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Objective@#To investigate the establishment of health care institutions and the staffing primary and secondary school health care in Shanghai, and to understand the capacity building needs of health care personnel.@*Methods@#A survey was conducted on all primary and secondary schools in Shanghai from April to August in 2020. The content of the questionnaire covers the establishment of health care institutions, the staffing of school health care centers and the capacity building need of health care personnel. Chi square test was used to compare the difference of the health care institutions setting and staffing by schools and areas.@*Results@#In 2020, there were 1 847 primary and secondary schools in Shanghai (including branches schools). About 51.4% of primary and secondary schools in Shanghai were equipped with school health care personnel in the ratio of the number of students at least 600∶1 , and the staffing compliance rate of urban schools (59.3%) was higher than that of suburban schools (47.3%)( χ 2=24.27, P <0.01). All school health care personnel believed that there are currently few opportunities for capacity buliding services from health facilities.@*Conclusion@#School health care institutions in Shanghai are well equipped, but the staffing shortage is substantial, with strong need for capacity building.
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The delta checks are one of the patient-based quality control options to identify the errors and the significant changes in patients′ condition. Compared with the traditional internal quality control method, the delta checks have the characteristics of real-time monitoring, with no additional detecting cost, thus the delta checks are widely used in clinical laboratories. In addition, the delta checks are also useful in the auto-verification system to screen out the abnormal results for manual verification. This article reviewed the delta checks′ development history, parameters selection, application values in quality control and auto-verification.
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Objective:To analyze the mechanism of Qiwei Qinggan Powder in the treatment of hepatic fibrosis by animal experiment and network pharmacology.Methods:A total of 50 rats were randomly divided into blank group, model group and low, medium and high dose of Qiwei Qinggan Powder groups with 10 rats in each group. Except the blank group, other groups were gavaged with 50% carbon tetrachloride peanut oil solution to prepare liver fibrosis model. Rats of low, medium and high dose of Qiwei Qinggan Powder groups were gavaged with 135, 270 and 405 mg/kg Qiwei Qinggan Powder 0.5% CMC-Na solution once a day for 10 weeks. The contents of serum GPT and GOT were detected by Wright's method, the content of ALP was detected by visible light colorimetry method, and the liver structure was observed by HE staining and Masson staining. The mRNA and protein expressions of α-SMA and collagen Ⅰ were detected by Q-PCR and Western blot from hepatic stellate cells. Flow Cytometry was used to detect the effect of Qiwei Qinggan Powder on hepatic stellate cells apoptosis. By searching for Traditional Chinese Medicines Integrated Database, Traditional Chinese Medicine Systems Pharmacology Database as well as literature retrieval, the active chemical components and targets of Qiwei Qinggan Powder were obtained. The targets of hepatic fibrosis were obtainable through OMIM and PubMed. By using Cytoscape 3.7.2, the Medicine-active components-Gene-Disease network was constructed. Obtaining Protein-Protein Interaction Networks screens the central target by using STRING, and using R language to retrieve Bioconductor online GO function enrichment and KEGG pathway enrichment analysis were carried out on the platform.Results:Compared with the model group, the levels of GFT, GOT and ALP in high, medium and low dose groups were decreased ( P<0.01). Compared with the control group, the mRNA levels of α- SMA (0.24 ± 0.12, 0.25 ± 0.12, 0.41 ± 0.15 vs. 1.00 ± 0.00), collagenⅠ (0.64 ± 0.24, 0.33 ± 0.13, 0.28 ± 0.11 vs. 1.00 ± 0.00)was decreased ( P<0.05 or P<0.01) of serum containing low, medium and high dose groups of Qiwei Qinggan Powder, and α-SMA (0.03 ± 0.01, 0.01 ± 0.00, 0.01 ± 0.00 vs. 0.04 ± 0.00), collagenⅠ (0.08 ± 0.01, 0.10 ± 0.01, 0.13 ± 0.01 vs. 0.18 ± 0.01) mRNA levels was decreased of serum containing low, medium and high dose groups ( P<0.01). A total of 35 active components, 196 targets, 3 740 disease targets and 170 disease common targets were screened out. 159 items were obtained by GO enrichment analysis; 43 signal pathways were obtained by KEGG enrichment analysis. Conclusion:Qiwei Qinggan Powder can promote HSCs apoptosis and treat HF through multi-component, multi-target and multi-channel therapy.
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OBJECTIVE：To i nvestigate the clini cal ch aracteristics of anaphylactic shock induced by piperacillin and its compound preparation ，and to provide reference for prevention and treatment of the severe ADR. METHODS ：A case of anaphylactic shock induced by piperacillin and sulbactam were analyzed in our hospital ，meanwhile ADR literatures about piperacillin alone and its compound preparation-induced anaphylactic shock were collected from Medline ，CNKI，Wanfang database and VIP during the inception to Jul. 2020. Gender and age of patients ，allergic history ，primary disease and treatment ，skin test ， administration route and dosage of piperacillin and its compound preparation ，occurrence time and main manifestations of anaphylactic shock ，treatment measure and prognosis were analyzed ，then prevention and treatment suggestions were put forward. RESULTS：The patient in this case was transferred to the ICU after partial hepatectomy. The use of piperacillin and sulbactam to prevent postoperative infection caused anaphylactic shock. A total of 28 literatures about anaphylactic shock induced by piperacillin and its compound preparations were collected from the database （involving 28 patients）. Among totally 29 patients，there were 12 male and 17 female；the majority of patients were 50-59 years old （6 cases，20.69％）. Three patients had allergic history （food， latex gloves ，etc.），and most of the primary diseases were infectious diseases or the drug used in perioperative period. Skin tests were carried out in 22 patients（75.86％）before medication and the results were negative. The possible allergenic drugs of 27 cases which were administered by intravenous route included piperacillin ，piperacillin sulbactam and piperacillin tazobactam. The dosage was different according to the primary disease and severity. 14 patients（55.56％）developed anaphylactic shock within 5 minutes after drug exposure. The main symptoms were systemic allergic reaction ，mainly involving the circulatory system. Except for two death cases ，the other patients ’symptoms were relieved after treatment. CONCLUSIONS ：Allergic history and skin test results may have limitation in predicting anaphylactic shock induced by piperacillin and its compound preparation. Close monitoring needs to be taken in patients during these medications. Rescue therapy should be prepared in advance and countermeasures need to be carried out promptly in case of anaphylactic shock.
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Objective:To investigate the expression of four cancer stem cell (CSC) markers (EpCAM, CD133, CD90 and CD24) in hepatocellular carcinoma tissues and peripheral blood circulating tumor cells (CTC),their value in the prognosis of patients with hepatocellular carcinoma.Methods:A total of 50 hepatocellular carcinoma tissues and 29 peripheral blood sample from 50 patients with hepatocellular cancer treated in Zhongshan Hospital Fudan University from October 2013 to September 2014 were collected and analyzed by flow cytometry or qRT-PCR to examine the expression of EpCAM, CD133, CD90 and CD24. The clinical data of patients were collected, including tumor size, tumor number, satellite lesions, vascular invasion, Edmondson stage, BCLC stage and liver cirrhosis, etc. The correlation between the expression of four markers in hepatocellular carcinoma tissues and CTC with the clinical data and survival time of patients were compared.Results:The positive expression rates of EpCAM, CD133, CD90 and CD24 in hepatocellular carcinoma tissues were 66% (33/50), 18% (9/50), 60% (30/50) and 56% (28/50); the positive expression rates in CTC were 55% (16/29), 38% (11/29), 31% (9/29) and 59% (17/29). CD90 expression in hepatocellular carcinoma tissue was positively correlated with the occurrence HCC liver cirrhosis ( P<0.05), while CD133 expression was negatively correlated with the 5-year survival rate of patients ( P<0.05). The expression of EpCAM and CD24 in peripheral blood CTC were closely related to the patient′s Edmondson stage ( P<0.05). The survival time of patients with CD133 positive expression in hepatocellular carcinoma tissue was lower than those without CD133 expression ( P<0.05); the survival rate of patients with EpCAM expressed in either tissue or peripheral blood CTC was lower than that of patients with EpCAM double negative expression ( P<0.05). The survival rate of patients with CD90 negative in HCC tissue and positive in peripheral blood was lower than that in patients with double negative/double positive in tissue and peripheral blood or patients positive in hepatocellular carcinoma tissue and negative in peripheral blood ( P<0.01). Conclusion:Different expression characteristics of four markers in cancer tissues and peripheral blood CTC might provide useful information about predicting prognosis of hepatocellular carcinoma. The expression of CD133 in tissues can be used as an important survival predictor of hepatocellular carcinoma patients. The differential expression of cancer markers in tissue samples and blood samples can provide more clinical prognostic information.
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OBJECTIVE：To study the improv ement effects of Mongolian medici ne eligen- 7 on hepatic fibrosis （HF）and its mechanism. METHODS ：Taking rat hepatic stellate cells HSC-T 6 as research object ，the cells were divided into model group （blank serum ）and low-dose ，medium-dose and high-dose groups of eligen- 7 containing serum （10％，15％ and 20％ eligen-7 containing serum ）. Transforming growth factor β solution（0.2 mg/mL）was added into the cells for 48 h to induce liver fibrosis model，and then added into the corresponding blank or drug-contained serum. The optical density （OD）of cells in each group was measured and inhibition rate of cell proliferation was calculated （after treated for 24，48 and 72 h）. The apoptotic rate and cycle distribution of cells were detected ；mRNA and protein expression of type Ⅰ collagen（Collagen Ⅰ），α-smooth muscle actin （α-SMA），phosphatidylinositol-3-kinase and protein-serine-threonine kinase （PI3K/Akt）signaling pathway related factors （PI3K， Akt，PTEN）were also detected （after treated for 24 h）. Wistar rats were further divided into blank group ，model group and low-dose，medium-dose and high-dose groups of eligen- 7（135，270，405 mg/kg），with 10 rats in each group. Blank group and model group were given 0.5％ sodium carboxymethyl cellulose solution intragastrically ；other groups were given relevant medicine intragastrically，once a day ，for consecutive 10 weeks. After last intragastric administration ，the pathomorphological changes of liver tissue were observed ；mRNA and protein expression of Collagen Ⅰ，α-SMA，PI3K，Akt and PTEN were detected in liver tissue. RESULTS ：Compared with model group ，OD value （except for medium-dose and high-dose groups of eligen- 7 containing serum）and the proportion of cells at S phase in administration groups were decreased significantly （P＜0.01）；late apoptotic rate ， early apoptotic rate （except for low-dose group ），total apoptotic rate and the proportion of cells at G 2/M phase increased significantly（P＜0.01）；mRNA and protein expression of Collagen Ⅰ，α-SMA，PI3K and Akt in cells and liver tissue were decreased significantly （P＜0.05 or P＜0.01），those of PTEN were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ： Eligen-7 shows the effect of anti-hepatic fibrosis ， themechanism of which may be related to regulating the activity of PI 3K/Akt signaling pathway and promoting the apoptosis of hepatic stellate cells.
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Objective@#Physical literacy is the breakthrough point and fundamental goal to achieve the integration of sports and education, sports and public health and expand the function of physical education. Studying the children and adolescents physical literacy is a common responsibility for children and adolescents health, sports and health education workers. This article was based on the latest research evidence and expert opinions in China, aiming to develop the core items of physical literacy guidelines for Chinese children and adolescents.@*Methods@#This article systematically combed the dimensions and index system of children and adolescents physical literacy through systematic literature review. After five rounds of Delphi methods, the core items were extracted.@*Results@#The core items included four interrelated dimensions of body, emotion, behavior, and cognition, which were specifically composed of four components: physical ability, emotional experience, physical activity related behaviors, and knowledge understanding and application ability.@*Conclusion@#Children and adolescents are the key periods, sensitive periods, and window periods to cultivate physical literacy. The core items can provide framework recommendations for further refining guidelines. More empirical studies should be carried out in the future, in order to accumulate enough evidences and further to improve Physical Literacy guidelines, better to guide physical literacy promotion.
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Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.
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Objective To analyze the differences of brain structure volume in normal middle-aged and elder Chinese using automatic brain segmentation technique. Methods MRI was performed in 96 healthy middle-aged and elderly volunteers, and the volume of each brain structure was obtained with automatic brain segmentation technology. The differences of brain structure volumes in different genders, age, left and right side of the brain were analyzed, and the impact of aging was observed. Results Statistical differences of the absolute value of whole brain volume, also of standard volume of brain structures, including right putamen, bilateral caudate nucleus, right globus pallidus, gray matter of right frontal lobe and right parietal lobe were found between different genders. There were statistical differences of bilateral standard volume of cerebral ganglion, putamen, caudate nucleus, frontal lobe, parietal lobe, occipital lobe, temporal lobe, insular lobe, gray matter of cingulated gyrus and the third ventricle of cerebrum. The volume of cerebrospinal fluid, right ventricle and the third ventricle of cerebrum were positively correlated with aging (r=0.60, 0.51, 0.57, all P<0.05), whereas of bilateral frontal lobe and left insula lobe, cortical gray matter, gray matter of parietal lobe, temporal lobe and left occipital lobe were negatively correlated with aging (all P<0.05). Conclusion Automatic brain segmentation technology can directly and rapidly display brain structure volume. There are differences of brain structure volume in healthy middle-aged and elderly Chinese people between different genders. The volume of cerebrospinal fluid, lateral ventricle and third ventricle increase, while of cortical gray matter, frontal gray and white matter, parietal, occipital, temporal gray matter and insula lobe decrease with aging.
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Objective:To construct Z-score ranges for normal fetal middle cerebral artery peak systolic velocity(MCA-PSV).Methods:From May 2017 to October 2019, 865 normal singleton fetuses of 10th to 40th gestational weeks underwent prenatal ultrasound in the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. Using fetal biometric parameters as independent variables, and measurement of MCA-PSV on standard section as dependent variables, the regression analyses of the mean(M) and the standard deviation(SD) for each parameter were calculated separately and then the best fitting equation was selected. A group of diseases which might cause the abnormal MCA-PSV were assessed using these standards.Results:①Strong correlations were found between MCA-PSV and fetal biometric parameters ( r=0.935-0.939, P<0.001). ②Quadratic or cubic regression equations were fitted to the models of the means of the MCA-PSV, whereas linear equations were fitted to the SDs. ③In these case groups, intrauterine growth restriction, severe preeclampsia, intrauterine infection and homozygous α-thalassemia-1 demonstrated Z-score>2 reflective of increased MCA-PSV with varying degrees, especially with the homozygous α-thalassemia-1 fetus being the most significant (17/20, 85%). Conclusions:The calculation of Z-score for MCA-PSV as a function of fetal biometric parameters is intuitive and simple, it can be used as an important indicator especially for homozygous α-thalassemia-1.
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Objective:To observe the effect of different asparaginase on the incidence of drug-induced diabetes in children with acute lymphoblastic leukemia(ALL) during combined chemotherapy.Methods:A total of 100 ALL children hospitalized in Zhucheng People's Hospital from January 2016 to December 2018 were selected in this study.According to the difference of asparaginase, 67 cases were divided into L-asparaginase group, and 33 cases were divided into pegaspargase group.The demographic, clinical indicators and remission after chemotherapy were compared between the two groups, and logistic regression model was used to analyze the influencing factors of diabetes mellitus during treatment.Results:There were statistically significant differences in random blood glucose ( t=2.515, P=0.014), albumin ( t=2.407, P=0.018), serum C-peptide ( t=2.030, P=0.045) and diabetes mellitus ( t=5.380, P=0.002) between the two groups after chemotherapy ( P<0.05). During chemotherapy, drug-induced diabetes mellitus had the highest incidence in induction remission period.The incidence of the L-asparaginase group (31.3%, 21/67) was higher than that of the pegaspargase group (12.1%, 4/33) (χ 2=4.357, P=0.037). Age (χ 2=7.748, P=0.005), risk stratification (χ 2=10.500, P=0.005) and types of chemotherapeutic drugs (χ 2=7.752, P=0.005) were independent influencing factors for the occurrence of drug-induced diabetes in children with ALL during chemotherapy ( P<0.05). The older the age, the greater the risk of diabetes mellitus during chemotherapy.The risk of drug-induced diabetes mellitus in pegaspargase group was 0.107 times higher than that in L-asparaginase group.The risk of drug-induced diabetes in high-risk children was 9.916 times higher than that in low-risk children. Conclusion:Drug-induced diabetes mellitus in ALL children treated with asparaginase combined with chemotherapy mainly occurs in the early stage of chemotherapy.The risk of drug-induced diabetes mellitus in ALL children treated with L-asparaginase combined with chemotherapy is higher than that of pegaspargase.Pegaspargase combined with chemotherapy in the treatment of ALL children can effectively reduce the incidence of drug-induced diabetes during chemotherapy.
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Objective:To discuss how to avoid the occurrence of adverse events and provides basis for improving the extracorporeal membrane oxygenation (ECMO) transport safety management to formulate the corresponding preventive measures through analyzing the causes and characteristics of adverse events in transport of ECMO.Methods:By using a self-designed ECMO transport observation table to collect data, with a retrospective study of adverse events in patients with ECMO transport in ECMO center of Beijing Chaoyang Hospital from January 2013 to June 2017, carrying out classification and analysis according to the causes of adverse events and the potential risks of the patients, thus put forward the feasible preventive measures.Results:There were 53 cases of ECMO transport in study period, with 18 cases (33.96%) of adverse events, among which the incidence of adverse events in inner-hospital transport was 34.21% (13/38) and that in inter-hospital transport was 33.33% (5/15). There was no patient died in ECMO transport. In the adverse events of ECMO transport, the main causes were related to transport staff, transport equipment and patient, which accounting for 1/3 of each. Among them, the most prominent was 4 cases (22.22%) of equipment lacking and 3 cases of battery and power supply (16.67%). In classification according to the risk degree of patients, 6 cases (33.33%) of third grade risk were found.Conclusions:It is safe and feasible to carry out ECMO transport in inner-hospital transport and inter-hospital transport based on ECMO transport team and transport process of this hospital. However the unexpected events of high risk or crisis of life is inevitable in ECMO transport. Through standardized training for ECMO team, with full assessment before transport, by the use of ECMO checklist and strict implementation of various transport processes and specifications, the incidence of adverse events in ECMO transport may be reduced.
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Purpose@#The purpose of this study was to evaluate the diagnostic value of soluble Axl (sAxl) in hepatocellular carcinoma (HCC) in comparison with serum α-fetoprotein (AFP). @*Materials and Methods@#Eighty HCC patients, 80 liver cirrhosis patients (LC), 80 patients with hepatitis B virus (HBV) infection, and 80 healthy controls (HC) were enrolled. sAxl levels were measured by an enzyme-linked immunosorbent assay, serum AFP levelswere measured by an electrochemiluminescence immunoassay. Receiver operating characteristic (ROC) curves were used to evaluate diagnostic performances. @*Results@#The results show that levels of sAxl were high expression in patients with HCC (p LC > HC > HBV. Logistic regression and ROC curve analysis identified the optimal cut-off for sAxl in differentiating all HCC and non-HCC patients was 1,202 pg/mL (area under the receiver operating characteristic [AUC], 0.888; 95% confidence interval [CI], 0.852 to 0.924) with sensitivity 95.0%, specificity 73.3%. Furthermore, differential diagnosis of early HCC with non-HCC patients for sAxl showed the optimal cut-off was 1,202 pg/mL (AUC, 0.881; 95% CI, 0.831 to 0.931; sensitivity, 94.1%; specificity, 73.3%). Among AFP-negative HCC patients with non-HCC patients, the cut-off was 1,301 pg/mL (AUC, 0.898; 95% CI, 0.854 to 0.942) with a sensitivity of 84.6%, a specificity of 76.3%. The optimal cut-off for sAxl in differentiating all HCC and chronic liver disease patients was 1,243 pg/mL (AUC, 0.840; 95% CI, 0.791 to 0.888) with sensitivity 93.8%, specificity 61.9%. The combination of AFP and sAxl increased diagnostic value for HCC. @*Conclusion@#sAxl outperforms AFP in detecting HCC, especially in early HCC and in AFP-negative HCC. Combination sAxl with AFP improved the specificity for early HCC diagnosis. In summary, sAxl is a candidate serum marker for diagnosing HCC.
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OBJECTIVE：To rapidly evaluate the effectiveness ，safety and economics of Ginkgo biloba extract（EGb）in the treatment of Alzheimer ’s disease （AD）patients，and to provide evidence-based reference for clinical drug selection and decision. METHODS：Retrieved from PubMed ，Embase，Cochrane Library ，Web of Science ，CNKI，CBM，Wanfang database ，health technology assessment （HTA）organization websites and database during the inception to Aug. 10，2020，HTA reports ，systematic reviews/Meta-analysis，and pharmacoeconomic studies of EGb versus placebo in the treatment of AD were collected. After literature screening and data extration ，HTA checklist ，AMSTAR-2 scale and CHEERS scale were used respectively to evaluate the literature quality of the included HTA report ，systematic review/Meta-analysis and pharmacoeconomics studies. The conclusion of the included studies were summarized by using qualitative description. RESULTS ：A total of 9 literatures were included ，involving 8 systematic reviews and 1 economic studies. In terms of effectiveness ，there was no statistical significance in MMSE score of EGb group，ADAS-Cog score of 120 mg EGb group ，compared with placebo group （P＞0.05）. Dementia Quality of Life （DQoL）score of EGb group was significantly higher than that of placebo group. The scores of short cognitive aptitude tests ，neuropsychiatric inventory（NPI），NPI caregiver version score ，ADAS-Cog score of 160 mg EGb group and 240 mg EGb group were significantly lower than those of control group （P＜0.05）. ADL scores of patients were inconsistent ；ADL scores of EGb group were significantly lower than those o f placebo group （P＜0.05），or there was no significant diff erence between 2 groups（P＞0.05）； . subgroup analysis by dose showed that there was no RDY2019-39） significant difference in ADL score between 120 mg EGb group and placebo group （P＞0.05）；ADL score of 240 mg E-mail：renxiaolei83@126.com EGb group were signicantly lower than that of placebo group （P＜0.05）. Subgroup analysis of clinical global impression 010-88325751。E-mail：lyi1267@126.com change （CGIC） score showed that there was no significant difference in CGIC score between EGb group and placebo group after receiving ＜200 mg EGb and 26 weeks of treatment （P＞ 0.05）；CGIC score of EGb group was significantly higher than that of placebo group after receiving ＞200 mg EGb and 24 weeks of treatment （P＜0.05）. In terms of safety ，there was no statistical significance in the incidence of ADR or the incidence of severe ADR between EGb group and placebo group （P＞0.05）. Subgroup analysis by dose showed that the incidence of ADR in 240 mg EGb group was significantly higher than placebo group （P＜0.05）. Economically ，EGb treatment for AD is cost-effective ，which could indirectly save the nursing costs of AD patients. CONCLUSIONS ：The efficacy of EGb in the treatment of AD is uncertain ， and the safety and economy are good.
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Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in the expression of aquaporin 4 (AQP4) in brain tissue of rats with cardiopulmonary resuscitation (CPR) during mild hypothermia. Methods Forty-eight healthy male Sprague-Dawley (SD) rats were divided into sham operation group, normal temperature group and mild hypothermia group according to random number table method, with 16 in each group. The rat model of cardiac arrest-cardiopulmonary resuscitation (CPR) was established by asphyxia method. The sham operation group only experienced venous catheterization and tracheal intubation. The mild hypothermia group was treated with hypothermia 0.5 hours after restore of spontaneous circulation (ROSC, maintaining esophageal temperature at 32-34 ℃); the normal temperature group was treated at room temperature after ROSC (maintaining esophageal temperature at 36-38 ℃). Brain tissue was harvested at 6 hours after ROSC, and histopathological changes were observed by hematoxylin-eosin (HE) staining. The water content of brain tissue was determined by dry-wet specific gravity method. The protein expressions of phosphorylation of p38 mitogen-activated protein kinase (p-p38MAPK), p38MAPK and AQP4 in brain tissue were determined by Western Blot. Results Compared with the sham operation group, the nerve cells in the normal temperature group were reduced in size, cytoplasmic loosening, nuclear pyknosis, and in apoptotic body formation, water content of brain tissue was significantly increased [(83.64±2.53)% vs. (77.95±0.94)%, P < 0.05], the protein expressions of p-p38MAPK, p38MAPK, AQP4 were significantly increased (p38MAPK/β- actin: 1.010±0.217 vs. 0.427±0.090, p-p38MAPK/p38MAPK: 0.451±0.172 vs. 0.191±0.141, AQP4/β- actin: 3.129±0.754 vs. 1.598±0.464, all P < 0.05). Compared with the normal temperature group, the degree of necrosis of nerve cells in the mild hypothermia group was reduced, the water content of brain tissue was significantly decreased [(80.49±2.05)% vs. (83.64±2.53)%, P < 0.05], the protein expression of p38MAPK, p-p38MAPK and AQP4 in brain tissue were significantly decreased (p38MAPK/β- actin: 0.590±0.162 vs. 1.010±0.217, p-p38MAPK/p38MAPK: 0.298±0.076 vs. 0.451±0.172, AQP4/β- actin: 2.061±0.340 vs. 3.129±0.754, all P < 0.05). Conclusion Mild hypothermia may regulate the expression of AQP4 in brain tissue of CPR rats through p38MAPK signaling pathway, and reduce brain edema, thereby exerting brain protection.
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Objective To investigate the application of microlecture in clinical practice teaching of cardiovascular internal medicine.Methods A total of 98 students who received practice teaching in Department of Cardiology,the Second Affiliated Hospital of Xi'an Jiaotong University,from January to September,2016,were randomly divided into control group and observation group.The students in the control group received traditional practice teaching,and those in the observation group received microlecture combined with the traditional practice teaching.The two groups were compared in terms of the scores of theoretical and skill examinations,and the degree of satisfaction with practice teaching was surveyed.Results The observation group had a significantly higher score of clinical skill examination than the control group (P＜0.05).The observation group had a significantly higher degree of satisfaction with the teaching methods of cardiovascular internal medicine than the control group (P＜0.05).Conclusion The introduction of microlecture into the clinical practice teaching of cardiovascular internal medicine can significantly enhance students' mastery of clinical operation skills and improve their satisfaction with practice teaching of cardiovascular internal medicine.
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Objective To investigate the feasibility of a model of vertebrobasilar dolichoectasia (VBD)in rats induced by injection of elastase into cisterna magna. Methods Forty male SD rats were randomly divided into elastase model group (n = 20) and saline control group (n = 20). The elastase model group was intracisternal injected with 0. 3 μl of elastase at a concentration of 1. 5 U/μl, and the saline control group was injected with 0. 3 μl of normal saline. All the animals were sacrificed at 28 d after model preparation.The degree of VBD was observed in both groups, and conventional HE and elastic fiber stain were performed. The tortuosity index and increased percentage of artery diameter were used to determine whether the model was successful. Results One and three rats died in the saline control group and the elastase model group, respectively. The diameter of the basilar artery in the elastase model group was significantly thicker than that in the saline control group (0. 452 ± 0. 062 mm vs. 0. 284 ± 0. 046 mm; t = 9. 113, P < 0. 001).None of the saline control groups showed morphological characteristics of VBD, and 15 in the elastase model group met the morphological characteristics of VBD. The success rate of model preparation was 88. 2％ (15/17 ). Histopathological examination showed that the structure of the vascular wall of was destroyed, the wall of the blood vessel was thinned, and internal elastic layer was discontinuous in the elastase model group; the saline control group had a clear wall structure, a uniform wall thickness, and a complete continuous elastic layer. Conclusion Injection of elastase into occipital cistern can successfully induce VBD in rats, which can be used to make a rat VBD model.
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To investigate psychological characteristics in different clinical subgroups of insomniacs, and to provide the basis for the accurate simplification of cognitive behavioral therapy for insomnia. Methods: A total of 212 insomniacs from November 2014 to June 2017 in Clinical Psychology Department or Sleep Department of 2 general hospitals in Hunan Province were included in convenient and classified into sleep onset insomnia (SOI), difficulty maintaining insomnia (DMI), early morning awakening insomnia (EMAI), and combined insomnia (CI) subgroups. Ford Insomnia Response to Stress Test (FIRST), Simplified Coping Style Questionnaire (SCSQ), Dysfunctional Beliefs and Attitudes about Sleep Scale 16 version (DBAS-16), Sleep-Related Behavior Questionnaire (SRBQ), Pre-sleep Arousal Scale (PSAS), Center for Epidemiological Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI) were used to investigate the psychological characteristics. Results: SOI and CI insomniacs had a higher frequency in use of sleep-related behavior than those with DMI; CI had a higher frequency in use of sleep-related behavior than those with EMAI (all P<0.05). Both SOI and CI insomniacs had a higher level of pre-sleep cognitive arousal than DMI and EMAI (all P<0.05). CI insomniacs noticed more consequences of insomnia and had more worries on insomnia than DMI, and CI insomniacs had more expectations of sleep than SOI (all P<0.05). Conclusion: Insomniacs with different clinical subgroups have different features of psychological characteristics. Both the insomnia subgroups and the psychological characteristics should be taken into account when we simplify cognitive behavioral therapy for insomnia (CBT-I) precisely.
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Humans , Anxiety , Arousal , Cognitive Behavioral Therapy , Sleep , Sleep Initiation and Maintenance Disorders , Surveys and QuestionnairesABSTRACT
Objective@#To understand the mechanism of chemotherapy resistance in nasopharyngeal carcinoma under hypoxic conditions through the perspective of protein SUMOylation modification.@*Methods@#Cobalt chloride (CoCl2) was used to establish the hypoxic model of human nasopharyngeal carcinoma CNE1 cells. Then, the cell cycle was detected by flow cytometry, and the expression level of small ubiquitin-related modifier(SUMO) and cyclin-dependent kinase 6 (CDK6) proteins were detected by western blotting. MTT assay was used to determine the median lethal dose (IC50) of cancer cells against cisplatin, and enzyme-linked immunosorbent assay (ELISA) was used to determine lactate dehydrogenase (LDH) level.@*Results@#The cell cycle of CNE1 induced by hypoxia was arrested in G0/G1 phase.The results of Western blot showed that the protein expression level of CDK6 in CNE1 cells was lower than that in the control group (0.83±0.25 vs. 0.43±0.21, t=14.67, P=0.003). The protein level of conjugated SUMO1 was significantly lower than that in the control group (2.69±0.48 vs. 1.38±0.31, t=17.22, P=0.001), while the level of free SUMO1 protein was significantly higher than that in the control group (2.01±0.43 vs. 2.60±0.59, t=15.45, P=0.002).The LC50 of CNE1 cells in the control group was significantly lower than that in the hypoxic group (29.44 μg/ml vs. 97.72 μg/ml, t=12.79, P=0.001). After CNE1 cells received 50 μg/ml cisplatin for 48 h, the LDH content in the supernatant of the control group was significantly higher than that in the hypoxic group ((541.49±64.59) ng/ml vs. (234.67±41.03) ng/ml, t=11.94, P=0.007)). The apoptosis rate of CNE1 cells in the control group was significantly higher than that in the hypoxic group ((76.64±5.37)% vs. (32.84±4.77) ng/ml, t=8.49, P=0.003)).@*Conclusion@#Hypoxia can dissociate the covalent modification of CDK6 and SUMO1, inhibit cell cycle and increase the chemotherapy resistance of nasopharyngeal carcinoma.
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Objective@#To investigate the application of microlecture in clinical practice teaching of cardiovascular internal medicine.@*Methods@#A total of 98 students who received practice teaching in Department of Cardiology, the Second Affiliated Hospital of Xi’an Jiaotong University, from January to September, 2016, were randomly divided into control group and observation group. The students in the control group received traditional practice teaching, and those in the observation group received microlecture combined with the traditional practice teaching. The two groups were compared in terms of the scores of theoretical and skill examinations, and the degree of satisfaction with practice teaching was surveyed.@*Results@#The observation group had a significantly higher score of clinical skill examination than the control group (P<0.05). The observation group had a significantly higher degree of satisfaction with the teaching methods of cardiovascular internal medicine than the control group (P<0.05).@*Conclusion@#The introduction of microlecture into the clinical practice teaching of cardiovascular internal medicine can significantly enhance students' mastery of clinical operation skills and improve their satisfaction with practice teaching of cardiovascular internal medicine.