Effects of metabolites of eicosapentaenoic acid on promoting transdifferentiation of pancreatic OL cells into pancreatic β cells / 中国药理学通报

Aim To investigate the role of metabolites of eicosapentaenoic acid (EPA) in promoting the transdifferentiation of pancreatic α cells to β cells. Methods Male C57BL/6J mice were injected intraperitoneally with 60 mg/kg streptozocin (STZ) for five consecutive days to establish a type 1 diabetes (T1DM) mouse model. After two weeks, they were randomly divided into model groups and 97% EPA diet intervention group, 75% fish oil (50% EPA +25% DHA) diet intervention group, and random blood glucose was detected every week; after the model expired, the regeneration of pancreatic β cells in mouse pancreas was observed by immunofluorescence staining. The islets of mice (obtained by crossing GCG

Three-dimensional finite element study on the effects of maxillary anterior two-step retraction and en-masse retraction with clear aligners / 中华口腔医学杂志

Objective: To investigate the effects of two-step retraction and en-masse retraction on tooth movement pattern of anterior teeth and posterior anchorage with clear aligners using three-dimensional finite element analysis. Methods: A finite element model of maxillary first premolar extraction case undergoing clear aligner treatment was established based on maxillofacial cone-beam CT data of a 24-year-old adult male with individual normal occlusion, who visited Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine for impacted mandibular third molar in June, 2022. The initial tooth displacement of five anterior retraction protocols (two-step with canine retraction, two-step with incisor bodily retraction, two-step with incisor retraction-overtreatment, en-masse bodily retraction, and en-masse retraction-overtreatment) were evaluated. Results: Two step with canine retraction caused distal tipping of the canine and labial tipping of the incisors (0.18° for central incisor and 0.13° for lateral incisor). Two step with incisor retraction caused mesial tipping of the canine. In two step with bodily retraction protocol, uncontrolled lingual tipping was found in central incisor (0.29°) and lateral incisor (0.32°). In two-step with incisor retraction-overtreatment protocol, the movement pattern of the incisors didn't change, but the inclinations reduced to 0.21° and 0.18°. En-masse retraction caused distal tipping of the canine. In en-masse bodily retraction protocol, uncontrolled lingual tipping was also found in central incisor (0.19°) and lateral incisor (0.27°). In en-masse retraction-overtreatment protocol, the central incisor showed controlled lingual tipping (0.02°) and the lateral incisor showed palatal root movement (0.03° labial inclination). Posterior teeth exhibited mesial tipping in all five protocols. Conclusion: En-masse retraction with incisor overtreatment was beneficial to incisor torque control in clear aligner treatment.

Application of early respiratory training program based on 4E model in children with bronchiolitis obliterans / 中国实用护理杂志

Objective:To explore application effect of early respiratory training schemes based on 4E mode (Engage, Educate, Execute, Evaluate) in children with bronchiolitis obliterans (BO) and provide evidence for the clinical implementation of early respiratory rehabilitation in children with BO.Methods:This was a quasi-experimental study. The children with BO who were admitted to 2 wards of the Department of Respiratory Medicine of Hunan Children's Hospital from January 1 to December 31, 2021 were selected as the research objects. They were randomly divided into the control group and the experimental group, with 23 cases in each group. The control group received routine treatment, nursing and rehabilitation guidance. The experimental group established a multidisciplinary team based on the control group, and used the early respiratory training program based on the 4E model to implement intervention. The clinical symptom severity scale was used to evaluate the improvement of the clinical symptoms of the children within 24 hours of being diagnosed as BO, the day of discharge, and 1 and 3 months after discharge for re-examination, and the hospitalization time of the children and the incidence of adverse events related to respiratory training were counted by using medical records and questionnaires.Results:The clinical symptom severity scores of the experimental group within 24 hours of admission diagnosis and the day of discharge were (20.00 ± 2.51) and (11.30 ± 2.46)points respectively, while those of the control group were (20.57 ± 2.21) and (11.70 ± 2.42) points respectively, with no statistically significant difference ( t=0.81, 0.54, both P>0.05). The clinical symptom severity scores of the experimental group were(10.52 ± 2.31) and (8.55 ± 1.06) points, lower than (12.32 ± 1.39) and (12.45 ± 2.19) points of the control group when they returned to the hospital for re-examination 1 and 3 months after discharge, with a statistically significant difference ( t=3.14, 7.25, both P<0.05). The experimental group was hospitalized for (11.78 ± 1.17) days, which was showter than (13.74 ± 1.63) days in the control group, with a statistically significant difference ( t=4.68, P<0.05). No respiratory training-related adverse events occurred in both groups of children during hospitalization. During home respiratory training after discharge, 1 and 2 respiratory training-related adverse events occurred in the experimental group 1 and 3 months after discharge, respectively, compared with 6 and 9 in the control group. The difference was statistically significant ( χ2=4.64, 5.94, both P<0.05). Conclusions:Early respiratory training solutions based on the 4E mode can improve the clinical symptoms of BO children, shorten the hospitalization time, reduce the number of adverse events related to respiratory training, and promote the recovery of children.

Visualization analysis of pulmonary rehabilitation research based on Web of Science and China National Knowledge Infrastructure / 中国实用护理杂志

Objective:To analyze the related literature of pulmonary rehabilitation research at home and abroad, understand its research focus and development trend, and provide a reference and basis for future pulmonary rehabilitation research.Methods:Literature related to pulmonary rehabilitation published in the database of Web of Science and China National Knowledge Infrastructure from January 2015 to February 2022 was retrieved, and the contents such as the number of articles published annually, authors, research institutions, and high-frequency keywords were visually analyzed by bibliometrics and CiteSpace software.Results:The number of articles published each year showed an obvious upward trend from 2015, and the number of Chinese documents was higher than that of English documents from 2019 to 2020. MARTIJN A SPRUIT was the author with the largest number of articles published in English, with a total of 65 articles published, with close cooperation among scholars. Che Guowei was the author with the largest number of articles published in Chinese literature, with 13 articles published in total. The cooperation among the authors was relatively lacking and scattered. The main research institutions abroad were universities, and the institution with the highest number of papers was Maastricht University in the Netherlands, with a total of 85 articles. The research institutions cooperated closely and formed a cooperation network. Hospitals were the main research institutions in China, and the thoracic surgery Department of West China Hospital of Sichuan University had the highest total number of publications, with 14 articles. The cooperation among institutions was not close, and there was a lack of cooperation with universities and scientific research institutions. Through keyword co-occurrence and clustering and timeline view analysis, it was concluded that the research hotspots in this field were pulmonary rehabilitation of patients with different chronic respiratory diseases, the influence of pulmonary rehabilitation on lung function and quality of life of patients with chronic obstructive pulmonary disease, and the intervention methods of pulmonary rehabilitation. The future trend was predicted as the clinical application value of pulmonary rehabilitation in the treatment of lung cancer.Conclusions:At present, pulmonary rehabilitation research is in a stable development period. However, the cooperation between domestic authors and institutions is not close enough compared with foreign countries. In the future, China should strengthen the communication and cooperation between research teams, and learn from foreign research results to further develop the application of pulmonary rehabilitation in lung cancer patients, to promote the development of pulmonary rehabilitation research in China.

Clinical application value of human papillomavirus typing combined with cervical thin-prep cytology test in cervical cancer screening / 上海预防医学

Objective To explore the clinical value of the third-generation hybrid capture nucleic acid detection technology （DH3） typing detection of human papillomavirus （HPV） combined with thin-prep cytology test （TCT） in screening cervical cancer. Methods A total of1 582 female patients who received HPV and TCT cervical screening in Liuzhou Workers Hospital， Fourth Affiliated Hospital of Guangxi Medical University， from October 2020 to March 2021， were selected for this retrospective analysis. The cervical histopathological diagnosis was used as the gold standard to evaluate the diagnosis accuracies of HPV and TCT test results. Results Among the 1 582 patients， 334 were positive for HPV and 1 248 were negative； 234 were positive for TCT and 1 348 were negative； 180 were positive for histopathological diagnostic and 1 402 were negative. The sensitivity of HPV detection was 100%， the positive predictive value was 53.9%， the specificity was 89.0%， and the negative predictive value was 100.0%. In the HPV typing test， the positive rate for high-risk types 16/18 was 94.8%， and the positive rate for other 12 high-risk types was 73.8%. There was a little difference between TCT test and pathological test， and the detection consistency rate of high-grade squamous intraepithelial lesions and squamous carcinoma was same. Conclusion HPV testing combined with TCT to screen cervical cancer can reduce the misdiagnosis rate by a single test. The classification test is helpful for the hierarchical management of patients， and has a high clinical value for examination triage and grade screening.

Effect of Huangqisan Pellets on PI3K/Akt/mTOR Signaling Pathway and Autophagy in Kidney of Diabetic Nephropathy Rats / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Huangqisan pellets （HQS） on the phosphatidylinositol-3 kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR） signaling pathway and autophagy in the kidney of diabetic nephropathy （DN） rats. MethodDN rat model was established through high-fat diet combined with intraperitoneal injection of streptozotocin （35 mg·kg-1）. DN rats were randomly assigned into model group， irbesartan （0.027 g·kg-1） group， low-dose HQS （0.54 g·kg-1） group and high-dose HQS （1.08 g·kg-1） group. The levels of 24 h urinary total protein （UTP）， serum albumin （Alb）， serum creatinine （SCr）， urea nitrogen （BUN）， triglyceride （TG） and total cholesterol （TC） were measured after 12 weeks of continuous administration. The pathological changes of renal tissue were observed via hematoxylin-eosin （HE） staining. The expression of podocyte split diaphragm proteins nephrin and podocin in the renal tissue were detected by immunohistochemistry. The protein levels and phosphorylation of key proteins in PI3K/Akt/mTOR signaling pathway， as well as the expression of yeast Atg6 homolog （Beclin1） and microtubule-associated protein 1 light chain 3 （LC3） in the renal tissue were analyzed by Western blot. ResultCompared with the control group， the model group showcased increased 24 h UTP， SCr， BUN， TG， and TC levels and decreased Alb level （P<0.01）. After modeling， the rats showed granulosity of epithelial cells of renal tubules， thickening of capillary basement membrane， proliferation of mesangial cells， and sclerosis of glomerulus. Furthermore， modeling down-regulated the expression of nephrin and podocin in the podocyte hiatus of glomerulus （P<0.01） as well as the protein levels of p-PI3K， p-Akt， and p-mTOR and the autophagy markers LC3 and Beclin1 in renal tissue （P<0.01）. Compared with model group， irbesartan and HQS decreased the 24 h UTP， Cr， BUN， TG， and TC levels， increased the Alb level， and alleviated the pathological damage of kidney. Moreover， they up-regulated the expression of Nephrin and Podocin in the podocyte hiatus of glomerulus， as well as the protein levels of p-PI3K， p-Akt， p-mTOR， LC3， and Beclin1 in renal tissue （P<0.05， P<0.01）. ConclusionHQS may inhibit the PI3K/Akt/mTOR signaling pathway to enhance podocyte autophagy and protect the glomerulus， thus slowing down the development of DN.

The immunoregulatory effect of co-3 polyunsaturated fatty acids on lymphocyte in cGVH mice / 中国药理学通报

Aim To investigate the effect of dietary intake of o)-3 poly unsaturated fatty acids ( u>-3 PUFAs) on the immune function of chronic graft versus host disease (cGVH) lupus model mice.Methods A single intraperitoneal injection of bml2 mice lymphocytes was used to establish a cGVH mouse model.On the day of modeling, 90% cd-3 PUFAs and 97% EPA were given by gavage for 14 days.The immune indexes of mice were evaluated by flow cytometry, and the serum total J J J ∗ IgG levels were measured by ELISA.Results Compared with control group, cGVH group significantly down-regulated Treg subsets, and up-regulated the Tfh , GC B and plasma subsets in the lupus mice.Comparer] with model control group, u>-3 PUFAs could significantly elevate Treg subsets, and decrease TFH, (X] B, and plasma subsets; serum total IgG levels in the 97% EPA group were significantly reduced.Conclusion In the cGVH lupus mouse model, co-3 PUFAs can suppress some immune functions by increasing Treg cells, reducing TFH, GC B, plasma cells and inhibiting the secretion of IgG.Such immunomodulatory effect provides new sights into the development of a potentially novel treatment modality for cGVH.

Effect of FKBP38 expression on occurrence and development of nonalcoholic fatty liver disease in mice / 中国药理学通报

Aim To investigate the effects of FKBP38 gene on nonalcoholic fatty liver disease ( NAFLD ) model induced by methionine and choline deficiency j J diet (MCD) in mice.Methods The mutant model of hepatocellular specific deletion of FKBP38 gene was successfully established.The mice were divided into wild-type group ( WT) and homologous knockout group (L-FKBP38 ).Mice were fed with MCD for four weeks to construct NAFLD model.Liver injury was e- valuated by the contents of alanine transaminase (ALT), aspartate transaminase (AST) in the serum samples.We also performed HE staining, examined lipid accumulation by triglyceride (TG) and total cholesterol (CHO) and oil red staining, as well as macrophage infiltration by F4/80 immunohistochemical stai-ning of the liver sections.Fatty acid metabolism-relat ed genes were quantifier] by Quantitative Real-time PCR assays.Results Comparer] with WT group, the levels of ALT, AST, TG and CHO in serum signifi- eantly inereased ( P < 0.05 ) ; liver damage , lipid ac- eumulation, and maerophage infiltration were markedly more severe, and the expressions of fatty aeirl oxidation related genes PPARa, ACOX-1 , CPT-la and SIRT3 markedly rleereaserl ( P < 0.05) in the liver samples of L-FKBP38 group.Conclusions Hepatocellular speeifie deletion of FKBP38 intensifies lipid accumula- tion by inhibiting fatty aeid oxidation in the liver, thus exaeerbating nonaleoholie fatty liver disease.

A comparative study of femoral neck system versus inverted triangle cannulated compression screws in fixation of adult femoral neck fracture / 中华创伤骨科杂志

Objective:To compare the clinical efficacy between femoral neck system (FNS) and inverted cannulated compression screws (ICCS) in the fixation of adult femoral neck fracture.Methods:The clinical data were retrospectively analyzed of the 119 patients with femoral neck fracture who had received FNS or ICCS internal fixation at Department of Traumatic Orthopedics, West China Hospital from September 2019 to June 2020. They were divided into 2 groups according to their internal fixation methods. In the FNS group of 62 patients, there were 38 males and 24 females, with an age of (54.0±13.0) years, and 13 cases of type Ⅱ, 34 cases of type Ⅲ and 15 cases of type Ⅳ according to the Garden classification; in the ICCS group of 57 patients, there were 42 males and 15 females, with an age of (53.2±11.3) years, and 9 cases of type Ⅱ, 33 cases of type Ⅲ and 15 cases of type Ⅳ according to the Garden classification. The operation time, intraoperative blood loss, fluoroscopy frequency, hospitalization time, fracture healing time, Harris hip score and incidence of complications were compared between the 2 groups.Results:The 2 groups were comparable due to insignificant differences in their preoperative general data or follow-up duration ( P>0.05). There were significant differences between the FNS and ICCS groups in fluoroscopy frequency [(8.8±2.9) times versus (15.6±3.4) times], operation time [(45.2±10.1) min versus (51.8±11.7) min], fracture healing time [(3.2±0.4) months versus (4.0±0.6) months], Harris hip score at the last follow-up [(91.8±4.4) points versus (84.6±3.3) points], and femoral neck shortening at the last follow-up, favoring the FNS group (all P<0.05). There were no significant differences in follow-up time, hospitalization time, intraoperative blood loss or incidence of complications between the 2 groups ( P>0.05). Conclusions:In the fixation of adult femoral neck fractures, compared with ICCS, FNS can significantly reduce fluoroscopy frequency, shorten fracture healing and operation time, reduce risk of femoral neck shortening and hospitalization time, and promote functional recovery of the hip.

Magnolol attenuates right ventricular hypertrophy and fibrosis in hypoxia-induced pulmonary arterial hypertensive rats through inhibition of the JAK2/STAT3 signaling pathway / 中国药理学与毒理学杂志

OBJECTIVE Right ventricular (RV) remodeling is one of the essential pathological features in pulmonary arterial hypertension (PAH). RV hypertrophy or fibrosis are the leading causes of RV remodeling. Magnolol is a com?pound isolated from Magnolia officinalis. It possesses multiple pharmacological activities, such as anti-oxidation and anti-inflammation. This study aims to evaluate the effects and underlying mechanisms of magnolol on RV remodeling in hypoxia-induced PAH. METHODS ① Male SD rats (220 g) were randomly divided into 5 groups (n=10): the normoxia group, the hypoxia group, the hypoxia plus Magnolol (10 and 20 mg·kg-1·d-1) group, and the vehicle group. Rats in the normoxia group were kept in a normoxia environment for 4 weeks, while rats in the hypoxia group were kept in a hypoxic chamber (10％ O2). The rats in the hypoxia plus magnolol groups were administered with magnolol at 10 or 20 mg·kg-1 (ip) once a day for 4 weeks. At the end of 4 weeks, the heart function was assessed by Doppler echocardiography, and then the rats were anesthetized with sodium pentobarbital (30 mg·kg-1, ip). The RVSP was measured by the right heart catheterization method. The heart tissues were collected and dissected to calculate the index of RV remodeling (RV/LV+IVS, RV/tibial length, or RV/body weight). Part of the RV samples was fixed with 4％paraformaldehyde for morphological analysis, while other samples were frozen at-80℃for molecular studies (measurements of ANP, BNP,α-SMA, and col?lagen Ⅰ/Ⅲ mRNA expression as well as p-JAK2/JAK2 and p-STAT3/STAT3 protein levels). ② To evaluate the effect of magnolol on hypoxia-induced myocardial hypertrophy and fibrosis, H9c2 or cardiac fibroblasts were divided into 7 groups: the control group, cells were cultured under normal conditions; the hypoxia group, cells were cultured under hypoxic condition (3％ O2);the hypoxia plus magnolol 10 mg·kg-1 group, magnolol10μmol·L-1 was added to the culture medium before the hypoxia treatment;the hypoxia plus magnolol 30 mg·kg-1 group, magnolol 20μmol·L-1 was added to the culture medium before the hypoxia treatment;the hypoxia plus TG-101348 group, TG-101348 (a specific inhibitor of JAK2) 1μmol·L-1 was added to the culture medium before the hypoxia treatment;the hypoxia plus JSI-124 group, JSI-124 (a specific inhibitor of JAK2) 1μmol·L-1 was added to the culture medium before the hypoxia treatment;and the hypoxia plus vehicle group, an equal volume of vehicle (DMSO) was added to the culture medium before the hypoxia treatment. At the end of the experiments, the cells were collected for morphological and molecular analysis. RESULTS In vivo, male Sprang-Daley rats were exposed to 10％ O2 for 4 weeks to establish an RV remodeling model, which showed hypertrophic and fibrotic features (increases of RV remodeling index, cellular size, hypertrophic and fibrotic marker expression), accompanied by an elevation in phosphorylation levels of JAK2 and STAT3;these changes were attenuated by treating rats with magnolol. In vitro, the cultured H9c2 cells or cardiac fibroblasts were exposed to 3％ O2 for 48 h to induce hypertrophy or fibrosis, which showed hypertrophic (increases in cellular size as well as the expression of ANP and BNP) or fibrotic features (increases in the expression of collagenⅠ, collagenⅢandα-SMA). Administration of mag?nolol and TG-101348 or JSI-124 (JAK2 selective inhibitors) could prevent the process of myocardial hypertrophy and fibrosis, accompanied by the decrease in the phosphorylation level of JAK2 and STAT3. CONCLUSION Magnolol can attenuate RV hypertrophy and fibrosis in hypoxia-induced PAH rats through a mechanism involving inhibition of the JAK2/STAT3 signaling pathway.

Diagnosis and treatment of postoperative malignant hyperthermia in a pediatric patient with congenital myopathy due to RyR1 gene mutations / 中华麻醉学杂志

A 14-year-old male pediatric patient was admitted to the hospital mainly because of neck and back deformity, with limited activity for 7 yr, dysphagia and short of breath for more than 10 months.He was diagnosed with cervical lordosis deformity, RyR1 gene-related myopathy, high possibility of multi-minicore disease and being susceptible to malignant hyperthermia.Posterior cervical orthopedic internal fixation surgery was successfully performed under total intravenous anesthesia with propofol.The vital signs were stable during anesthesia and operation which lasted for 10 h. The patient was admitted to intensive care unit after the uneventful operation.When emerging from general anesthesia, the patient suddenly presented with symptoms of muscular fasciculation in the head, face, trunk and limbs, along with elevated body temperature as high as 39.4℃, severe acidosis and hypercapnia, meanwhile, the blood creatine kinase, blood myoglobin and urinary myoglobin gradually increased.The patient was diagnosed with malignant hyperthermia based on the clinical grading scale score of 63.Dantrolene sodium was infused intravenously, combined with multiple treatments such as physical cooling, correction of acidosis and electrolyte disturbance, alkalization of urine, intermittent hemofiltration and plasma exchange.The arrhythmia and delirium were treated symptomatically.The pediatric patient was fully recovered and discharged with good outcomes.

Strengthening and improving the integration of traditional Chinese and Western medicine in severe tetanus therapy: retrospective study and analysis of survive and decease cases / 中华危重病急救医学

Objective:To investigate the perfection and improvement of the execution of integrative medicine therapy in severe tetanus therapy, to successfully control tetanus severe spasms, autonomic dysfunction and prevent lethal side-effect of prolong and high-dosage sedative-muscle-relaxant therapy, resulted in significant reduction of mortality of tetanus.Methods:Symptoms, treatments and outcome of tetanus patients admitted to Peking University Third Hospital from 1965 to 2020 were reviewed. Patients were classified with Ablett classification. The cases of Ablett grade Ⅲ and Ⅳ were severe tetanus. The patients were divided into two groups according to whether they were treated together with traditional Chinese medicine (TCM) simultaneously during the standard tetanus treatment; the patients in the TCM group were divided into the tetanus TCM medication group and the non tetanus TCM medication group according to the medicine provided whether was in accord with the conventional tetanus TCM prescriptions. The mortality of each group was calculated. In addition, one survived and one deceased case with severe convulsion, autonomic nerve dysfunction (Ablett grade Ⅳ) were selected, combined with the treatment methods and curative effects, the types, use methods and outcomes of Chinese and Western medicine were analyzed.Results:The 46 tetanus cases were treated with Western medicine. Twenty-two of them, TCM were applied. Fifteen of the 22 cases took the TCM prescription which was accord with the conventional tetanus prescription. The mortality of the 46 cases was 21.7% (10/46). The number of non-TCM group was 24 cases, with mortality of 20.8% (5/24); 1 case was Ablett Ⅱ, 1 was Ablett Ⅲ and 3 were Ablett Ⅳ. The number of the TCM group was 22 cases, with mortality of 22.7% (5/22), 2 cases were Ablett Ⅲ, 3 were Ablett Ⅳ. The TCM prescription of these 5 deceased cases was not directed towards tetanus. The tetanus TCM medication group was 15 cases, with no mortality. Case analyses: case 1 was intubated because of severe spasms. Autonomic dysfunction occurred on the 8th day after admission. Esmolol with increasing the dosage of the sedatives and muscle relaxant, was not effective. Tetanus TCM was applied after 2 days of autonomic dysfunction happened. Autonomic dysfunction was then under controlled on the 2nd day post-TCM. She was recovery and discharged after 4 weeks. Case 2, also was intubated because of severe spasms. Autonomic dysfunction happened on the 3rd day after admission, and failed to be controlled by large-dose sedatives, muscle relaxant, and Esmolol. After 8 days of persistent autonomic dysfunction, tetanus TCM was applied and autonomic dysfunction was under controlled on the 2nd day post-TCM administration. Large dosage of muscle-relaxant was applied continuously. After 5 days' administration of TCM, the TCM was withdrew. One day after the withdrawal of TCM, respiratory and cardiac arrest happened because of the diffused bronchiole obstruction with pulmonary secretions loading.Conclusion:Based on the precise and real-time diagnosis of the state of the disease, integrative medicine therapy with an overall analysis tetanus TCM prescription, is the key of declining tetanus mortality.

Application of workshop in pediatric intravenous indwelling needle training for nursing undergraduates / 中华医学教育探索杂志

Objective:To investigate the application effect of workshop in pediatric intravenous indwelling needle training for nursing undergraduates.Methods:A total of 214 undergraduate nursing interns were randomly divided into experimental group ( n=106) and control group ( n=108). Workshop teaching model was used in the experimental group, while the traditional teaching model in the control group. Clinical Decision Making in Nursing Scale (CDMNS), General Self-efficacy Scale (GSES) and theoretical assessment of the two groups were compared respectively before and after training, and operation evaluation was performed after training. Results:Scores of GSES, theory and operation evaluation in the experimental group were all higher than those in the control group with statistically significant differences ( P<0.05). The scores of clinical decision-making awareness was higher in the experimental group than in the control group, but the difference was not statistically significant ( P>0.05). Conclusion:Application of workshop teaching model in the training of pediatric patients with intravenous indwelling needles could enhance nursing students' self-efficacy, theoretical and operational achievements, thus improve the teaching quality.

Comparative Analysis of Outcomes and Clinicopathological Characteristics of Synchronous and Metachronous Contralateral Breast Cancer: A Study of the SEER Database / 한국유방암학회지

PURPOSE: Numerous previous studies have reported inconsistent results about the differences between synchronous contralateral breast cancer (sCBC) and metachronous contralateral breast cancer (mCBC). This study aimed to compare the clinical characteristics and outcomes between sCBC and mCBC and determine predictive factors for the survival of sCBC and mCBC patients. METHODS: Using the Surveillance, Epidemiology, and End Results Program database, we identified sCBC or mCBC patients from 2000 to 2010. The Kaplan-Meier method and Cox proportional hazards regression analysis were used to analyze overall survival and breast cancer-specific survival (BCSS) rates of sCBCs and mCBCs, respectively. RESULTS: Overall, 14,057 sCBC (n = 8,139, 57.9%) and mCBC (n = 5,918, 42.1%) patients were included. The first tumors of sCBC were more likely to have higher stage and more lymph and distant metastases, whereas those of mCBC were more often infiltrating ductal carcinoma (IDC), had localized stage, were estrogen receptor (ER) and progesterone receptor (PR) negative, and had less axillary nodal involvement. The second tumors of mCBC tended to be IDC and have higher grade, adverse stage, ER and PR-negativity; and more axillary nodal involvement, compared to the second tumors of sCBC. mCBC patients had significantly favorable 5-year BCSS but worse long-term BCSS compared with sCBC patients. Moreover, subgroup analysis revealed no significant difference of BCSS between sCBC and mCBC among patients aged 18–60 years. Multivariate analysis indicated that age, grade, and stage of 2 tumors; surgery for second tumor; and ER status of the second tumor were independent prognostic factors for BCSS of contralateral breast cancer (CBC). CONCLUSION: The characteristics and outcomes of sCBCs and mCBCs were substantially different. sCBC and mCBC patients may have different prognosis, and the prognosis of CBC depends on the first and second tumors.

Correlation between Methylation of SALL3 and Cervical Cancer / 中国医学科学院学报

Objective To detect the methylation status of SALL3 gene promoter region in normal cervical tissues,cervical cancer tissues,and cervical cancer cell lines and thus explore the relationship between methylation status and the expression of SALL3 gene.Methods The DNA methylation statuses of SALL3 gene in normal cervical,cervical cancer tissues and cervical cancer cell lines were analyzed by methylation-specific PCR(MS-PCR).The expressions of SALL3 mRNA in cervical cancer cell lines,cervical cancer tissues,and normal cervical tissues were detected by RT-PCR.Results In cervical cancer and matched peri-carcinomatous samples,the methylation levels of SALL3 were up-regulated(CCa .CCap:=0.046;CCa .NC =0.039)and the protein expressions were down-regulated(CCa .CCap:=0.012;CCa .NC =0.000)when compared with normal cervix samples.The mRNA levels of SALL3 in HeLa and SiHa cells treated with 5-Azacytidine were elevated in a dose-dependent manner(HeLa:=0.001;SiHa:=0.002).The methylation level of SALL3 was higher in high risk human papillomavirus(HPV)-positive cervical samples than in HPV-negative cervical samples(=0.014),which also resulted in a descending SALL3 expression in HPV-positive samples(=0.021).Conclusions The hypermethylation of SALL3 in promoter regions inhibits the expression of SALL3 in cervical cancer tissue samples.Infection with high-risk HPV serotypes may increase the methylation of SALL3 promoter region,silence its expression,and thus promote the development of cervical cancer.

Mesenchymal Stem Cells Attenuate Acute Lung Injury Through Inducing M2 Macrophage Polarization / 中山大学学报(医学科学版)

@#【Objective】 To investigate whether mesenchymal stem cells （MSC）can alleviate acute lung injury by inducing alveolar macrophages to polarize to M2 phenotype. 【Methods】 Umbilical cord MSC was extracted by adherent method and cell phenotypes were analyzed by flow cytometry. The differentiation along osteogenic and adipogenic pathways were assessed by histological staining in vitro. Mouse alveolar macrophage cell line（MH- S cells）which was stimulated by LPS was isolated co-culture with MSC and MSC soluble factor inhibitor was added. We set up three groups （LPS， LPS+MSC ，and MSC inhibitor）. After being cultured for 48 hours ，the macrophage polarization was analyzed by flow cytometry and qPCR. Thirty balb/c male mice were randomly divided into control group（n = 10），ALI group（n = 10）， and ALI+MSC group（n = 10）. LPS was instilled intranasally to establish acute lung injury model in mice. After treatment with MSC for 48 hours ，HE staining of lung tissue was performed for damage assessment. The alveolar lavage fluid （BALF）was obtained and the cells in BALF were analyzed by flow cytometry and qPCR to detect the expression of M2-type macrophage markers including CD206，IL10 and Arg1. The concentration of M1-type macrophage marker TNF-α in the supernatant was measured by ELISA. 【Results】 MSC showed adherent growth and had the ability of osteogenic and adipogenic differentiation. MSC can induce MH- S cells to polarize to M2 type and with a significant increase of CD206 positive proportion cells （P<0.05）. Prostaglandin E2 （PGE2） inhibitors can reverse this effect. Mouse ALI model was successful. After treatment with MSC，the pathology and lung injury score was significantly improved. The proportion of CD206 positive macrophages in alveolar lavage fluid in ALI + MSC group was significantly higher than that in ALI group. The expression of CD206 and IL-10 in mRNA level was significantly higher in ALI+MSC group than that in ALI group. The concentration of inflammatory cytokine TNF- α in alveolar lavage fluid was significantly lower in the ALI+ MSC group than in the ALI group（P<0.05）.【Conclusion】Umbilical cord mesenchymal stem cells can effectively alleviate acute lung injury induced by LPS in mice via PEG2 to induce macrophage to polarize to M2 type.

Cardioprotective effect of recombinant adeno-associated virus mediated nerve growth factor gene transfection in diabetic rats / 中国药理学通报

Aim: To investigate the feasibility of recombinant adeno-associated virus serotype9 (rAAV9) mediated nerve growth factor (NGF) transfection in diabetic rats by intramyocardial injection, and to confirm the protective effect of this method on diabetic cardiac autonomic neuropathy. Methods: At 4th week after the establishment of diabetic model, recombinant adeno-associated virus (rAAV9-NGF) carrying NGF gene was injected into the heart of rats. Five weeks later, the distribution of NGF, calcitonin gene-related peptide (calcitonin gene-related peptide, CGRP) and nerve fibers were detected by immunofluorescence. Hemodynamic parameters were used to evaluate cardiac function, and ELISA method was used to detect the expression of NGF, CGRP in myocardium. Results: The exogenous gene NGF mediated by rAAV9 could be stably transfected and over-expressed in the myocardium of diabetic rats. The left ventricular systolic pressure, heart rate, and maximal rate of increase of left ventricular pressure significantly decreased, the left ventricular end-diastolic pressure and the maximal decrease rate of left ventricular pressure significantly increased, and the cardiac function was improved. NGF, CGRP protein in myocardial tissues were up-regulated, and immunofluorescence showed that the decrease of NGF, CGRP and nerve fibers in myocardial tissues could be partially reversed after transfection. Conclusions: Intramyocardial injection of NGF gene can effectively enhance the expression of NGF and promote the growth of nerve fiber, exerting a protective effect in diabetic rat heart.

Acute necrotizing fasciitis complicated with multiple organ dysfunction: one case report / 中华危重病急救医学

The treatment of acute necrotizing fasciitis consists of early and aggressive incision and drainage, together with effective antibiotics and active organ support. On January 4th, 2018, a 50-year-old man admitted to intensive care unit (ICU) of Peking University Third Hospital was diagnosed with acute necrotizing fasciitis in the right lower extremity caused by group A Streptococcal infection complicated with multiple organ dysfunction. The disease progressed rapidly. The lesion rapidly spread from the right calf to the entire right lower limb and was associated with septic shock and multiple organ dysfunction within a few hours after admission. The treatment included surgical debridement and amputation of his right lower extremity, multiple antimicrobials combination therapy, gamma globulin-assisted anti-infection, anti-shock, bedside continuous hemofiltration and other comprehensive treatment. The patient was successfully cured. The key to successful treatment of this patient is that when the acute necrotizing fasciitis progresses rapidly, amputation should be done to debride the infected lesions, together with early empirical broad-spectrum antibiotics combination therapy and active organ function support treatment.

Hypoglycemic Mechanism of Ziya Biti Tablet Based on LC-MS Metabolomics Technique / 中国实验方剂学杂志

Objective: To observe the hypoglycemic effect of Uygur medicine Ziya Biti tablet on the type 2 diabetic rats, and analyze the hypoglycemic mechanism based on metabolomic techniques. Method: According to the results of clinical research about different origins of Ziya Biti tablet, the optimal composition was screened out; type 2 diabetic rats were taken as an experimental object in the pharmacodynamic experiments;the control group and model group were given the same dose of normal saline, Ziya Biti bablet group was given 300 mg·kg-1, the metformin group was given 300 mg·kg-1 metformin hydrochloride. The fasting blood and weight changes of the experimental group after the treatment were recorded and compared with normal group; ultra-high performance liquid chromatography-linear ion trap/electrostatic field orbit trap combined-type high resolution mass spectrometry (UHPLC-LTQ/Orbitrap MS) technology was used to conduct the metabolomics analysis on the rat serum, and principal component analysis (PCA), partial least squares discriminant analysis (OPLS-DA) on different groups of rat serum metabolites were performed to identify potential biomarkers. Result:Compared with the model group, the rats in the Uygur medicine Ziya Biti tablet showed a healthy states, and the blood glucose were decreased(PPPConclusion:The experimental results showed that Uygur medicine Ziya Biti tablet can reduce the blood glucose of type 2 diabetic rats and allivate general physiological characteristics. The mechanism of action may be related to the improvement of amino acid metabolism and lipid metabolism.

Effect of Canna edulis Type 3 Resistant Starch in Reducing Body Weight, Serum Lipid and Acute Toxicity / 中国实验方剂学杂志

Objective: To evaluate effect of Canna edulis type 3 resistant starch(RS3) on weight loss and lipid reduction in obese hyperlipidemia mice and acute toxicity in mice. Method: KKAy mice were fed with high-fat diet for 20 weeks to establish a hyperlipidemia model and then randomly divided into model group,positive group (4 mg·kg-1), high-dose resistant starch group and low-dose resistant starch group (2,1 g·kg-1).Mice in normal group were fed with standard diet. The medication groups received corresponding drugs by gavage. Normal group and high-fat model group were given equal volume of deionized water. After 8 weeks,mice were put to death. The levels of total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum of mice were measured,and weigh fat mass,fat/body ratio,body fat rate and Lee's index were calculated accurately. The pathological changes of liver and adipose tissue were observed byhematoxylin-eosin (HE). The acute toxicity of RS3 to mice was evaluated by limit test. The mice were continuously observed for 14 days, and the toxicity of mice was recorded. Result: The indicators of high-dose RS3 group were significantly reduced,such as body weight,fat mass,body fat rate,fat/body ratio,Lee's index,and serum TC,TG,LDL-C,AST,ALT levels(P-1 was administered,no toxic reaction and death occurred in the animals. Conclusion: RS3-type Canna Edulis Resistant Starch has a good effect in reducing body weight and serum lipid,with a better effect in the high-dose group and no toxicity. And the commonly used clinical dose is safe and reliable.