Analysis of influencing factors of enteral nutrition interruption in critically ill patients in general surgery department and its impact on prognosis / 中国实用护理杂志

Objective:Analysis of influencing factors of enteral nutrition interruption in critically ill patients in general surgery department and its impact on prognosis.Methods:A total of 91 cases of critically ill patients in general surgery department were selected who were admitted to the general surgery of General Hospital of Eastern Theater Command of the Chinese People′s Liberation Army in Nanjing from June 2021 to March 2022 by convenient sampling method, demographic and enteral nutrition interruption data were collected,and patients were divided into enteral nutrition interruption group and enteral nutrition uninterrupted group to investigate the analysis of the factors of affecting enteral nutrition interruption and its impact on prognosis by Logistic regression analysis.Results:There were 59 cases in the enteral nutrition interruption group and 32 cases in the enteral nutrition uninterrupted group. There were statistically significant differences in gender, analgesic and sedatives, Gastro-kinetic agent and feeding intolerance between both groups ( χ2 values were 4.51-9.97, all P<0.05). Logistic regression analysis results showed that gender ( OR=4.566, 95%CI 1.332-15.657, P<0.05), analgesic and sedatives ( OR=3.437, 95%CI 1.112-10.621, P<0.05), and feeding intolerance ( OR=4.116, 95%CI 1.257-13.479, P<0.05) were the factors of enteral nutrition interruption. There were statistically significant differences between the two groups in the number of days of enteral nutrition up to goal in 3 days, 3-7 days and 7 days, albumin,length of stay in intensive care unit, total length of stay and hospitalization expenses between both groups ( Z values were -2.80 - -0.73, all P<0.05). Conclusions:Female, analgesic and sedatives and feeding intolerance are the risk factors of enteral nutrition interruption in critically ill patients in general surgery department, and enteral nutrition interruption has an adverse impact on the prognosis.Medical staff should avoid excessive use of analgesic and sedatives, and do well in feeding tolerance management to reduce the occurrence of enteral nutrition interruption.

Replantation of severed auricle distal to helix with microsurgical technique: Report of 5 cases / 中华显微外科杂志

Objective:To summarise the clinical experience in replantation of the severed auricle distal to helix with microsurgical technique.Methods:From December 2018 to October 2021, a total of 5 patients with severed auricle injury were treated in the Department of Hand and Foot Surgery of The Affiliated Hospital of Qingdao University. They were 4 males and 1 female with 23-62 years old. After complete debridement of the auricular pinna, the retrograde replantation method was used. For arteries: a dorsal vein of the foot was used to bridge the posterior auricular artery. For veins: 2 patients had the veins directly anastomosed, 2 had the arteriovenous bridging to the posterior ear vein with dorsal foot veins, and the veins in 1 case were not anastomosed. Among the patients, 2 developed venous occlusions after severed auricle, and were treated with bloodletting through small incision at the skin margin. Two patients who received the arteriovenous of the severed auriclse achieved good blood supply. All the patients underwent treatments including anti-freezing, anti-spasm and anti-infection after the emergency surgery. The follow-ups were conducted regularly by telephone and by display photos via WeChat after surgery.Results:All 5 severed auricles were successfully replanted and survived. Postoperative follow-up ranged from 3 months to 2 years, with an average of 10 months. In the 2 cases with venous crisis, the auricles had mild atrophy. All auricles had no obvious pigmentation, and had the sensation recovery back to normal in 1 year after surgery.Conclusion:The pre-judgment of blood vessel quality and high-quality microsurgery skills are the necessary pre-conditions for auricle replantation. For replantation of severed auricle, it is the key to prevent vascular crisis by having the injured blood vessels thoroughly removed.

Correlation of fetal cervical cystic hygroma with chromosomal and structural abnormalities: analysis of 70 cases / 中华围产医学杂志

Objective:To analyze the correlation of fetal cervical cystic hygroma (CCH) with chromosomal and structural abnormalities and to assess the prognosis of CCH.Methods:This study retrospectively enrolled 70 fetuses with CCH diagnosed by prenatal ultrasound in the First Affiliated Hospital of Xi'an Jiao Tong University from July 2015, to December 2021. According to whether complicated by structural malformations or other anomalies, all the subjects were divided into the non-isolated and isolated CCH groups. The correlation of CCH and the gestational age at detection with chromosomal and structural abnormalities were analyzed and the prognosis of the cases were summarized using Chi-square test. Results:There were 34 isolated CCH (34/70, 49%) and 36 non-isolated CCH (36/70, 51%) among the 70 cases. In the non-isolated CCH group, there were eight cases (22%, 8/36) with abnormal heart structure, ten (28%, 10/36) with abnormal anterior abdominal wall, 16 (44%,16/36) with systemic edema and/or pleural effusion, one (3%,1/36) with craniocerebral abnormalities and one with holoprosencephaly and cardiac structural abnormalities. Eighteen out of 44 cases undergoing chromosome testing had chromosomal abnormalities, which were trisomy-18 ( n=6), trisomy-21 ( n=3), trisomy-13 ( n=3), 45,XO ( n=3), and chromosome segment duplication or deletion ( n=3). The detection rate of chromosome abnormality was higher in non-isolated CCH group comparing with isolated CCH group [59%(13/22) vs 23%(5/22), χ2=6.02, P=0.014]. There was no significant difference in the gestational age at the detection of CCH or proportion of women of advanced maternal age between the isolated and non-isolated CCH groups (both P>0.05). The ratios of isolated CCH cases with normal chromosome detected at the gestational weeks of 14-27 +6 was higher than those detected at 11-13 +6 weeks [62%(13/21) vs 17%(4/23), χ2=7.39, P=0.001]. Out of the 17 cases with isolated CCH and normal chromosomes, 12 were live births. One of the 12 cases still had a cystic mass with a diameter of 3 cm in the neck nine months after birth, and the other 11 cases had no mass at birth but one case died at the age of five months (hospitalized one week for neonatal edema),one case was found with anal atresia three days after birth and underwent operation and the remaining nine cases were normal during five months to six years follow-up. Conclusions:Non-isolated CCH is at a higher risk of chromosomal abnormalities. Isolated CCH cases detected later had higher rate of normal chromosome and often have a higher survival rate.

Application and effect evaluation of multidisciplinary collaboration in patients with tophi during perioperative period / 中华风湿病学杂志

Objective:To explore the application and effect of multidisciplinary collaboration in patients with tophi during perioperative period.Methods:Forty-five patients undergoing tophaceous gout surgery in our hospital from May to October 2020 were selected as the control group and treated with routine treatment.From November 2020 to April 2021, 41 patients undergoing tophaceous gout surgery in our hospital who were treated with multidisciplinary collaboration management mode were included as the intervention group. Postoperative pain, blood uric acid level, hospitalization expenses, hospitalization days and patient satisfaction were compared between the two groups.Results:After implementing the multidisciplinary integration man-agement mode, the pain score of the patients at 4 hours, 1 day and 3 days after operation was lower than that of the control group [(3.6±1.0) vs (4.1±1.0), t=2.33, P=0.022; (2.5±0.8) vs (3.0±0.6), t=3.85, P<0.001; (1.8±0.5) vs (2.2±0.7), t=3.52, P<0.001], the serum uric acid level was significantly lower than that of the control group at 1 month and 3 months after operation [(355±58) vs (3928±39), t=3.50, P=0.001; (316±48) vs (366±47), t=4.84, P<0.001], the hospitalization days and hospitalization expenses were significantly decreased [(8.90±2.48) d vs (10.62±3.96) d, t=2.44, P=0.017; (1.00±0.13) ten thousand yuan vs (1.11±0.17) ten thousand yuan, t=3.34, P=0.001], and the patient satisfaction was markedly improved (97.6% vs 82.2%, χ2=3.87, P=0.049). Conclusion:The multi-disciplinary collaboration mode in patients with tophi during perioperative period can effectively reduce the postoperative pain, improve the quality of care, promote reha-bilitation, improve the outcome, and reduce the economic burden of patients, which is worthy of popularization and being applied in clinic.

Etiology and clinical characteristics of fever of unknown origin in 357 pediatric patients / 中华儿科杂志

Objective: To explore the etiologies and clinical characteristics of fever of unknown origin (FUO) and to provide clues for early diagnosis of FUO. Methods: The data about etiology, age, sex, clinical course, length of hospital stays and the expression levels of inflammatory factors in fever phase of 357 pediatric inpatients who were diagnosed with FUO in Children's Hospital of Fudan University from 1 January 2016 to 31 December 2020 were collected and retrospectively analyzed. Participants were grouped into infectious disease, inflammatory disease, malignancy and others and according to the classification of diseases and also grouped into those aged<1 year, 1-<3 years,3-<6 years, 6-<12 years and 12-<18 years. Comparisons between groups were performed using the Mann-Whitney U test, Kruskal-Wallis H test and χ² test. Results: Among the 357 patients (217 males and 140 females). The age of onset was 3.9 (1.3, 9.2) years and visiting age was 5.1 (2.0, 9.3) years. The time-consuming of diagnosis was 94 (66, 213) days. The hospital stay was 8 (6, 14) days. The most frequently identified cause of FUO was infectious diseases (163 cases, 45.7%), followed by non-infectious inflammatory diseases (133 cases, 37.2%), malignancy (21 cases, 5.9%) and others (40 cases, 11.2%). The patients at younger age were more likely to be attacked by malignancy, oncologic diagnoses, and others, nevertheless patients at older age were more likely to be attacked by non-infectious inflammatory diseases oppositely (9.8 (3.6, 11.5) vs. 3.0 (1.2, 7.0), 2.3 (1.0, 5.2), 0.9 (0.5, 1.8) years, U=41.30, 15.94, 37.08, all P<0.01);106 (65%) patients were male, and 57 (35%) patients were female. This result indicated that boys were more susceptible to infectious diseases (χ²=14.73, P<0.01). Analysis of inflammatory factors in serum among 103 patients, interleukin (IL)-6 level in 40 infectious diseases patients (9 (2, 38) ng/L) was significantly lower than those of 6 tumor patients (89 (64, 599) ng/L) and 57 non-infectious inflammatory diseases patients (25 (8, 78) ng/L, U=51.05, 15.70, both P<0.05), no significant difference was observed in IL-2, IL-4, IL-10, tumor necrosis factor α and interferon among the groups (all P>0.05). The patients grouped into those aged 1-<3 years and 3-<6 years were more likely to be attacked by infectious diseases (51.3% (59/115) and 57.1% (40/70)), while patients grouped into those aged 6-<12 years and 12-<18 years were more likely to be attacked by non-infectious inflammatory diseases (55.6% (65/117) and 72.4% (21/29)). Conclusions: Infectious disease is still the main cause of FUO in children and the boys are more susceptible to infectious diseases. However, the morbidity of non-infectious inflammatory diseases increases to number 1 in FUO of children over 6 years of age.

Clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement:a comparative study between Inside-out and Outside-in approach / 中国骨伤

OBJECTIVE@#To compare the clinical outcomes and complications of hip arthroscopic treatment for femoroacetabular impingement (FAI) performed with either Inside-out or Outside-in approach.@*METHODS@#The clinical date of 48 patients with FAI treated by hip arthroscopy surgery and follow-up from June 2016 to June 2019 were retrospectively analyzed. According to the different operative methods, the patients were divided into two groups. Inside-out group, from central compartment to peripheral compartment;Outside-in group, from peripheral compartment to central compartment. There were 14 males and 10 females in Inside-out group with an averageage of (39.8±7.6)years old, 13 males and 11 females in Inside-out group with an average age of (39.5±9.1)years old in Outside-in group. There was no significant difference in age, gender, body mass index, side, impingement type, medical history and follow-up time between the two groups. The complication occurrence rate, modified Harris hip score (mHHS)and nonarthritic hip score (NAHS) were compared between these two groups.@*RESULTS@#The mHHs and NAHS scores of the two groups were significantly higher than those before operation, but there was no significant difference between the two groups (@*CONCLUSION@#Both hip arthroscopic surgery methods can obtain satisfactory clinical efficacy in the treatment of FAI, but the incidence of postoperative complications of Outside-in surgical method is lower. The out-side in method can be preferentially selected for the patients with the indications of operation.

Meta analysis of the effects of high intensity interval training on metabolic syndrome in overweight college students / 中国学校卫生

Objective@#In this study, a meta analysis was conducted to evaluate and compare the effects of different types of interval training, such as, repeated sprint training(RST), high intensity interval training(HIIT) and sprint interval training(SIT) on body index of overweight/obese college students and the effect of moderate intensity continuous training(MICT), so as to provide a reference for taking appropriate exercise measures.@*Methods@#The data was searched and selected from the database of Web of Science, PubMed, Scopus, The Cochrane Library and CNKI, and from the articles about random research on the effects of HIIT, SIT, RST, and MICT on overweight/obese college students for the evaluation of bias risk. And Stata 16.0 software was used for Meta analysis and network analysis.@*Results@#Totally 815 samples selected from 18 articles were included in the study. Meta analysis showed that HIIT( SMD=-0.26, 95%CI =-0.52--0.00, P <0.05) and SIT( SMD=-0.39, 95%CI =-0.72--0.07, P <0.05) could make greater effects on BMI than MICT. The differences between RST and MICT were of no statistical significance( SMD=0.28, 95%CI =0.32-0.87, P >0.05). According to the SUCRA method combined with effect size, the best effect on improving MetS related physiological indexes of overweight college students was found in SIT( SUCRA =79.3), followed by HIIT( SUCRA =78.2), RST( SUCRA =56.8), and MICT( SUCRA =35.7).@*Conclusion@#Compared with MICT, high intensity interval training can greatly improve BMI of the obese/overweight college students, and could achieve the optimal effect of reducing the fat by exercising through SIT.

Effects of Qishenhuoxue granule in sepsis combined with myocardial injury / 中国医师杂志

Objective@#To research the effect of Qishenghuoxue granules in the treatment of sepsis combined with myocardial injury.@*Methods@#A total of 63 patients with sepsis combined with myocardial injury were randomly divided into two groups: 33 cases in control group (conventional therapy for 7 d) and 30 cases in observation group (Qishenhuoxue granule for 7 d). Thromboxane A2 (TXA2), prostaglandin I2 (PGI2), endothelin 1 (ET-1) and other cytokines were detected by enzyme-linked immunosorbent assay (ELISA). At the same time blood pressure, pulse, echocardiography were recorded. The mortality rate at the 28th day and the above values were statistically analyzed.@*Results@#On the 7th day after the intervention of Qishenhuoxue granule, N-terminal pro-brain natriuretic peptid (NT-proBNP) and troponin T (TNT) in the observation group and the control group were significantly lower than those on the 1st day, but there was no significant difference between the two groups at the same time point (P>0.05); On the 7th day after the intervention of Qishenhuoxue granule, the levels of angiotensin Ⅱ (Ang-Ⅱ) and ET-1 in the observation group were significantly lower than those in the control group (P<0.01), but there was no significant difference between the two groups in cardiac function index and 28 day mortality.@*Conclusions@#The Chinese herbal preparation Qishenhuoxue granule could reduce the blood levels of Ang-Ⅱ and ET-1, but its effect on improving myocardial injury is still worthy of further study.

Effects of Qishenhuoxue granule in sepsis combined with myocardial injury / 中国医师杂志

Objective To research the effect of Qishenghuoxue granules in the treatment of sepsis combined with myocardial injury.Methods A total of 63 patients with sepsis combined with myocardial injury were randomly divided into two groups:33 cases in control group (conventional therapy for 7 d) and 30 cases in observation group (Qishenhuoxue granule for 7 d).Thromboxane A2 (TXA2),prostaglandin I2 (PGI2),endothelin 1 (ET-1) and other cytokines were detected by enzyme-linked immunosorbent assay (ELISA).At the same time blood pressure,pulse,echocardiography were recorded.The mortality rate at the 28th day and the above values were statistically analyzed.Results On the 7th day after the intervention of Qishenhuoxue granule,N-terminal pro-brain natriuretic peptid (NT-proBNP) and troponin T (TNT) in the observation group and the control group were significantly lower than those on the 1 st day,but there was no significant difference between the two groups at the same time point (P ＞0.05);On the 7th day after the intervention of Qishenhuoxue granule,the levels of angiotensin Ⅱ (Ang-Ⅱ) and ET-1 in the observation group were significantly lower than those in the control group (P ＜ 0.01),but there was no significant difference between the two groups in cardiac function index and 28 day mortality.Conclusions The Chinese herbal preparation Qishenhuoxue granule could reduce the blood levels of Ang-Ⅱ and ET-1,but its effect on improving myocardial injury is still worthy of further study.

Effect of Indirubin and Sheng-Xue-Xiao-Ban Capsule (SXXBC) on Promoting Peripheral Platelet in ITP Model Mice / 中国实验血液学杂志

OBJECTIVE@#To compare the effect of Sheng-Xue-Xiao-Ban Capsule (SXXBC) and indirubin to the peripheral platelets of the Idiopathic thrombocytopenic purpura (ITP) model mouse.@*METHODS@#The ITP mouse model was established by the method of passive immunization. SXXBC and indirubin were used for intervention treatment. Then the hemorrhagic phenomena of ITP mice were observed and the numbers of peripheral platelets, hemoglobin and white blood cells, bone marrow megakaryocytes and their classification and coagulation function were detected and compared.@*RESULTS@#The improvement rate of hemorrhage in SXXBC group was 40% for small dose, 60% for medium dose and 80% for high dose, while the improvement rate of hemorrhage in indirubin group was 30% for small dose, 50% for medium dose and 60% for high dose. There was no statistically significant difference in the improvement rate of hemorrhage between the two groups (P＞0.05). Compared with the model control group, PLT and Hb increased in different doses of SXXBC and indirubin group 4th-8th day after drug intervention (P＜0.05, 0.01). However, there was no significant difference between the different doses of SXXBC group and indirubin group (P＞0.05). Compared with the model control group, the WBC in each group was significantly lower (P＜0.05, 0.01) on the 4th-8th day after drug intervention; However, there was no statistical significance between the two groups of SXXBC and indirubin (P＞0.05). Compared with the model control group, the total number of megakaryocytes in each treatment group were decreased (P＜0.05, P＜0.01), in which the number of primary megakaryocytes in the large and medium dose groups of SXXBC and indirubin were decreased (P＜0.05, 0.01), and the number of juvenile megakaryocytes in the large dose group of SXXBC and indirubin were also decreased (P＜0.05). The number of granular megakaryocytes were decreased in each intervention groups (P＜0.05, 0.01), and the number of thromocytogenic megakaryocyte was increased in the high and medium dose groups of SXXBC and indirubin (P＜0.01). The time of prothrombin was shortened in the high and medium dose groups of SXXBC and indirubin (P＜0.05), and the fibrinogen (FIB) content in the high and medium dose groups of SXXBC was close to that of the normal control group.@*CONCLUSION@#Both of the SXXBC and the indirubin standard all show good hemostatic effects. Indirubin shows a positive effect on increasing the peripheral platelet and hemoglobin in ITP model mice, regulating the immune response, reducing the total number of bone marrow megakaryocytes, increasing the thromocytogenic megakaryocyte, and increasing coagulation function.

Successful replantation of a completely amputated ear beyond anthelix during the epdiemic of coronavirus disease 19 (COVID-19) / 中华显微外科杂志

To report a case of completely amputated ear beyond the anthelix with a severe cross section contusion. After the inspection and exclusion of coronavirus disease (COVID-19) as per prevention and control procedure, an ear replantation surgery was performed under strict protective measures. At 2 week of followed-up, the replanted auricle survived well and the left ear showed a good appearance.

Effect of iguratimod on diclofenac metabolism by CYP2C9 in rats and human recombinant CYP2C9 yeast cells

Iguratimod (IGU, also known as T-614), a novel disease modifying antirheumatic drug intended to cure patients with rheumatoid arthritis (RA). The purpose of this study is to evaluate the effect of IGU on the pharmacokinetics of CYP2C9 probe drug diclofenac and its metabolite 4′-hydroxy diclofenac in vivo and in vitro. In in vivo experiments, 24 rats were randomly assigned to three groups consisting of the control group (Normal saline), low dose IGU group (10 mg/kg) and high dose IGU group (30 mg/kg). Blood samples were collected from orbital sinuses vein before 1 hour and serial times of giving diclofenac (15 mg/kg) to all the rats. Plasma concentration of diclofenac and its metabolite 4´-hydroxy diclofenac were assayed by high performance liquid chromatography. Pharmacokinetic parameters were assessed by Winnonlin 6.4 pharmacokinetic software. Moreover, in vitro studies were performed in recombinant human CYP2C9 yeast cell system. IGU at low dose showed no significant differences in the pharmacokinetic parameters of diclofenac and 4-hydroxy diclofenac in vivo when compared with control group (p>0.005). However, at the high dose of IGU, the pharmacokinetic parameters of 4´-hydroxy metabolite of diclofenac increase in half-life (T1/2) and mean area under the curve (AUC0→24), while a decrease in mean clearance (CL, mL/h/kg) and volume of distribution Vz (mL/kg). In addition, in in vitro study, high doses of IGU reduces the metabolism rate of diclofenac. IGU at high dose significantly increase the pharmacokinetics parameters of 4´-hydroxy diclofenac in rats. Additionally, it also showed the potent inhibitory effect on diclofenac metabolism in recombinant human CYP2C9 yeast cells.

Effect of Genkwa Flos on Transient Receptor Potential Vanilloid 1 of Thermosensitive Channel / 中国实验方剂学杂志

Objective:To study the effect of Genkwa Flos on the thermosensitive channel, transient receptor potential vanilloid 1 (TRPV1) by electrophysiological whole cell patch clamp technique and animal behavior experiment, in order to explore its mechanism. Method:The whole-cell patch clamp technique was used to measure transmembrane currents induced by 75%ethanol extract from different concentrations of Genkwa Flos in HEK293 cells that expressed human TRPV1.TRPV1 specific antagonist capsaicin was used to observe whether it could inhibit the transmembrane current induced by Genkwa Flos. Totally 30 C57BL/6 mice were taken for behavioral detection, and divided into blank group (6 mice), high-dose group (6 mice), medium-dose group (6 mice), low-dose group (6 mice) and ibuprofen positive control group (6 mice). Genkwa Flos treatment group was given low dose (0.195 g·kg-1·d-1), medium dose (0.39 g·kg-1·d-1) and high dose (0.78 g·kg-1·d-1) by gavage. One hour later, the changes of behavioral latency of cold pain and hot pain in mice were observed in cold plate at (0±2)℃ and hot plate at (55±1)℃. Result:Whole cell patch clamp experiment showed that 75%ethanol extract of Genkwa Flos in hTRPV1/HEK293 cells could activate TRPV1 channel to generate obvious transmembrane current, which was similar with that generated by the known TRPV1 agonist capsaicin in current density and current-voltage relationship. The dose-effect experiments showed that compared with extracellular fluid, 10 g·L-1 ethanol extract of Genkwa Flos could activate hTRPV1/HEK293 cells to induce significant transmembrane current (P-1 ethanol extract of Genkwa Flos was more than 3 g·L-1(P-1 ethanol extract of Genkwa Flos. In the experiment of cold plate and hot plate in mice, there was a dose-effect relationship between the latencies of cold pain behavior and hot pain behavior in mice prolonged by Genkwa Flos. In the experiment of cold plate, compared with the blank group, the cold pain behavior latency of mice in the medium-dose group was significantly prolonged (PPPPPConclusion:More than one TRPV1 agonist was included in 75%ethanol extract of Genkwa Flos. The warm, analgesic and anti-inflammatory effects of Genkwa Flos may be a series of effects after activation of TRPV1.

Management of pregnancy with pulmonary arterial hypertension / 中国实用妇科与产科杂志

Pulmonary arterial hypertension is a severe complication in pregnant women and poses a significant risk to mother and fetus.We post an introduction in the diagnosis and clinical classification of PAH,risk assessment of pregnancy,gestation and postpartum management of common classification.Standardized assessment and treatment in the corresponding medical institutions helps to improve the prognosis of mothers and infants in pregnancy with pulmonary hypertension.

Advances in Study on Statins in Prevention of Colorectal Cancer / 胃肠病学

Statins,the inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA)reductase,are mostly prescribed for the treatment of hyperlipidemia and prevention of cardiovascular events. Several studies have suggested that statins can reduce the risk of colorectal cancer,however,there is still a debate on its chemopreventive effect. This article summarized the local and overseas studies focusing on this issue,and made a brief overview on the effect of statins in prevention of colorectal cancer and adenoma and its potential mechanisms.

Chemical constituents from hypoglycemic active part of Plantaginis Semen / 中国中药杂志

The chemical constituents of Plantaginis Semen with hypoglycemic effect was investigated in this paper. The previous results of the in vivo hypoglycemic effect showed that 60% ethanol extract of Plantaginis Semen decreased the levels of FBG and improved the glucose tolerance in high fat diet(HFD)-induced diabetic C57BL/6 mice. Then, in the present study, the above potential bioactive extract was separated and purified by silica gel, ODS, Sephadex LH-20 column chromatography, medium pressure liquid chromatography(MPLC)and preparative HPLC. The structures of isolated compounds were identified by physicochemical properties and spectral analyses. Eight compounds were obtained and identified as 4, 4a, 5, 7a-tetrahydro-7-(hydroxymethyl)cyclopenta[c]pyran-3(1H)-one(1), iridolactone(2), pedicularislacton(3), rehmaglutin C(4), geniposidic acid(5), p-hydroxylphenylglycerol(6), 1, 2-benzenediol-4-(2-hydroxyethyl)(7), and 3-buten-2-one-4-[3-(β-D-glucopyranosyloxy)-4-hydroxyphenyl](8). Among them, compounds 1-5 were iridoids, and 6-8 were phenolic acids. Compound 1 was a new natural product, and compounds 2-4, 6 and 8 were isolated from the Plantaginaceae family for the first time.

Value of nutritional risk screening in evaluating adverse clinical outcomes in children with severe pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes.</p><p><b>METHODS</b>According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53). Fasting blood samples were collected to measure the levels of insulin-like growth factor-1 (IGF-1), adiponectin, leptin, non-esterified fatty acid (NEFA), albumin, transferrin, prealbumin, and retinol binding protein (RBP). The adverse clinical outcomes were recorded.</p><p><b>RESULTS</b>Compared with the MR and LR groups, the HR group had significantly lower serum levels of IGF-1, leptin, adiponectin, prealbumin, and RBP, as well as a significantly higher serum level of NEFA (P<0.05). Compared with the MR and LR groups, the HR group had a significantly higher proportion of children admitted to the intensive care unit and a significantly longer duration of mechanical ventilation (P<0.05). The HR group had a significantly longer mean hospital stay and a significantly higher incidence rate of complications compared with the LR and MR groups (P<0.05).</p><p><b>CONCLUSIONS</b>Nutritional risk screening has an important value in evaluating the clinical outcome of children with severe pneumonia, and children at a higher nutritional risk tend to have more adverse clinical outcomes.</p>

Risk factors of selective biliary cannulation in endoscopic retrograde cholangiopancreatography for choledocholithiasis and the value of assistant cannulation methods / 中华消化内镜杂志

Objective To investigate the risk factors of standard selectivity biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) for patints with choledocholithiasis,and the effect and safety of assistant cannulation methods.Methods The clinical data were retrospectively analyzed in 372 patients,who received ERCP for choledocholithiasis in the Yijishan Hospital of Wannan Medical College from January 2014 to December 2014.The risk factors of standard biliary cannulation were assessed by univariate and multivariate logistic regression analysis.The success rate of assistant biliary cannulation and the incidence of post-ERCP pancreatitis (PEP) of standard biliary cannulation were compared with doubleguide wire technique (DGT) and precut sphincterotomy (PS),which were used when standard biliary cannulation failed.Results The univariate analysis showed that floppy and long duodenal papilla (P=0.000),angulated common bile duct(P=0.013) were related to failure of standard biliary cannulation.Multivariate analysis showed that floppy and long papilla (P=0.000,OR=0.131,95％CI:0.056-0.307),angulated common bile duct (P =0.003,OR =0.378,95 ％ CI:0.197-0.726) were independent risk factors for standard biliary cannulation.The success rate of standard biliary cannulation was 83.3％ (310/372),62 cases undergone DGT or PS after standard biliary cannulation failure,and the total success rate of cannulation was 99.7％ (371/372).There were 29 cases suffered from PEP in 371 successful cases of biliary cannulation,including 18 cases (5.8％,18/310) of standard biliary cannulation,8 cases (16.3％,8/49) of DGT,and 3 cases (25.0％,3/12) of PS.The incidence of PEP by DGT (x2 =5.532,P =0.019) and PS (x2 =6.994,P=0.008) was significantly higher than that of standard biliary cannulation,but there was no statistical difference on the incidence of PEP between DGT and PS (x2 =0.079,P =0.778).Conclusion Floppy and long duodenal papilla and angulated common bile duct could easily induce the failure of standard biliary cannulation in ERCP for patients with choledocholithiasis.DGT and PS are effective assistant cannulation methods when the standard cannulation fails.

Analysis of anxiety and depression symptoms in hospitalized patients with cardiovascular diseases / 中华老年医学杂志

Objectives To examine clinical characteristics,predisposing factors,treatment and care of depression and/or anxiety symptoms in hospitalized patients with cardiovascular diseases.Methods A retrospective analysis of clinical data of 1 005 hospitalized patients with cardiovascular diseases at our hospital from January 2015 to December 2015 was conducted and psychological assessment for all patients was carried out using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale.The incidence of depression and anxiety and predisposing factors were investigated.The effectiveness of psychological intervention in addition to cardiovascular medications was evaluated.Results The overall incidence of depression and anxiety was 23.4％ (235 cases) among the 1 005 hospitalized patients with cardiovascular diseases.Of the 235 cases,73 cases(31.1％) had anxiety,33 cases had depression (14.0％),and 129 cases had both anxiety and depression (54.9％).The occurrence of anxiety was significantly higher than that of depression(P＜0.05).Risk factors for anxiety and depression in patients with cardiovascular diseases included work-related fatigue,working conditions and health status.The rate of effectiveness of psychological intervention was 95.4％,and no serious adverse events were observed.Conclusions Depression and anxiety are common in hospitalized cardiovascular patients and can be attributed to factors such as work-related fatigue,working conditions and health status.Favorable clinical outcomes can be achieved through psychological interventions,in addition to cardiovascular drug therapy.

Effects of basic fibroblast growth factor modified skeletal muscle satellite cell transplantation on neovascularization following acute myocardial infarction / 中国组织工程研究

BACKGROUND: Previous studies have found that skeletal muscle satellite cell transplantation can induce angiogenesisin myocardial infarction area, reduce infarct size and improve cardiac function. But the overall effect is not satisfactory.OBJECTIVE: To observe the survival of basic fibroblast growth factor (bFGF) gene modified skeletal muscle satellitecells in acute myocardial infarction and to observe the expression of bFGF gene and the effect of cell transplantation onangiogenesis in myocardial infarction area.METHODS: Eighteen New Zealand white rabbits were divided into three groups by random: skeletal muscle satellite cellgroup (control group), bFGF gene enhanced skeletal muscle satellite cell group (experimental group) and blank controlgroup. The left anterior descending branch of the coronary artery of the rabbits was ligated so as to establish an animalmodel of acute myocardial infarction in the former two groups. After labeled by DAPI before transplantation, the skeletalmuscle satellite cells, bFGF gene modified skeletal muscle satellite cells and the equivalent amount of DMEM/F12 wereinjected into the local infarct myocardium correspondingly. Samples were taken 4 weeks after transplantation. Then, thesurvival of skeletal muscle satellite cells and the expression of bFGF gene were observed under light microscope andfluorescence microscope, and the neovascularization in the myocardial infarction area was examined byimmunohistochemical staining.RESULTS AND CONCLUSION: No DAPI-labeled cells were visible in the blank control group, but in the other twogroups, a large amount of DAPI-labeled skeletal muscle satellite cells were seen in the infarction area. Enhanced greenfluorescent protein was highly expressed in the experimental group. Microvessel density in the infarction area washighest in the experimental group followed by the control and blank control groups (P < 0.05). These findings indicatethat bFGF gene modified skeletal muscle satellite cells can survive and promote neovascularization in the acutemyocardial infarction area.