In vitro experiment of stem cell engineered two-sided anisotropic electrospun membranes for promoting dural repair / 中国组织工程研究

BACKGROUND:Currently,the dura mater is clinically repaired using autologous tissue or materials such as gelatin sponge,but all of them have their inherent defects.Therefore,there is an urgent need for a biomaterial that can promote dural repair. OBJECTIVE:The two-sided anisotropic electrospun membrane was constructed by using directional electrospinning technology and collagen self-assembly technology,and was used as a carrier for bone marrow mesenchymal stem cells to investigate various physicochemical properties and biological characteristics of the artificial dura mater. METHODS:Ordered polylactic acid electrospun fibers with double-sided(collagen protein on one side and polylactic acid on the other side)anisotropic electrospun membranes(collagen group),disordered polylactic acid electrospun membranes(disordered fiber group),and ordered oriented polylactic acid electrospun membranes(ordered fiber group)were prepared by electrospinning technique as well as collagen self-assembly technique.Scanning electron microscopy,mechanical stretching,water contact angle testing,and degradation experiments were used to characterize the physicochemical properties of the electrospun membranes.Electrospun membranes in the collagen group(bone marrow mesenchymal stem cells were inoculated on the collagen surface to obtain the stem cell-engineered electrospun membranes),disordered fiber group and ordered fiber group were cocultured with bone marrow mesenchymal stem cells.The biocompatibility of electrospun membranes was evaluated using CCK-8 assay and live/dead staining.Integrin β1 immunofluorescence staining was used to evaluate the adhesion characteristics of electrospun membranes.The stem cell-engineered electrospun membrane and the electrospun membrane in the collagen group were cocultured with bone marrow macrophages respectively.Immunomodulatory properties were assessed by detecting the expression of inflammation-related genes using inducible nitric oxide synthase(M1 type),CD206(M2 type)immunofluorescence staining,and qRT-PCR. RESULTS AND CONCLUSION:(1)The oriented electrospun fiber membrane could mimic the structure of the longitudinally aligned natural dura mater,and the addition of collagen increased the hydrophilicity of the fiber membrane by about 2-fold and the mechanical properties by 1.2-fold.(2)When cocultured with bone marrow mesenchymal stem cells,CCK-8 assay and live/dead staining suggested that the cellular bioactivity in the collagen group was significantly higher than that in the disordered fiber group and ordered fiber group.Immunofluorescence staining revealed that the expression of integrin β1 in the collagen group was about 2.6 times higher than that of the disordered and ordered fiber groups,and the cell spreading morphology was good.(3)When cocultured with bone marrow macrophages,immunofluorescence staining exhibited that the fluorescence intensity of M1 type macrophages in the stem cell-engineered electrospun membrane group was lower than that in the collagen group(P<0.01),and the fluorescence intensity of M2 type macrophages was higher than that in the collagen group(P<0.01).qRT-PCR demonstrated that proinflammatory gene tumor necrosis factor α and interleukin-1β mRNA expression in the stem cell-engineered electrospun membrane group was lower than that of the collagen group(P<0.001);anti-inflammatory genes such as interleukin-10 and transforming growth factor β mRNA expressions were higher than those in the collagen group(P<0.001).(4)The above results suggest that the stem cell-engineered amphipathic artificial dura mimics the directional structure of normal dura,with the inner surface facilitating cell growth and adhesion and the outer edge avoiding tissue adhesion,while the polarization of macrophages to the M2 subtype is promoted and the local inflammatory microenvironment is regulated through the mesenchymal stem cell paracrine component.

Mechanism of black phosphorus regulating oxidative stress-inflammation cascade in retarding intervertebral disc degeneration / 中国组织工程研究

BACKGROUND:Oxidative stress plays a critical role in intervertebral disc degeneration.As a reducing material with good biocompatibility,black phosphorus quantum dots have the potential to resist oxidative stress and retard intervertebral disc degeneration.OBJECTIVE:To evaluate the effect of black phosphorus quantum dots on scavenging reactive oxygen species in the microenvironment of an intervertebral disc through in vivo and in vitro experiments,and further explore the role of black phosphorus quantum dots in Nrf2/ARE pathway and intervertebral disc inflammation.METHODS:Black phosphorus quantum dots were prepared by a liquid exfoliation technique.(1)In vitro experiment:The nucleus pulposus cells of SD rats were isolated and extracted,and the passages 2-4 nucleus pulposus cells were cocultured with different solutions,including F12-DMEM medium(blank group),black phosphorus quantum dot solution,hydrogen peroxide solution,hydrogen peroxide+black phosphorus quantum dot solution,hydrogen peroxide+black phosphorus quantum dot+Nrf2 specific inhibitor ML385 solution.Cell live/dead staining and intracellular reactive oxygen species,mitochondrial membrane potential and western blot assay were performed respectively.(2)In vivo experiment:Thirty SD rats were randomly divided into sham operation,puncture and puncture + black phosphorus groups,with 10 rats in each group.A Co7-10 intervertebral disc degeneration model was established using intervertebral disc puncture in the puncture group and the puncture+black phosphorus group.Black phosphorus quantum dot solution was injected in the intervertebral disc after a puncture in the puncture+black phosphorus group.The intervertebral disc tissue imaging and histological staining were evaluated at 4 and 8 weeks after surgery.RESULTS AND CONCLUSION:(1)In vitro experiment:Live/dead staining revealed that the black phosphorus quantum dots had good biocompatibility,were non-toxic to cells,and had a protective effect on nucleus pulposus cells under oxidative stress.Intracellular reactive oxygen species and JC-1 fluorescent probes showed that black phosphorus quantum dots could regulate the reduction of mitochondrial membrane potential caused by oxidative stress in nucleus pulposus cells and protected cells from hydrogen peroxidation-induced intracellular oxidative stress.Western blot analysis showed that compared with the blank group,the protein expressions of Nrf2,heme oxygenase 1,quinone oxidoreductase and type Ⅱ collagen were decreased in the hydrogen peroxide group(P<0.05),while the protein expressions of tumor necrosis factor α,interleukin 1β,matrix metalloproteinase 13 and p65 were increased(P<0.05).The addition of black phosphorus quantum dots could reverse the inhibitory effect of hydrogen peroxide on the Nrf2 pathway and reduce the inflammatory response caused by oxidative stress,but NrF2-specific inhibitors could cancel this effect.(2)In vivo experiment:X-ray and MRI demonstrated that at 4 and 8 weeks after surgery,the intervertebral disc height and water content of nucleus pulposus in the puncture group were lower than those in the sham operation group(P<0.05),and the intervertebral disc height and water content of nucleus pulposus in the puncture+black phosphorus group were higher than those in the puncture group(P<0.05).Histological staining exhibited that the degree of intervertebral disc degeneration in the puncture+black phosphorus group was less than that in the puncture group,and the expression of heme oxygenase 1 protein was higher than that in the puncture+black phosphorus group.(3)Our results have indicated that black phosphorus quantum dots can exert an antioxidant effect and delay intervertebral disc degeneration by regulating Nrf2/ARE pathway.

Association between hearing loss and physical performance in patients on maintenance hemodialysis

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. Methods: This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. Results: Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = –0.356, p < 0.001 and r = –0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73–1.81), 1.69 (1.07–2.70), and 2.87 (1.69–4.88) (p for trend = 0.005). Conclusion: Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Influence of Huayu xiaozhong decoction on inflammatory response in rats with deep vein thrombosis / 中国药房

OBJECTIVE To investigate the influence of Huayu xiaozhong decoction （HXD） on inflammatory response in rats with deep vein thrombosis （DVT）. METHODS The male SD rats were divided into control group （CK group）， model group （Model group）， HXD low-dose group （HXD-L group， HXD 10.86 mg/kg）， HXD medium-dose group （HXD-M group， HXD 21.71 mg/kg）， HXD high-dose group （HXD-H group， HXD 32.57 mg/kg）， positive control group （LMWHS group， low molecular weight heparin sodium 600 IU/kg）， silent information regulator 2 （SIRT2） inhibitor group （AK-7 group， AK-7 20 mg/kg）， HXD-M+AK-7 group （HXD 21.71 mg/kg+AK-7 20 mg/kg）， with 12 rats in each group. Except for the CK group， the DVT rat was induced by the Reyers method in other groups； after modeling， administration groups were given relevant medicine intragastrically/intraperitoneally， once a day， for consecutive 2 weeks. Twenty-four hours after the last medication， the coagulation function indexes [activated partial thromboplastin time （APTT）， thrombin time （TT）， prothrombin time （PT）， fibrinogen （FIB）] and inflammatory indexes in serum and inferior vena cava tissue [interleukin-1β （IL-1β）， IL-6， tumor necrosis factor-α （TNF-α）] of rats were detected. The formation of thrombus was observed， and the wet and dry masses of the thrombus were weighed. The protein expressions of tissue factor （TF） and SIRT2 as well as the phosphorylation and acetylation levels of nuclear factor kappa B （NF-κB） p65 in inferior vena cava tissue were detected. RESULTS Compared with CK group， APTT， TT and PT of rats in Model group were shortened significantly（P＜0.05）； the content of FIB， the levels of IL-1β， IL-6 and TNF-α， wet weight and dry weight of venous thrombus， TF protein staining score， the phosphorylation and acetylation levels of NF-κB p65 protein increased significantly （P＜0.05）； the inferior vena cava was full of thrombus， and the protein expression of SIRT2 decreased （P＜0.05）. Compared with Model group， above indexes of HXD-L group， HXD-M group， HXD-H group and LMWHS group were improved， while the improvement effects of HXD-M group， HXD-H group and LMWHS group were significantly better than those of HXD-L group （P＜0.05）. The trends of the corresponding indicators in AK-7 group were opposite to the above （P＜0.05）； AK-7 attenuated the inhibitory effect of medium-dose HXD on the inflammatory response in model rats （P＜0.05）.CONCLUSIONS HXD may inhibit the inflammatory response of DVT rats by activating SIRT2/NF-κB signaling pathway.

Cortical Mechanisms of Multisensory Linear Self-motion Perception / 神经科学通报·英文版

Accurate self-motion perception, which is critical for organisms to survive, is a process involving multiple sensory cues. The two most powerful cues are visual (optic flow) and vestibular (inertial motion). Psychophysical studies have indicated that humans and nonhuman primates integrate the two cues to improve the estimation of self-motion direction, often in a statistically Bayesian-optimal way. In the last decade, single-unit recordings in awake, behaving animals have provided valuable neurophysiological data with a high spatial and temporal resolution, giving insight into possible neural mechanisms underlying multisensory self-motion perception. Here, we review these findings, along with new evidence from the most recent studies focusing on the temporal dynamics of signals in different modalities. We show that, in light of new data, conventional thoughts about the cortical mechanisms underlying visuo-vestibular integration for linear self-motion are challenged. We propose that different temporal component signals may mediate different functions, a possibility that requires future studies.

HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems / 中华预防医学杂志

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R2 of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.

Clinicopathological analysis of primary gastric (gastrointestinal)-type mucoglandular lesion of endometrium / 中华病理学杂志

Objective: To investigate the clinical and pathological features of primary gastric (gastrointestinal)-type mucoglandular lesions of the endometrium. Methods: Eight cases of primary gastric (gastrointestinal)-type mucoglandular lesions of endometrium diagnosed between 2014 to 2022 were retrieved from pathology archives of the Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai, China. The clinical history, pathological sections and follow-ups were analyzed. Results: The eight patients ranged in age from 35 to 67 years, with an average age of 55.5 years. Seven patients were examined for high-risk human papillary virus (HPV) before operation. Only one of them was positive for high-risk HPV52. No cervical mucinous lesions were found in any of the patients. Two cases were invasive gastric (gastrointestinal)-type adenocarcinoma, 2 cases were benign gastric (gastrointestinal)-type mucinous metaplasia, and the other 4 cases were atypical gastric (gastrointestinal)-type mucinous gland hyperplasia. Microscopically, tumor cells showed mucous epithelium with gastrointestinal differentiation. Immunophenotyping showed that MUC6 was diffusely or focally positive in 5 cases, CK20 and CDX2 were positive in 3 cases. And p16 was negative or focally positive in 5 cases and strongly positive in 1 case. ER was expressed in both benign and atypical lesions, and weakly positive or negative in the invasive adenocarcinoma. p53 showed mutant expression in one case and wild-type expression in the rest. HPV in situ hybridization was negative. Conclusions: Primary gastric (gastrointestinal)-type mucoglandular lesions of the endometrium show various forms of gastrointestinal differentiation, which are high-risk HPV independent. Morphology combined with immunohistochemistry is helpful for the diagnosis, which can only be made on exclusion of cervical gastrointestinal glandular lesion, gastrointestinal metastatic carcinoma and the mucinous subtype of endometrioid carcinoma.

Analysis of high risk factors for chromosomal aberrations in peripheral blood lymphocytes of 200 radiation workers in Hainan Province / 上海预防医学

ObjectiveTo investigate the current status and high-risk factors of chromosomal aberrations in peripheral blood lymphocytes （PBL） of radiation workers in Hainan Province. MethodsA total of 200 radiological workers who underwent occupational health examination in Hainan Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were selected to collect the occupational health examination data and the rate of PBL chromosomal aberrations. The influencing factors of PBL chromosomal aberrations were analyzed by logistic regression model. The predictive value of logistic regression prediction model on PBL chromosomal aberrations were determined by using the reciver operator characteristic （ROC） curve. ResultsA total of 20 000 cells （100 cells/person） were tested. The chromosomal aberration rate was 0.37% （74/20 000） and the PBL chromosomal aberration rate in the subjects was 6.00% （12/200）. Univariate analysis showed that PBL chromosomal aberrations in radiological workers were related to age， length of service， type of work and education （all P<0.05）， but not to gender （P>0.05）. The logistic regression prediction model was constructed based on the influencing factors， with χ2=9.413， df=9， P=0.852， suggesting a good model fit. The logistic regression prediction model predicted the area under the curve （AUC） for the occurrence of PBL chromosomal aberrations in radiation workers was 0.914 （95%CI： 0.866‒0.949）， with a cut-off value of 3.05， corresponding to a prediction sensitivity and specificity of 100.00% and 75.98%， respectively. ConclusionThe incidence of PBL chromosomal aberrations in radiological workers in Hainan Province was 6.00%， with age， working age and job type as high-risk factors and education level as a protective factor. The prediction model constructed by the above factors can provide a reliable basis for clinical prediction of PBL chromosomal aberrations in radiological workers.

Research progress on low carbohydrate diet in type 1 diabetes / 中国医师杂志

Low carbohydrate diet (LCD), as an adjunctive therapy of type 1 diabetes (T1DM), has attracted much attention in recent years, but its exact efficacy and safety have not yet been determined. Limited literature has reported that LCD plays an important role in controlling blood sugar and its complications in T1DM patients, regulating intestinal microbiota, and autoimmunity. This article elaborates on the research progress of T1DM medical nutritional therapy related to LCD mode in recent years, including its control of blood sugar, adverse reactions, and regulation of intestinal microbiota.

Application of immunological markers in the diagnosis and prediction of type 1 diabetes / 中国医师杂志

Type 1 diabetes mellitus (T1DM) is an organ-specific autoimmune disease mediated by T cells. Untreated T1DM deteriorate rapidly. Early prediction and diagnosis lead to early treatment and prognosis of patients. Immune system plays an important role in the destruction of β cells in T1DM patients, and the emergence of immunological markers has facilitated the diagnosis and prediction of T1DM. Based on the results of various cohort studies and clinical studies in recent years, this review comprehensively discusses the application of immunological markers in the prediction and diagnosis of T1DM from two aspects: humoral immune markers and cellular immune markers.

Status Quo and Innovative Directions for Inpatient Fall Interventions / 기본간호학회지

Purpose@#The purpose of this study was to explore nurses’ experience of falls, and their perception of the status quo of inpatient fall interventions. @*Methods@#The participants were 28 ward nurses in a university hospital, Seoul, Korea. Five focus group interviews and three individual interviews were conducted. The interviews were analyzed using thematic analysis. @*Results@#The findings from this study suggest that nurses face limitations in providing conventional fall interventions due to patient disease related characteristics, situations in hospital, and medical devices used in the hospital settings. Although nurses adopted their own strategies to prevent falls effectively, they expressed the need for innovative approaches to overcome these limitations. @*Conclusion@#Systematic, technology-based approaches are needed to create a safer physical environment and to improve current nursing interventions to prevent falls.

Kyphoplasty with bone cement injection for the treatment of osteoporotic vertebral compression fractures in different parts of the spine / 中国组织工程研究

BACKGROUND: Kyphoplasty with bone cement injection for the treatment of osteoporotic vertebral compression fractures has a good clinical effect, but it is unclear whether there is a difference in the efficacy on the fractures in different parts of the spine. OBJECTIVE: To compare the outcomes of kyphoplasty with bone cement injection in the treatment of osteoporotic vertebral compression fractures in different parts of the spine. METHODS: We retrospectively analyzed the clinical data of 247 cases of single-segmental osteoporotic vertebral compression fractures undergoing kyphoplasty with bone cement injection at the Department of Orthopaedic Surgery, the First Affiliated Hospital of Soochow University in China from January 2011 to August 2014. There were 24 cases of upper and middle thoracic (T1-T10) fractures, 187 cases of thoracolumbar (T11-L2) fractures and 36 cases of lower lumbar (L3-L5) fractures. The surgical time, X-ray exposure time, bone cement volume and leakage, the Visual Analog Scale score, the Oswestry Disability Index score, anterior vertebral height ratio and Cobb angle were assessed preoperatively, at 1 day posteroperatively and at the final visit. RESULTS AND CONCLUSION: (1) All patients underwent the surgery successfully, and were followed up for 12-44 months, with an average of (25.44±7.85) months. (2) There were 18 cases of bone cement leakage in the three groups, including 3 (12.5％) cases of upper and middle thoracic fractures, 13 (6.4％) cases of thoracolumbar fractures and 2 (5.6％) cases of lower lumbar fractures. (3) The surgical time and X-ray exposure time were significantly higher in the patients with upper and middle thoracic fractures than those with thoracolumbar fractures or lower lumbar fractures (P < 0.05) , while the volume of bone cement was significantly lower than that in the other two groups (P < 0.05) . Additionally, there were no significant differences in the surgical time, X-ray exposure time, and amount of bone cement between the patients with thoracolumbar fractures and with lower lumbar fractures (P> 0.05) . (4) There were no significant differences in the Visual Analog Scale score, Oswestry Disability Index score, anterior vertebral height ratio and Cobb angle among the three groups preoperatively, at 1 day postoperatively and at the final visit (all P> 0.05) . However, compared with baseline, these indicators were significantly improved in each group at 1 day postoperatively and at the final visit (P < 0.05) . (5) To conclude, kyphoplasty with bone cement injection has achieved satisfactory outcomes in the treatment of osteoporotic vertebral compression fractures in different parts of the spine.

Screening and Identification of Blood Group Alloantibody by Surface Plasmon Resonance Technique and Its Preliminary Application / 中国实验血液学杂志

OBJECTIVE@#To investigate the feasibilily of screening and identifying the red blood cell type alloantibodies by means of surface plasman resonance(SPR) technique so as to provide a new method for detecting the transfusion compatibility of red blood cells.@*METHODS@#The RBC antigens for screening the alloantibody were fixed on the SPR chip surface by means of amino coupling method; the analysis conditions of SPR chip were optimized and then the control serum with RBC blood group antibody positive was detected; the performance of SPR chip for detection of serum was analysed; the consistance of rusults detected by SPR technique and microcolum agglutination for clinieal samples of 129 thalasstmia patients with history of lone-term blood transfusion were compared; at the same time, the blood group amtibodies in 7 patients with blood group antibody positive were identified before blood transfusion by using SPR chip so as to select the RBC antigen compatible blood for transfusion; and the efficacy of RBC transfusion was followed up and evaluated.@*RESULTS@#The repeatability, sensitivity and specificity of SPR chip technique for detecting the blood group alloantibodies all were better. The SPR technique and microcolumn agglutination method were not significant different for screening blood group alloantibodies (χ2 = 0.333, P＞0.05), and the overall consistency was 97.2%; the results of SPR technique in 7 patients with positive blood group antibodies were as follows: 3 cases with anti-E, 1 case anti-M, 1 case anti-C, 1 case anti-Jka and 1 case autoantibody, which were consistent with the results of microcolumn agglutination tests, and the compatible red blood cells were selected for transfusion, of which the infusion of 6 cases was effective. In only 1 case the infusion was ineffective because of autoantibody.@*CONCLUSION@#For screening and identification of blood group alloantibodies, the performance of SPR chip technique is equivalent to the micro-column agglutination, but the procedure of SPR technique is simpler, faster and high-throughput and label-free, which can meet the basic requirements for rapid screening and identification of blood group alloantibodies before transfusion of red blood cells.

Determination of arsenic speciation in 17 commonly used traditional Chinese herbal medicines by HPLC-ICP-MS / 中国中药杂志

The element speciation analysis for heavy metals in herbal medicines is still in the beginning stage. In this study,the total amount of arsenic( As) in 103 batches of 17 commonly used Chinese medicines( including 16 plant medicines and 1 medicinal fungus) was detected by inductively coupled plasma mass spectrometry( ICP-MS). Furthermore,based on HPLC-ICP-MS,the simultaneous detection methods of six As speciation kinds in traditional Chinese medicines were established. An AS7 anion exchange column was selected and the As forms in 17 traditional Chinese medicines was systematically analyzed. The results showed that the method of pretreatment of medicinal materials by microwave digestion and the detection of total amount of As by ICP-MS was stable and reliable. As for the speciation analysis of As,the high-speed ultrasonic extraction method was adopted,and it showed that the linear relationship of the six As speciation was satisfied with the correlation coefficient R2>0. 999 9. The LOQ of six kinds of As speciation were 0. 20,0. 10,0. 15,0. 10,0. 25,0. 10 μg·L~(-1) for arsenic betaine( As B),arsenious acid [As( Ⅲ) ],dimethyl arsenic( DMA),arsenic choline( As C),monomethyl arsenic( MMA),arsenic acid[As( Ⅴ) ],respectively. The recoveries were between 84. 24% and 121. 5%,and the relative standard deviations were 2. 7% to 11%. Among the 103 batches of medicinal materials,only one batch of sample As exceeded the Chinese Pharmacopoeia limit standard; As( Ⅲ) and As( Ⅴ) had high detection rate in 103 batches of Chinese herbal medicines,within which As( Ⅴ) was the main detected form,and inorganic As accounted for the ratio reached 80. 90%-98. 73%; some samples detected DMA,MMA and As B,As C was not detected in any batch. This study established an analytical method suitable for the speciation of As in Chinese herbal medicines,and provided basic data for As residual residue in Chinese herbal medicines,which can provide important reference for the risk assessment and quality standards.

A survey on the present status of diagnosis and treatment of Graves' disease in Jiangsu province / 中华内分泌代谢杂志

Objective To investigate the management of Graves' disease in Jiangsu province. Methods According to the 2011 management of GD survey from American Thyroid Association and the 2013 survey from European Thyroid Association, a questionnaire was designed for this survey to acquire the diagnosis, treatment, and follow-up of Graves' disease among endocrinologists from 35 tertiary hospitals in Jiangsu province. Results A total of 476 valid questionnaires were collected. For patients with symptoms of hyperthyroidism, a large majority of respondents monitored serum FT3 , FT4 , TSH, thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody, and finding of thyroid ultrasound, accounted for 95. 6％, 95. 0％, 95. 4％, 95. 8％, 90. 3％, 90. 5％, and 93. 9％physicians, respectively. 91.2％ of physicians preferred anti-thyroid drugs as the first-line treatment, and 92. 6％ of them gave priority to the use of methimazole. For the duration of anti-thyroid drugs therapy, 41.2％of endocrinologists chose 24 months, while 20％ chose 18 months. When patients have moderate and active ophthalmopathy, most respondents with medium or senior professional titles preferred anti-thyroid drugs, while most resident physicians chose radioactive iodine plus corticosteroids. When pregnancy was confirmed in the patients of Graves' disease, 88％ of respondents preferred propylthiouracil during the first trimester of pregnancy, and 58. 4％ of them would continue propylthiouracil into the second trimester. Conclusions The mastering of basic perception of Graves' disease knowledge is satisfactory among the endocrinologists. But by comparing to the American and European survey results and related guidelines, there are still some differences in diagnosis and treatment. Therefore, physicians should notice those differences and make improvement on standardized treatment for patients to raise the response ratio while reducing the recurrent events.

Effect of Multisensory Training on Visual Information Processing Ability for Children with Autism / 中国康复理论与实践

Objective:To explore the effect of multisensory training on the visual processing capacity for children with autism. Methods:The multisensory training intervention was developed and implemented in perceptual abilities for four children with autism. The intervention experiment design for single subject with multiple baseline was adopted to the monitor the change of abilities for children to receive colorful food signals and adapt to the changes of living space during the multisensory training from June to September, 2017, four children finishied training. They were assessed with Perception Ability Assessment before and after training. Results:Four subjects improved in accepting colorful food signals and adapting to the changes of living space after intervention. The scores of the visual, auditory and feeling perception abilities significantly improved at the end of intervention compared to those at baseline. Conclusion:The multisensory training could improve the visual information processing ability for children with autism.

Investigation and analysis of infection and antibiotic resistance of Helicobacter pylori in armed policemen in Shaanxi province / 解放军医学杂志

Objective To investigate and analyze the situation of Helicobacter pylori (Hp) infection and antibiotic resistance in armed police officers and soldiers (APOSs) in Shaanxi province, and provide a theoretical basis for the rational selection of drugs for the eradication of Hp in the armed police forces in this region. Methods Two hundred and three APOS patients from the Shaanxi Armed Police Corps Hospital who underwent gastroscopy for gastrointestinal symptoms from June 2016 to December 2017 were enrolled in this study. Biopsy samples were extracted by gastroscope and Hp was isolated, identified and cultured. Four types of antibiotics were used to analyze the sensitivity of resistance to drugs: amoxicillin, clarithromycin, levofloxacin and metronidazole. Results A total of 119 Hp strains were isolated from 203 endoscopic biopsies. The positivity rate was 58.6%. The positivity rate of Hp isolation and culture in patients with peptic ulcer was 58.1% (36/62), which was significantly higher than that in patients with chronic gastritis (35.2%, 32/91, χ2=7.832, P=0.005); There was no statistical difference compared with other pathological types of diseases (P>0.05). The resistance rates of Hp to amoxicillin, clarithromycin, levofloxacin, and metronidazole were 1.7% (2/119), 10.1% (12/119), 14.3% (17/119) and 28.6% (34/119), respectively. There were 12 of 119 strains were detected to be resistant to two drugs, of them 7 were resistant to clarithromycin and metronidazole, and 5 were resistant to levofloxacin and clarithromycin. We did not find the strains which are antibiotic resistant to three or more drugs. There was no significant difference in Hp resistance between different pathological disease types (P>0.05). Conclusions The role of Hp in the development of peptic ulcers among local armed police officers is very important. The current first-line therapy should be selected for eradication treatment of APOS patients in the region.

Role of HMGB1 in Post-traumatic Endoplasmic Reticulum Stress in Rat Lung Tissues / 法医学杂志

OBJECTIVES@#To explore the role of high mobility group B1 （HMGB1） protein in the post-traumatic endoplasmic reticulum stress （ERS） in rat lung tissues.@*METHODS@#The rat model of acute lung injury was established by crushing the hind limbs of rats with standard weight. The first experiment was to divide rats into postural control group and crush groups （6 h, 18 h and 30 h after crushing）. The second experiment was to divide rats into postural control group, 18 h crush group, HMGB1 inhibitor sodium butyrate （SB） group and 18 h crush+SB group. The protein expression changes of HMGB1 and ERS- related proteins （GRP78, caspase-12, CHOP and IRE1α） in rat lung tissues were detected with Western blotting. Meanwhile, the pathological changes of rat lungs were observed by HE stain.@*RESULTS@#Compared with the postural control group, the expression levels of ERS-related proteins （GRP78, caspase-12, CHOP and IRE1α） and HMGB1 protein in rat lung tissues by crushing the hind limbs of rats were obviously increased. The protein levels reduced at 30 h after crushing but were still higher than those of postural control group and obvious pathological changes of acute lung injury were observed simultaneously in rats. Compared with the 18 h crush group, the expression levels of the ERS-related proteins and HMGB1 protein in rat lung tissues were attenuated in 18 h crush+SB group, and the pathological changes of rat lung injury began to alleviate.@*CONCLUSIONS@#HMGB1-ERS pathway activated by traumatic stress can lead to acute lung injury in rats.

Optic Nerve Crush Induces Changes of Hydrogen Sulfide Synthases Expression in the Rat Retina / 法医学杂志

Objective To investigate the expression changes of the hydrogen sulfide synthases cystathionineγ-lyase (CSE), cystathionineβ-synthase (CBS), and 3-mercaptopyruvate sulfurtransferase (3-MST), after optic nerve crush (ONC) in rat the retina.Methods The rat model of ONC was established.Rats were divided into normal control, ONC, and sham control groups.Histopathologic changes in retina, the number of retinal ganglion cells (RGC) and retinal thickness of inner part (RTIP) were measured.The changes of CSE, CBS and 3-MST mRNA expression were detected with quantitative real-time PCR.Results The retinal histostructure was normal in normal controls and with minor changes in sham controls, respectively.Compared with sham group, significant retina damages were found in the ONC group:a time-dependent reduction of RGC number and RTIP.Expressions of CSE, CBS and 3-MST mRNA in rat retina were detected in normal control.Compared with normal controls, the expressions of CSE, CBS and 3-MST mRNA did not show any significant changes in the sham controls.Compared with sham controls, CBS mRNA expressions showed a time-dependent increase at 3 d, 7 d and 14 d after crush in the ONC group;CSE mRNA expressions increased to the peak at 3 d and then slightly reduced at 14 d after crush;3-MST mRNA expressions showed the trend of increase at 3 d and 7 d and then enhanced remarkably at 14 d after crush.Conclusion Hydrogen sulfide synthases CSE, CBS and3-MST expressions were up-regulated in rat retina following ONC, which may cause an increase in local endogenous hydrogen sulfide production in the retina and a compensatory protective effect.

Estimation of bioaccessibility and risk assessment of heavy metals in decoction pieces of Bupleuri Radix / 中国中药杂志

This project was launched to study on the overall residual status of heavy metals of comprehensive understanding in decoction pieces of Bupleuri Radix (DPBR) from different habitats and risk assessment. In this study, inductively coupled plasma mass spectrometry was used to determine the heavy metals of 30 batches of Bupleuri Radix in different producing areas. Simulated gastrointestinal fluid method was used to determine the dissolution rate of heavy metals in the simulated gastrointestinal fluid and the average daily intake Average Daily Dose (ADD) and Hazard Quotient (HQ) index were used to assess the risk of heavy metals in DPBR. The results showed that the contents of copper (Cu), lead (Pb), arsenic (As), cadmium (Cd), and mercury (Hg) in the 30 batches of DPBR didn't exceed the limit of Chinese Pharmacopeia, however, the chromium (Cr) in DPBR exeeded the limit set by NSF in USA and the limit for herbal ingredients in Canada. The mean bioaccessible heavy metal concentrations decreased from Cu (5.27 mg·kg⁻¹)>Cr (4.67 mg·kg⁻¹)>As (0.18 mg·kg⁻¹)>Pb (0.12 mg·kg⁻¹)>Cd (0.06 mg·kg⁻¹), and Hg was not detected in this test. In addition, cumulative non-carcinogenic health risks (HI) for adults and children were 0.799 and 0.714, respectively. Both HI values in adults and children for combined trace element and heavy metal element exposures were below the value of 1 (HI<1), indicating very low carcinogenic health risk. Heavy metals toxicity in herbal medicines and its health risk to humans would be overestimated when assessed only by the total concentrations without considering the bioaccessibility. Therefore, bioaccessibility has great significance for evaluating the human health risks induced by heavy metals.