Effect of transcutaneous electrical acupoint stimulation on postoperative sore throat in patients un-dergoing double-lumen endobronchial intubation / 临床麻醉学杂志

Objective To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS)on postoperative sore throat(POST)in patients undergoing double-lumen bronchial intubation based on general anesthesia.Methods A total of 103 patients,45 males and 58 females,aged 18-64 years,BMI 18-28 kg/m2,ASA physical status Ⅰ-Ⅲ,who received selective operation of double-lumen bronchial intubation under general anesthesia were selected.The patients were divided into two groups using the random number table method:TEAS group(n = 51)and control group(n = 52).In the TEAS group,TEAS on Tiantu acupoint and bilateral Hegu acupoints started 30 minutes before anesthesia induction,and the stimulation lasted until the patients were sent to the recovery room.In the control group,electrodes were placed on the same acupoints without electrical stimulation.The Mallampati grade,number of tracheal intu-bation attempts,compression of cricoid cartilage,resistance during intubation,and double-lumen endobron-chial tube(DLT)retention time were recorded.The incidence and severity of POST,VAS pain scores of sore throat,and the incidence of hoarseness 1 hour,6,and 24 hours after extubation were recorded.Results Compared with the control group,the incidence of POST,the incidence of POST level 1,and VAS pain scores of sore throat were significantly decreased 1 hour,6,and 24 hours after extubation(P＜0.05),the incidence of POST level 2 was significantly decreased 6 hours after extubation in the TEAS group(P＜0.05).There were no significant differences in the situations related to tracheal intubation,and the inci-dence of hoarseness 1 hour,6,and 24 hours after extubation between the two groups.Conclusion The transcutaneous electrical acupoint stimulation on Tiantu acupoint and bilateral Hegu acupoints can signifi-cantly reduce the incidence and severity of postoperative sore throat,and VAS pain scores of sore throat in patients undergoing double-lumen bronchial intubation.

Construction and Validation of A Prediction Model for Pulmonary Nodule Nature Based on Clinicopathological Features,Imaging and Serum Biomarkers / 现代检验医学杂志

Objective The study aimed to construct and validate a predictive model for pulmonary nodules(PN)nature based on clinicopa-thological features,imaging,and serum biomarkers,so as to provide scientificdecision-making for early diagnosis and treatment of lung cancer.Methods A retrospective was performed on 816 PN patients with definited pathological diagnosis who received surgical resection analysisor lung biopsy in the Department of Thoracic Surgery and Oncology of Shenzhen Traditional Chinese Medicine Hospital from January 2019 to February 2023.Among them,113 cases that did not meet the inclusion criteria were excluded,and the remaining 703 cases were included in the study.The study based on the clinicopathologic features(age,gender,smoking history,smoking cessation history and family history of cancer),chest imaging(maximum diameter of nodule,location of lesion,clear border,Lobulation,spiculation,vascular convergence sign,vacuole,calcification,air bronchial sign,emphysema,nodule type and pleural indentation,nodule number)and serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCA)in patients with PN.These cases were randomly divided into a modeling group(n=552,237 benign,315 malignant)and a validation group(n=151,85 benign,66 malignant).First,univariate analysis was performed to screen for statistically significant predictors of nodules nature.Then,multivariate regression analysis was performed to screen for independent predictors of nodules nature.Finally,the prediction model of PN nature was constructed by logistic regression analysis.Subsequently,the validation group data were entered into the proposed model and Mayo clinic(Mayo)model,veterans affairs(VA)model,Brock University(Brock)model,Peking University(PKU)model and Guangzhou Medical University(GZMU)model,respectively.PN malignancy probability was calculated.The receiver operating characteristic(ROC)curves were plotted.The diagnostic efficiency of each model was compared according to the area under the curve(AUC).Results There were statistically significant variables including age,family history of cancer,maximum nodule diameter,nodule type,upper lobe of lung,calcification,vascular convergence sign,lobulation,clear border,spiculation,and serum CEA,SCCA,CYFRA21-1 using univariate analysis.Multiple regression analysis showed that age,CEA,clear border,CYFRA21-1,SCCA,upper lobe of lung,maximum nodule diameter,family history of cancer,spiculation and nodule type were independent predictors of PN nature.The prediction model equation constructed in this study is as follows:f(x)= ex/(1+ex),X=(-6.318 8+0.020 8×Age+0.527 4×CEA-0.928 4×clear border+0.294 6×Cyfra21-1+0.294×maximum nodule diameter+1.220 1×family history of cancer +0.573 2×upper lobe of lung +0.064 8×SCCA +1.461 5×Spiculation +1.497 6×nodule type).The AUC(0.799 vs 0.659,0.650)of the proposed model was significantly higher compared with Mayo model and VA model,and there were statistically significant differences(Z=3.029,2.638,P=0.003,0.008).However,compared with Brock model,PKU model and GZMU model,the differences of AUC(0.799 vs 0.762,0.773,0.769)were not statistically significant(Z=1.063,0.686,0.757,P=0.288,0.493,0.449).Conclusion The prediction model for PN nature established in this study is accurate and reliable,which can help clinics with early diagnosis and early intervention,and this prediction model deserves to be popularized.

Using machine learning algorithm to predict the risk of post-traumatic stress disorder among firefighters in Changsha / 中南大学学报(医学版)

OBJECTIVES@#Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset.@*METHODS@#This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score.@*RESULTS@#The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism.@*CONCLUSIONS@#PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.

41 cases of chronic obstructive pulmonary disease caused by occupational irritating chemicals / 中华劳动卫生职业病杂志

Objective: To analyze the case characteristics of Chronic obstructive pulmonary disease caused by occupational irritant chemicals (OI-COPD). To provide basis for revising its diagnostic criteria. Methods: From June to December 2021, we investigated the information of OI-COPD patients confirmed by Shandong Institute of Occupational Health and Prevention of Occupational Diseases, Guangxi Zhuang Autonomous Region Institute of Occupational Disease Prevention and Control, Qingdao Central Hospital affiliated to Qingdao University and other diagnostic institutions in the past five years, a total of 41 cases. The basic information of OI-COPD cases, occupational risk factors exposure information, medical history, smoking history and clinical symptoms were analyzed retrospectively. The measurement data were tested for normal distribution, which was described by x±s, and compared between groups by t test; Those who do not conform to the normal distribution are described by the median [M (Q(1), Q(3)) ] and analyzed by nonparametric test; The counting data were expressed in frequency and rate (% ), and the comparison between groups was tested. Results: Of the 41 cases, 33 were male and 8 were female. The age of the patient diagnosed with OI-COPD was (49.5±10.3) years old, and the minimum age was 30 years old; Among them, 8 patients had a definite long-term smoking history (more than 5 years) ; The exposure duration of occupational risk factors was (18.6±10.3) years, of which 3 patients had exposure duration of less than 5 years; The occupational risk factors leading to OI-COPD include acids and acid-forming compounds, bases, aldehydes, nitrogen oxides, chlorine and its compounds, etc. The exposure level of occupational risk factors is related to the degree of COPD airflow restriction (χ(2)=6.17, P <0.05). 18 patients with diagnosis age <50 years old were diagnosed as early-onset COPD. The incidence of respiratory symptoms in the early diagnosis COPD group was lower than that in the non-early diagnosis COPD group, and the FEV1% pred was significantly higher than that in the non-early diagnosis COPD group. The difference was statistically significant (P<0.01 ) . Conclusion: The exposure level of occupational risk factors may be the risk factor affecting the degree of COPD airflow restriction. With the increase of the exposure level of COPD patients, the proportion of respiratory symptoms will also increase accordingly.

Analysis on the Current Situation,Influencing Factors and Strategies of Data Sharing in Cross-regional Specialty Medical Alliances / 医学信息学杂志

Purpose/Significance To clarify the construction mode and key factors of data sharing in Chinese medical alliances,and to provide references for promoting data sharing in medical alliances.Method/Process Taking children's medical alliance of Yangtze River Delta as an example,Delphi method and qualitative interview method are used to explore the key contents and effect evaluation of specialty alliance construction,and the key factors of specialty alliance data sharing are defined based on the technology-organization-environment framework;SWOT analysis model is used to propose development strategies.Result/Conclusion Member hospitals are less satisfied with the construction effect of information interconnection.Key factors for realizing data sharing in specialty alliances include:support from government administrative departments,uniform and systematic compatibility of information standards,information security emergency response,patient privacy protection and informed consent,willingness of department directors to share,and internal communi-cation and compensation mechanism of alliances.

Prevalence of liver fibrosis in patients with chronic HBV infection detected by ultrasound transient elastography / 中华全科医师杂志

Objective:To investigate the prevalence of liver fibrosis in patients with HBV infection detected by ultrasound transient elastography.Methods:A total of 2 689 patients with HBV infection who received liver transient elastography examination at the Department of Hepatology, Zhongnan Hospital of Wuhan University from November 2021 to April 2022 were enrolled in the study. The severity of liver fibrosis was graded according to the liver stiffness value. The association of liver fibrosis detection rate with gender, age and physiological stages of patients was analyzed, and the correlation between liver stiffness value and HBV DNA, HBsAg, HBeAg level, alanine aminotransferase (AST), aspartate aminotransferase (ALT) and serum albumin levels was further analyzed.Results:Among 2 689 patients with chronic HBV infection, there were 1 417 males aged 46 (34, 57) years and 1 272 females aged 45 (33, 55) years. A total of 1 382 patients (51.03%) showed varying degrees of liver fibrosis, including 381 cases (14.20%) of significant liver fibrosis and 259 (9.60%) cases of progressive fibrosis. Male patients had a significantly higher prevalence of liver fibrosis than that of female patients [60.78%(840/1 382) vs. 39.22%(542/1 382), χ2=74.566, P<0.001]. There were significant differences in liver stiffness values and liver fibrosis detection rates ( F=46.516, 199.079, P<0.001) among patients of different age groups. The liver stiffness index (9.41±4.49 vs. 8.10±3.89, t=9.011, P<0.001) and the prevalence of liver fibrosis in males was higher than those in females in age groups younger than 60 years [61.59%(643/1 044) vs. 38.41%(401/1 044), χ2=78.418, P<0.001]; However, there was no significant gender difference in people over 60 years of age [73.80%(200/271) vs. 71.71%(142/198), χ2=0.252, P>0.05; 20.30%(55/271) vs. 21.21%(42/198), χ2=0.059, P>0.05]. The prevalence of liver fibrosis was significantly lower in premenopausal and perimenopausal females than that in males of the same age groups [29.70%(188/633)and 52.20%(154/295) vs. 64.50%(202/313), χ 2=56.683, P<0.001; χ 2=9.519, P=0.029], whereas there was no significant difference between postmenopausal females and males in the same age group [65.40%(220/336) vs. 72.20%(319/441), χ 2=5.822, P=0.061]. The prevalence of liver fibrosis increased significantly in postmenopausal females as compared to premenopausal females[38.40%(497/1 294) vs. 67.50%(532/787), χ 2=56.683, P=0.002]. The value of liver stiffness in patients with chronic HBV infection was positively correlated with total bilirubin, AST and ALT levels( r=0.208, 0.227, 0.218, P<0.05). Conclusions:The prevalence of liver fibrosis detected by ultrasound transient elastography in chronic HBV-infected patients is substantial, the liver stiffness value and detection rate are higher in males than those in females, however, the prevalence is increased in postmenopausal females. The liver stifness value is related to some biochemical indicators of the liver.

Identification of Chemical Constituents in Chaishi Tuire Granules by UPLC-ESI-Q-TOF-MS/MS / 中国实验方剂学杂志

Objective:To rapidly identify the chemical constituents of Chaishi Tuire granules by ultra-performance liquid chromatography-electrospray/quadrupole time-of-flight tandem mass spectrometry （UPLC-ESI-Q-TOF-MS/MS）. Method:Chromatographic separation was conducted on a Phenomenex^® Luna omega C₁₈ column （2.1 mm×100 mm， 1.6 μm） with 0.1% formic acid aqueous solution （A）-acetonitrile （B） as the mobile phases for gradient elution （0-20 min， 5%-40%B； 20-40 min， 40%-95%B； 40-43 min， 95%B）， the flow rate was set at 0.3 mL·min^-1. MS data were collected in positive and negative ion modes， the scanning range was <italic>m</italic>/<italic>z</italic> 150-1 500 and electrospray ionization （ESI） was employed. The chemical constituents of Chaishi Tuire granules were identified by comparing with the retention time and the mass data of the reference substances， as well as the accurate mass， MS/MS fragment ions， mass spectrometry databases （PubChem， MassBank， ChemicalBook and others） and related literature. Result:A total of 85 chemical constituents were identified， including 28 flavonoids， 24 phenylpropanoids， 11 terpenoids， 10 alkaloids， 4 quinones， and 8 others. Among them， 19 constituents derived from Lonicerae Japonicae Flos， 14 constituents derived from Scutellariae Radix， 10 constituents derived from Isatidis Radix， 9 constituents derived from Taraxaci Herba， 9 constituents derived from Forsythiae Fructus， 4 constituents derived from Bupleuri Radix， 4 constituents derived from Anemarrhenae Rhizoma， and 4 constituents derived from Rhei Radix et Rhizoma. Conclusion:Chaishi Tuire granules is rich in phytochemicals， which are derived from many of traditional Chinese medicines. This study can lay a foundation for the quality control， material basis and <italic>in vivo</italic> metabolic analysis of this preparation.

Inpatient Care Expenditure of Terminally Ill Patients in the Geriatric Ward of Peking Union Medical College Hospital / 中国医学科学院学报

Objective To describe the inpatient care expenditure of the terminally ill patients in the geriatric ward of Peking Union Medical College Hospital and facilitate future research on the economic outcomes of hospice and palliative care.Methods The histories of patients admitted to the Department of Geriatrics of Peking Union Medical College Hospital during 2018 were reviewed by trained doctors.According to the diagnosis and overall health state,terminally ill patients were selected and enrolled in the study.Demographics,health and disease information,prescriptions,and expenditure details were retrieved from the HIS system.Results In 2018,35 patients were terminally ill and eligible for hospice care,including 20 males and 15 females,with the average age of(78±8)years(59-91 years),the average age-adjusted Charlson Comorbidity Index of 10±3,and the median Barthel index of 40(10,70).These patients had malignant tumor(23 cases),heart failure(4 cases),end-stage renal disease(1 case),end-stage liver disease(2 cases),dementia(4 cases)and other severe diseases(3 cases).The patients received standard care within the scope of internal medicine and geriatrics.Finally,8 patients died during hospitalization,and 27 were discharged alive.The 35 patients had the median length of stay of 15(12,23)days,the median inpatient expenditure of CNY 21 500(13 800,37 600),and the median daily expenditure of CNY 1425(970,2503).The percentage of expenditure was(28.5±12.3)% for medication,(33.2±18.0)% for tests and examinations,and 11.5%(6.4%,15.8%)for accommodation and medical services.The medications for symptom control costed CNY(77±58)per day on average,accounting for(5.2±3.5)% of the total expenditure.Conclusions The inpatient expenditure for terminally ill patients in the tertiary grade A hospital was higher than that reported in community hospitals providing hospice care.In terms of expenditure constitution,the money spent on medications and tests/examinations were similar,and the percentage of expenditure on medications for symptom control was low.There is a need for further research on the economic impact of hospice and palliative care among terminally ill patients in China.

Effect of Xihuangwan on NLRP3 Inflammatory Bodies and Their Products and Tumor Proliferation of Lung Cancer A549 Bearing Nude Mice in Inflammatory Microenvironment / 中国实验方剂学杂志

Objective:To study the antitumor effect of Xihuangwan on A549 lung cancer nude mice in inflammatory microenvironment, and explore the effect of Xihuangwan on the expressions of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammatory bodies and their products in serum and tumor tissue of A549 lung cancer nude mice. Method:The lung cancer A549 cell model was established in nude mice with lung cancer, and the lung cancer A549 cell model was established in inflammatory microenvironment by adding lipopolysaccharide (LPS) + adenosine triphosphate (ATP) to the culture medium. After modeling, the rats were randomly divided into blank group (equal volume of normal saline), positive drug control group (MCC950 solution, 0.79 g·kg-1), and low, medium, high-dose Xihuangwan groups (0.39, 0.78, 1.95 g·kg-1). The rats were administered orally once a day for 21 days, and then sacrificed. The tumor tissues were stripped to measure the tumor body. The expressions of NLRP3, malondialdehyde（MDA）, interleukin (IL)-1β, IL-18 and NLRP3 were detected by Western blot, and the levels of IL-1β, IL-18 and MDA were detected by enzyme linked immunosorbent assay（ELISA）. Result:Compared with the blank group, the tumor inhibition rates in the positive drug control group and the low, medium and high dose Xihuangwan group were 39.21%, 31.72%, 42.24% and 55.68%. ELISA showed that the high-dose Xihuangwan group could significantly reduce the expressions of MDA, IL-1β and IL-18 in the serum of nude mice (P<0.05). Western blot showed that the high-dose Xihuangwan group could effectively reduce the protein expressions of MDA, IL-1β, IL-18 and NLRP3 in tumor of nude mice (P<0.05), the results of immunohistochemistry showed that the expression rate of NLRP3 in the tumor tissues of nude mice was reduced in the positive drug group and each dose of Xihuangwan group (P<0.05). Conclusion:Xihuangwan can inhibit the growth of tumor tissue of A549 cells bearing lung cancer in nude mice. The mechanism may be that it can inhibit the growth of tumor cells by inhibiting the expression of NLRP3 inflammatory bodies, IL-1β, IL-18, MDA tables, and then inhibiting the inflammatory microenvironment of tumor cells.

Application of antenatal corticosteroids of late preterm and term infants / 国际儿科学杂志

Respiratory diseases are serious complications of premature infants, especially respiratory distress syndrome , and also the main cause of early death.antenatal corticosteroids can significantly reduce respiratory complications in preterm infants before 34 weeks of gestation, but there is no consensus on the application of Antenatal corticosteroids in late preterm infants and term infants.The review summarizes the recent studies on the use of antenatal corticosteroids in the outcome of late preterm and term infants, especially in the respiratory system, in order to guide clinical treatment.

Intranodal lymphangiography combined thoracic duct embolization in the treatment of chylous leakage / 中华放射学杂志

Objective:To evaluate the safety and feasibility of intranodal lymphangiography combined thoracic duct embolization in the treatment of chylous leakage.Methods:The clinical data of ten patients with chylous leakage from July to December 2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 6 cases of chylothorax, 1 case of chylous ascites, and 3 cases of chylothorax combined with chylous ascites, respectively. Conservative treatment was invalid in all cases. The locations of cisterna chyli and thoracic duct were defined by percutaneous puncture intranodal lymphangiography. Then the percutaneous transabdominal puncture of cisterna chyli was performed and the microcatheter was inducted. The location of fistula was visualized by thoracic duct lymphangiography, and the embolization was performed by microcoils combined tissue adhesive agents. The post-operative curative effect and complications were recorded.Results:One patient did not receive thoracic duct embolization because it was failed to visualize cisterna chyli by intranodal lymphatic angiography; thoracic duct embolization was successfully performed in the other 9 patients after chylous leakage fistula was located. Percutaneous transabdominal puncture of cisterna chyli was successfully accomplished in 8 patients. As for the other patient, after repeated failure of puncture, fluoroscopy-guided retrograde puncture at the proximal thoracic duct was performed successfully. After the operation, the drain output was completely disappeared within 3 to 7 days in 8 patients, and decreased down to 120 ml/d in 1 patient. Mild abdominal hemorrhage was found in 1 patient after thoracic duct embolization, without any treatment. No serious complications was found in all cases.Conclusion:Intranodal lymphangiography and thoracic catheter embolization is safe and effective in the treatment of chylous leakage, with a low complication rate.

Effects of exercises with different durations and intensities on mitochondrial autophagy and FUNDC1 expression in rat skeletal muscles / 生理学报

The aim of the present study was to investigate the effects of exercises with different durations and intensities on mitochondrial autophagy and FUNDC1 in rat skeletal muscles. Sixty male Sprague-Dawley rats were randomly divided into 2- and 4-week control groups (Con), moderate-intensity exercise groups (M-ex groups, treadmill exercise, 16 m/min, 1 h/d, 6 d/week), and high-intensity exercise groups (Hi-ex groups, treadmill exercise, 35 m/min, 20 min/d, 6 d/week). The bilateral soleus muscles were separated after the intervention, and paraffin sections were prepared for transmission electron microscopy. ELISA method was used to detect the content of citrate synthase (CS). The co-localizations of microtubule-associated protein 1 light chain 3 (LC3)/cytochrome c oxidase IV (COX-IV), FUNDC1/COX-IV and LC3/FUNDC1 were observed by immunofluorescent staining in frozen sections. The skeletal muscle mitochondria were extracted, and the expression of autophagy-related proteins, including AMPKα, p-AMPKα, Unc-51 like kinase 1 (ULK1), FUNDC1, LC3 and p62, were detected by Western blot. The results showed that exercise increased mitochondrial function, i.e. peroxisome proliferator-activated receptor γ co-activator-1α (PGC-1α), COX-I protein expression levels and CS content. There was no difference of mitochondrial function parameters between 2-week M-ex and 2-week Hi-ex groups, while mitochondrial function of 4-weeks Hi-ex group was significantly lower than that of 4-week M-ex group. Under the same exercise intensity, mitochondrial autophagy activation in skeletal muscle of 4-week exercise was higher than that in 2-week exercise group; Under the same duration of exercise, mitochondrial autophagy activation of Hi-ex group was higher than that in M-ex group. Both 2- and 4-week exercise intervention increased LC3/COX-IV, COX-IV/FUNDC1, and FUNDC1/LC3 co-localizations. Exercise increased LC3-II/LC3-I ratio, down-regulated p62 protein expression level, up-regulated FUNDC1, ULK1 protein expression levels and AMPKα phosphorylation, and the changes of these proteins in 4-week Hi-ex group were significantly greater than those in 4-week M-ex group. These results suggest exercise induces mitochondrial autophagy in skeletal muscles, and the activity of autophagy is related to the duration and intensity of exercise. The induction mechanism of exercise may involve the mediation of FUNDC1 expression through AMPK-ULK1 pathway.

Study on transformation rules of terrestrosin D in course of Tribuli Fructus stir-frying based on simulated processing technology / 中国中药杂志

The contents of terrestrosin D and hecogenin from Tribuli Fructus were determined before and after stir-frying. The results showed that the content of terrestrosin D was decreased significantly,and the content of hecogenin was increased significantly after such processing. In order to verify the inference that terrestrosin D was converted to hecogenin by stir-frying,the quantitative variation rules of terrestrosin D and hecogenin were studied by simulated processing technology,and the simulated processing product of terrestrosin D was qualitatively characterized by ultra performance liquid chromatography/time of flight mass spectrometry( UPLC-TOF/MS) to clarify its transformation process during stir-frying. The results showed that the content of terrestrosin D was decreased significantly at first and then a platform stage appeared with the prolongation of processing time at a certain temperature. Raising the stir-frying temperature could further decrease the content of terrestrosin D and delay the time that the platform stage appeared. When the processing was simulated at higher temperatures( 220 ℃ and 240 ℃),the content of hecogenin was increased gradually with the increase of processing temperature and the prolongation of processing time. In the process of stir-frying,the deglycosylation reaction of terrestrosin D to hecogenin was not completed in one step. The deglycosylation reaction occurred first at the end of the sugar chain,and then other glycosyl units in the sugar chain were sequentially removed from the outside to the inside to finally form the hecogenin. This study provides a basis for further revealing the detoxification mechanism of stir-fried Tribuli Fructus.

Changes and mechanisms of terrestroside B and terrestrosin K in stir-frying Tribuli Fructus / 中国中药杂志

The contents of terrestroside B and terrestrosin K in Tribuli Fructus with different degree of stir-frying were determined by high performance liquid chromatography with evaporative light-scattering detector( HPLC-ELSD). The results showed that the contents of terrestroside B and terrestrosin K were increased at first and then decreased,and both of them had the highest content at the best time of heating. The results of simulated processing of Tribulus Terrestris saponins showed that when the processing time kept constant,the contents of terrestroside B and terrestrosin K were decreased gradually with the increase of processing temperature from 180 ℃ to240 ℃. At a certain temperature,the content of terrestrosin K was increased first and then decreased with the prolongation of processing time,and reached the highest level at 5 min. However,the content of terrestroside B was increased first and then decreased with the increase of processing time only at 180 ℃,and reached the highest level at 10 min. When the processing temperature was controlled at200,220 and 240 ℃ respectively,the content of terrestroside B was decreased gradually with the increase of processing time. The simulated processing products of tribuluside A,terrestroside B and terrestrosin K were qualitatively characterized by ultra-performance liquid chromatography-time of flight mass spectrometry( UPLC-TOF/MS). It was proved that tribuluside A and terrestrosin Ⅰ containing C-22-OH were dehydroxylated in the processing of Tribuli Fructus and transformed respectively into terrestroside B and terrestrosin K containing C-20-C-22 double bond. As a result,the contents of terrestroside B and terrestrosin K were increased. The sugar chains at C-3 and C-26 positions of terrestroside B and terrestrosin K could be deglycosylated and converted into monosaccharide chain saponins and short sugar chain saponins,so the contents of terrestroside B and terrestrosin K were reduced. The study provides reference for further revealing the processing principle of Tribuli Fructus.

Prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection / 中华围产医学杂志

Objective To investigate the prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection (TAPVC).Methods Forty-one cases who received prenatal ultrasound examination and then were diagnosed with TAPVC by postnatal surgery at the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018 were enrolled.Echocardiography findings of all cases were analyzed retrospectively,and the prenatal imaging features were summarized.Results Among all cases,21 were confirmed as supracardiac type,14 as intracardiac type,four as infracardiac type and two as mixed type after surgery.The echocardiographic features of TAPVC were as follows:all 41 cases showed smooth posterior wall of left atrium without visible part of pulmonary venous connected to the left atrium in the-four chamber view;in 33 cases,the space between left atrium and descending aorta was widened and the pulmonary venous confluence was observed in the four-chamber view;ten cases showed a dilated coronary sinus in the four-chamber view and 27 cases showed vertical vein in the three vessels and trachea or the upper abdomen view.None of the 41 cases was complicated by other structural intracardiac abnormalities.However,seven cases were complicated by obstruction of blood flow,and the blood flow velocity measured by Doppler ultrasound was 0.76 m/s to 1.25 m/s.Conclusions Blood flow in pulmonary veins should be carefully observed in prenatal ultrasonography,and anomalous pulmonary venous connection should be considered when pulmonary veins do not connect to the left atrium.

Diagnostic value of three sections of aortic arch under ultrasonography in fetal aortic coarctation / 中华围产医学杂志

Objective To investigate the diagnostic value of three sections of aortic arch under ultrasonography, including the three vessels and tracheal view (3VT), long-axis and coronal view of the aortic arch, in fetal coarctation of the aorta (CoA) and the reasons for missed diagnosis and misdiagnosis. Methods This study involved 52 fetuses with CoA who were identified by prenatal ultrasonography and confirmed in postnatal operation in the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018. Echocardiographic findings of all cases were analyzed retrospectively to summarize the prenatal imaging features. Results The 3VT was displayed in all cases (100%). The long-axis view of the aortic arch was observed in 88.5%, while the coronal view was observed in 76.9%. Among the 52 cases, nine were missed diagnosis and three were misdiagnosed due to unsatisfactory views of the three sections of aortic arch. All cases showed an increased ratio of the pulmonary artery to the aorta diameter in 3VT, which was a critical indicator of CoA in prenatal ultrasonographic diagnosis. Satisfactory aortic arch coronal views were obtained in 40 cases and all showed constriction at the isthmus of aortic arch and an connection to the descending aorta. Out of the 46 with a satisfactory long-axis view of the aortic arch, a narrow isthmus of aortic arch was shown in 38 cases, with the inner diameter of (1.8±0.2) mm ranging from 0.9 to 2.9 mm. Conclusions Observation of three sections of aortic arch under ultrasonography is of great importance in prenatal diagnosis of CoA.

Application of mesenchymal stem cells in sepsis / 中华危重病急救医学

Sepsis is defined as life-threating organ dysfunction caused by a dysregulated response to infection. Severe cases may develop into multiple organ dysfunction syndrome (MODS) and even death. However, conventional therapeutic intervention for sepsis is not ideal. Mesenchymal stem cells (MSCs) are multipotent stem cells that can differentiate into a variety of cell types. They are characterized by anti-inflammatory, anti-microbial, and immunomodulatory power, and rehabilitation of tissues and organs and anti-apoptosis. The role of MSCs in regulating immune function, regulating signal transduction pathways, repairing tissues and organs, and antibacterial and antiviral effects, is summarized in this review in order to understand the mechanism of application of MSCs in the field of sepsis, and lay the foundation for further research.

Analysis of Solubilization of Fatty Oil from Euphorbiae Semen on Four Euphorbia Factors Based on Thinking of Self-assembled Micelles in vivo / 中国实验方剂学杂志

Objective: The solubilization of 4 compounds(Euphorbia factor L1,L2,L3 and L8),caused by mixed micelles self-assembled from fatty oil of Euphorbiae Semen and bile salt of intestinal juice,was researched in the simulated human intestinal environment. Method: The mixed micelles were prepared with different amounts of fatty oil of Euphorbiae Semen.The transmission electron microscope(TEM) was used to observe the morphology of the micelles.Particle size detector was used to determine the particle size and Zeta potential.HPLC was used to assay the solubility of these 4 compounds.The variation tendency of the total dissolution of these 4 compounds with the change of standing time was observed. Result: Particle size of the mixed micelles was uniform and its morphology was spherical.The absolute values of Zeta potential were less than 20 mV.When the amount of sodium deoxycholate was fixed 4.96 g·L-1,the solubility of these 4 compounds with the concentration of fatty oil at 0.1-4 g·L-1 were significantly greater than that at the dosage of 0 g·L-1.The solubility of these 4 compounds in the micelles formed by fatty oil was 1.3 to 4 times as much as the micelles without fatty oil.The micelles was stable for 36 h. Conclusion: The micelles self-assembled from fatty oil of Euphorbiae Semen and bile salt of intestinal juice,have significant solubilization effect on Euphorbia factor L1,L2,L3 and L8.This research can lay the foundation for clarifying the detoxification mechanism of removing fatty oil and making frostlike powder from the perspective of pharmaceutics.

Influences of follow-up methods on rehabilitation and compliance of patients with severe scar after burns / 中华烧伤杂志

Objective@#To observe the influences of different follow-up methods on rehabilitation and compliance of patients with severe scar after burns.@*Methods@#From January 2012 to May 2016, medical records of 116 patients with severe scar after burns who were admitted to our unit, discharged after wound healing and conforming to the criteria, were retrospectively analyzed. They were divided into face-to-face follow-up group [n=59, 45 males and 14 females, aged (36±9) years] and routine follow-up group [n=57, 44 males and 13 females, aged (35±9) years] based on different follow-up methods they received. On the day of discharge and in post discharge month (PDM) 1, 3, and 6, the Vancouver Scar Scale (VSS) was used to evaluate the hypertrophic scar in joints, Activities of Daily Living (ADL) scale was used to evaluate the disability of patients in the 2 groups. In PDM 1, 3, and 6, Medical Compliance Behavior Questionnaire was used to investigate the medical compliance behaviors of patients in the 2 groups. Data were processed with chi-square test, t test with Bonferroni correction, and analysis of variance for repeated measurement.@*Results@#(1) The VSS score of patients in face-to-face follow-up group on the day of discharge was (11.1±0.7) points, which was close to (11.7±0.7) points of routine follow-up group (t=2.021, P>0.05). The VSS scores of patients in face-to-face follow-up group in PDM 1, 3, and 6 were (10.5±0.6), (8.6±0.7), and (4.7±0.5) points, which were significantly lower than (11.4±0.7), (10.9±1.0), and (9.4±0.8) points of routine follow-up group respectively (t=2.034, 2.033, 2.042, P<0.05 or P<0.01). (2) The ADL score of patients in face-to-face follow-up group on the day of discharge was close to that of routine follow-up group (t=1.781, P>0.05). The ADL scores of patients in face-to-face follow-up group in PDM 1, 3, and 6 were higher than those of routine follow-up group respectively (t=9.683, 8.584, 9.772, P<0.01). (3) The compliance rates of consisted rehabilitation, reasonable diet, and timing consultation of patients in face-to-face follow-up group were better than those of routine follow-up group respectively (χ2=19.015, 13.251, 8.652, P<0.01).@*Conclusions@#Compared with routine follow-up by phone, face-to-face follow-up can do better in evaluating the scar condition and ADL of patients with severe scar after burns, and improve the medical compliance rates of patients, which is worthy of clinical promotion.

Applications and challenges of paper-based microfluidic in laboratory medicine / 中华检验医学杂志

Paper-based microfluidic, as a rapid, low-cost and portable detection technology, has been widely used in many fields such as disease diagnosis, food safety and environmental monitoring, especially in laboratory medicine. Compared with conventional methods, paper-based microfluidic provides reliable support for rapid and immediate diagnosis of diseases due to its unique physical and chemical properties of test strips. Based on the construction scheme and result analysis strategy of paper-based microfluidic, this paper reviews its application in clinical detection of nucleic acid and protein, and looks forward to its potential opportunities and challenges in laboratory medicine.