than 1％，clustered into one category ；the total protein contents of P. cocos produced in Hubei ，Yunnan，Anhui and Hunan（S1，S5-S10，S12，S13，S16，S17，S19-S21，S23-S25，S28，S30，S31）were 0.653 5％-0.946 1％，clustered into one categony，and the remaining batch content were 0.388 4％-0.601 2％，clustered into one category. CONCLUSIONS ：Established method is suitable for the content determination of total protein content of P. cocos . The protein content of P. cocos from Yingshan county of Hubei province is the highest ，followed by Yunnan and Anhui in 34 batches of P. cocos from different producing areas.
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Cancer is one of the most important diseases threatening human health. Frequently-used traditional cancer treatment methods, like radiotherapy, chemotherapy and surgery, have serious toxic side effects and limitations. The widely-used drug delivery carriers (liposomes, nanoparticles, etc.) have also possessed many issues such as drug leakage and incomplete loading in the late clinical stage. Currently, using tumor-targeting vectors to deliver anti-tumor drugs or small molecules is one of the promising strategies for mediating safe and effective tumor therapy. In recent years, bacterial-derived non-replicating minicells, which are nanoscale non-nucleated cells produced during abnormal bacterial division, have got more and more attention. With a diameter of 200-400 nm, minicells have a large drug loading capacity. Meanwhile, the surface of minicells are able to be modified to load the assembly of antibodies/ligands that bind to tumor cell surface specific antigens or receptors, which can significantly improve tumor targeting of minicells. This tumor-targeting nanomaterials of minicells not only are used to deliver anti-tumor chemotherapeutic drugs, functional nucleic acids or plasmids encoding functional small molecules to mammalian cells, but also greatly increase drug loading and reduce drug penetration. Thus, the use of minicells combining with chemical therapy could help reduce the toxicity and maximize the effectiveness of the drug in the body. This paper summarizes the research and development of production purification, drug loading, tumor cells targeting, and internalization process of minicells, as well as its use in the delivery of anti-tumor drugs, to provide some information for the development and utilization of minicell carriers.
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Animals , Humans , Drug Carriers , Drug Delivery Systems , Nanoparticles , Neoplasms , PlasmidsABSTRACT
Objective@#To investigate the effects of abdominal drawing-in maneuver with real-time ultrasound biofeedback on transversus abdominis activation level during functional tasks in different positions in patients of chronic low back pain with stabilization-deficit.@*Methods@#Nineteen patients of chronic low back pain with stabilization-deficit were randomly divided into verbal instruction group(n=9) and ultrasound biofeedback group(n=10), and received abdominal drawing-in maneuver with verbal instruction and ultrasound biofeedback respectively. Percentage changes of transversus abdominis thickness during supine and upright loaded tasks were compared before and after intervention.@*Results@#After intervention, percentage changes of transversus abdominis thickness increased significantly in verbal instruction group during supinehip external rotation, straight leg raising and upright loaded functional tasks (P<0.05), and percentage changes of transversus abdominis thickness during supine hip and knee flexion demonstrated great increases(P<0.01). After intervention, percentage changes of transversus abdominis thickness demonstrated great increases in ultrasound biofeedback group during all functional tasks(P<0.01). No differences were observed between the two groups(P>0.05).@*Conclusions@#Ultrasound image could effectively assess the thickness changes of transversus abdominis in patients with chronic low back pain during supine and upright loaded functional tasks. Ultrasound image could provide chronic low back pain patients with real-time and dynamic visual feedback. However, compared with verbal instruction, adding real-time ultrasound biofeedback to abdominal drawing-in maneuver does not further increase the transversus abdominis activation level.
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Objective To investigate the effects of abdominal drawing‐in maneuver with real‐time ultrasound biofeedback on transversus abdominis activation level during functional tasks in different positions in patients of chronic low back pain with stabilization‐deficit . Methods Nineteen patients of chronic low back pain with stabilization‐deficit were randomly divided into verbal instruction group( n ＝9 ) and ultrasound biofeedback group ( n ＝ 10 ) ,and received abdominal drawing‐in maneuver with verbal instruction and ultrasound biofeedback respectively . Percentage changes of transversus abdominis thickness during supine and upright loaded tasks were compared before and after intervention . Results After intervention , percentage changes of transversus abdominis thickness increased significantly in verbal instruction group during supinehip external rotation ,straight leg raising and upright loaded functional tasks ( P＜0 .05) ,and percentage changes of transversus abdominis thickness during supine hip and knee flexion demonstrated great increases( P ＜0 .01) . After intervention ,percentage changes of transversus abdominis thickness demonstrated great increases in ultrasound biofeedback group during all functional tasks ( P ＜0 .01) . No differences were observed between the two groups( P ＞0 .05) . Conclusions Ultrasound image could effectively assess the thickness changes of transversus abdominis in patients with chronic low back pain during supine and upright loaded functional tasks . Ultrasound image could provide chronic low back pain patients with real‐time and dynamic visual feedback . However ,compared with verbal instruction , adding real‐time ultrasound biofeedback to abdominal drawing‐in maneuver does not further increase the transversus abdominis activation level .
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Objective@#To evaluate the immunogenicity of different strains of inactivated poliomyelitis vaccines (IPV) by sequential program.@*Methods@#This parallel-group controlled trial was conducted in immunization clinics in Shanghai from March 2016 to September 2017. Sabin strains inactivated poliomyelitis vaccines (sIPV), WPV strains inactivated poliomyelitis vaccines (wIPV) and live poliomyelitis Type Ⅰ Type Ⅲ vaccine (bOPV) as the investigational vaccine were used at 2, 3, 4 months old in 325 infants in Shanghai. Infants vaccinated by four sequential program were divided into 4 groups: sIPV+sIPV+bOPV, sIPV+wIPV+bOPV, wIPV+sIPV+bOPV and wIPV+wIPV+bOPV. A total of 230 investigators′ blood samples were collected before primary immunization and 163 investigators′ blood samples were collected after primary immunization. A total of 151 investigators (36, 44, 30 and 41 in each group) finished primary immunization and blood sampling before and after the primary immunization. The geometric mean titer (GMT) of poliovirus typesⅠ and Ⅲ neutralizing antibody was tested and calculated, and the positive results of antibody before and after primary immunization were analyzed.@*Results@#Among the 151 investigators, the age were (2.27±0.61) months and birth weight were (3.27±0.43) kg, and 70 were male. The positive rates of typeⅠwas 98.68% (149 cases), and type Ⅲ was 97.35% (147 cases); the number of investigators tested in each group was 36, 44, 30 and 41, respectively; the positive rates of typeⅠwas 97.22% (35 cases), 100.00% (44 cases), 96.67% (29 cases) and 100.00% (41 cases) (P=0.345); the positive rates of type Ⅲ were 97.22% (35 cases), 95.45% (42 cases), 96.67% (29 cases) and 100.00% (41 cases) (P=0.614).@*Conclusion@#Using sIPV and wIPV simultaneously or alternately for sequential immunization of poliomyelitis vaccines showed good immunogenicity for infants at appropriate age.
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Objective To test the clinical validity of use of the Chinese version of Munro adult pressure ulcer risk-assessment scales (Munro scales),Braden scales,Qian Weiming operation pressure ulcer risk-assessment scales (self-designed scales) in the patients with general anesthesia surgery.Methods Three investigators respectively used the Munro scales,Braden scales and self-designed scales to conduct the pressure ulcer risk-assessment on 261 patients with general anesthesia surgery before operation,at the end of operation and at exiting from anesthesia recovery room.The sensitivity,specificity,positive predictive value and negative predictive value of each assessment tool were calculated.Results The best critical values of the Munro scales before operation,at the end of operation and at exiting from anesthesia recovery room were 8.0,24.5,28.5 points respectively;which of the Braden scale were 18.5,11.5,13.5 points respectively;which of self-made scale were 12.5,13.5,13.5 points respectively.The area under the ROC curve of the three different scales at the beginning of the operation above was 0.653,0.596,0.652.The area under the ROC curve of the three different scales at the end of the operation above was 0.872,0.548,0.792.The areas under the ROC curve of the three different scales before operation were 0.868,0.773 and 0.813 respectively.Conclusion The Chinese version of Munro scales is more suitable for the assessment of operative patient's pressure ulcer risk than the Braden scale and self-designed scales,but the preoperative risk assessment needs to be improved.
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The prevalence of diabetes is increasing rapidly which becomes a serious economic burden to society. The effects of vitamin D beyond bone are increasingly recognized. Circulating level of vitamin D is associated with the development of obesity and type 2 diabetes in cross-sectional human studies. However, as to the therapeutic efficacy of vitamin D supplementation on the prevention of diabetes, the results derived from randomized controlled clinical trials were disappointing, probably due to variations in the vitamin D receptor genotypes, the dosages and courses of vitamin D treatments. However, two recent basic studies found that central administration of active vitamin D can improve glucose metabolism in diet induced obesity rats; and the combining use of active vitamin D analogue and BRD9 inhibitor rendered the chromatin of vitamin D response elements more accessible, thus more efficiently exerted its anti-inflammatory efficacy and protected islet β cell function in obese and diabetic mice models. Thus it is paramount important to explore some new approaches to prevent and treat diabetes with vitamin D and its active analogues.
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Objective@#To analyze the molecular epidemiological characteristics of rubella virus wild strains isolated in Shanghai during 2011-2017.@*Methods@#Throat swabs were collected from suspected measles or rubella patients in Shanghai during 2011-2017, which were identified as rubella and excluded measles by laboratory tests. Throat swabs were used to conduct cell culture for rubella virus isolation. After identification by RT-PCR, the nucleic acid of gene E1 of rubella virus was amplified and sequenced, followed by molecular epidemiological analysis.@*Results@#Totally 395 strains of rubella virus were isolated from 684 throat swabs. Compared 377 isolates with the WHO reference strains of all genotypes, phylogenetic tree was constructed based on the amplified 739 nucleotides sequences. These isolates were characterized as two genotypes respectively, 109 strains were defined as genotype 1E which were closer to the WHO reference strain from China (RVi/Shandong.CHN/0.02/), and others were genotype 2B while 5 strains of them were defined as a lineage. Most of the nucleotide mutations were nonsense mutation, and the amino acid sequences were highly conserved. All the genotype 1E rubella viruses except one strain had the same mutation at aa338 site.@*Conclusions@#Two genotypes of rubella virus circulated in Shanghai during 2011-2017.Genotype 1E appeared to be the predominant genotype during 2011-2013, genotype 2B was continuously existing since being found in 2011 and appeared to be the predominant genotype during 2014-2016.
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Objective@#To explore the time and genotype distribution of human enterovirus (HEV) isolated from sewage in Shanghai in 2013-2014.@*Methods@#One sewage sample each was collected from two local sewage plants located in Minhang District and Jiading District on the same day at the day 24-28 of every month from 2013 to 2014. Each sample weighed 1 L. The specimens were concentrated by anionic membrane absorption, eluted with beef extract solution, and then used to inoculate RD, HEp-2, and L20B cell lines. A total of 249 enterovirus strains were isolated from sewage samples during the study period, including 185 non-polio enterovirus (NPEV) and 64 poliovirus (PV) strains, which were identified as vaccine strains. RT-PCR and Sanger sequencing were performed to identify HEV genotypes. Homologous analysis of VP1 sequences was conducted using BioEdit (version 7.0.0). Phylogenetic analysis was performed using the neighbor-joining method based on the alignment of VP1 gene sequences using MEGA (version 4.0.2).@*Results@#Among 185 NPEV strains, 178 strains were successfully sequenced and classified into 15 genotypes, including coxsackievirus group B (CVB) 2, 3, and 5; enteric cytopathic human orphan (ECHO) virus 1, 3, 6, 7, 11, 13, 19, 20, 24, 25, and 30; and coxsackievirus group A 4. CVB5 and ECHO6 genotypes accounted for 33.5% (56 strains) and 24.9% (43 strains) of NPEV isolates, respectively. During the study period, HEV isolates were mainly isolated in summer and autumn in Minhang District. ECHO6 strains were frequently isolated from June 2013 to July 2014. Thereafter, the number of ECHO6 strains gradually reduced in the second half of 2014. CVB5 strains demonstrated scattered distribution from 2013 to the first half of 2014 and gradually increased in the second half of 2014. The distribution of ECHO6 and CVB5 strains in Jiading District was similar to that in Minhang District. In 2013-2014, CVB5 strains comprised C6 and C8 subgenotypes, which belong to two transmission chains and show large differences compared with foreign strains isolated during the same period. ECHO6 strains comprised C6, C8, and D9 subgenotypes, which belong to three transmission chains. Moreover, ECHO6 subgenotype D9 was a dominant subgenotype in Shanghai, with broad geographical distribution both at home and abroad.@*Conclusion@#Poliovirus was identified as a vaccine strain in environmental surveillance from June 2013 to April 2014 in Shanghai. Several transmission strains of ECHO6 and CVB5 were identified, which were the dominant serotypes.
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Objective To analyze the internal and external environment of nursing scientific research management by using SWOT analysis method,so as to promote the improvement of nursing scientific research work in our hospital.Methods Based on the analysis of the strength,weakness,opportunities and threats of nursing staff in scientific research activities in our hospital,this paper draws some conclusions and puts forward corresponding measures according to the analysis results.Results With the continuous development of nursing discipline in our hospital,the construction of the platform was improved,and the nursing scientific research work was improved.However,funding,personnel,consciousness and so on,have become the bottleneck restricting the development of nursing research in our hospital.Combined with the opportunities and challenges,a number of improvement measures are put forward.Conclusions We should strengthen the management of nursing scientific research,improve the relevant systems and measures to improve the internal and external environment,and promote the level and quality of nursing research activities in our hospital.
ABSTRACT
In recent years, extensive studies have been conducted on the pathogenesis of nonalcoholic fatty liver disease (NAFLD), and the action of mechanism of traditional Chinese medicine (TCM) in NAFLD has become a new research topic. TCM has achieved good clinical efficacy in the treatment of NAFLD, with the advantages of specific, flexible, multilevel, and multi-target treatment. This article introduces the role of TCM in improving insulin, regulating lipid metabolism, preventing lipid peroxidation, regulating cytokines, regulating and maintaining the dynamic balance of factors involved in lipid metabolism, and maintaining the balance of intestinal microflora, and analyzes the major problems in TCM research.