Analysis of findings of ear, nose, and throat exam of some freshmen in military college entrance examination in Shandong Province / 中国学校卫生

Objective@#To analyze the ear, nose, and throat exam of some freshmen in the military college entrance examination in Shandong Province in 2020 and to facilitate adolescent targeted health promotion.@*Methods@#The 1 411 freshmen participating in the military college entrance examination in Jinan, Zibo and Weifang of Shandong Province were included. The ear, nose, and throat exam were performed by professionals using electric otoscope, 5 meter whispering test, and front rhinoscope.@*Results@#Nasal septal deviation and hypertrophy of inferior turbinate accounted for the highest proportion. Among 489 cases of nasal septum deviation, the detection rate of Jinan (15.97%) was significantly lower than that of Weifang (43.60%) and Zibo (46.53%) ( χ 2=63.32， P <0.05). For deviation of nasal septum, the detection rate in students with urban residence (31.53%) was significantly lower than that of rural students (39.03%) ( χ 2=4.11， P <0.05). Seventy two cases of inferior turbinate hyperplasia were detected, and the detection rate in Jinan (2.99%) was significantly lower than that in Weifang (6.51%) and Zibo (6.04%) ( χ 2=6.63， P <0.05). The detection rate of tonsil hypertrophy was significantly lower in boys (4.63%), students from urban area (3.94%), compared with that of girls(9.56%) and rural students (6.70%) ( χ 2=5.35，4.86， P <0.05). In pharyngeal examination, tonsil hyperplasia was the most common condition of enlarged tonsils ( n =214), which was significantly higher in Jinan(22.36%) than that of Weifang (11.71 %) and Zibo (10.74%) ( χ 2=22.39， P <0.05), and was significantly lower in boys (14.38%) and rural students (12.40%) than that in girls (22.79%) and urban students (17.24%) ( χ 2=4.70，4.65， P <0.05).@*Conclusion@#Nasal septum deviation and tonsil hypertrophy are the most prevalent upper airway diseases among freshmen participating in the military college entrance examination. Prevention and treatment of nasopharynx diseases should be emphasized.

Clinical analysis of cognitive dysfunction and its influencing factors in patients with multisystem atrophy / 中华老年医学杂志

Objective:To analyze the cognitive dysfunction and its influencing factors in patients with multisystem atrophy(MSA).Methods:A total of 143 hospitalized patients with MSA in our hospital from January 2015 to January 2020 were selected as the research objects.The cognitive function was evaluated by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)scales, meanwhile, the influencing factors of cognitive function were analyzed.Results:The average score of MMSE scale of 143 MSA patients ranged from 9 to 30 points, and the MMSE test identified 86 patients(60.1%)with cognitive impairment, including 58 cases(40.6%)with mild cognitive impairment, 27 cases(18.9%)with moderate cognitive impairment and 1 case(0.7%)with severe cognitive impairment.The average score of MoCA scale of 143 MSA patients ranged from 5 to 30 points, among which 111 cases(77.6%)had cognitive impairment, including 69 cases with mild cognitive impairment(48.3%), 35 cases with moderate cognitive impairment(24.5%)and 7 cases with severe cognitive impairment(4.9%). Both the total scores of MMSE and MoCA scores of MSA patients were not correlated with age of onset, old age, gender, disease duration, type of MSA(MSA-C), orthostatic hypotension(OH), urinary retention, positivity of anal sphincter electromyography(ASEMG), triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), fasting blood glucose and glycosylated hemoglobin, serum uric acid and residual urine volume(all P>0.05). Logistic regression analysis showed that fasting blood glucose was a risk factor for cognitive impairment identified by MMSE( OR=2.224, 95% CI: 1.108-4.462, P=0.024); MSA-C( OR=3.905, 95% CI: 1.302-11.713, P=0.015)and TG( OR=3.494, 95% CI: 1.061-11.501, P=0.040)were risk factors for cognitive impairment identified by MoCA.There were no significant differences in above clinical characteristics between moderate to severe cognitive impairment patients and mild cognitive impairment patients identified by MMSE scale( P>0.05). Similarly, there were no significant differences in the above clinical characteristics between moderate to severe cognitive impairment patients and mild cognitive impairment patients by MoCA scale( P>0.05). Logistic regression analysis showed that TG was a risk factor for moderate to severe cognitive impairment identified by MMSE( OR=17.624, 95% CI: 2.596-119.669, P=0.003), while TC was a protective factor( OR=0.006, 95% CI: 0.000-0.714, P=0.036). Logistic regression analysis did not find the influencing factors of moderate to severe cognitive impairment as suggested by MoCA score. Conclusions:There is a high incidence of cognitive impairment in MSA patients.The type of MSA(MSA-C), blood glucose and blood lipid may be influence factors of cognitive impairment in MSA patients.Age of onset, old age, gender, disease duration, autonomic dysfunction, and uric acid have no significant correlation with cognitive impairment of MSA.

Procalcitonin and C-reactive protein levels in patients with genital ureaplasma urealyticum infection and analysis of related risk factors / 中国基层医药

Objective:To investigate the changes in procalcitonin (PCT) and C-reactive protein (CRP) levels in married women with genital ureaplasma urealyticum infection and analyze the risk factors of genital ureaplasma urealyticum infection.Methods:A total of 116 married women with genital ureaplasma urealyticum infection who received treatment in the First Affiliated Hospital of Wenzhou Medical University from January 2019 to December 2019 were included in the observation group. An additional 50 healthy married women who concurrently received physical examination in the same hospital were included in the control group. Serum levels of PCT and CRP were compared between the two groups. Questionnaire outcomes and the risk factors for genital ureaplasma urealyticum infection were subjected to univariate analysis and logistic regression analysis.Results:Serum levels of PCT and CRP in the observation group were (3.71 ± 0.64) μg/L and (34.26 ± 4.23) mg/L, respectively, which were significantly higher than those in the control group [(0.49 ± 0.16) μg/L, (4.84 ± 0.75) mg/L, t = 35.05, 48.76, both P < 0.001]. In the observation group, the proportions of women who used condom each time, who had no abortion, who had one sexual partner, who had first sexual intercourse at the age of ≥ 20 years, who had sexual intercourse ≤ 3 times/week, who had no history of unclean sexual contact, and who knew knowledge of genital ureaplasma urealyticum infection were 54.55%, 24.24%, 65.15%, 54.55%, 42.42%, 69.70%, 34.85%, respectively, which were significantly lower than those in the control group [80.00%, 48.00%, 88.00%, 76.00%, 66.00%, 94.00%, 60.00%, χ2 = 9.79, 9.33, 8.81, 6.89, 7.89, 11.56, 9.32, P = 0.002, 0.009, 0.003, 0.008, 0.005, 0.001, 0.002). Multivariate analysis showed that abortion frequency, number of sexual partners, age at first sexual intercourse < 20 years, frequency of sexual intercourse and history of unclean sexual contact were independent risk factors for genital ureaplasma urealyticum infection ( OR = 2.12, 3.58, 2.34, 2.84, 4.24). Frequent condom use and knowledge of genital ureaplasma urealyticum infection were protective factors for genital ureaplasma urealyticum infection ( OR = 4.03, 3.03). Conclusion:Abnormal increases in serum PCT and CRP levels in married women can be used as sensitive indicators for early diagnosis of genital ureaplasma urealyticum infection. Frequency of sexual intercourse, number of sexual partners, more times of abortion, premature sexual activity, and history of unclean sexual contact are the risk factors of genital ureaplasma urealyticum infection.

Effects of traditional Chinese Songchi ointment combined with treadmill training on PI3K/Akt/mTOR signal pathway and inflammation in rats with disused muscles atrophy / 中华物理医学与康复杂志

Objective:To observe any effect of supplementing treadmill training with applications of the traditional Chinese Songchi ointment in the rehabilitation of gastrocnemius muscles atrophied through disuse.Methods:Forty-five Wistar rats were randomly divided into a normal control group ( n=8) and a model group ( n=37). The rats in the model group had their left hind limbs immobilized by the Nagai method to induce disused muscle atrophy (DMA). That group was then randomly subdivided into a model control (MC) group, a treadmill training group (the EX group), a Songchi ointment group (SC group) and a comprehensive rehabilitation group (the CR group), each of 8. The EX and SC groups were given treadmill training at 18m/min or topical application of Songchi ointment once a day, 6 days a week for 6 weeks. The CR group was given both treatments. After the 6 weeks, hematoxylin and eosin staining was used to evaluate the pathological changes in the gastrocnemius of each rat′s left hind limb. Serum levels of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β) and interleukin-10 (IL-10) were detected using enzyme-linked immunosorbent assays. PI3K, Akt and mTOR mRNA and protein were assayed using real-time quantitative PCR and western blotting. Results:The arrangement of muscle fibers in the MC group was disordered and there was a large number of infiltrated inflammatory cells. Such conditions were significantly relieved in the CR group. After the intervention the levels of inflammatory factors TNF-α and IL-1β in the CR group were, on average, significantly lower than those observed in the MC group, the EX group or the SC group, while the level of anti-inflammatory factor IL-10 was significantly higher. The average PI3K, Akt and mTOR mRNA and protein levels of group CR were significantly higher than those of the MC and EX groups.Conclusions:The traditional Chinese Songchi ointment can usefully supplement treadmill training to relieve DMA. It upregulates IL-10, activates the PI3K Akt/mTOR signaling pathway and promotes the synthesis of muscle fiber protein while down-regulating TNF-α and IL-1β and muscle fiber inflammatory response.

Aging and pelvic floor dysfunction / 中华物理医学与康复杂志

Objective:To investigate the pelvic floor muscle functioning of persons with pelvic floor dysfunction (PFD) at different ages in order to provide a reference for clinical treatment.Methods:A total of 580 PFD patients were divided into group A ( n=163, ≤29 years old), Group B ( n=161, 30-39), Group C ( n=114, 40-49), Group D ( n=128, 50-59) and Group E ( n=14, ≥60 years old). All were given a surface electromyography (sEMG) examination of their pelvic floor muscles. Average sEMG amplitude and its variability were recorded in the pre-resting and post-resting stages. The maximum sEMG amplitude and its rise time and recovery time during rapid contraction of pelvic floor muscles were recorded. Average sEMG amplitude and variability were also recorded during slow muscle contraction. The observations were correlated with the age. Results:Significant differences among the 5 groups were found in all of the measurements. Spearman correlation analysis showed that age was positively correlated with the variation in the sEMG amplitudes in the pre-resting stage, with the rise time and with the recovery time. Age also correlated with the maximum sEMG amplitude in the rapid stage, the variation of the EMG amplitude in the slow-muscle stage, and the EMG amplitude in the post-resting stage. But it was negatively correlated with the average sEMG amplitude during pelvic floor contraction.Conclusions:The stability and coordination of the pelvic floor muscles gradually deteriorates with age. The rate of activation and recovery become slower, with prolonged recruitment, slower response and poor excitability.

Effect of Asari Radix et Rhizoma-Zingiberis Rhizoma Herb Pair on Lung and Liver Lipid Metabolism in Rats with COPD Based on Metabolomics and Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo investigate the effects of Asari Radix et Rhizoma-Zingiberis Rhizoma herb pair （XGHP） on lung and liver lipid metabolism in rats with chronic obstructive pulmonary disease （COPD）. MethodForty SD male rats were divided into a normal group （10 rats） and a model group （30 rats）. The method of cigarette smoke + tracheal injection of lipopolysaccharide（LPS） + cold stimulation was used to replicate COPD model with the syndrome of cold phlegm obstruction in lung. A COPD group， a XGHP group （5.4 g·kg-1·d-1）， and an aminophylline group （0.5 g·kg-1·d-1） were established after successfully inducing the model， with 10 rats in each group. After treatment， the serum triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） levels of rats in each group were measured. Gas chromatography-mass spectrometer （GC-MS） was used to detect the differential metabolites in the lung and liver tissues of rats in each group， and the relevant targets of the differential metabolites were predicted by network pharmacology. Molecular docking was used to verify the binding ability of key components in XGHP to the relevant targets in network pharmacology. The mRNA and protein expression levels of peroxisome proliferator-activated receptor α （PPARα） and fatty acid binding protein 4 （FABP4） in lung and liver tissues of rats in each group were detected by real-time polymerase chain reaction （PCR） and Western blot. ResultXGHP significantly increased the levels of TG， TC， and LDL-C in serum （P<0.05）， and decreased the level of HDL-C （P<0.05） in rats with COPD. GC-MS results showed that there were 8 lung differential metabolites and 17 liver differential metabolites in the COPD group and XGHP group. Network pharmacology predicted 59 common targets for the two differential metabolites， mainly enriched in the PPAR signaling pathway. Molecular docking results showed that the main components in XGHP were well combined with both PPARα and FABP4. Real-time PCR showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 mRNA （P<0.05）， and Western blot showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 proteins （P<0.05） in lung and liver tissues of rats with COPD. ConclusionXGHP effectively improves the blood lipid levels of rats with COPD， which may be related to the increase of the expression levels of PPARα and FABP4 mRNA and proteins in the PPAR signaling pathway， thus regulating lung and liver lipid metabolism.

Effect of Asari Radix et Rhizoma-Zingiberis Rhizoma Herb Pair on Lung and Liver Lipid Metabolism in Rats with COPD Based on Metabolomics and Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo investigate the effects of Asari Radix et Rhizoma-Zingiberis Rhizoma herb pair （XGHP） on lung and liver lipid metabolism in rats with chronic obstructive pulmonary disease （COPD）. MethodForty SD male rats were divided into a normal group （10 rats） and a model group （30 rats）. The method of cigarette smoke + tracheal injection of lipopolysaccharide（LPS） + cold stimulation was used to replicate COPD model with the syndrome of cold phlegm obstruction in lung. A COPD group， a XGHP group （5.4 g·kg-1·d-1）， and an aminophylline group （0.5 g·kg-1·d-1） were established after successfully inducing the model， with 10 rats in each group. After treatment， the serum triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） levels of rats in each group were measured. Gas chromatography-mass spectrometer （GC-MS） was used to detect the differential metabolites in the lung and liver tissues of rats in each group， and the relevant targets of the differential metabolites were predicted by network pharmacology. Molecular docking was used to verify the binding ability of key components in XGHP to the relevant targets in network pharmacology. The mRNA and protein expression levels of peroxisome proliferator-activated receptor α （PPARα） and fatty acid binding protein 4 （FABP4） in lung and liver tissues of rats in each group were detected by real-time polymerase chain reaction （PCR） and Western blot. ResultXGHP significantly increased the levels of TG， TC， and LDL-C in serum （P<0.05）， and decreased the level of HDL-C （P<0.05） in rats with COPD. GC-MS results showed that there were 8 lung differential metabolites and 17 liver differential metabolites in the COPD group and XGHP group. Network pharmacology predicted 59 common targets for the two differential metabolites， mainly enriched in the PPAR signaling pathway. Molecular docking results showed that the main components in XGHP were well combined with both PPARα and FABP4. Real-time PCR showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 mRNA （P<0.05）， and Western blot showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 proteins （P<0.05） in lung and liver tissues of rats with COPD. ConclusionXGHP effectively improves the blood lipid levels of rats with COPD， which may be related to the increase of the expression levels of PPARα and FABP4 mRNA and proteins in the PPAR signaling pathway， thus regulating lung and liver lipid metabolism.

Clinical features and genetic analysis of a case with Perlman syndrome due to variant of DIS3L2 gene / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical phenotype and genetic characteristics of a child with Perlman syndrome.@*METHODS@#Genomic DNA was extracted from peripheral blood samples from the patient and her parents. Whole exome sequencing (WES) was carried out to detect potential variant in the proband. Candidate variant was verified by Sanger sequencing. The pathogenicity of candidate variants was evaluated according to the guidelines of the American College of Medical Genetics and Genomics (ACMG).@*RESULTS@#The results of WES showed that the proband has harbored compound heterozygous variants of the DIS3L2 gene, namely c.2109delC and c.1829.c.1830insC, which were respectively inherited from her mother and father. The results were confirmed by Sanger sequencing. Based on the ACMG guidelines, the two novel variants were both predicted to be pathogenic (PVS1+PS2+PM2).@*CONCLUSION@#The compound heterozygous variants of the DIS3L2 gene probably underlay the Perlman syndrome in this patient. Above finding has enriched the spectrum of DIS3L2 gene mutations.

Ratio of Treg to Th17 cells in peripheral blood of children with B-cell acute lymphoblastic leukemia / 中华检验医学杂志

Objective:To investigate the expression and ratio of CD4 +CD25 +Foxp3 +regulatory T cells (Tregs) to helper T cells 17 (Th17) in the peripheral blood of children with B-cell acute lymphoblastic leukemia (B-ALL). Method:54 children with newly diagnosed B-ALL in Children′s Hospital Capital Institute of Pediatrics from February 2017 to October 2019 were selected as the research subjects, with a median age of 4.9 (3.1 to 7.4) years. These children were divided into a pre-treatment group and a post-treatment group. According to the disease outcome after treatment, they were further divided into a complete remission group (45 cases), and a relapse/refractory group (9 cases). 20 healthy children were selected as the control group. Flow cytometry (FCM) was used to detect the proportions of CD4 +CD25 +Foxp3 +Treg cells and Th17 cells. The ratio of Treg/Th17 cells was calculated. Result:Before treatment, the proportion of Treg cells in the relapse/refractory group and the complete remission group (respectively 6.11±0.48, 6.20±1.16) were higher than those in the control group (4.89±1.46) (P<0.05), and the ratio of Treg/Th17 cells in peripheral blood of children with B-ALL in relapse/refractory stage and complete remission stage (respectively 8.34±2.14, 5.91±1.92) were higher than those in the control group (3.55±1.68) (P<0.05); The ratio of Treg/Th17 cells in the relapsed/refractory group was higher than that in the complete remission group (P<0.05). After treatment, the proportion of Treg cells and ratio of Treg/Th17 cells in peripheral blood of children with B-ALL in relapse/refractory stage (respectively 6.09±0.80, 7.37±1.19) were higher than those in complete remission stage (respectively 5.25±0.87, 4.22±1.50) and control group (respectively 4.89±1.46, 3.55±1.68) (P<0.05). Compared with that before treatment, children in complete remission stage after treatment had lower proportions of Treg cells and the ratio of Treg/Th17 cells, as well as higher proportions of Th17 cells in the peripheral blood (P<0.05). There were no significant differences in the proportions of Treg cells and Treg/Th17 ratio between the pre-treatment group and the post-treatment group of children in relapse/refractory stage (P>0.05).Conclusion:In peripheral blood of children with B-ALL, there is a ratio change of Treg/Th17 cells caused by the increase of CD4 +CD25 +Foxp3 +Treg cells and the decrease of Th17 cells, which tends to be normal with the remission of the disease. Regular detection of Treg and Th17 cells helps to monitor the immune status and provide prognosis of children with B-ALL, and may provide a basis for the immunotherapy of B-ALL.

Robotic versus laparoscopic total mesorectal excision surgery in rectal cancer: short-mid term oncological outcomes / 中华普通外科杂志

Objective:To investigate the safety and mid-term efficacy of robotic versus laparoscopic total mesorectal excision surgery in rectal cancer.Methods:A total of 240 patients were diagnosed with rectal cancer at the Anorectal Department of Gansu Provincial Hospital from Aug 2015 to Mar 2021, 112 patients underwent laparoscopic total mesorectal excision (L-TME group) and 128 patients did robotic-assisted total mesorectal excision (R-TME group).Results:Compared to the R-TME group, the L-TME group had higher conversion rate (5.4% vs. 0.8%, χ2=4.417, P=0.036), higher incidence of complications (32.1% vs. 17.2%, χ2=7.290, P=0.007), higher circumferential resection margin involvement (7.1% vs. 1.6%, χ2=4.658, P=0.031), lower 3-year DFS and OS(74.1% vs. 85.2%, χ2=4.962, P=0.026) and (81.3% vs. 91.4%, χ2=5.494, P=0.019), lower 3-year DFS and OS in AJCC stage Ⅲ(52.5% vs. 76.1%, χ2=5.799, P=0.016) and (65.0% vs. 84.8%, χ2=4.787, P=0.029). Conclusion:R-TME can achieve better oncological outcomes and is more beneficial for RC patients compared with L-TME, especially for those with stage Ⅲ rectal cancers.

Correlation between fish intake and cognitive function in the elderly / 中华老年医学杂志

Objective:To explore the correlation between fish intake and cognitive function in the elderly.Methods:Based on data for Hubei province of the Chinese Health and Nutrition Survey 2015, 335 participants aged 60 and over were included in the study.Face-to-face cognitive screening was used to evaluate cognitive function.Fish intake was converted into four classifications: 0 g/d, 0-50 g/d, 50-100 g/d, and >100 g/d.The multiple linear regression model was used to analyze the correlation between fish intake and cognitive function in the elderly.Results:There were 335 subjects, including 142 males(42.4%)and 193 females(57.6%). In the overall population( F=4.19, P=0.006)and females( F=2.30, P=0.079), cognitive scores of the elderly increased with increased fish intake, but no increase was found in males( F=1.99, P=0.119). After adjusting for confounding factors such as age, sex, urban and rural living, education level, marital status, smoking, alcohol consumption, daily total energy intake, dietary fat-to-energy intake ratio, BMI, history of hypertension and stroke, fish intake >100 g/d in the elderly was positively correlated with the cognitive score( β=2.68, 95% CI: 0.38-4.98), compared with the lowest fish intake group(0 g/d); gender-stratified analysis showed that the regression coefficient was 4.26(95% CI: 1.23-7.30)for women and 1.70(-1.76-5.15)for men. Conclusions:Increased fish intake is positively correlated with improved cognitive function in elderly women, but the same is not true in elderly men.Increasing fish intake may be beneficial in preventing cognitive decline in elderly women.

Preparation and in vitro characterization of remdesivir-loaded liposomes for inhalation / 中国药科大学学报

@#Remdesivir-loaded liposomes for inhalation were prepared and the in vitro properties were evaluated. Firstly, preparation methods of remdesivir-loaded liposomes were screened, and single-factor experiments were conducted to optimize the prescription and preparation process. Then the physical property, deposition ratio and aerodynamic particle size distribution of remdesivir-loaded liposomes suspension for inhalation were comprehensively evaluated. As a result, the optimal liposomes were prepared by the thin-film dispersion method with pH 6.5 phosphate-buffered saline as the hydration medium. In the prescription, the ratio of drug to DPPC was 1∶20; the cholesterol accounted for 10% of total lipids; and 20% DSPE-mPEG 2000 was added as stabilizer.4% trehalose was added as lyoprotectant when lyophilizing to obtain ideal appearance, good stability and a small particle size change after reconstitution. Remdesivir-loaded liposomes were spherical with smooth surface and uniform particle size distribution under transmission electron microscope. In vitro release tests showed no significant change for release curves of remdesivir-loaded liposomes suspension before and after nebulization. Deposition experiments indicated that the fine particles fraction of liposomes was 51.4%, and the mass median aerodynamic diameter was less than 5 μm measured by next generation impactor. To sum up, remdesivir-loaded liposomes for inhalation with high encapsulation efficiency and stability can achieve a suitable particle size distribution to effectively deposit in the lung after nebulization, which provides a new approach for the treatment of COVID-19.

miRNA-541-5p inhibits proliferation and migration of colon cancer cells by negatively regulating cyclin D1 / 肿瘤研究与临床

Objective:To investigate the effect of cyclin D1 (CCND1) negatively regulated by miRNA-541 (miR-541-5p) on the proliferation and migration of colon cancer cells as well as its related mechanism.Methods:Expression levels of miR-541-5p in colon cancer cell lines HT29, SW480, SW620, HCT116 and enterocyte line HIEC of the normal people as well as cancer tissues and pericarcinomatous normal tissues of 112 patients undergoing the colon cancer surgery from the First Affiliated Hospital of Hebei North University between April 2017 and March 2020 were detected by using quantitative real-time polymerase chain reaction(qRT-PCR). The potential target gene of miR-541-5p was predicted by using TargetScan, and was verified by using dual luciferase reporter gene assay, qRT-PCR and Western blot. Expression level of CCND1 was detected in colon cancer cell lines and tissues. Cells with the lowest expression level of miR-541-5p were divided into miR-NC group (the transfected control plasmid), miR-541-5p group (the transfected miR-541-5p mimics), miR-541-5p+CCND1 group (the co-transfected miR-541-5p mimics and CCND1). Effect of miR-541-5p and CCND1 on proliferation and migration ability of colon cancer cells was detected by using cell counting kit-8 (CCK8) and Transwell method. The xenograft model of colon cancer in nude mice was constructed to observe the effect of miR-541-5p on tumor growth.Results:The relative expression level of miR-541-5p in colon cancer tissues was lower than that in pericarcinomatous normal tissues (0.45±0.06 vs. 1.00±0.12, t = 43.385, P < 0.01). The relative expression level of miR-541-5p was 0.46±0.03, 0.67±0.04, 0.57±0.06, 0.17±0.02, 1.00±0.15, respectively in colon cancer cell lines HT29, SW480, SW620, HCT116 and enterocyte line HIEC of the normal people, and the difference was statistiacally significant ( F = 5.621, P < 0.01); the relative expression level of miR-541-5p in all colon cancer cell lines was lower than that in enterocyte line HIEC of the normal people. HCT116 cells were selected to make the subsequent experiments. The predicted results of TargetScan showed that 3'UTR of CCND1 might have sites complementary to those of miR-541-5p. Dual luciferase reporter gene assay showed that CCND1 was the target gene of miR-541-5p, and miR-541-5p negatively regulated the expression of CCND1. CCK-8 method showed that cell proliferation rate of HCT116 was (2.00±0.16)%, (0.89±0.08)%, (2.56±0.23)%, respectively in miR-NC group, miR-541-5p group, miR-541-5p+CCND1 group, and the difference was statistically significant ( F = 6.715, P < 0.01); among HCT116 cells with the overexpression of miR-541-5p, the transfected CCND1 chould reverse the inhibitory effect of miR-541-5p on cell proliferation. Transwell results showed that the overexpression of miR-541-5p inhibited the cell migration ability of HCT116, while the co-transfection of miR-541-5p mimics and CCND1 could reverse the inhibitory effect. In the colon cancer nude mice xenograft model, the tumor mass and size of nude mice in miR-541-5p group was decreased compared with that in the control group (all P < 0.05). Conclusions:miR-541-5p inhibits cell proliferation and migration of colon cancer cells via negatively regulating CCND1, and inhibits tumor growth in xenograft model of colon cancer in nude mice, thereby acting as a tumor suppressor in colon cancer.

Preliminary exploration of Internet-based practice of stomatology hospitals / 中华医院管理杂志

Internet-based practice of stomatology hospitals plays an important role in promoting hierarchical medical system and overcoming the social problems of " high costs and difficulties of medical services" . The authors introduced the practice of free online consultations at a tertiary stomatology hospital during this period. They also analyzed such characteristics of the practice as the doctors′ response rate, doctors′ response timeliness, as well as the specialties and timeframe distribution of patient consultations. The hospital provides online consultations on Guangdong cloud-based hospital platform in two modes. For example, the normal consultation mode operates in a many-many manner, with services provided by attendings and associate chief physicians appointed less than three years. In off hours, patients can also raise questions online. The expert consultation mode offers consultations during business hours in a one-to-one manner, with services provided by associate chief physicians appointed over three years and chief physicians. From February 10 to March 22 2020, 2 156 persons/times of consultations were served in the normal mode, and 1 043 persons/times received in the expert mode. The response timelines of the latter (16.19 min) was much better than the former (27.10 min). In terms of consultation workload of sub-specialties, oral medicine ranked the top (69.30%), while the consultations of the normal mode in work hours accounted for only 73.47% of total consultation workload. It is recommended to optimize resources deployment, introduce artificial intelligent inquiry service, explore an online-offline combined stomatological service, and improve performance management. These measures, when in place, can promote sustainable development of Internet-based stomatology hospitals.

The interventitive effect of Ziyin-Huatan Decoction by regulating exosomes on mice with gastric cancer / 国际中医中药杂志

Objective:To observe the interventative effect of Ziyin-Huatan Decoction by regulating exosomes on subcutaneous tumor of mice with gastric cancer. Methods:MGC-803 cells were randomly divided into exosome control group, low-dose group and high-dose group. The low-dose group and high-dose group were intervened with Ziyin-Huatan Decoction of 25 μg/ml and 100 μg/ml respectively. After 48 hours, the exosomes secreted by MGC-803 cells in each group were extracted. Twenty BALB/c male mice were randomly divided into exosome control group, low-dose Ziyin-Huatan Decoction group, high-dose Ziyin-Huatan Decoction group and blank control group, with 5 mice in each group. Except for the blank control group, the mice in the other groups were injected with exosomes extracted from the cells of the corresponding group through the orbit, 10 μg/time for each mouse, once every other day, a total of 15 times; the blank control group was injected with the same amount of PBS. Then SGC-7901 cells were inoculated into mice to establish a tumor model. The tumorigenic rate and body weight of mice were observed. The levels of CD31, VEGF and bFGF in tumor tissues were detected by immunohistochemistry. Results:Compared with the blank control group, the tumor weight [(170.00 ± 10.00) mg vs. (343.33 ± 20.82) mg] and the expression of CD31 (37.43 ± 0.55 vs. 63.30 ± 0.85), VEGF (11.37 ± 1.19 vs. 70.30 ± 0.72) and bFGF (43.77 ± 1.53 vs. 84.97 ± 1.86) in the high-dose Ziyin-Huatan Decoction group significantly decreased ( P<0.05). Compared with exosome control group, the expressions of CD31, VEGF and bFGF in low and high dose Ziyin-Huatan Decoction groups were decreased ( P<0.05). Conclusion:Ziyin-Huatan Decoction can significantly inhibit the growth of subcutaneous tumor of gastric cancer in mice by regulating exudation, which may be related to the inhibition of tumor angiogenesis.

Long Non-Coding RNA RMRP Contributes to Sepsis-Induced Acute Kidney Injury

Purpose@#This study aimed to explore the role of the long non-coding RNA (lncRNA) RNA component of mitochondrial RNAase P (RMRP) in sepsis-induced acute kidney injury (AKI). @*Materials and Methods@#Venous blood was collected from septic patients and healthy people. C57BL/6 mice who underwent cecal ligation and puncture (CLP) were used as in vivo models of septic AKI. Lipopolysaccharide (LPS)-induced HK-2 cells were employed as in vitro models of AKI. Flow cytometry analysis was conducted to detect cell apoptosis. Enzyme-linked immunosorbent assay and Western blot assays were used to detect levels of pro-inflammatory cytokines. @*Results@#RMRP was upregulated in sera from patients with AKI and in LPS-induced cells. Knockdown of RMRP inhibited cell apoptosis and reduced production of inflammatory factors in LPS-induced cells, as well as alleviated AKI in CLP mice. RMRP facilitated inflammation by activating NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome. We found that microRNA 206 (miR-206) binds with and is negatively regulated by RMRP: miR-206 directly targets the 3’ untranslated region of DEAD-box helicase 5 (DDX5) and negatively regulates DDX5 expression. By binding with miR-206, RMRP upregulated DDX5 expression. Rescue assays revealed that overexpression of DDX5 counteracted the effect of RMRP inhibition on cell apoptosis and inflammatory response in LPS-induced cells. @*Conclusion@#The lncRNA RMRP contributes to sepsis-induced AKI through upregulation of DDX5 in a miR-206 dependent manner and through activation of NLRP3 inflammasome. This novel discovery may provide a potential strategy for treating AKI.

Progress of clinical laboratory tests and molecular imaging for diagnosis of Alzheimer's disease / 中华检验医学杂志

With the expansion of aging population, Alzheimer′s disease (AD) is increasingly imposing a substantial burden on the society. Because of irreversible neuronal death in the brain, effective control of AD relies on early diagnosis for timely therapeutic intervention, and this requires efficient laboratory tests and molecular imaging. Current laboratory tests for AD includes measurements of Aβ peptides, Tau, and a number of other recently discovered molecules in the cerebrospinal fluid and the peripheral blood. PET-based imaging of glucose metabolism, amyloid Aβ, Tau neurofibrillary tangles, TSPO protein, and neuronal receptors, has also proven to be useful in clinical finding of AD. This review will focus on the progress in studies of these biomarkers and methodologies for ADdiagnosis.

Predictive performance of population pharmacokinetic software on vancomycin steady-state trough concentration / 中华危重病急救医学

Objective:To estimate the predictive performance of the population pharmacokinetics software JPKD-vancomycin on predicting the vancomycin steady-state trough concentration, and to analyze the related factors affecting the predictive performance.Methods:The clinical data of patients who were treated with vancomycin and received therapeutic drug monitoring (TDM) admitted to Suzhou Hospital Affiliated to Nanjing Medical University from July 2013 to December 2018 were enrolled. All patients were designed an empirical vancomycin regimen (initial regimen) according to vancomycin medication guidelines. Steady-state trough concentrations of vancomycin were determined at 48 hours after the first dose and 0.5 hour before the next dose. Dosage regimen was adjusted when steady-state trough concentration was not in 10-20 mg/L (adjustment regimen), and then the steady-state trough concentration was determined again 48 hours after adjustment. First, the JPKD-vancomycin software was used to calculate the initial regimen and predict the steady-state trough concentration according to the results calculated by classic pharmacokinetic software Vancomycin Calculator. Second, the JPKD-vancomycin software was used to adjust the vancomycin dosage regime and predict the steady-state trough concentration of adjustment regimen. The weight residual (WRES) between the predicted steady-state trough concentration (C pre) and the measured steady-state trough concentration (C real) was used to evaluate the ability of the JPKD-vancomycin software for predicting the vancomycin steady-state trough concentration. The TDM results of initial regimen were divided into accurate prediction group (WRES < 30%) and the inaccurate prediction group (WRES ≥ 30%) according to the WRES value. Patient and disease characteristics including gender, age, weight, height, the length of hospital stay, comorbidities, vasoactive agent, mechanical ventilation, smoking history, postoperative, obstetric patients, trauma, laboratory indicators, vancomycin therapy and TDM results were collected from electronic medical records. Univariate and multivariate Logistic regression analysis was used to screen the related factors that influence the predictive performance of JPKD-vancomycin software, and the receiver operating characteristic (ROC) curve was drawn to evaluate its predictive value. Results:A total of 310 patients were enrolled, and 467 steady-state trough concentrations of vancomycin were collected, including 310 concentrations of initial regimen and 157 concentrations of adjustment regimen. Compared with the initial regimen, the WRES of adjusted regimen was significantly reduced [14.84 (6.05, 22.89)% vs. 20.41 (11.06, 45.76)%, P < 0.01], and the proportion of WRES < 30% increased significantly [82.80% (130/157) vs. 63.87% (198/310), P < 0.01]. These results indicated that JPKD-vancomycin software had a better accuracy prediction for steady-state trough concentration of the adjusted regimen than the initial regimen. There were 198 concentrations in the accurate prediction group and 112 in the inaccurate prediction group. Univariate Logistic regression analysis showed that women [odds ratio ( OR) = 0.466, 95% confidence interval (95% CI) was 0.290-0.746, P = 0.002], low body weight ( OR = 0.974, 95% CI was 0.953-0.996, P = 0.022), short height ( OR = 0.963, 95% CI was 0.935-0.992, P = 0.014), low vancomycin clearance (CL Van; OR < 0.001, 95% CI was 0.000-0.231, P = 0.023) and postoperative patients ( OR = 1.695, 95% CI was 1.063-2.702, P = 0.027) were related factors affecting the predictive performance of JPKD-vancomycin software. Multivariate Logistic regression analysis indicated that women ( OR = 0.449, 95% CI was 0.205-0.986, P = 0.046), low CL Van ( OR < 0.001, 95% CI was 0.000-0.081, P = 0.015) and postoperative patients ( OR = 2.493, 95% CI was 1.455-4.272, P = 0.001) were independent risk factors for inaccurate prediction of JPKD-vancomycin software. The ROC analysis indicated that the area under ROC curve (AUC) of the CL Van for evaluating the accuracy of JPKD-vancomycin software in predicting vancomycin steady-state trough concentration was 0.571, the sensitivity was 56.3%, and the specificity was 57.1%. The predictive performance of JPKD-vancomycin software was decreased when CL Van was lower than 0.065 L·h -1·kg -1. Conclusions:JPKD-vancomycin software had a better predictive performance for the vancomycin steady-state trough concentrations of adjustment regimen than initial regimen. JPKD-vancomycin software had a poor predictive performance when the patient was female, having low CL Van, and was postoperative. The predictive performance of JPKD-vancomycin software was decreased when CL Van was lower than 0.065 L·h -1·kg -1.

Investigation on sedation level and influencing factors in postoperative patients with mechanical ventilation in ICU / 中国实用护理杂志

Objective:To investigate sedation level for postoperative patients with mechanical ventilation in ICU, and to explore the related factors and patient outcomes with different sedation level.Methods:Totally 163 postoperative ICU patients from 11th June to 30th October 2018 were prospectively analyzed. Medical information and all the RASS (Richmond Agitation Sedation Scale) scores was recorded by nurses.Results:The 163 enrolled patients received 11 261.62 hours mechanical ventilation therapy, and 2 815 RASS scores were assessed and recorded by nurses. Among these scores, 80.3% (2 261/2 815) were at light sedation level, while 17.4% (490/2 815) and 2.3% (64/2 815) were at excessive or insufficient sedation level, respectively. All patients were divided into satisfactory sedation group and unsatisfactory sedation group according to the recommendations of guidelines, and used both univariate analysis and multivariate analysis. Compared to males, female patients tend to be in a satisfactory sedation level ( OR value was 0.39, P<0.05); use of midazolam may increase the risk of unsatisfactory sedation level ( OR value was 5.60, P<0.05); the longer sedation assessment interval ( OR value was 1.70, P<0.05), the more likely the patient′s sedation level is unsatisfactory ( OR value was 1.70, P<0.05) . Patients in sedation unsatisfactory group have higher rate of tracheostomy ( χ 2 value was 9.70, P<0.01), longer ICU stay ( U value was -2.33, P<0.05) and more medical expense ( t value was -4.26, P<0.01). Conclusion:The current sedation management in our ICU is satisfactory, but there is still a small part of patients in a state of insufficient sedation or excessive sedation. Sedation level is closely related to sedatives, RASS assessments interval performed by the nurses. This study provides a reference and basis for clinical sedation management and the sedation assessment strategies in the ICU.

Application of less invasive surfactant administration and nasal high-frequency oscillation ventilation in the treatment of neonatal respiratory distress syndrome in very low and extremely low birth weight preterm infants / 中华实用儿科临床杂志

Objective:To explore the application and treatment efficacy of less invasive surfactant administration (LISA) and nasal high-frequency oscillation ventilation (nHFOV) in very low and extremely low birth weight preterm infants with neonatal respiratory distress syndrome (NRDS).Methods:A total of 85 very low and extremely low birth weight preterm infants with gestational age ranging between 27-32 weeks who were diagnosed with NRDS in the Second Affiliated Hospital of Zhengzhou University from July 2018 to October 2019 were enrolled.After being stratified by gestational age of >27-29 weeks, >29-30 weeks, >30-31 weeks, >31-32 weeks, the neonates were divided into the LISA group (40 cases) and the intubation-surfactant-extubation (INSURE) group (45 cases) by the random envelope method.The LISA group was subdivided into the continuous positive airway pressure (CPAP) group (25 cases) and the nHFOV group (15 cases) by the same method.The patients in the INSURE group were infused with pulmonary surfactant (PS) through the endotracheal tube under positive airway pressure, and then treated with CPAP after extubation.The patients in the LISA group were first treated with CPAP and injected with PS through the gastric tube.After removing the gastric tube, the patients in the CPAP group were given CPAP-assisted ventilation, while the patients in the nHFOV group were given nHFOV-assisted ventilation or mechanical ventilation if nHFOV-assisted ventilation failed.The feasibility of LISA technology and nHFOV was observed, and the adverse reactions, mechanical ventilation, oxygen duration, hospital stay and the incidence of NRDS complications in different groups of the patients were compared.Results:(1) The mechanical ventilation rate (5.0% vs.22.2%), the incidence of broncho-pulmonary dysplasia (BPD) (20.0% vs.42.2%) and the incidence of periventricular leukomalacia (PVL) (12.5% vs.42.2%) in the LISA group were significantly lower than those in the INSURE group (all P<0.05). There were no statistically significant differences in total oxygen duration, hospitalization duration, intraventricular he-morrhage (IVH), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) between the LISA group and the INSURE group (all P>0.05). (2) There was no significant difference in adverse reactions between the LISA group and the INSURE group as well as between the CPAP group and the nHFOV group (all P>0.05). (3) The younger the gestational age at birth, the higher the incidence of NRDS complications.Patients in the LISA group had a lower incidence of NPDS complications than patients of the same gestational age in the INSURE group, but the diffe-rence was not statistically significant (all P>0.05). (4) There was no significant difference in the mechanical ventilation rate and the incidence of BPD, IVH, PVL, NEC and ROP complications between the CPAP group and the nHFOV group (all P>0.05). Conclusions:In the treatment of very low and extremely low birth weight preterm infants with NRDS at the gestational age of 27-32 weeks, LISA technology is a safe and effective PS delivery method, which can reduce the mechanical ventilation rate and the incidence of BPD and PVL.The nHFOV can be used as an initial model for respiratory support of NRDS preterm infants with very low and ultra-low birth weight.LISA combined with nHFOV is applicable to the treatment of preterm infants with NRDS.