Effect of Zuoguiwan on Pancreatic Islet Function in Offspring of Maternal Rats with GDM / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Zuoguiwan on pancreatic islet function in offspring of gestational diabetes mellitus （GDM） maternal rat model and explore the mechanisms of Zuoguiwan in improving pancreatic islet function based on postpartum pancreatic regeneration. MethodHealthy female SD rats with normal blood glucose levels were paired with male rats in a 2∶1 ratio and housed together. Pregnancy was confirmed based on vaginal plugs or vaginal smears. The pregnant rats were divided into the following groups： normal group， model group， insulin group （insulin Detemir， 20 U·kg-1）， low-dose Zuoguiwan group （1.89 g·kg-1）， and high-dose Zuoguiwan group （3.78 g·kg-1）. The GDM rat model was induced using streptozotocin in rats except for those in the normal group. The model was confirmed by blood glucose testing in the maternal rats. Except for the normal and model groups， the other groups received daily administration of corresponding treatments. At 21 days after birth， fasting blood glucose （FBG） and fasting serum insulin （FINS） levels were measured in 6 offspring from each group. The homeostasis model assessment of insulin resistance （HOMA-IR） was calculated， and an oral glucose tolerance test （OGTT） was performed on additional 12 offspring from each group. Blood samples were taken from the abdominal aorta of the offspring at postnatal day 22， and enzyme-linked immunosorbent assay （ELISA） was used to measure insulin， glucagon （GC）， pancreatic polypeptide （PPY）， and somatostatin （SS） levels in the serum. Hematoxylin-eosin （HE） staining was performed to observe pathological changes in the pancreatic tissue of the offspring. Immunofluorescence （IF） was used to observe the area and structure of the pancreatic islets. Western blot was used to detect the expression of key proteins involved in the development and functional expression of pancreatic β-cells， namely pancreatic and duodenal homeobox factor 1 （Pdx1）， Nkx6.1， and Glucose transporter 2 （Glut2）. ResultCompared with the normal group， the model group showed significant increases in FBG and FINS levels， and HOMA-IR （P<0.01）. Compared with the model group， the insulin group showed significant decreases in FBG levels and HOMA-IR （P<0.01）， the low-dose Zuoguiwan group showed a significant decrease in FBG levels （P<0.05）， and the high-dose Zuoguiwan group showed significant decreases in FBG and FINS levels， and HOMA-IR （P<0.01）. Compared with the normal group， the model group showed significant increases in OGTT 60-min blood glucose levels and AUC index （P<0.05， P<0.01）. Compared with the model group， the high-dose Zuoguiwan group showed significant decreases in OGTT60-min blood glucose levels and area under the curve（AUC） index （P<0.05， P<0.01）. HE staining of pancreatic tissue showed that compared with the normal group， the model group had a reduced number of islets and a loose arrangement of acinar cells. Compared with the model group， the groups with drug treatment showed increased number of islets and a compact arrangement of acinar cells. Compared with the normal group， the model group had significantly increased levels of insulin， GC， PPY， and SS in the serum （P<0.01）. Compared with the model group， the low-dose and high-dose Zuoguiwan groups and the insulin group showed significantly decreased serum levels of insulin， GC， PPY， and SS （P<0.05， P<0.01）. IF results showed that compared with the normal group， the model group had a significantly lower positive rate of insulin （P<0.05）. Compared with the model group， the low-dose and high-dose Zuoguiwan groups showed a significant increase in the positive rate of insulin （P<0.05）. There was no significant difference in the positive rate of GC among the groups. In terms of the proportion of insulin and GC in individual islets， compared with the normal group， the model group showed a significant decrease in the proportion of insulin （P<0.01） and a significant increase in the proportion of GC （P<0.01）. Compared with the model group， the low-dose and high-dose Zuoguiwan groups showed significantly increased proportion of insulin （P<0.01） and significantly decreased proportion of GC （P<0.01）. Compared with the normal group， the model group showed significantly decreased expression levels of Pdx1， Nkx6.1， and Glut2 proteins in the pancreatic tissue of GDM offspring （P<0.05）. Compared with the model group， the insulin group and the low-dose Zuoguiwan group showed significant increases in the expression levels of Pdx1 and Nkx6.1 proteins in the pancreatic tissue of GDM offspring （P<0.05）， and the low-dose and high-dose Zuoguiwan groups showed significant increases in the expression levels of Glut2 protein （P<0.05）. ConclusionZuoguiwan can promote pancreatic islet development in offspring of GDM maternal rat model， improve pancreatic islet morphology and function， and alleviate insulin resistance. Its mechanism of action may be related to the regulation of Pdx1， Nkx6.1， and Glut2 protein expression in the pancreatic tissue of offspring.

Preliminary development of problematic short video media use scale for university students / 中华行为医学与脑科学杂志

Objective:To develop the problematic short video use scale for college students in the context of Chinese culture, and to test its reliability and validity.Methods:The questionnaire items were established based on bibliographic retrieval method, interviewing method and social investigation method.Totally 275 college students were selected as subjects for item analysis and exploratory analysis, and 642 college students were selected for confirmatory factor analysis, validity analysis and reliability analysis. One month later, 112 college students were retested and test-retest reliability data were collected. SPSS 26.0 and Mplus 8.3 softwares were used for correlation analysis, reliability and validity analysis of the questionnaires.Results:(1) The formal questionnaire contained three dimensions, 13 items in total, and the three dimensions were change of knowledge and behavior, physical discomfort and social viscosity. The internal consistency coefficients of three dimensions were 0.794, 0.820, and 0.716, respectively. The item load ranged from 0.577 to 0.805, and the variance contribution rate was 64.803%. (2) The confirmatory factor analysis results showed that χ2/ df=2.39, SRMR=0.038, RMSEA=0.047, CFI=0.970, TLI=0.963, indicated that the three-factor structure accords with the requirements of psychometrics. (3) The split-half reliability of the questionnaire was 0.885, Cronbach's α was 0.882, and the test-retest reliability after one month was 0.991. The internal consistency reliability of the total questionnaire and each dimension ranged 0.716-0.882. Conclusion:The problematic short video media use scale has good psychometric indicators and it benefits the studies of problematic short video use among Chinese college students.

Semantic and orthographic processing characters in Chinese school-age children / 中华行为医学与脑科学杂志

Objective:To explore the developmental characteristics of Chinese semantic and orthographic processing in normal school-age children by event-related potential (ERP) technique.Methods:Children aged 7-11 in an ordinary primary school in Changzhou were randomly selected and divided into 7-year old group ( n=21 ), 8-year old group ( n=21), 9-year old group ( n=19), 10-year old group ( n=20) and 11- year old group ( n=22) according to their age.ERP was recorded while subjects completed the Chinese character semantic activation task and pseudo word judgment task. Then the N400 and P200 amplitudes of school-age children under the conditions of semantic correlation, semantic uncorrelation and pseudo word judgment were collected, and the data were analyzed by three factors mixed design ANOVA.Data of behavioral accuracy and response time were analyzed by one-way ANOVA and Bonferroni correction was used for multiple hypothesis testing. The statistical software was SPSS 25.0. Results:(1)Behavioral results: the accuracy of semantic related and semantic unrelated tasks of children in the five groups aged 7, 8, 9, 10 and 11 were statistically significant ( F=15.55, 4.01, both P<0.01), and the accuracy of children in the 7-year old group was significantly lower than those in the other four groups (all P<0.05). There was no significant difference in the accuracy of pseudo word judgment task among the five groups ( F=0.68, P=0.609). The response time of children in the five groups under semantic related and semantic unrelated tasks was significantly different ( F=3.90, 3.13, both P<0.05). The response time of the 11-year old group under semantic related tasks was significantly shorter than those of the 7-, 8- and 9-year old groups (all P<0.05). The response time of the 7-year old and 11-year old groups under semantic unrelated tasks was significantly shorter than those of the 8-, 9- and 10-year old groups (all P<0.05). (2)ERP results: N400 amplitudes of 7-, 8-, 9-, 10- and 11-year old children under semantic related tasks were significantly smaller than those under semantic unrelated tasks and pseudo word judgment tasks (all P<0.05). The N400 amplitude of the subjects gradually decreased with the increase of age, except that there was no statistical difference between the 10-year old and 11-year old groups under the semantic related task, between the 8-year old and 9-year old groups under the semantic unrelated task and the pseudo word judgment task, and between the 10-year old and 11-year old groups (all P>0.05), there were statistical differences between the other age groups (all P<0.05). P200 amplitude of semantic related task at 7-, 8-, 9- and 10-year old was significantly higher than that at semantic unrelated task (all P<0.05), and the amplitude of semantic related task at 7-, 8-, 10- and 11-year old was significantly higher than that at pseudo word judgment (all P<0.05). The amplitude of P200 gradually increased with age, and there were significant differences in pairwise comparison among other age groups ( P<0.05), except semantic related task and unrelated task among 7-, 8- and 9-year old groups, between 10- and 11-year old groups, and pseudo word task between 7- and 8- years old groups, 10- and 11- year old groups (all P>0.05). Conclusion:The semantic processing and orthographic processing of school-age children develop with age in a unique way. The age of 7 is an important period for cognitive development of Chinese language.The age of 8-9 may be a sensitive period for the development of brain plasticity, and the development slows down at the age of 10-11.

Semantic priming processing in children with Chinese developmental dyslexia / 中华行为医学与脑科学杂志

Objective:To explore the semantic priming processing characteristics of children with Chinese developmental dyslexia(DD).Methods:According to scores of the dyslexia checklist for Chinese children, character recognition test and Raven's standard progressive matrices (RSPM), 19 primary school students from a school in Wuqia County of Xinjiang were selected as DD group.Meanwhile, 19 children were selected as chronological-age control(CA) group matching in age and RSPM scores, and 20 children were selected as reading-level control(RL) group according to the character recognition test and RSPM scores.The amplitude of N400 of children in three groups were tested by semantic priming paradigm under the conditions of semantic related, unrelated and pseudo words.Results:The accuracy of the DD group under the conditions of irrelevant semantics((0.55±0.25) vs (0.81±0.16), P<0.05), and pseudo characters((0.43±0.27) vs (0.68±0.26), P<0.05) were significantly lower than those of CA group.There was no difference between DD group and RL group, as well as between RL group and CA group(both P>0.05). There was no significant difference in the response time among the three groups of children under semantic related and unrelated conditions( F=1.23, 2.03, both P>0.05). In terms of ERP data, in semantic related condition, there was no significant difference in N400 amplitude among the three groups ( F=0.55, P>0.05). In semantic unrelated condition, the amplitude of N400 in DD group was smaller than that in CA Group((-5.92±3.70)μV vs (-9.76±3.45)μV, P<0.05), and there was no statistically significant difference between DD group and RL Group((-5.92±3.70)μV vs (-7.41±4.02)μV, P>0.05), as well as between CA gorup and RL group.As to pseudo words condition, children in DD group had a lower amplitude of N400 than those in CA and RL groups ((-6.03±2.92)μV vs (-9.98±3.40)μV, (-8.91±3.40)μV, both P<0.05). While no significant differences were found between CA group and RL group. Conclusion:Children with Chinese DD have cognitive defects in semantic and orthographic processing.The semantic cognitive defects may caused by their low reading level, rather than their inherent defect, while the defect in orthographic processing may be their inherent defect.

Expression of HMGB1 protein in breast cancer and its clinicopathological significance / 中华病理学杂志

Objective@#To investigate the expression and clinicopathological significance of high mobility group box protein B1 (HMGB1) protein in breast cancer.@*Methods@#The expression of HMGB1 protein in 26 normal breast tissues and 417 invasive breast cancer tissues diagnosed at Dongyang People′s Hospital, Zhejiang Province from 2016 to 2018 were detected by immunohistochemical EnVision method. The relationship between nuclear and cytoplasmic HMGB1 protein expression and clinicopathologic features of breast cancer patients were analyzed.@*Results@#The nuclear and cytoplasmic expression of HMGB1 protein was 80.8% (337/417) and 16.8% (70/417) respectively in breast cancer, and was 46.2%(12/26) and 0(0/26) respectively in normal breast tissue. Both nuclear and cytoplasmic expression of HMGB1 protein in breast cancer were significantly higher than normal breast tissue (P<0.001, P=0.046, respectively). The nuclear expression of HMGB1 protein was also higher in high grade, estrogen receptor (ER) negative, progesterone receptor (PR) negative (P=0.006, P=0.004, P<0.001, respectively); whereas the cytoplasmic expression of HMGB1 protein was also higher in high grade, estrogen receptor (ER) negative, progesterone receptor (PR) negative (P<0.001 in all) breast cancers. Multivariate logistic regression model showed that nuclear HMGB1 expression correlated with histologic grade (OR=2.188, 95%CI=1.078-4.443, P=0.030), while cytoplasmic HMGB1 expression correlated with histologic grade (OR=3.031, 95%CI=1.600-5.742, P=0.001), ER (OR=0.129, 95%CI=0.034-0.494, P=0.003) and TNM staging (OR=3.820, 95%CI=1.042-14.001, P=0.043). Multivariate analysis of Cox proportional hazard model showed that nuclear HMGB1 expression was an independent risk factor for the overall survival of breast cancer patients (HR=0.366, 95%CI=0.138-0.972, P=0.044).@*Conclusion@#Nuclear and cytoplasmic HMGB1 proteins are related to multiple poor prognostic factors in breast cancer, and may be a potential biomarker for breast cancer treatment.

The expression of Resistin protein in breast cancer and its clinicopathological significance / 中华内分泌外科杂志

Objective:To study the expression of Resistin protein in breast cancer and to evaluate its significance to clinicopathology.Methods:The immunohistochemical technique, EnVision method, was used to evaluate the expression of Resistinin in 42 cases of normal breast tissues and 145 cases of breast cancer, and to analyze the relationship between Resistin protein expression and clinicopathological characteristics and molecular typing of invasive breast cancer patients.Results:The positive rate and strong positive rate of Resistin protein in normal breast tissue were 23.8% (10/42) and 0.0% (0/42) , respectively, while the positive rate and strong positive rate in invasive breast cancer were 88.3% (128/145) and 24.8% (36/145) . The positive rate and strong positive rate of Resistin protein in invasive breast cancer tissues were significantly higher than those in normal breast tissues (both P=0.000) . The positive rate of Resistin protein in invasive breast cancer was significantly higher in estrogen receptor (ER) -negative patients than in ER-positive patients ( P=0.006) , and it was higher in histological grade III and progesterone receptor (PR) -negative subjects than that of I-II and PR-positive, but the difference was not statistically significant ( P=0.053 and P=0.058, respectively) . The strong positive rate of Resistin protein in histological grade III, ER negative, PR negative and human epidermal growth factor receptor 2 (HER2) positive was significantly higher than that in histological grade I-II, ER positive, PR positive and HER2 negative ( P=0.001, P=0.001, P=0.001, and P=0.015, respectively) .The positive rate and strong positive rate of Resistin protein in triple negative breast cancer (TNBC) were significantly higher than those in other breast cancer subtypes ( P=0.048 and P=0.003, respectively) . Conclusion:Resistin plays an important role in the development of breast cancer and is expected to be a potential anti-cancer therapy biologic marker.

Event-related potential characteristics analysis on vigilant attention development of school-age children / 中华行为医学与脑科学杂志

Objective To explore the characteristics of event-related potential(ERP) in the development of alert attention of children aged 6-11 years old.Methods A total of 144 children aged 6-11 years old were enrolled in a continuous performance test (CPT,Go/Nogo stimulus task).The latency and amplitude of frontal region cue/uncue-P3 and CNV were analyzed and compared in all age groups.Results (1)Behavioral comparison among different age groups:correct number(35 (31,38),37 (34,38.25),37 (34.75,39),38(35,39.25),39(37.25,40),39(39,40)),correct reaction time ((566.88± 86.63) ms,(530.10±83.40) ms,(509.17±88.99)ms,(488.31±76.23)ms,(463.45±75.78)ms,(417.24±75..78)ms),the differences were statistically significant (P＜ 0.01).(2) Fz lead ERP characteristics:①Comparison of cueCNV and uncue-CNV:6-year-old group((-8.54±4.56) μV vs (-10.13±6.36) μV),7-year-old group ((-9.20±5.34) μV vs (-11.53±4.29) μV),8-year-old group((-8.37±4.78) μV vs (-11.35±6.38) μV) in amplitude and 9-year-old group((689.25±268.22) ms vs (826.13± 174.62) ms) in latency were significantly different (P＜0.05).(②)Comparison of cue-P3 and uncue-P3:6-year-old group((4.29±4.11) μV vs (7.45±3.83) μV),7-year-old group((4.47±4.71) μV vs (5.82±4.40) μV),8-year-old group((3.76± 3.39) μV vs (6.24 ± 4.91) μV),9-year-old group ((4.27 ± 3.57) μV vs (5.93 ± 3.08) μV),11-year-old group ((4.24±4.66) μV vs (6.13 ±4.42) μV) in amplitude were significantly different (P＜ 0.05).③Longitudinal comparison among age groups:the latency of cue-CNV in 9-year-old group and 11-year-old group were shorter,and the difference was significant(P＜0.05).The amplitudes of cue-CNV and cue-P3 in 10-year-old group were shorter than those in other age groups(P＜0.05).Conclusion With the increase of age,the reaction time of school-age children shortened and the correct rate improved.The age of 9-10 may be the highspeed period of the development for brain network on vigilant attention and psychological prediction which may be related to the maturation and development of frontal cortex.

Event-related potential characteristics analysis on vigilant attention development of school-age children / 中华行为医学与脑科学杂志

Objective@#To explore the characteristics of event-related potential(ERP) in the development of alert attention of children aged 6-11 years old.@*Methods@#A total of 144 children aged 6-11 years old were enrolled in a continuous performance test (CPT, Go/Nogo stimulus task). The latency and amplitude of frontal region cue/uncue-P3 and CNV were analyzed and compared in all age groups.@*Results@#(1)Behavioral comparison among different age groups: correct number(35(31, 38), 37(34, 38.25), 37(34.75, 39), 38(35, 39.25), 39(37.25, 40), 39(39, 40)), correct reaction time((566.88±86.63)ms, (530.10±83.40)ms, (509.17±88.99)ms, (488.31±76.23)ms, (463.45±75.78)ms, (417.24±75.78)ms), the differences were statistically significant(P<0.01). (2)Fz lead ERP characteristics: ①Comparison of cue-CNV and uncue-CNV: 6-year-old group((-8.54±4.56)μV vs (-10.13±6.36)μV), 7-year-old group((-9.20±5.34)μV vs (-11.53±4.29)μV), 8-year-old group((-8.37±4.78)μV vs (-11.35±6.38)μV)in amplitude and 9-year-old group((689.25±268.22)ms vs (826.13±174.62)ms)in latency were significantly different(P<0.05). ②Comparison of cue-P3 and uncue-P3: 6-year-old group((4.29±4.11)μV vs (7.45±3.83)μV), 7-year-old group((4.47±4.71)μV vs (5.82±4.40)μV), 8-year-old group((3.76±3.39)μV vs (6.24±4.91)μV), 9-year-old group((4.27±3.57)μV vs (5.93±3.08)μV), 11-year-old group((4.24±4.66)μV vs (6.13±4.42)μV)in amplitude were significantly different(P<0.05). ③Longitudinal comparison among age groups: the latency of cue-CNV in 9-year-old group and 11-year-old group were shorter, and the difference was significant(P<0.05). The amplitudes of cue-CNV and cue-P3 in 10-year-old group were shorter than those in other age groups(P<0.05).@*Conclusion@#With the increase of age, the reaction time of school-age children shortened and the correct rate improved.The age of 9-10 may be the high-speed period of the development for brain network on vigilant attention and psychological prediction which may be related to the maturation and development of frontal cortex.

Predictive value of protein C for long-term mortality of patients with community-acquired pneumonia / 中国基层医药

Objective@#To investigate the predictive value of protein C(PC) for long-term mortality of patients with community-acquired pneumonia(CAP).@*Methods@#A total of 657 patients with CAP were enrolled in Taian Central Hospital from January 2011 to December 2011.The patients were divided into short-term group(≤30 days), medium-term group(>30~90 days) and long-term group(>90 days). PC, high sensitivity C-reactive protein(hs-CRP), procalcitonin(PCT), pneumonia severity index(PSI) score and CURB-65 score were measured at the time of admission.The ROC curve was used to evaluate the independent risk factors.The Kaplan-Meier survival function curve was used to analyze the difference of mortality between the short-term group and long-term group.Independent risk factors for CAP risk were analyzed by COX regression.@*Results@#A total of 597 cases were followed up, there were 49 cases(8.09%) in the short-term group, 11 cases(1.84%) in the medium-term group, and 537 cases(89.93%) in the long-term group.The PC levels in the short-term group, medium-term group and long-term group were (32.2±10.6)%, (43.1±9.9)%, (69.6±23.0)%, respectively.The level of PC was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q=6.18, P<0.05, short-term group vs.long-term group, q=9.87, P<0.05). The hs-CRP levels in the short-term group, medium-term group and long-term group were (108.1±22.4)mg/L, (68.2±12.9)mg/L, (25.1±17.1)mg/L, respectively.The level of hs-CRP was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q=5.23, P<0.05, short-term group vs.long-term group, q=12.95, P<0.05). Meanwhile, PC showed higher accuracy(AUC, 0.889) than CURB-65(AUC, 0.828) and hs-CRP(AUC, 0.711) in the long-term group.The Kaplan-Meier survival function curve showed that the mortality rate was significantly higher in the high-value group compared with the low-value group(F=17.10, P<0.01). PC was an independent factor for long-term mortality and was associated with poorer survival by the COX regression analysis.@*Conclusion@#PC has a high predictive value for long-term mortality in CAP patients.

Predictive value of protein C for long-term mortality of patients with community-acquired pneumonia / 中国基层医药

Objective To investigate the predictive value of protein C( PC) for long -term mortality of patients with community-acquired pneumonia(CAP).Methods A total of 657 patients with CAP were enrolled in Taian Central Hospital from January 2011 to December 2011.The patients were divided into short-term group(≤30 days),medium-term group(>30~90 days) and long-term group(>90 days).PC,high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),pneumonia severity index(PSI) score and CURB-65 score were measured at the time of admission.The ROC curve was used to evaluate the independent risk factors.The Kaplan-Meier surviv-al function curve was used to analyze the difference of mortality between the short-term group and long-term group. Independent risk factors for CAP risk were analyzed by COX regression.Results A total of 597 cases were followed up,there were 49 cases(8.09% ) in the short-term group,11 cases(1.84% ) in the medium -term group,and 537 cases(89.93% ) in the long-term group.The PC levels in the short-term group,medium-term group and long-term group were (32.2 ± 10.6)% ,(43.1 ± 9.9)% ,(69.6 ± 23.0)% ,respectively.The level of PC was signifi-cantly increased in the short-term group compared with the medium-term group and long-term group ( short-term group vs.medium-term group,q =6.18,P <0.05,short -term group vs.long -term group,q=9.87,P <0.05).The hs-CRP levels in the short-term group,medium-term group and long-term group were (108.1 ± 22.4)mg/L,(68.2 ± 12.9 ) mg/L, ( 25.1 ± 17.1 ) mg/L, respectively. The level of hs - CRP was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q =5.23, P <0.05, short -term group vs. long -term group, q =12.95, P<0.05 ). Meanwhile,PC showed higher accuracy(AUC,0.889) than CURB-65( AUC,0.828) and hs-CRP( AUC,0.711) in the long-term group.The Kaplan-Meier survival function curve showed that the mortality rate was significantly higher in the high-value group compared with the low-value group(F=17.10,P<0.01).PC was an independent factor for long - term mortality and was associated with poorer survival by the COX regression analysis. Conclusion PC has a high predictive value for long-term mortality in CAP patients.

Research advances on function and molecular mechanism of peroxisome proliferator activated receptors in liver diseases / 中华消化外科杂志

Peroxisome proliferator activated receptors (PPARs) are ligand activated nuclear transcription factors and one of the members of the non steroidal nuclear receptor superfamily.It can be divided into PPAR alpha,PPAR beta / delta and PPAR gamma three subtypes according to the different of its structure and function.Previous studies showed that PPARs participated in biochemical reactions and the regulation of other important biological activities such as lipogenesis,glucose metabolism,inflammation,insulin sensitivity and so on.Recent researches showed that PPARs also had effect of anti-fibrosis,protecting ischemia-reperfusion injury and inhibiting the growth and differentiation of tumor cells.This article reviewed the recent research progress of PPARs in these liver diseases.

Application of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric hip fractures / 中国修复重建外科杂志

Objective: To investigate the effectiveness of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric patients with hip fractures. Methods: The clinical data of 489 geriatric patients with hip fractures (femoral neck fracture and intertrochanteric fracture) between January 1st 2016 and January 1st 2018 was retrospectively analyzed. Among them, 279 patients were treated with the multidisciplinary doctor-nurse collaboration care (observation group) and 210 patients were treated with the conventional therapeutics and nursing care (control group). There was no significant difference in gender, age, cause of injury, type and classification of fracture, the interval between injury and admission, and Charlson index between the two groups ( P>0.05). The surgery rates, time from hospitalization to operation, length of stay, and the incidences of perioperative complications were compared between the two groups. Results: The surgery rate was 90.32% (252/279) in observation group and 80.48% (169/210) in control group, showing significant difference between the two groups ( χ2=9.703, P=0.002). The time from hospitalization to operation and length of stay in observation group [(5.39±2.47), (10.56±3.76) days] were significant shorter than those in control group [(6.13±2.79), (12.27±3.11) days] ( t=-3.075, P=0.002; t=-5.330, P=0.000). The incidence of respiratory complications was 46.15% in control group and 30.56% in observation group; the incidence of cardiovascular system complications was 69.23% in control group and 51.19% in observation group; the incidence of cerebrovascular system complications was 20.12% in control group and 11.11% in observation group; the incidence of deep venous thrombosis was 40.24% in control group and 25.40% in observation group. The incidences of perioperative complications were significantly lower in observation group than in control group ( P<0.05). Conclusion: Multidisciplinary doctor-nurse collaboration team is conducive not only to improve the surgery rates, but also to reduce perioperative complications as well as shorten the length of stay and preoperative waiting time.

Application of the exosome in diagnosis and treatment of digestive system cancers / 中华消化外科杂志

The concept of precision medicine and precision oncology has been widely accepted.However,the application of this concept still faces many challenges.Exosome investigation is a hot spot in the field of liquid biopsy.Exosomes are extracellular vesicles composed of a lipid bilayer and contain proteins and nucleic acids which regulate cell-cell communication.Exosomes can be isolated and enriched in various body fluids.It has the advantages of micro-invasive,stable and biological active,and it fits well with the practice of precision medicine.In this review,authors discussed potential application and challenge of exosomes in early diagnosis and metastasis monitoring of gastric cancer.

Expression of EGFR in breast cancer and its correlation to molecular subtyping and hormone receptor status / 中华内分泌外科杂志

Objective To study the expression of epidermal growth factor receptor 1 (EGFR) protein in breast cancer and its correlation to molecular subtyping and hormone receptor status.Methods 467 cases of breast cancer were included.According to ER,PR,HER2,and Ki-67 status,the cases were categorized into 4 molecular subtypes,including 185 cases of luminal A,109 cases of luminal B,76 cases of HER2-enriched,and 70 cases of triple-negative breast cancer (TNBC).According to ER and PR status,the cases were divided into 4 subtypes,including 240 cases of ER+/PR+,50 cases of ER+/PR-,4 cases of ER-/PR+,and 173 cases of ER-/PR-.Results EGFR protein expression rates in Luminal A,Luminal B,HER2-enriched and TNBC were 16.8％(31/185),54.1％(59/109),97.4％(74/76),78.6％(55/70),respectively.The EGFR expression in HER2-enriched was significantly higher than those in TNBC,Luminal B and Luminal A(P＜0.01),and EGFR expression in TNBC was significantly higher than those in Luminal B and Luminal A (P＜0.01),furthermore,EGFR expression in Luminal B was significantly higher than that in Luminal A (P＜0.01).EGFR protein expression rates in ER+/PR+ subtype,ER+/PR-subtype,ER-/PR+ subtype and ER-/PR-subtype were 25.4％ (61/240),52.0％ (26/50),75.0％ (3/4),88.4％(153/173),respectively.The EGFR expression in ER-/PR-subtype was significantly higher than in ER+/PR+ subtype and ER+/PR-subtype (P＜0.01),and EGFR expression in ER+/PR-subtype was significantly higher than that in ER+/PR+ subtype (P＜0.01).EGFR protein expression rate was higher in ER-/PR-subtype than in ER-/PR+ subtype,and EGFR protein expression rate was higher in ER-/PR+ subtype than that in ER+/PR+ subtype and ER+/PR-subtype,but all of the difference were not statistically significant (P＞0.05).Conclusion EGFR protein expression is closely related to breast cancer molecular subtyping and negative hormone receptor expression,which is a potential biomarker of anti-breast cancer therapy.

Expression and correlation of Fascin-1 and EGFR in triple-negative breast cancer and non-triple-negative breast cancer / 中华内分泌外科杂志

Objective To explore the expression of Fascin-1 and EGFR in triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (non-TNBC) and its correlation.Methods According to ER,PR,and HER2 status,breast cancer were categorized into 2 subtypes:70 cases of TNBC and 370 cases of non-TNBC.The immunohistochemical technique,EnVision method,was used to evaluate the expression of Fascin-1 and EGFR in breast cancer.Results Expression rate of Fascin-1 and EGFR protein in TNBC was 88.6％(62/70)and 78.6％(55/70),while it was 19.2％(71/370)and 44.3％(164/370)in non-TNBC,respectively.Fascin-1 expression rate was significantly higher in EGFR positive non-TNBC cases (34.8％,57/164) than in EGFR negative cases (6.8％,14/206)(x2=46.032,P=0.000).The positive rate of Fascin-1 protein in EGFR-positive TNBC cases (92.7％,51/55) was higher than that in EGFR negative cases (73.3％,11/15),and the difference had no statistically significance (x2=2.673,P=0.102).Conclusions EGFR signal pathway may positively regulate Fascin-1 expression in non-TNBC.The relationship between EGFR and Fascin-1 in TNBC is needed for further study.

Comparison of acarbose and metformin as add-on therapy to insulin in uncontrolled patients with type 2 diabetes mellitus: A randomized, open-labeled, and parallel group study / 中华内分泌代谢杂志

Objective To evaluate efficacy and safety of acarbose compared with metformin as add-on therapy in patients with type 2 diabetes mellitus inadequately controlled with insulin. Methods This was a randomized, open-labeled, and parallel group study. Ninety-one type 2 diabetic patients ( HbA1C7.5%-11.0%) who were suboptimally controlled despite receiving twice daily injection of insulin (30-60 U/d for at least 8 weeks) were enrolled. They were randomly assigned 1 ∶ 1 ∶ 1 to continuation of insulin, insulin with acarbose (Ins+Aca), and insulin with metformin (Ins+Met) groups to insulin treatment. The levels of HbA1C, oral glucose tolerance test, blood lipids etc were measured at baseline and 12 weeks, and adverse events were recorded. Results The mean HbA1C levelsdecreasedfrom(7.9±0.4)%atbaselineto(7.0±0.3)%atweek12(P＜0.01)intheIns+Acagroupand(7.8 ±0.2)%to(7.0±0.3)%in the Ins+Met group(P＜0.01), while no significant change in HbA1Cin the insulin alone group. Adding acarbose to insulin resulted in similar reductions in HbA1Crelative to metformin (P＝0.431). The achievement rate of HbA1Cbelow 7.0%at week 12 was the same(both 70%) between the Ins+Aca group and the Ins+Met group. Insulin combined with acarbose in improving blood glucose fluctuation effect was more significant than that incombinationwithmetformin(P＜0.01),withstandarddeviation(SD)ofbloodglucose[(1.1±0.5vs2.7±0.6) mmol/L, P＜0.01], postprandial blood glucose fluctuations [(0.5 ± 0.7 vs 2.8 ± 0.4) mmol/L, P＜0.01], the maximumbloodglucosefluctuations[(2.8±0.7vs4.6±0.6)mmol/L,P＜0.01].Theweightlossoccurredinboththe Ins+AcaandtheIns+Metgroups[-(0.5±0.8vs1.0±0.4)kg].Therewasnosignificantchangesinbloodpressure and lipid profile. Hypoglycemic episodes were comparable in all groups. No serious adverse event was noted in any group. Conclusions Adding acarbose or metformin to insulin therapy could achieve improvements in glycemic control with similar reductions in HbA1Clevels and weight, when comparing with insulin treatment alone. Add-on acarbose to insulin therapy may exist more effectively on glucose fluctuation than that of add-on metformin, which may have important clinical implications in those patients with postprandial hyperglycemia, large blood glucose fluctuation, and intolerance to metformin.

Expression and correlation of Fascin-1 and EGFR in hormone receptor-positive breast cancer / 中国医师杂志

Objective To explore the expression and correlation of Fascin-1 and epidermal growth factor receptor (EGFR) in hormone receptor-positive breast cancer.Methods The immunohistochemical technique,EnVision method,was used to evaluate the expression of Fascin-1 and EGFR in 294 cases of hormone receptor-positive breast cancer,which contains 290 cases of estrogen receptor (ER) positive and 244 cases of progestrone receptor (PR) positive.According to ER,PR,Epidermal growth factor receptor 2 (HER2),and Ki-67 status,all cases of hormone receptor-positive breast cancer were categorized into 2 subtypes:160 cases of luminal A and 134 cases of luminal B.Results Fascin-1 and EGFR protein positive rates in hormone receptor-positive breast cancer was 13.9％ (41/294) and 30.6％ (90/294),respectively.Fascin-1 positive rate was significantly higher in EGFR positive cases (30.0％,27/90) than in EGFR negative cases (6.9％,14/204) (x2 =27.857,P =0.000).In the ER positive and PR positive cases,Fascin-1 positive rates were both significantly higher in EGFR positive cases than in EGFR negative cases (x2 =29.23,P =0.000;x2 =27.596,P =0.000,respectively).In the Luminal A and Luminal B subtype,Fascin-1 positive rates were also both significantly higher in EGFR positive cases than in EGFR negative cases (x2 =23.247,P=0.000;x2 =5.325,P=0.021,respectively).Conclusions EGFR signal pathway may positive regulate Fascin-1 expression in hormone receptor-positive breast cancer.

Population Pharmacokinetics Analysis of Mitiglinide in Chinese Healthy Volunteers / 中国药师

Objective:To establish the population pharmacokinetics model of mitiglinide given by oral route in Chinese healthy volunteers using nonlinear mixed effect model (NONMEM), investigate the pharmacokinetic characteristics of mitiglinide in Chinese healthy people to evaluate the factors that can influence the clinical pharmacokinetics of mitiglinide .Methods: Clinical data from 22 healthy volunteers were collected and the experiment was with single-dose administration.The volunteers were given 10 mg mitiglinide calcium orally and mitiglinide plasma concentration was determined by LC-MS/MS.The data was analyzed by the first order conditional estimation, and the influences of fixed effect factors such as demographic index and biochemical index were quantitatively evaluated . The population pharmacokinetics model of mitiglinide was established , and the result was verified by using the VPC and self-test meth-od.Results:The result showed that mitiglinide pharmacokinetics was fit single-compartment model .The inter-individual variability could be described by an exponential model .The typical values including central volume of distribution , clearance and absorption con-stant was 2.4 L· h-1(24％), 9.82 L(4％) and 6.46 h-1(14％), respectively.The clearance was influenced by creatinine clear-ance rate , and the absorption constant was influenced by ALT .Conclusion:The population pharmacokinetic parameters were mainly influenced by creatinine clearance rate and ALT .The established population pharmacokinetics model can explain the reasons for the in -dividual variation in the plasma concentration of mitiglinide , which can be used to guide the clinical administration of Chinese people .

Investigation of the risk assessment ,prevention and management for perioperative stroke in elderly patients with hip fractures / 中华老年医学杂志

Objective To investigate the risk assessment ,prevention and management for perioperative stroke in elderly patients with hip fractures. Methods A total of 179 patients aged 65 years and older were admitted to our department due to hip fracture. In managements of perioperative stroke ,the preoperative risk assessment and the management of stroke ,identifying the risk population for stroke prevention ,controlling risk factors of the preoperative stroke ,intraoperative monitoring , postoperative treatment ,etc.were studied retrospectively.The incidence of perioperative stroke was recorded and analyzed. Results Of 179 patients with hip fracture ,overviews of diagnosis and treatment were as follows.Twenty-four (24/179 ,13.41% ) cases did not receive operative treatments.Head and neck CT angiography(CTA)-showed severe stenosis or occlusion of intracranial artery and internal carotid artery were in 9(5.03% ,9/179)patients ,of whom the 5(2.79% ,5/179) cases underwent cerebrovascular digital subtraction angiography (DSA ) ,balloon dilation and stent implantation ,then received the operation for hip fracture 10 days later ,finally were discharged uneventfully.1 (0.56% ,1/179 ) patient underwent orthopaedic surgery due to the results of DSA showing no indication of interventional therapy ,and was discharged unevenfully.3 (1.68% ,3/179 ) patients refused to receive the further DSA examination or interventional therapy ,strongly demanded for orthopaedic surgery and would take the surgical risk ,and were discharged uneventfully.2(1.12% , 2/179)patients were found to have cerebral aneurysm diagnosed by CTA and DSA ,and underwent surgery for hipfracture without special treatment.2(1.12% ,2/179)patients were diagnosed as new occurrence of cerebral infarction before the operation ,and received head and carotid stenting at the department of cerebrovascular surgery ,followed by combined antithrombotic therapy of aspirin , clopidogrel and low molecular weight heparin for 4 weeks ,then underwent orthopaedic surgery for hip fracture.2 (1.12% ,2/179 ) patients were diagnosed as new cerebral infarction after orthopaedic surgery ,then were transferred to the department of neurology for treatment. Conclusions The thorough preoperative risk assessment and management of stroke ,reasonable perioperative antiplatelet and anticoagulation therapy ,intense intraoperative monitoring and active postoperative complications management make it possible for high-risk and new ischemic stroke patients with hip fractures to receive early orthopaedic treatment.

Preparation of standard molecular weight fragment mixture based on molecular cloning / 中国法医学杂志

Objective To prepare the standard molecular weight fragment mixtures. Methods Primers were designed to prepare clones which contained different sizes of standard molecular weight fragments. The template used for amplification of insert fragments was the pMD18-T vector. Bacteria culture and plasmid extraction were used to obtain abundant target fragment. Unlabeled DNA fragments were prepared by double digestion of the recombinant plasmids, and the fluorescent adaptor was prepared by annealing with two partial reverse complimentary DNA fragments. The unlabeled fragments and fluorescent adaptor were connected by DNA ligation reaction assisted with T4 DNA ligase. In this way, different sizes of standard molecular weight fragments were prepared. Standard molecular weight fragment mixture was finally prepared by mixing all the fragments together before purification. Results Ten standard molecular weight fragments of different sizes were prepared. The sizes of each fragment are 80bp, 124bp, 194bp, 224bp, 254bp, 304bp, 349bp, 399bp, 424bp and 454bp. The internal standard could accurately determine the size of PCR products amplified with the DNATyper15 kit. Conclusion Using this method, the standard molecular weight fragment mixture which meet the requirements of research and laboratory use was prepared, perfectly providing a new method for preparation of the DNA molecular weight standards. The peaks and the size of the prepared DNA internal lane standard are correct, which can be used to calculate the DNA fragments size in capillary electrophoresis.