The Suppression Effects of Fat Mass and Obesity Associated Gene on the Hair Follicle-Derived Neural Crest Stem Cells Differentiating into Melanocyte by N6-Methyladenosine Modifying Microphthalmia-Associated Transcription Factor

Background and Objectives@#Melanocyte (MC), derived from neural crest stem cell (NCSC), are involved in the pro-duction of melanin. The mechanism by which NCSC differentiates to MC remains unclear. N6-methyladenosine (m6A) modification was applied to discuss the potential mechanism. @*Methods@#and Results: NCSCs were isolated from hair follicles of rats, and were obtained for differentiation. Cell via-bility, tyrosinase secretion and activity, and transcription factors were combined to evaluated the MC differentiation.RT-qPCR was applied to determine mRNA levels, and western blot were used for protein expression detection. Total m6A level was measured using methylated RNA immunoprecipitation (MeRIP) assay, and RNA immunoprecipitation was used to access the protein binding relationship. In current work, NCSCs were successfully differentiated into MCs.Fat mass and obesity associated gene (FTO) was aberrant downregulated in MCs, and elevated FTO suppressed the differentiation progress of NCSCs into MCs. Furthermore, microphthalmia-associated transcription factor (Mitf), a key gene involved in MC synthesis, was enriched by FTO in a m6A modification manner and degraded by FTO. Meanwhile, the suppression functions of FTO in the differentiation of NCSCs into MCs were reversed by elevated Mitf. @*Conclusions@#In short, FTO suppressed the differentiating ability of hair follicle-derived NCSCs into MCs by m6Amodifying Mitf.

Association of Perceived Stress With Depression Among Vaccinated Healthcare Workers During the SARS-CoV-2 Variant Outbreak: The Mediating Role of Compassion Fatigue

Objective@#Depression was common during coronavirus disease-2019 (COVID-19) pandemic, while the association of perceived stress with depression among vaccinated healthcare workers has not been investigated. This study aimed to address this issue. @*Methods@#We included a total of 898 fully vaccinated healthcare workers during the outbreak of severe acute respiratory syndrome coronavirus 2 Delta variant in Nanjing, 2021. Depression was ascertained by Patient Health Questionnaire-9, with a cut-off score of ≥5 indicative of mild-to-severe depression. Perceived stress, resilience, and compassion fatigue were assessed by Perceived Stress Scale-10, Resilience Scale-25, and Professional Quality of Life Scale version-5, respectively. Logistic regression analyses were used to estimate the odds ratio (OR) and 95% confidence interval (CI), along with subgroup and mediation analyses. @*Results@#The prevalence of mild-to-severe depression was 41.1% in vaccinated healthcare workers. The odd of mild-to-severe depression was increased with higher perceived stress. Compared with vaccinated healthcare workers with the lowest tertile of perceived stress, those with the highest tertile had increased odds of mild-to-severe depression by 120% (OR 2.20, 95% CI 1.46 to 3.31) after multivariable-adjustment. However, perceived stress was not associated with mild-to-severe depression in vaccinated healthcare workers with strong resilience, but was in those with weak resilience (pinteraction=0.004). Further analysis showed that compassion fatigue mediated the relationship between perceived stress and mild-to-severe depression, with a mediating effect of 49.7%. @*Conclusion@#Perceived stress was related to an increased odd of mild-to-severe depression in vaccinated healthcare workers during COVID-19 pandemic, and this relationship might be explained by compassion fatigue.

Effects of interhemispheric multi-target intermittent theta burst stimulation on upper limb function in patients with stroke / 中国康复理论与实践

ObjectiveTo investigate the effect of intermittent theta burst stimulation (iTBS) of the multi-target cerebral cortex after stroke on functional recovery of the upper limb of the hemiplegic side. MethodsFrom November, 2019 to August, 2020, 40 stroke patients in Gansu Provine Hospital Rehabilitation Center were included and randomly divided into single-target stimulation group (n = 20) and multiple-target stimulation group (n = 20). Both groups underwent basic neurorehabilitation drug therapy and conventional rehabilitation exercises. The single-target stimulation group received repetitive transcranial magnetic stimulation (rTMS) (iTBS mode) only in the primary motor cortex (M1) of the affected side. The multi-target stimulation group received rTMS (iTBS mode) in the cerebellar cortex of the healthy brain and M1 of the affected side, once a day, six days a week, for four weeks. Before and after treatment, the scores of Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI), and the latency and amplitude of somatosensory-evoked potentials N20 were compared. ResultsNo serious adverse reaction occurred during treatment. After treatment, the scores of FMA-UE, MBI and ARAT, and the amplitude and latency of N20 improved in both groups (|t| > 3.478, |Z| > 2.243, P < 0.05); and the scores of FMA-UE and ARAT, and the amplitude of N20 were better in the multiple-target stimulation group than in the single-target stimulation group (t > 2.939, Z = -2.697, P < 0.01). ConclusionMulti-target stimulation is superior to single-target stimulation for improving upper limb motor function and N20 amplitude in the hemiplegics after stroke.

Exploration of home nutrition support in children with intestinal failure and clinical experience with 10 cases / 中华临床营养杂志

Objective:To explore the application of home nutrition support in children with intestinal failure.Methods:Children with intestinal failure admitted to Division of Pediatric Gastroenterology and Nutrition and Department of Pediatric Surgery in Xinhua Hospital were retrospectively enrolled since January 2009. The details of home nutrition support, nutritional status and home parenteral nutrition (HPN) associated complications were collected.Results:A total of 10 children received HPN support, 7 of whom were with short bowel syndrome (SBS) and the other 3 with pediatric intestinal pseudo-obstruction. The average length of remnant small bowel in 7 SBS children was (36.7±32.4) cm. The average age at HPN onset was (5.4±4.7) years. The average duration of follow-up was (3.1±2.1) years. The average duration of HPN was (619.5±669.1) days after (391.8±340.1) days of parenteral nutrition support in our hospital. All 10 cases started home enteral nutrition (HEN) with tube feeding (3 cases transited to oral feeding during treatment). The average duration of HEN was (536.1±429.6) days. Daily calorie intake was 104.0%±39.0% of the recommended intake according to the guideline, with 46.5%±21.3% via HPN and 57.5%±29.2% via HEN. During follow-up, 3 cases were found with severe malnutrition, 5 with moderate malnutrition and 2 with mild malnutrition. Four children suffered from catheter-related thrombosis and five children were identified with catheter-related blood stream infection. No intestinal failure associated liver disease was observed.Conclusions:HPN is feasible but needs the support of national medical insurance policy. At present, there are still frequent nutritional deficiencies and complications in HPN. Nutrition support team (NST) should provide guidance for more scientific nutrition screening and nutrition management.

Intravenous thrombolytic therapy in patients with mild stroke / 国际脑血管病杂志

Mild strokes are often excluded from intravenous thrombolysis (IVT) because of their mild symptoms and unclear risk-benefit ratio. However, in recent years, more and more studies have confirmed that about 1/3 of patients with mild stroke who have not received IVT have a poor outcome. Although a large number of studies have shown that IVT treatment can reduce the morbidity and mortality of patients with mild stroke, relevant studies also consider that they do not benefit from it. Whether need to be treated with IVT in patients with mild stroke has become a hot research topic. This article reviews the outcomes of mild stroke, whether IVT treatment is beneficial, and which patients with mild stroke are eligible for IVT treatment.

Effect of transcranial direct current combined with mirror neuronal rehabilitation training / 中国医师进修杂志

Objective To observe the effect of transcranial direct current stimulation (tDCS) with mirror neuronal rehabilitation training system (MNST-V1.0) in post-traumatic unconscious patients after severe craniocerebral injury. Methods A prospective, self controlled and open-label method was used. Thirty-six post-traumatic unconscious patients with severe craniocerebral injury from January 2016 to July 2017 were selected. Four cases of the patients did not complete the treatment and the last 32 cases completed the study. All patients were given routine wake-up therapy, and tDCS combined with MNST-V1.0 (20 min/time, 1 time/d, 6 times/week, a total of 8 weeks) was given at the same time. The Glasgow coma scale (GCS), JFK coma recovery scale and Four coma rating scale before treatment and 2, 4, 8 weeks after treatment were recorded. Results The scores of open reaction, language and motor response score of GCS 2, 4, 8 weeks after treatment were significantly higher than those before treatment:(1.56 ± 0.82), (2.06 ± 1.01) and (3.11 ± 1.45) scores vs. (1.00 ± 0.45) scores, (2.23 ± 1.06), (2.56 ± 1.08) and (3.02 ± 1.04) scores vs. (1.00 ± 0.61) scores, (2.79 ± 1.12), (3.22 ± 1.33) and (4.44 ± 1.07) scores vs. (1.00 ± 0.54) scores, and there were statistical differences (P ＜ 0.01 or ＜0.05). The scores of hearing, vision, movement, speech response, communication and arousal of JFK coma recovery scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.01). The scores of open reaction, sport reaction, brainstem response of Four coma rating scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.05); there was no statistical difference in respiratory score of Four coma rating scale before and after treatment (P＞0.05). Conclusions The tDCS combined with MNST-V1.0 can improve the consciousness level in post-traumatic unconscious patients with severe craniocerebral injury, and have the effect of promoting awakening.

Implementation effect of nursesˊ hierarchical training plan based on training outline and nurses′needs / 中国实用护理杂志

Objective To explore the implementation effect of nurses′ hierarchical training plan based on training outline and nurses′ needs. Methods Nurses′ hierarchical training outline was established in accordance with three theoretical training modules(humanistic accomplishment, professional competence, career planning/development) as well as three skill training modules(basic nursing skills, specialist nursing skills and first aid nursing skills); the training needs of nurses were investigated by adopting a self-made Training Needs Questionnaire, then the hierarchical training plan was developed based on the training outline and nurses′ training needs. Results There were some differences in the training needs of different levels of nurses in the fields of clinical knowledge and skills,nursing management, nursing education, scientific research and new nursing guidelines and progress(F=2.80-22.47,P<0.05 or 0.01). Before the implementation of nurses′ hierarchical training plan based on training outline and nurses′ needs, nurses′ satisfaction about training, theoretical examination result, clinical working ability and patients′satisfaction towards nursing were 89.06%(228/256),94.80%(1 185/1 250), 96.63%(1 060/1 097) and 95.35%(5 470/5 737), respectively. Then, after the implementation, the corresponding values got improved into 96.76%(239/247), 97.44%(1 297/1 331), 98.75%(1 106/1 120) and 99.22%(6 070/6 118),which were statistically significant(χ2=11.11-176.27,P<0.01). Conclusion Integrating nurses′hierarchical training outline with the training needs helps to provide targeted hierarchical training so as to improve the professional quality of nurses and the patients′satisfaction towards nursing.

Study on Pharmacognosy of Chongqing Local Medicinal Material Heracleum hemsleyanum / 中国药房

OBJECTIVE:To establish a method for the identification of Chongqing local medicinal material Heracleum hemsley-anum. METHODS:The original plant morphology,morphological characteristics,microscopic characteristics (transverse section and powder),were identified. RESULTS:H. hemsleyanum had cone shape root,brown,many-branched with special fragrance;the microscopic characteristics of taproot a transverse showed no differences with lateral root transverse section,primary xylem was di-arch,secondary phloem was more developed than secondary xylem,secondary phloem was rich in the oil chamber. Vascular tissues contained a large number of parenchyma cells. In TLC chromatrogram,the test sample showed the same color fluorescent spots with-the substance reference of osthole and columbianadin in the corresponding locations. CONCLUSIONS:The established method is simple with high accuracy,and can be used as the basis for identification of H. hemsleyanum.

The analysis of risk factors of nonalcoholic fatty liver diseases in primary school students / 临床儿科杂志

Objective To evaluate the relationship between birth weight and nonalcoholic fatty liver diseases (NAFLD) in Chinese primary school students. Methods A cross-section study was conducted in ifve elementary schools in Gao Hang Town, Shanghai and 2163 students were enrolled in the study (1120 boys/1043 girls). Height, body weight, waist circumference and per-cent of body fat (bioelectrical impedance analysis) were measured by professional nutritionist after training. Birth weight, feeding pattern, height and body weight of parents were obtained by a self-completed questionnaire. NAFLD was diagnosed by ultra-sound. The risk factors of NAFLD were analyzed. Results The prevalence of NAFLD in the study population was 8.9%. The prevalence of NAFLD was signiifcantly higher in boys than that in girls (12.5%vs 5.0%, P<0.01). Logistic regression showed that sex (OR=1.97, 95%CI:1.21-3.21) and percent of body fat (OR=1.12, 95%CI:1.07-1.17) were the risk factors of NAFLD, and normal BMI was the protective factor of NAFLD (OR=0.09, 95%CI:0.04-0.19) in the study population. Conclusions The pre-valence of NAFLD is higher in boys than that in girls. Also overweight, and high percent of body fat are risk factors of NAFLD in children.

Awareness of Knowledge about Stroke Rehabilitation in Medical Professionals / 中国康复理论与实践

@#Objective To investigate the awareness of knowledge about stroke rehabilitation in medical professionals in Gansu. Methods 520 professionals of neurology, neurosurgery, and others from 10 hospitals of different level were investigated with questionnaire. Results The awareness of the knowledge about stroke rehabilitation was different with the gender (χ2=17.50), education levels (χ2=66.35), professional levels (χ2=16.81), specialities (χ2=124.39) and duties (χ2=29.99) of the professionals (P<0.05). Conclusion It is necessary to improve the education of rehabilitation in hospitals.

Survey on Acquaintance of Early Symptoms of Stroke Patients / 中国康复理论与实践

@# Objective To understand the awareness of early symptoms of stroke patients in Gansu. Methods 1100 stroke patients in neurology and neurosurgery departments in 10 hospitals of different levels in Gansu in 2010 were surveyed by questionnaire. Results The awareness rate of early symptoms of stroke was generally low in all age groups. Conclusion Stroke patients were lack of awareness of early symptoms in Gansu, we should step up publicity efforts to enable more patients to receive early treatment and reduce morbidity and mortality.

Survey of Knowledge about Stroke and Rehabilitation in Stroke Patients / 中国康复理论与实践

@#Objective To investigate the knowledge of stroke risk factors, early symptoms, and rehabilitation in stroke patients. Methods 1043 cases with stroke were stratified randomly sampled from 10 hospitals at different levels in Gansu, and were surveyed with self-designed questionnaire. Results For risk factors for stroke, hypertension was the most aware (61.55%), 6.42% knew all the factors. For the prevention and treatment, reasonable diet was the most aware (56.18%), followed with giving up smoking and drinking (52.92%). For the early symptoms, dysaesthesia of one side body was the most aware (53.88%), and then the headache and dizzy (50.14%). It was less than 30% to know the blurring, nausea and vomiting, and stiff tongue, etc. as the early symptoms. 60% of the patients did not know any about the rehabilitation, 22% did not know if rehabilitation be needed. 80% of the patients with stroke chose medication regardless of family income, and rehabilitation was chosen less than 30%. Conclusion It is important to popularize the knowledge of risk factors, early symptoms, and rehabilitation of stroke.

Effect of Integrated Psychotherapy on Activities of Daily Living in Post-stroke Depression / 中国康复理论与实践

@#ObjectiveTo investigate the effect of integrated psychotherapy on activities of daily living (ADL) in patients with post-stroke depression. Methods60 stroke patients were divided into 2 groups: the treatment group and the control group, each including 30 cases. Both groups were treated with routine medicine and rehabilitation, while the treatment group was also treated with psychological approaches in addition. Before and 4 and 12 weeks after treatment, all the patients were assessed with the Zung Self-rating Depression Scale (SDS) and the modified Barthel Index (MBI). ResultsThere was no significant difference between these 2 groups in all the assessment parameters before treatment. The scores of SDS and MBI improved more in treatment group than in control group (P<0.05) 4 and 12 weeks after treatment. ConclusionThe integrate psychotherapy is effective on ADL in patients with post-stroke depression.

Efficacy and Safety in Secondary Prevention of Ischemic Stroke with Cilostazol or Aspirin: A Systematic Review / 中国康复理论与实践

@#ObjectiveTo review the efficacy and safety in secondary prevention of ischemic stroke with cilostazol or aspirin.Methodswe searched Cochrane Library(the 4th issue, 2009 ), PubMed(1980.1～2009.11), EMBASE(1980.1～2009.11), CBM(1978.1～2009.11), CNKI(1979.1～2009.11) and some other databases, then collected all of the studies describing the outcomes in curing the ischemic stroke after taking cilostazol or aspirin. According to the strict inclusion and exclusion criteria, two reviewers independently selected trials, extracted datas, made cross-checking and methodological quality assessment of the homogeneity studies by using the Cochrane systematic review methods, then made Meta analysis using RevMan 5.0 software.ResultsThis systematic review study included two randomized controlled trials and a cross-over trial, which contained a total of 838 participants. The evidence quality of one of the randomized controlled trials was high, however, the evidence quality of another randomized controlled trial and the cross-over trial was poor. Meta analysis results suggested that the effectiveness of cilostazol and aspirin in the secondary prevention of ischemic stroke performed no significantly statistical difference: primary endpoint(30 d［RR=3.00, 95%CI(0.31,28.70)］; 90 d［RR=1.67, 95%CI(0.40,6.92)］; 180 d［RR=1.25, 95%CI(0.50, 3.13)］; 360 d［RR=0.65, 95%CI(0.33, 1.29)］; 540 d［RR=0.80,95%CI(0.54, 1.18)］); combined endpoint(30 d［RR=4.00, 95%CI(0.45,35.61)］; 90 d ［RR=1.75,95%CI(0.52,5.93)］; 180 d［RR=1.00, 95%CI(0.48, 2.07)］; 360 d ［RR=0.77, 95%CI(0.45, 1.29)］; 540 d［RR=0.66,95%CI(0.40,1.09)］); the recurrence of ischemic stroke: cilostazol group: RR=0.64, 95%CI(0.31,1.30)，aspirin group: RR=0.21, 95%CI(0.04,1.06); PDMP［RR=1.00, 95%CI(0.39, 2.58)］. But in terms of the probability of intracranial hemorrhage (［RR=7.14, 95%CI(0.7,58.33)］) and other safety standards, taking cilostazol performed lower than taking aspirin.ConclusionThe side effects of cilostazol and aspirin in the treatment for ischemic stroke were similar to each other, but in terms of the probability of dizziness, headache, tachycardia and palpitation, taking cilostazol performed higher than taking aspirin, however, taking cilostazol performed lower in the probability of intracranial hemorrhage and other organ hemorrhage than taking aspirin. Since this study included a small amount of studies, in which the evidence quality of one of the randomized controlled trials and the cross-over study was poor, therefore, it would be necessary to make a further validation with lots of high-quality clinical trials.

Effect of Rational-emotive Uherapy on Rehabilitation of Patients with Depression after Stroke / 中国康复理论与实践

@#Objective To observe the effect of rational-emotive therapy(RET)on rehabilitation of patients with depression after stroke.Methods 62 hemiplegic patients with depression after stroke were randomly divided into the RET group and control group with 31 cases in each group.All patients were evaluated with Hamilton Rating Scale for Depresstion(HAMD)and Barthel Index(BI)before and after treatment.Results After treatment,the scores of HAMD and BI of the patients in the RET group was superior to those in the control group(P<0.01).Conclusion The rational-emotive therapy is effective to improve not only depressive symptoms but also the quality of living.