The joint influence of subjective social status and life skill level on adolescent health risk behaviors / 中国学校卫生

Abstract@#Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.

Comparative study on the axial length measurement with A-scan on different postures for difficult measuring eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To provide guidance for more accurate measurement of axial length(AL)of difficult measuring eyes by comparing the differences in the AL of the patient's difficult measuring eye with three methods of the sitting position, supine position A-scan and Lenstar 900(Lenstar, LS900). METHODS: Clinical case-control study. We selected 102 cases(102 eyes)including cataract patients with combined silicone oil filled, vitreous hemorrhage or retinal detachment and patients with dislocation of the lens or IOL in Zhengzhou Second Hospital from May 2019 to September 2020. AL were measured using LS900 and A-scan on sitting position and supine position respectively, and the results of the three methods were statistically analyzed.RESULTS: The detection rates of LS900 and A-scan axial measurement were 83% and 100% respectively. Three methods of A scan in sitting position, supine position and LS900 to measure the overall AL, silicone oil group, lens dislocation group and vitreous hemorrhage group, the differences were statistically significant(P<0.001), The mean values of AL measured by overall A-scan, supine positions of silicone oil group, supine position of lens dislocation group and vitreous hemorrhage group were statistically significant differences with LS900 measurement(all P<0.05), while there was no statistical difference between the results of the overall sitting position and the difficult measuring eye groups' sitting position compared with the LS900 measurement of AL. The three measurements showed good consistency within the 95% consistency range, but the result of A-scan on sitting position was closer to LS900.CONCLUSION: Changing the conventional decubitus position to the sitting position can improve the accuracy of the measurement results and provide clinicians with more reliable guidance for the treatment of patients with difficult measuring eyes of A-scan axial measurement, especially in diseases with altered ocular structure.

Effect of Qinggan Xiefei Fang on increasing susceptibility of influenza virus caused by "liver fire invading lung" / 药学学报

In this study, chronic emotional stress-induced H1N1 influenza susceptibility model was employed to simulate the states of "emotional stagnation" and "liver fire invading lung", and the protective effect of Qinggan Xiefei Fang on viral pneumonia was investigated. Survival rate and morbidity rate of mice were observed within 21 days after H1N1 infection, the symptoms of viral pneumonia and the level of phospholipid peroxidation were detected in lungs of mice after 6-day infection. The experimental results showed that Qinggan Xiefei Fang could alleviate the decline of survival rate and morbidity rate of mice caused by chronic constraint stress loaded with H1N1, inhibit the replication of H1N1 and the production of inflammatory factors, reduce the level of phospholipid peroxidation, and improve the symptoms of pneumonia in mice. The results also showed that compound-target network of Qinggan Xiefei Fang contained 171 compounds and 260 corresponding targets involved in the signaling pathway of oxidative stress, inflammation and immunity. All the above results indicate that Qinggan Xiefei Fang protecting influenza virus pneumonia was related to the regulation of oxidative stress. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Jinan University, in compliance with the Institutional Animal Care Guidelines.

Clinical features and prognostic factors of blastemal Wilms tumor / 中华泌尿外科杂志

Objective:To describe the clinical features and analyze the prognostic factors of blastemaltype Wilms tumor. To explore the clinical risk factors affecting the prognosis of blastoma.Methods:Clinical data of 75 patients admitted to the surgery department of Beijing Children's Hospital from January 2008 to June 2020 who were confirmed to be blastemal-type Wilms tumor by postoperative pathology without preoperative chemotherapy. The patients' general information, clinical characteristics, inspection data, surgical methods and follow-up results were collected. The related factors which influences its prognosis were analyzed. Among the 75 patients, 45 cases (60.0%) were male and 30 cases (40.0%) were female. The diagnosis age was 6-144 m, mean age was 39.1 m. Left side: 38 cases (50.7%), right side: 37 cases (49.3%). The clinical manifestations were abdominal mass in 35 cases (46.7%), hematuria in 24 cases (32.0%), abdominal pain in 7 cases (9.3%) and physical examination in 9 cases (12.0%). There were Stage Ⅰ 30 cases, Stage Ⅱ 28 cases, Stage Ⅲ 15 cases, Stage Ⅳ 2 cases. There were preoperative tumor rupture in 5 cases, intraoperative tumor rupture in 2 cases. Clinical stage Ⅰ and Ⅱ were classified as early, while stage Ⅲ, Ⅳ were classified as late. According to COG protocol, stage Ⅰ and Ⅱ patients received EE4A, stage Ⅲ and Ⅳ patients received DD4A protocol and radiotherapy. The number of lymph nodes sampled during operation was more than 7 in 10 patients.Results:7 cases were tested for 1p16q. One case(stage Ⅱ) was absent at 1p/16q LOH, and chemotherapy was upgraded from EE4A to DD4A. After the recurrence of 1 case in clinical stage Ⅰ, the 1p/16q heterozygotic deletion test was performed, which was changed to M regimen chemotherapy. Only 1p lost in one case, and 1p/16q was negative in 4 cases, so the original chemotherapy regimen was maintained. A total of 67 patients were recruited to the study. The median follow-up time was 57 months. The 5-year relapse-free survival(RFS) rate was74.7%, and the 5-year overall survival(OS) rate was 88.0%. Cox multivariate regression analysis showed that: advanced clinical stage ( HR=4.9, 95% CI 1.2-19.6, P=0.025), tumor volume ( HR=1.7, 95% CI 0.4-6.9, P=0.048), and tumor rupture ( HR=20.1, 95% CI 4.7-85.5, P<0.001) were independent risk factors for prognosis of blastoma. Gender, age, side profile, clinical manifestations, tumor embolism, and number of lymph nodes sampled had no significant influence on the survival rate of blastoma ( P>0.05). Conclusion:Advanced stage (Ⅲ-Ⅳ), tumor volume≥1 000 ml, tumor weight and tumor rupture were independent risk factors for relapse. Insufficient lymph node sampling and incomplete 1p16q, may be the reasons for the increased risk of local recurrence in low-stage patients due to the underestimated risk classification and insufficient treatment intensity.

Expression differences of miR-200c, miR-19a and miR-155 in gefitinib sensitive and drug resistant NSCLC patients and their effects on prognosis / 国际肿瘤学杂志

Objective:To investigate the expression differences of miR-200c, miR-19a and miR-155 in gefitinib sensitive and resistant non-small cell lung cancer (NSCLC) patients, and to analyze the effects of miR-200c, miR-19a and miR-155 expression differences on the prognosis of patients.Methods:From August 1, 2015 to August 1, 2019, 80 patients with stage Ⅲ-Ⅳ NSCLC who were treated with gefitinib in the Fourth Affiliated Hospital of Nanjing Medical University were selected as the research objects. Among them, 36 cases were sensitive to gefitinib as the sensitive group, and 44 cases were resistant to gefitinib as the drug-resistant group. The general data, serum levels of miR-200c, miR-19a and miR-155 were compared between the two groups, and the sensitive factors of gefitinib in NSCLC patients and the correlations between serum miR-200c, miR-19a, miR-155 and clinicopathological characteristics of NSCLC patients were explored. The survival of the patients was analyzed.Results:Compared with the drug-resistant group, the number of smoking cases in the sensitive group was less ( χ2=5.541, P=0.019), the number of clinical stage Ⅲ cases was more ( χ2=8.984, P=0.003), the number of well-differentiated cases was more ( χ2=8.673, P=0.003), the number of patients with lymph node metastasis was less ( χ2=6.082, P=0.014), and the levels of serum miR-200c, miR-19a and miR-155 were higher ( t=7.249, P<0.001; t=8.222, P<0.001; t=10.467, P<0.001). Multivariate logistic regression analysis showed that smoking ( OR=0.355, 95% CI: 0.149-0.845, P<0.001), clinical stage ( OR=0.494, 95% CI: 0.274-0.892, P=0.021), degree of differentiation ( OR=6.062, 95% CI: 3.258-11.279, P=0.013), lymph node metastasis ( OR=0.422, 95% CI: 0.245-0.726, P=0.019), the levels of serum miR-200c ( OR=5.521, 95% CI: 3.126-9.752, P<0.001), miR-19a ( OR=5.384, 95% CI: 2.947-9.836, P<0.001) and miR-155 ( OR=5.325, 95% CI: 3.058-9.274, P<0.001) were all influencing factors of gefitinib sensitivity in NSCLC patients. The levels of serum miR-200c, miR-19a and miR-155 were significantly correlated with clinical stage ( t=3.230, P=0.002, r=-0.578; t=3.188, P=0.002, r=-0.612; t=3.123, P=0.003, r=-0.594), degree of differentiation ( t=2.586, P=0.012, r=0.610; t=4.009, P<0.001, r=0.632; t=4.773, P<0.001, r=0.594) and lymph node metastasis ( t=2.902, P=0.005, r=-0.587; t=3.721, P<0.001, r=-0.629; t=3.391, P=0.001, r=-0.614) of NSCLC patients. Compared with the patients with low levels of serum miR-200c, miR-19a and miR-155, the 1-year survival rates of the patients with high levels of serum miR-200c (63.19% vs. 4.37%, χ2=32.562, P<0.001), miR-19a (61.01% vs. 4.75%, χ2=37.807, P<0.001) and miR-155 (57.82% vs. 0, χ2=44.454, P<0.001) were higher, with statistically significant differences. Conclusion:The levels of serum miR-200c, miR-19a and miR-155 are significantly increased in gefitinib-sensitive NSCLC patients, which are important influencing factors of gefitinib sensitivity, and are closely related to clinicopathological characteristics such as clinical stage, differentiation degree and lymph node metastasis of NSCLC patients, and the prognosis is better in patients with high serum levels.

Effect of / 生物医学与环境科学（英文）

Objective@#This study aimed to investigate the effects of @*Methods@#In this study, 0.1% DMG was supplemented in 20% casein diets that were either folate-sufficient (20C) or folate-deficient (20CFD). Blood and liver of rats were subjected to assays of Hcy and its metabolites. Hcy and its related metabolite concentrations were determined using a liquid chromatographic system.@*Results@#Folate deprivation significantly increased pHcy concentration in rats fed 20C diet (from 14.19 ± 0.39 μmol/L to 28.49 ± 0.50 μmol/L; @*Conclusion@#DMG supplementation exhibited hypohomocysteinemic effects under folate-sufficient conditions. By contrast, the combination of folate deficiency and DMG supplementation has deleterious effect on pHcy concentration.

Reserch progress of neuro-ophthalmic manifestations of coronavirus disease 2019 / 中华眼底病杂志

Currently, coronavirus disease 2019 (COVID-19) is still widely prevalent around the world, leading to a major threat to the global public health. COVID-19 mainly involves the respiratory system, but extrapulmonary manifestations including that of the nervous system also exist in the setting of COVID-19. Misdiagnosis and delayed treatment of the disease may easily cause when ocular, especially neuro-ophthalmological symptoms are the first symptoms in early COVID-19, as the neuroophthalmological manifestations are rarely reported. First-line clinicians need to ask about not only respiratory symptoms such as fever, cough and sore throat, but also diplopia, impaired vision, eye motion pain, abnormal gait or other neurological deficits at the first reception, as these extrapulmonary manifestations are often signs of serious infection. The neuroophthalmological manifestations and possible underlying etiology of COVID-19 were summarized in this review, hoping to provide an early identification and effective treatment of COVID-19 for clinicians. More extensive studies are needed in the future to confirm the causal relationship between COVID-19 and neuroophthalmological disease to provide a sufficient basis for a comprehensive understanding of COVID-19.

Clinical characteristics of vascular neuro-ophthalmology in patients with central retinal artery occlusion / 中华眼底病杂志

Objective:To investigate the clinical characteristics of vascular neuro-ophthalmology in patients with central retinal artery occlusion (CRAO).Methods:A single-center, prospective clinical study. From January 2018 to December 2020, 49 eyes of 49 CRAO patients of The Neuro-ophthalmology Department of Xi'an First Hospital were included in the study. Data on patient demographic characteristics, vascular risk factors, disease characteristics, digital subtraction angiography (DSA) imaging characteristics of internal carotid arteries, treatment, treatment-related adverse events, and 1-month follow-up vascular events were collected. All patiens were examined by visual acuity, head CT and or magnetic resonance imaging. At the same time, 35 cases of internal carotid artery vascular DSA were examined; 14 cases of head and neck CT angiography were examined. The anatomical variation of the extracranial segment of the internal carotid artery was divided into tortuous, tortuous, and coiled; the aortic arch was divided into type Ⅰ , type Ⅱ , type Ⅲ, and bovine type. Intravenous thrombolysis, arterial thrombolysis, conservative treatment were performed. The follow-up time was1 month after treatment. Functional vision was defined as vision ≥20/100. Vascular events were strokes, cardiovascular events, deaths and neovascular glaucoma during follow-up.Results:Among 49 eyes of 49 cases, 40 eyes were male (81.6%, 40/49), and 9 eyes were female (18.4%, 9/49); the average age was 60.7±12.9 years. There were 33, 17, and 16 cases with hypertension, type 2 diabetes, and cerebrovascular disease, respectively; 27 and 34 cases had a history of smoking and tooth loss, respectively. Taking antihypertensive, hypoglycemic, antiplatelet aggregation/anticoagulation, and hypolipidemic drugs were 15, 5, 8, and 5 patients, respectively. There were 11 cases of transient amaurosis before the onset, and 17 cases of CRAO after waking up. There were 33 cases (67.3%, 33/49) with infarction of the affected side of the brain tissue. DSA was performed in 35 cases, and the stenosis rate of the internal carotid artery on the affected side was 70%-99% and 100% were 3 (8.6%, 3/35) and 4 (11.4%, 4/35) cases, respectively. The ophthalmic artery on the affected side originated from the external carotid artery in 5 cases (14.3%, 5/35). There were 17 (54.8%, 17/31) and 2 (6.5%, 2/31) cases of tortuousity and kinking in the extracranial segment of the internal carotid artery. There were 15 (42.9%, 15/35), 6(17.1%, 6/35), and 2 (5.7%, 2/35) cases of aortic arch type Ⅱ, type Ⅲ, and bovine type, respectively. Intravenous thrombolysis and arterial thrombolysis were performed in 13 and 29 cases, respectively. Complications occurred in 2 cases during treatment; 3 cases of symptoms fluctuated after treatment, and 10 cases of asymptomatic new infarcts occurred in imaging studies. Forty-eight cases were treated with antiplatelet aggregation/anticoagulation and hypolipidemic treatment. At discharge and 1 month after treatment, the recovery of functional vision was 7 and 17 cases, respectively. One month after treatment, 1 case died because myocardial infarction; 2 cases of neovascular glaucoma occurred.Conclusion:The proportion of CRAO patients with vascular risk factors and internal carotid artery abnormalities on the affected side is relatively high; the prognosis is relatively good after intravenous thrombolysis and/or arterial thrombolysis and secondary stroke prevention.

Electroacupuncture can promote hippocampal neurogenesis relieving chronic cerebral hypoperfusion / 中华物理医学与康复杂志

Objective:To observe the expression of noggin mRNA in the hippocampus of rats with chronic cerebral hypoperfusion, and explore the effect of electroacupuncture (EA) at the " baihui" and " dazhui" acupoints on their learning and memory and on hippocampal neurogenesis.Methods:In total, 120 Sprague-Dawley rats had cerebral hypoperfusion induced by permanent bilateral ligation of the common carotid artery. The 104 successfully induced were divided at random into a model group and an EA group, each of 52. The EA group was given EA on the baihui and dazhui acupoints for 20 minutes daily for seven days followed by a two-day break. The output current was 1mA at 15Hz. No special treatment was given to the model group. After one, two, four and six weeks of treatment, 6 rats were given BrdU injections to observe the proliferation and differentiation of neural stem cells. Learning and memory were assessed using the Morris Water Maze. The expression of noggin mRNA and neurogenesis in the dentate gyrus of the hippocampus were measured using reverse-transcription polymerase chain reactions and immunohistochemistry.Results:After one, two and five weeks of intervention, the average learning and memory ability of the EA group were significantly better than those of the control group. The average expression of noggin mRNA was significantly higher in the EA group than in the model group at the same time points. Compared with the model group, there were more BrdU-positive cells in the hippocampal dentate gyrus in the EA group, and the number decreased with the prolongation of ischemia. Pearson correlation analysis showed that the levels of noggin mRNA in the hippocampus of both groups were positively correlated with their number of BrdU-positive cells. The correlation was stronger in the EA group than in the model group.Conclusions:Electroacupuncture can promote hippocampal neurogenesis in rats with chronic cerebral hypoperfusion by regulating the expression of hippocampal noggin mRNA, thereby improving their spatial learning and memory ability.

The effects of electro-acupuncture on learning, memory and stem cell differentiation in the hippocampus of rats modeling chronic cerebral ischemia / 中华物理医学与康复杂志

Objective:To observe the effect of electro-acupuncture (EA) on learning, memory and the differentiation of neural stem cells in the hippocampus in the presence of chronic cerebral ischemia.Methods:A total of 120 male Sprague-Dawley rats had chronic cerebral ischemia induced by bilateral ligation of the common carotid arteries. The model was successfully established in 104 of them, and they were randomly divided into a model group and an EA group, each of 52. The EA group was given 20 minutes of EA at acpoints Baihui and Dahui every day for 7 days, followed by an interval of 2 days. The current output was 1mA and the frequency was 15Hz. The model group was not given any intervention. One, 2, 4 and 6 weeks after the modelling, 6 rats from each group were injected with BrdU, and any proliferation and differentiation of neural stem cells was observed. The rats′ learning and memory were also evaluated using the Morris water maze, and neurogenesis of in the dentate gyrus was observed using BrdU+ NeuN and BrdU+ GFAP double-labelled immunofluorescence.Results:The learning and memory of the EA group were significantly better than those of the model group 2, 4 and 6 weeks after the modelling. After two weeks BrdU+ NeuN and BrdU+ GFAP-positive cells were found in the granule cell layer of the hippocampus, and compared with the model group, there were siginificantly more such neurons in the EA group. The gliocyte levels were not significantly different.Conclusion:Electro-acupuncture can improve learning and memory in the face of chronic cerebral ischemia by promoting the differentiation of neural stem cells.

Selection of light sources and radiation parameters in photodynamic therapy for skin diseases / 中华皮肤科杂志

Photodynamic therapy (PDT) is the first-line treatment of some intractable skin diseases, such as actinic keratosis, condyloma acuminatum and moderate to severe acne vulgaris. In clinical practice, radiation parameters and light sources are important for the efficacy of PDT. This review focuses on the selection of radiation parameters and light sources for PDT in terms of the wavelength and type of light sources and dose of radiation, and summarizes research progress in new light sources for PDT.

The Auxiliary Diagnostic Value of Serum Adenosine Deaminase in Acute Leukemia at Clinical Test / 中国实验血液学杂志

OBJECTIVE@#To investigate the auxiliary diagnostic value of serum adenosine deaminase (ADA) in acute leukemia (AL) at clinical test.@*METHODS@#123 AL patients hospitalized in Zhejiang hospital from November 2018 to March 2020 were enrolled as the observation group, and 98 healthy people in the same period were randomly enrolled as the control group. AL patients were divided into two groups: 77 acute myeloid leukemia (AML) patients for AML group and 46 acute lymphoblastic leukemia (ALL) patients for ALL group. The levels of adenosine deaminase (ADA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH) and homocysteine (Hcy) in serum of the patients were detected, and the correlation of ADA with these items was analyzed. Receiver operating characteristic curve (ROC) was used to analyze the clinical diagnostic value of ADA, Yoden index was used to confirm the best cut-off point.@*RESULTS@#The serum ADA level in AL patients was significant higher than that in control group (P < 0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation of ADA with Hcy, ALT, AST, GGT, LDH in AML group (r = 0.47, r = 0.28, r = 0.37, r = 0.22, r = 0.55); and also there was a significant positive correlation of ADA with GGT in ALL group (r = 0.54). In AML group, the maximum area under ROC curve was 0.761 (P = 0.00), 95% confidence interval was 0.682-0.841, sensitivity was 54.50%, specificity was 98.90%, and the best cut-off point was 17.1 U/L. In ALL group, the maximum area under ROC curve was 0.785, 95% confidence interval was 0.694-0.877, sensitivity was 65.90%, specificity was 84.00%, and the best cut-off point was 13.45 U/L.@*CONCLUSION@#The detection of ADA in serum can be used as an auxiliary examination in patients with AL, which can provide a certain value for the diagnosis of the disease.

Metabolic engineering of L-cysteine supply modules for enhanced production of bacitracin in Bacillus licheniformis / 生物工程学报

Bacitracin is a broad-spectrum antibiotics mainly produced by Bacillus, and is used as veterinary medicine in the fields of livestock and poultry breeding. Insufficient supply of precursor amino acids might be an important factor that hinders high-level microbial production of bacitracin. We investigated the effect of strengthening L-cysteine supply on bacitracin production by an industrial bacitracin producer, Bacillus licheniformis DW2. Overexpression of cysK encoding L-cysteine synthase led to a 9.17% increase of the bacitracin titer. Moreover, overexpression of cysE encoding L-serine acetyltransferase and cysP encoding thiosulfate/sulfate intracellular transporter increased the bacitracin titers by 7.23% and 8.52%, respectively. Moreover, overexpression of a putative cystine importer TcyP led to a 29.19% increase of intracellular L-cysteine, and bacitracin titer was increased by 7.79%. Subsequently, the strong promoter PbacA was used to replace the promoters of genes cysP, cysE and tcyP in strain DW2::ysK, respectively. The resulted strain CYS4 (DW2::cysK-PbacA-(cysP)-PbacA(cysE)- PbacA(tcyP) produced 910.02 U/mL bacitracin, which was 21.10% higher than that of the original strain DW2 (747.71 U/mL). Together with the experiments in 3 L fermenters, this research demonstrated that enhancing intracellular L-cysteine supply is an effective strategy to increase bacitracin production of B. licheniformis.

Research progress of targeted drug use related to nanoparticles / 中国基层医药

Nanoparticles refer to particles having a particle size between 1 and 100 nm.Nanomaterials also have many applications in medicine and bioengineering.They have some physical properties that can effectively guide drugs into specific tissues and specific sites.For a long time, clinicians have been plagued by adverse drug reactions.Most drugs cannot be concentrated in targeted sites(tissue, organs, cells, etc.) due to pharmacokinetics.Scientists have been seeking a way to enter through various channels.In vivo, a drug that is distributed at a targeted site.This article will review the characteristics of nanoparticles in targeted therapy, the characteristics of in vivo distribution and current relevant application prospects.

Action mechanism of Sijunzi Decoction in treatment of type 2 diabetes mellitus based on network pharmacology / 中草药

Objective: The main active components and targets of Sijunzi Decoction for type 2 diabetes mellitus (T2DM) treatment were predicted by network pharmacology, and the potential mechanism of multi-component-multi-target-multi-pathway was discussed, and INSR and PI3K in the AMPK signal pathway were verified in animal experiment. Methods: Based on TCM system pharmacology database and analysis platform (TCMSP), literature mining and previous studies of our research group, the chemical components of Sijunzi decoction and its four herbs Codonopsis pilosula, Atractylodes macrocephala, Poria cocos, Glycyrrhiza uralensis were screened. Three conditions of oral absorption rate (OB), drug-like (DL), half-life (HL) were used to screen the active components of the drug; The targets of active components were predicted through the Swiss Target Prediction database; TTD, Drupe and DisGNET databases were used to screen the targets of T2DM. After mapping the component target and disease target, the interaction network of the target proteins of the active components was constructed by using the software of Cytoscape 3.2.1. Through topological analysis of the network, the nodes with degree of freedom ≥ average degree of freedom were screened out, and the core target network of core active ingredient was obtained, while using the String database to draw core-target protein-protein interaction (PPI) networks, using DAVID database for GO analysis and KEGG analysis of core target genes to construct core active components-core target-metabolism Path network diagram to explore the potential mechanism of Sijunzi Decoction against T2DM. The system docking site was used for molecular docking of the top 5 components and the top 3 proteins. Further, animal experiments were used to verify. SD rats were fed with high-sugar high-fat diet combined with low-dose streptozotocin (STZ) to induce T2DM model, and administrated with 5.65 g/kg Sijunzi Decoction for 28 d, and the levels of blood glucose (FBG) and oral glucose tolerance (OGTT) of each group of mice were determinated. The InsR, PI3K mRNA expression in AMPK signaling pathway was detected by RT-PCR. Results: A total of 113 chemical components were selected from Sijunzi Decoction, involving 47 targets for the treatment of T2DM. Twenty-two core components and 27 core targets were screened according to node degree of freedom ≥ average degree of freedom. The GO analysis results showed that it involved seven biological processes such as blood glucose homeostasis, positive regulation of adipose tissue development, four molecular functions including steroid hormone receptor activation and drug binding, and cell composition including the plasma membrane and nuclear chromatin. The results of KEGG analysis showed that it might treat diabetes through 14 signaling pathways, such as AMPK signaling pathway, PPAR signaling pathway and insulin resistance. A total of 60% of the molecules had intense binding activity and 40% had stronger binding activity. The results of animal experiments showed that Sijunzi Decoction could significantly improve OGTT (P < 0.001), and decrease FBG (P < 0.01) in T2DM rats, and significantly increase the expression of INSR mRNA (P < 0.001) and PI3K mRNA (P < 0.001). Some of the predicted results of network pharmacology were verified. Conclusion: This study reflects that Sijunzi Decoction can treat type 2 diabetes mellitus through multi-target and multi-channel, which lays a foundation for the future study of molecular mechanism.

Combined intraoral and cutaneous using of long pulsed 1064 nm and 2940 nm lasers in facial rejuvenation: a prospective study of two consecutive patients / 中华医学美学美容杂志

Objective:To study the effectiveness and safety of combined intraoral and cutaneous using of long pulsed 1064 nm Nd∶YAG and 2940 nm Er∶YAG lasers in facial rejuvenation.Methods:Twenty-one female patients with different grades of nasolabial fold were treated with 6 sessions of the combination lasers therapy once a month. Standardized photographs of VISIA were taken before and after treatment to record any changes of facial contour and nasolabial folds. The efficacy assessment was judged by two non-group experienced dermatologists using modified Fitzpatrick Wrinkle Scale (MFWS), based on the VISIA photos at base line, twelve-week and six-month after treatment. Self-scoring of 5-level satisfaction from patients was also collected and analyzed. Any side effects and complications were recorded.Results:At 12 weeks, mild and moderate nasolabial folds were improved notably, the mean value of MFWS decreased from 1.59 to 0.90, whereas severe nasolabial folds had no remarkable improvement. Six-month after treatment, 18 patients had notable improved, among them: five out of 7 mild cases, 9 out of 10 moderate cases and 2 out of 4 severe cases, and the mean value of MFWS significantly decreased to 0.57 ( P<0.001). The general satisfactory rate of self-scoring was 86%. Two patients had tolerable light burning pain during treatment and two patients got temporary pigmentation that vanished in three months. There were no other adverse reactions and complications. Conclusion:Combined intraoral and cutaneous using oflong pulse 1064 nm Nd∶YAG laser and 2940 nm Er∶YAG laser is a safe and effective therapy for facial rejuvenation.

Probe into the effect of nursing warning signs in the risk nursing of hyperbaric oxygen / 中国实用护理杂志

Objective:To analyze the application effect of nursing warning signs in hyperbaric oxygen risk nursing.Methods:Since March 2018, the hyperbaric oxygen Department of Heze City hospital in Shandong Province had adopted nursing warning signs in the risk management of hyperbaric oxygen nursing.55 patients who were treated with hyperbaric oxygen from March 2017 to February 2018 were taken as the regular group, and the basic nursing and hyperbaric oxygen nursing warning signs were implemented in the hospital from March 2018 to March 2019 55 patients with hyperbaric oxygen were treated as experimental group. The clinical data of each group were analyzed retrospectively.The occurrence rate of complications,skin damage rate,pipeline slippage rate,oxygen concentration exceeding standard rate and nursing satisfaction were compared between the two groups.Results:The incidence of complications was 9.09%(5/55) in the experimental group and 25.45%(14/55) in the routine group,the difference was statistically significant ( χ2 value was 9.367, P<0.05) .The rate of skin damage in the experimental group was 1.82%(1/55), and that in the routine group was 12.73%(7/55), the difference was statistically significant ( χ2 value was 8.822, P<0.05) . The slip rate of the experimental group was 1.82%(1/55), and that of the conventional group was 32.72%(18/55), the difference was statistically significant ( χ2 value was 33.414, P<0.05) . The excess rate of oxygen concentration was 0.00% in the experimental group and 7.27%(4/55) in the conventional group,the difference was statistically significant ( χ2 value was 7.544, P<0.05) .The satisfaction rate of the experimental group was 98.18%(54/55), and that of the routine group was 81.82%(45/55), the difference was statistically significant ( χ2 value was 14.869, P<0.05) . Conclusion:Through the use of nursing warning signs in hyperbaric oxygen nursing risk management, we can improve the risk awareness of nursing staff, reduce the incidence of complications, skin damage rate, pipeline slippage rate, oxygen concentration exceeding the standard rate,and improve patient satisfaction, which should be vigorously spread in clinic.

The effect of fluorescence detection technology on cleaning of robotic electrosurgical instruments / 中国实用护理杂志

Objective:To investigate the effect of different cleaning methods on the cleaning effect of Da Vinci robotic electrosurgical instruments and the feasibility of adenosine triphosphate(ATP) fluorescence detection technology for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.Methods:A total of 180 electrosurgical instruments were divided into control group and test group by random digits table method from June 2018 to June 2019 after robotic surgery. For the control group, 90 cases were manually cleaned to complete the device cleaning process, and for the test group, 90 cases were mechanically cleaned to complete the device cleaning process. Through visual observation, magnifying glass examination and ATP fluorescence detection technology, the cleaning effect of the two methods and the correlation between the evaluation results obtained by ATP fluorescence detection technique and traditional inspection method were compared.Results:The qualified rate of visual observation, magnifying lens examination and ATP fluorescence detection in the control group were 95.56%(85/90), 86.67% (78/90) and 84.44% (76/90), respectively, and that in the test group were 100.00% (90/90), 97.78% (88/90) and 98.89% (89/90), respectively. The test group was higher than the control group. The difference between the two groups was statistically significant ( χ2 values were 4.310, 7.745, 12.291, P<0.05 or 0.01). In the control group, there was a positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.374, P < 0.01), and a significant positive correlation between the qualified rate of magnifying lens examination ( r value was 0.538, P < 0.01). In the test group, There was also a significant positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.754, P < 0.01), and between the qualified rate of magnifying lens examination( r value was 0.556, P < 0.01). Conclusions:Mechanical cleaning is used to clean Da Vinci robotic electrosurgical instruments, which is superior to traditional manual cleaning. ATP fluorescence detection technology is feasible for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.

Functional outcome and recurrence 1 year after first-ever ischemic stroke in non-diabetic patients / 国际脑血管病杂志

Objective:To investigate the risk factors for poor outcome and recurrence at 1 year after first-ever ischemic stroke in non-diabetic patients.Methods:Using Xi'an Stroke Registry Research Database, the clinical data of patients with non-diabetic first-ever ischemic stroke diagnosed in 4 tertiary A hospitals in Xi'an from January to December 2015 were collected. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. Prognosis (functional outcome and recurrence) was followed up at 1 year after diagnosis. Functional outcome was assessed using the modified Rankin scale. 0-2 was defined as good outcome and >2 as poor outcome. Recurrence was defined as new focal neurological dysfunction caused by cerebral infarction or cerebral hemorrhage events during follow-up and confirmed by cranial CT or MRI. Multivariable logistic regression analysis was used to identify the independent influencing factors of clinical outcomes at 1 year. Multivariable Cox proportional hazard model was used to identify the independent influencing factors of recurrence within 1 year. Results:A total of 1 214 non-diabetic patients with first-ever ischemic stroke were included. One year follow-up showed that 210 patients (17.3%) had a poor outcome, 88 (7.2%) of them died, and 47 (3.9%) had recurrence. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.042-1.090; P<0.001), atrial fibrillation ( OR 3.170, 95% CI 1.588-6.327; P=0.001), white blood cell count ( OR 1.106, 95% CI 1.006-1.216; P=0 037), baseline NIHSS score ( OR 1.210, 95% CI 1.147-1.277; P<0.001), and stroke associated-pneumonia (SAP; OR 3.677, 95% CI 1.451-9.316; P=0.006) were independently associated with poor outcomes. Multivariate Cox proportional hazards regression analysis showed that baseline NIHSS score (hazard ratio [ HR] 1.055, 95% CI 1.003-1.109; P=0.036) and SAP ( HR 7.067, 95% CI 3.154-15.836; P<0.001) were independently associated with recurrence. Kaplan-Meier survival curve analysis showed that the 1-year recurrence rate of patients with severe stroke was significantly higher than that of patients with mild to moderate stroke (log-rank test, P<0.001), and the 1-year recurrence rate of patients with SAP was significantly higher than that of patients without SAP (log-rank test, P<0.001). Conclusion:Age, atrial fibrillation, white blood cell count, baseline NIHSS score and SAP are the independent predictors of poor outcomes at 1 year after first-ever ischemic stroke in non-diabetic patients. Baseline NIHSS score and SAP are the independent predictors of recurrence within 1 year after first-ever ischemic stroke in non-diabetic patients.

Linggui Zhugan Decoction () Inhibits Ventricular Remodeling after Acute Myocardial Infarction in Mice by Suppressing TGF-β/Smad Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate the inhibitory effect of Linggui Zhugan Decoction (LZD, ) on the ventricular remodeling (VR) after acute myocardial infarction (AMI) and related mRNA and proteins expression in transforming growth factor-beta 1 (TGF-β)/Smad signaling pathway, and explain its putative mechanism.@*METHODS@#A VR model was generated by ligation of coronary artery in mice. Two weeks after surgery, 60 mice were randomly divided into the model group, the sham-operation group (distilled water), the positive control group (2.4 mg/kg simvastatin), and the low-, medium- and high-dose LZD groups (2.1, 4.2, 8.4 g crude drug/kg, respectively) by a random number table, 10 mice in each group. Mice in each group was treated for 4 weeks. Changes of hemodynamics indices and cardiac weight index were detected by the PowerLab data acquisition and analysis recording instrument. Morphology changes of myocardial tissue were observed by hematoxylin-eosin and Masson staining. The expressions of TGF-β, Smad2, Smad3, p-Smad2 and p-Smad3 in myocardial tissue were detected by Western blotting. The mRNA expressions of TGF-β, Smad2 and Smad3 were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The expressions of matrix metalloprotein 2 (MMP2), MMP9, collagen I and collagen III were observed by immunohistochemical methods.@*RESULTS@#VR mice showed significant dysfunction in hemodynamic indices and cardiac structure and function. Compared with the shamoperation group, myocardial tissue damage, interstitial fibrosis occurred in the model mice, left ventricular systolic pressure (LVSP), left ventricular pressure maximum contraction rate (+dp/dt) and left ventricular pressure maximum relaxation rate (-dp/dt) decreased significantly (all P<0.01), while left ventricular end-diastolic pressure (LVEDP), cardiac weight index and left ventricular weight index elevated significantly, meanwhile TGF-β, p-Smad2, p-Smad3, Smad2, Smad3, MMP2, MMP9, collagen I, collagen III protein expressions in myocardial tissue and TGF-β, Smad2 and Smad3 mRNA expressions increased significantly (all P<0.01). Compared with the model group, LZD could significantly improve the pathological changes of myocardial tissue, increase LVSP, +dp/dtmax and -dp/dtmax, lower LVEDP, reduce the whole heart weight index and left ventricular weight index and inhibit the over-expressions of TGF-β, p-Smad2, p-Smad3, Smad2, Smad3, MMP2, MMP9, collagen I and collagen III proteins in myocardial tissue and mRNA expressions of TGF-β, Smad2 and Smad3 (P<0.05 or P<0.01).@*CONCLUSION@#LZD can significantly suppress VR induced by AMI, and its underlying mechanism may be associated with its inhibitory effect on the TGF-β1/Smad signaling pathway.