A preliminary study of fecal microbiota transplantation alleviating inhibition of radiation-induced hippocampal neurogenesis in mice / 中华放射肿瘤学杂志

Objective:To evaluate the effects of whole brain irradiation (WBI) and fecal microbiota transplantation (FMT) on hippocampal neurogenesis and the composition of gut microbiota in mice.Methods:Forty specific pathogen free ICR male mice (8-week-old, weighed 30 g) were divided into four groups by simple random sample method: control group (group C), radiation group (group R), group C+FMT and group R+FMT, 10 in each group. Animal models were established by WBI at a dose of 10 Gy by 4 MeV electron beam. In group C+FMT and group R+FMT, mice were gavaged with normal fecal bacteria suspension on day 2 post-irradiation, while those in group C and group R were gavaged with phosphate buffered saline as alternative. Hippocampal tissues and feces in four groups were collected on day 15 post-irradiation. 16S rRNA sequencing was used to detect the species and abundance of fecal flora. BrdU +/NeuN + immunofluorescence staining was performed to observe the neurogenesis in hippocampus of mice. Results:WBI and FMT had no effect on survival rate and body weight of mice. WBI induced the inhibition of hippocampal neurogenesis and flora disorder. The quantity of Bacteroideae and Rumen bacteria was increased by 28.6% and 102.9%, whereas that of Lactobacillus was significantly decreased by 70.6% ( P<0.05). FMT regulated the abundance of bacteria. The abundance of Enterobacteriaceae was significantly declined by 65.1% ( P=0.028), while that of Lactobacillus was increased by 58.2% ( P=0.015). FMT also promoted hippocampal neurogenesis to some extent after WBI. Conclusions:This preliminary study demonstrates that FMT alleviates the inhibition of hippocampal neurogenesis and flora disorder induced by WBI in mice. Ionizing radiation directly acting on the whole brain of mice indirectly disturbs the composition of gut microbiota, which in turn affects the degree of hippocampal neurogenesis in the brain of mice. There is a bidirectional interaction between gut microbiota and brain.

Research progress on vesicles from Chinese medicinal herbs / 浙江大学学报·医学版

Vesicles derived from Chinese medicinal herbs (VCMH) are nano-vesicular entities released by the cells of Chinese medicinal herbs. VCMHs have various biological effects and targeting characteristics, and their component chemicals and functional activities are closely related to the parent plant. VCMH differs from animal-derived vesicles in three ways: stability, specificity, and safety. There are a number of extraction and isolation techniques for VCMH, each with their own benefits and drawbacks, and there is no unified standard. When two or more approaches are used, high quantities of intact vesicles can be obtained more quickly and efficiently. The obtained VCMHs were systematically examined and evaluated. Firstly, they are generally saucer-shaped, cup-shaped or sphere, with particle size of 10-300 nm. Secondly, they contain lipids, proteins, nucleic acids and other active substances, and these components are an important part for intercellular information transfer. Finally, they mostly have good biocompatibility and low toxicity, with anti-inflammatory, antioxidant, anti-tumor and anti-fibrotic effects. As a new drug carrier, VCMHs have outstanding active targeting capabilities, and the capsule form can effectively preserve the drugs, considerably enhancing drug delivery efficiency and stability in vitro and in vivo. The modification of its vesicular structure by suitable physical or chemical means can further create more stable and precise drug carriers. This article reviews the extraction and purification techniques, activity evaluation and application of VCMH to provide information for further research and application of new active substances and targeted drug carriers.

Association between childhood maltreatment and the Big Five personality traits in middle school students / 中国学校卫生

Objective@#The study aimed to explore the relationship between childhood maltreatment (CM) and the Big Five personality traits of middle school students, so as to provide scientific evidence for promoting the healthy development of middle school students personality.@*Methods@#A total of 5 724 middle school students from Xuancheng, Hefei and Huaibei of Anhui Province were selected by using a multi stage stratified cluster sampling method to conduct a questionnaire survey, including demographic characteristics, CM experience and Big Five personality traits. Linear regression analysis and canonical correlation analysis were used to explore the associations between CM and the Big Five personality traits.@*Results@#Physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect of middle school students were significantly associated with conscientiousness ( β = -1.71 --2.55) and neuroticism ( β =1.93-3.87) personality traits( P <0.05). Except physical abuse, all other types of CM were significantly associated with extraversion ( β =-1.04--2.32) and agreeableness ( β =-1.07--1.37) personality traits( P <0.05), and only sexual abuse was associated with openness personality trait( β=-0.70, P <0.05). Except for openness personality trait, the relationship between the number of CM experience and the personality traits of middle school students was statistically significant; there was a dose response relationship between the number of CM experiences and the scores of personality traits each dimension( P < 0.05). In the canonical correlation analysis, the canonical correlation coefficient was -0.375( P <0.05). CM experiences were mainly reflected by emotional abuse, emotional neglect and physical neglect (canonical load coefficient was 0.556-0.951). The Big Five personality traits were mainly reflected by neuroticism, conscientiousness and extraversion (canonical load coefficient was -0.702 -0.639).@*Conclusion@#There is a correlation between CM and the personality traits of middle school students, and prevention of CM is of great significance for promoting the healthy development of middle school students personality.

Long-term clinical outcomes of patients with aneurysmal subarachnoid hemorrhage in Yunnan Province / 南方医科大学学报

OBJECTIVE@#To investigate the clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) after surgeries in Yunnan Province.@*METHODS@#We retrospectively analyzed the demographic features, vascular risk factors, severity at admission, and aneurysm locations in 85 patients with aSAH receiving surgical interventions in Yunnan Province. All the patients were treated by aneurysm clipping or coiling and followed up for clinical outcomes and recovery of daily activities evaluated by modified Rankin Scale (mRS) and Activities of Daily Living (ADL) scale, respectively.@*RESULTS@#Thirty-four of the patients (40.0%) underwent aneurysm clipping and 51 (60.0%) underwent aneurysm coiling. During a median follow- up period of 66.23 months (IOR, 12.03 months), 84.7% of the patients had low mRS scores, and 78.8% lived independently. The WFNS grade at admission was significantly correlated with the follow-up mRS scores (95%: 1.48-19.09, =0.011) and ADL (95%: 2.55-28.77, 0.05), but the cost of hospitalization was significantly higher in coiling group than in the clipping group ( < 0.001).@*CONCLUSIONS@#Both aging and a high WFNS grade at admission are associated with a poor prognosis of aSAH, for which aneurysm clipping and coiling have similar long- term outcomes, but for patients with a high WFNS score, aneurysm clipping is favored over coiling in terms of health economics.

Research progress on biomarkers for radiation-induced intestinal injury based on intestinal flora / 中华放射肿瘤学杂志

Recently,the relationship between intestinal flora and its metabolites and tumorigenesis,inflammatory bowel diseasesas well as radiation-induced intestinal injury has captivated widespread attention from researchers.Accumulated evidence derived from nuclear accident investigation,animal model experiment and clinical research has proven the role of intestinal flora and its metabolites as the biomarkers to evaluate the radiation dose and severity of radiation-induced intestinal injury.This article reviews the relationship between intestinal flora and its metabolites and radiation-induced intestinal injury,aiming to provide theoretical reference for assessing the risk of radiation-induced intestinal injury.

Effects of intervention based on WeChat on blood pressure control in patients with hypertension：Meta-analysis / 预防医学

Objective@#To evaluate the effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension. @*Methods@#The databases of CNKI，Wanfang，VIP，PubMed and the Cochrane Library were researched for the literatures about effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension published from 2011 to 2018. These papers were retrieved and evaluated according to inclusion and exclusion criteria. Stata 12.0 software was used for meta analysis.@*Results@#Eleven out of 880 papers were included into meta analysis. There were 1 174 cases，with 587 cases in the experimental group and 587 cases in the control group. The results of the meta analysis showed that compared with traditional health intervention method，the intervention based on WeChat significantly reduced the level of systolic blood pressure（WMD=14.77，95%CI：11.76-17.77）and diastolic blood pressure（WMD=8.17，95%CI：5.67-10.67）of hypertensive patients. Subgroup analysis showed that the longer the intervention，the better the effects（P<0.05）. @*Conclusion@#The intervention based on WeChat is more helpful than traditional health intervention for blood pressure control of patients with essential hypertension.

Qualitative and quantitative analyses of Chrysanthemum morifolium ‘Fubaiju’ by LC-MSn and HPLC-UV / 中国药科大学学报

@#A qualitative analytical method of liquid chromatography coupled with mass spectrometry(LC-MSn)was developed for the identification of main constituents in Chrysanthemum morifolium ‘Fubaiju’. High-performance liquid chromatography(HPLC)was developed for the quantification of five active components, including chlorogenic acid(1), luteolin-7-O-β-D-glucopyranoside(2), luteolin-7-O-β-D-glucopyranuronide(3), 3, 5-Di-caffeoylquinic acid(4), and apigenin-7-O-β-D-glucopyranoside(5). A total of 22 compounds, including 13 flavonoids and 9 phenolic acids, were identified based on their retention behaviors, UV profiles and MS fragment information. Furthermore, a validation method with good linearity(r> 0. 999 9), precision, stability, repeatability and recovery was successfully applied for simultaneous determination of five major components in 10 batches of C. morifolium ‘Fubaiju’ by HPLC-UV method. The established method was proved to be a validation strategy for the quality evaluation of C. morifolium ‘Fubaiju’.

Chemical constituents from the n-butanol portions of the fruits of Eucalyptus globulus / 中国药科大学学报

@#Phytochemical studies on the fruits of Eucalyptus globulus led to the isolation of twelve compounds. The structures of these compounds were elucidated as: ellagic acid(1), 3-O-methylellagic acid 4′-O-α-rhamnopyranoside(2), valoneic acid dilactone(3), isobiflorin(4), biflorin(5), 8-β-C-glucopyranosyl-5, 7-dihydroxy-2-isobutylchromone(6), 8-β-C-glucopyranosyl-5, 7-dihydroxy-2-isopropylchromone(7), quercetin 3-O-β-D-glucopyranoside(8), quercetin 3-O-β-D-glucuronide-6″-methyl ester(9), (+)-lyoniresin-4-yl β-D-glucopyranoside(10), cypellocarpins A(11), and eucaglobulin 1(12), by means of spectroscopic analyses(ESI-MS, 1H NMR and 13C NMR). Compounds 3-10 were isolated from this plant for the first time.

Research on effect of benazepril treat with diabetic nephropathy on Plasma NO and ET-1 / 中国生化药物杂志

Objective To evaluate the clinical efficacy and effect of benazepril treat with diabetic nephropathy on Plasma NO and ET-1. Methods 100 cases of DN patients were divided into two groups by random number table (50cases), group A with basic treatment, group B increased benazepril. Selected another 50 cases of simple diabetic patients as control group, observed the plasma NO (nitric oxide) and ET-1 (ET-1) levels changes of three groups,and compared the clinical efficacy. Results The levels of NO, ET-1 and Ang II in A group and B group were significantly lower than those in control group (P<0.05); the level of NO in B group was higher than that in group A, and the level of ET-1 and Ang II was lower than that of group A(P<0.05). The total effective rate of B group was 86.00％, which was significantly higher than that of control group 58.00％(P<0.05). Conclusion The clinical application benazepril treat with DN can effectively regulated plasma NO and ET-1 levels, protect the kidneys, and improve the therapeutic effect.

Effect of jujuboside A on glomerular cell apoptosis in diabetic model rats / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect of jujuboside A on glomerular cell apoptosis in diabetic rats, and to explore the possible mechanisms. METHODS SD rats were administered with streptozotocin 100 mg · kg-1 to estabilish the diabetic model. Diabetic SD rats received jujuboside A 10 and 20 mg · kg-1 daily for 4 weeks by lavage administration, respectively. The level of glycosylated hemoglobin (GHb) in the blood of each group was measured by fructosamine method. The morphological changes in glomerular cells were observed by PAS staining. Glomerular cell apoptosis was determined by TUNEL staining. The protein expression of Bcl-2 and Bax was detected by immunohistochemistry. The protein expression of cleaved caspase 9 and cleaved caspase 3 was detected by Western blotting. Trans?forming growth factor β1 (TGF-β1) mRNA expression was analyzed by qPCR. RESULTS Compared with model group, jujuboside A 10 and 20 mg·kg-1 treatment significantly reduced the level of GHb in blood (mmol · L- 1: 10.9 ± 0.8 vs 17.5 ± 1.5, P<0.05; 7.6 ± 0.5 vs 17.5 ± 1.5, P<0.05), PAS positive score of glomerular cells (26.8 ± 3.2 vs 36.4 ± 3.8, P<0.05; 18.4 ± 2.1 vs 36.4 ± 3.8, P<0.05) and the apoptosis of glomerular cells〔(8.2±0.8)%vs (17.6±1.8)%, P<0.05;(5.1±0.5)%vs (17.6±1.8)%, P<0.05〕. Moreover, Bcl-2 protein expression in kidney tissues was elevated (P<0.05), whereas Bax (P<0.05), cleaved caspase 9 (P<0.05) and cleaved caspase 3 (P<0.05) protein expression and TGF-β1 mRNA (P<0.05) expression were reduced after jujuboside A administration. CONCLUSION Jujuboside A can prevent glomerular cell apoptosis in diabetic rats, which may be associated with the regulation of mitochondrial apoptotic pathways and TGF-β1 expression.

Preliminary Study on Jianyi Recipe in Improving Islet Cell Function in Diabetic Rats Through Regulation of Glucagon-like Peptide-1 Expression / 广州中医药大学学报

Objective To explore the possible mechanism of Jianyi Recipe for improving the function of islet cells from the aspects of synthesis,secretion and inactivation of glucagon-like peptide-1 (GLP-1).Methods The diabetic rat model was established by feeding with high-lipid food combined with injection of streptozotocin (STZ).The rats were randomly divided into model group,Jianyi Recipe group,and normal group.The treatment for the rats lasted for 4 weeks.The blood glucose level was detected by the rapid blood glucose meter.The plasma levels of GLP-1 and insulin were detected by Luminex liquid phase protein chip technology.Pancreatic duodenal homeobox-1 (PDX-1) mRNA expression level was detected by quantitative real-time fluorescence polymerase chain reaction (PCR).The level of GLP-1 in ileum L cells was detected by immunohistochemistry,and dipeptidyl peptidase Ⅳ (DPP-Ⅳ)level was detected by enzyme-linked immunosorbent assay.Results Jianyi Recipe could decrease the levels of fasting blood glucose and postprandial glucose (P ＜ 0.05),promote the secretion of insulin (P ＜ 0.05),and increase PDX-1 mRNA expression level in the pancreas of the diabetic rats.Compared with the model group,plasma GLP-1 level,and ileal GLP-1 positive expression area and integrated optical density were increased (P ＜ 0.05) in Jianyi Recipe group,while the differences of serum DPP-Ⅳ levels were insignificant between the two groups (P＞ 0.05).Conclusion Jianyi Recipe maybe regulate the synthesis and secretion of GLP-1 to promote PDX-1 gene expression and insulin secretion,so as to reduce blood glucose in diabetic rats.

Bibliometric study of the articles on environment enrichment in china / 中国比较医学杂志

Objective To analyze the literature characteristics on environmental enrichment published in China , and provide reference for researchers .Methods The papers relevant to environmental enrichment published in CNKI database and Wanfang database were statistically analyzed from the aspects of publishing year, journal of publication, author, institution and subjects covered by the article with bibliometrics method.Results There were 422 papers published before Dec 31,2015, in which 273 papers published in 126 kinds of journals.The number of papers increased gradually, especially after 2006.The top 3 journals with the most articles published were Chinese Journal of Wildlife(28),Chinese Journal of Rehabilitation Medicine(15) and Chinese Journal of Behavioral Medicine and Brain Science(12).Xinqiao Hospital of TMMU and Fujian Medical University Union Hospital accounted for the top 2 total number of the papers, from which Yan-hui Chen and Cong-min Zhao published the more articles.Those papers covered 17 subjects, neurology, pathergasiology, biology and pediatrics were the main subjects. There were 3 kinds of animal that got enriched, the first was laboratory animals(69.6%), then zoo animals(22.9%),and farm animals(7.5%).Conclusions The research of environmental enrichment was relatively concentrated in terms of neurology and psychiatry.To improve animal welfare was mainly in the zoo animals;laboratory animal research in this direction was less .It is necessary to strengthen the work in this regard.

Efficacy of alendronate combined with atorvastatin in the treatment of type 2 diabetes mellitus with osteoporosis / 中国基层医药

Objective To explore the therapeutic effect of alendronate combined with atorvastatin in the treatment of patients with type 2 diabetes mellitus complicated with osteoporosis. Methods 80 patients with diabetic osteoporosis( DOP) treated by endocrinology were selected. They were divided into observation group and control group by random number table method. The patients in the control group were given alendronate sodium, and the patients in the observation group were given alendronate and atorvastatin at the same time. The bone mineral density ( BMD) of the forearm,lumbar vertebra,femoral neck and femoral trochanter Numeric rating scales( NRS score) were measured before and after treatment. Results Before treatment,the BMD in forearm,lumbar vertebra,femoral neck and femoral trochanter, and NRS score between the two groups had no statistically significant differences ( all P >0.05).Aftertreatment,theBMDofforearm[(0.64±0.10)g/cm2vs.(0.68±0.11)g/cm2,t=2.563]andlumbar vertebrae[(0. 82 ± 0. 28) g/cm2 vs. (0. 70 ± 0. 11) g/cm2,t =2. 448],femoral neck[(0. 71 ± 0. 09) g/cm2 vs. (0.66±0.05)g/cm2,t=3.002],femoraltrochanter[(0.76±0.14)g/cm2vs.(0.70±0.08)g/cm2,t=2.302] of the observation group were higher than those of the control group,and the NRS score[(1. 32 ± 0. 10) points vs. (2. 47 ± 0. 67)points]was lower than the control group(t=23. 651,P<0. 05). There were 2 cases of nausea,1 case of abdominal pain and 1 case of muscle pain in the observation group,and 1 case of nausea occurred in the control group,the incidence rate of adverse reaction between the two groups had no statistically significant difference (χ2 =1. 478,P=0. 224). Conclusion Alendronate combined with atorvastatin can improve BMD,relieve pain in patients with DOP,and it is safe and worthy of clinical application.

Efficacy of alendronate combined with atorvastatin in the treatment of type 2 diabetes mellitus with osteoporosis / 中国基层医药

Objective To explore the therapeutic effect of alendronate combined with atorvastatin in the treatment of patients with type 2 diabetes mellitus complicated with osteoporosis. Methods 80 patients with diabetic osteoporosis( DOP) treated by endocrinology were selected. They were divided into observation group and control group by random number table method. The patients in the control group were given alendronate sodium, and the patients in the observation group were given alendronate and atorvastatin at the same time. The bone mineral density ( BMD) of the forearm,lumbar vertebra,femoral neck and femoral trochanter Numeric rating scales( NRS score) were measured before and after treatment. Results Before treatment,the BMD in forearm,lumbar vertebra,femoral neck and femoral trochanter, and NRS score between the two groups had no statistically significant differences ( all P >0.05).Aftertreatment,theBMDofforearm[(0.64±0.10)g/cm2vs.(0.68±0.11)g/cm2,t=2.563]andlumbar vertebrae[(0. 82 ± 0. 28) g/cm2 vs. (0. 70 ± 0. 11) g/cm2,t =2. 448],femoral neck[(0. 71 ± 0. 09) g/cm2 vs. (0.66±0.05)g/cm2,t=3.002],femoraltrochanter[(0.76±0.14)g/cm2vs.(0.70±0.08)g/cm2,t=2.302] of the observation group were higher than those of the control group,and the NRS score[(1. 32 ± 0. 10) points vs. (2. 47 ± 0. 67)points]was lower than the control group(t=23. 651,P<0. 05). There were 2 cases of nausea,1 case of abdominal pain and 1 case of muscle pain in the observation group,and 1 case of nausea occurred in the control group,the incidence rate of adverse reaction between the two groups had no statistically significant difference (χ2 =1. 478,P=0. 224). Conclusion Alendronate combined with atorvastatin can improve BMD,relieve pain in patients with DOP,and it is safe and worthy of clinical application.

The Influence of Different Wrap Method on the Intracranial Pressure of Patients after Standard Craniectomy / 昆明医科大学学报

Objective To explore the influence of different methods of bandaging on the postoperative intracranial pressure of patients with severe brain injury patients after decompression craniectomy. Methods The standard decompressive craniectomy was use for the 36 cases of severe traumatic brain injury patients, and the intracranial pressure monitoring sensor probe was indwelled in operaion. Two different dressing methods of elasticity mesh cap and applicator were used for the patients respectively at 0h, 72h, 120h and 168h after operation, and the value of intracranial pressure was monitored and recorded. Result The intracranial pressure of elastic cap were significantly higher than the applicator respectively in operation immediate postoperative 72h, 120h and 168h (P<0.05), the difference was statistically significant. Conclusions The intracranial pressure of elastic cap is significantly higher than the applicator at different times after the surgery group.

Study of prevention and control of delirium in ventilated patients by simulating blockage of circadian rhythm with sedative in intensive care unit / 中华危重病急救医学

Objective To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). Methods A prospective double-blinded randomized controlled trial (RCT) was conducted. The patients admitted to Department of Critical Care Medicine of the Second Hospital of Lanzhou University from July 2014 to February 2015, undergoing invasive mechanical ventilation over 12 hours were enrolled. All the patients were given fentanyl for analgesia, and they were randomly divided into simulated circadian clock group (study group, n = 35) and non-simulated circadian clock group (control group, n = 35). The patients in each group were subdivided into three subgroups according to the kinds of sedative drugs, namely dexmedetomidine group (n = 8), propofol group (n = 14), and dexmedetomidine combined with propofol group (combination group, n = 13). Visual analogue scale (VAS) standard and Richmond agitation-sedation scale (RASS) were used to control the analgesic and to quantify the depth of sedation by titrating the dose of sedative drugs, the simulated circadian clock was set to control the RASS score at 0-1 during the day, and -1 to -2 at night in study group. The RASS score in the control group was set at -1 to -2 day and night. The urine 6-hydroxy acid melatonin (aMT6s) levels at different time points in the first diurnal rhythm (06:00, 12:00, 18:00, 24:00) were determined by enzyme linked immunosorbent assay (ELISA). The incidence of delirium, severe hypotension, severe bradycardia and other adverse reactions, duration of mechanical ventilation and the time of extubation, length of ICU stay, amount of sedative and analgesic drugs used were recorded. The correlation between delirium and other indexes was analyzed by using Spearman correlation analysis. Results ① There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score among groups. ② Urine aMT6s levels did not show circadian rhythm in both groups, aMT6s level at 06:00 in study group showed an increasing tendency as compared with the control group, but the difference was not statistically significant. ③ Compared with the control group, the incidence of delirium was significantly lowered in the study group (14.3% vs. 37.1%, P = 0.029), but no significant differences were found in the incidence of severe hypotension or severe bradycardia (20.0% vs. 25.7%, 11.4% vs. 20.0%, both P > 0.05). In simulated circadian clock group, the incidence of delirium in dexmedetomidine group was significantly lower than that of the propofol group (6.3% vs. 32.1%, P 0.05). Conclusions Administration of sedatives according to simulating circadian time could decrease the duration of mechanical ventilation, extubation time, and the length of ICU stay, decrease the dosage of sedative drugs, and reduce the incidence of delirium. Dexmedetomidine could reduce the incidence of delirium, and improve the prognosis of patients. Trial registration Registration of clinical trials in China, ChiCTR-IPR-15006644.

Medical waste management in primary medical institutions in China / 中国感染控制杂志

Objective To understand the current situation of medical waste management in primary medical insti-tutions in China.Methods The management of medical waste in 95 primary medical institutions in 5 provinces of China in 2016 were investigated.Results Of 95 primary medical institutions,90(94.74%)dispose medical waste by centralized processing,92(96.84%)separately collect medical waste,89(93.68%)have specific locations for temporary waste storage and handover registration,46(48.42%)have wastewater treatment facilities,and are re-sponsible by full-time or part-time personnel.Before 2000,only 4 (4.21%)primary medical institutions carried out medical waste classification management and centralized disposal,which increased to 92(96.84%)and 90(94.74%) respectively in 2014;before 2000,only 5(5.26%)primary medical institutions conducted temporarily medical waste storage and treatment,which increased to 89(93.68%)in 2014.Conclusion Medical waste management in primary medical institutions has been improved significantly,but there still remain some problems,training relevant to waste management knowledge needs to be strengthened among health care workers,medical waste management procedures should be standardized,sound medical waste management and supervision system should be improved.

Association between polymorphism of TGF-β1 gene and type 2 diabetes mellitus in Chinese Han population in Shanghai / 实用医学杂志

Objective To study the association between transforming growth factor-β1 (TGF-β1) polymorphism and type 2 diabetes mellitus in Han population of Shanghai. Methods In this case-control study , 1 234 cases of T2DM patients were recruited and 1 272 healthy individuals were selected as control. Five ml of blood sample was collected from each subject ,from which the whole genomic DNA was extracted.The polymorphism was detected by the Taqman technology. Result Significant association was observed in TGF-β1 T896C genotypes and alleles with T2DM (P = 0.0001 and P = 0.004, OR = 1.18 [1.05 ~ 1.33], respectively). Conclusion The polymorphism of T896C in TGF-β1 gene may be associated with T2DM in Han population from Shanghai.

Bone marrow mononuclear cell transplantation for repair of traumatic brain injury via different approaches / 中国组织工程研究

BACKGROUND:There are several routes for stem cel transplantation;however, it is stil unable to determine which one is the best. As for the different individuals with brain injury, the type of transplanted cel s, transplantation route and time wil affect the therapeutic effects. OBJECTIVE:To investigate the effect of bone marrow mononuclear cel s transplanted via different approaches on neurological function of rats with traumatic brain injury. METHODS:Bone marrow mononuclear cel s of rats were administered gradient centrifugation with Ficol lymphocyte separation medium, and were labeled with CFDA-SE in vitro as standby. Rat models of traumatic brain injury were established by the method of freefal . After successful establishment of rat models, bone marrow mononuclear cel s labeled with CFDA-SE were immediately transplanted into rats via injured area, lateral ventricle and internal carotid artery. One control group was designated for each transplantation route (bone marrow mononuclear cel s were replaced with the same volume of DMEM). The degree of neurological deficits was evaluated using mNSS scores at different time points after treatment. The brain tissue was harvested after the last neurobehavioral evaluation. The survival and migration of bone marrow mononuclear cel s in the injured area were observed under an inverted fluorescent microscope. RESULTS AND CONCLUSION:At 7, 10, and 14 days after treatment, the mNSS scores of rats in al groups were al lower than those at 1 and 3 days (P<0.05). At 7 and 10 days, the mNSS scores of rats in the internal carotid artery transplantation group were significantly lower than those in the control group (P<0.05). At 14 days after treatment, the number of fluorescence-labeled cel s of rats in the internal carotid artery transplantation group was greater than that in the other groups (P<0.05) and these labeled cel s were widely distributed. The results demonstrate that the neurological function of rats can be improved by transplanting bone marrow mononuclear cel s via the internal carotid artery, and a large number of transplanted cel s can survive and migrate in the injured area.

A study of using dexmedetomidine in ventilator bundle treatment in an ICU / 中华危重病急救医学

ObjectiveTo compare the sedative effect and safety of dexmedetomidine and midazolam in the intensive care unit (ICU) patients undergoing ventilator bundle treatment.MethodsA prospective single-blind randomized controlled trial (RCT) was conducted. Ninety patients receiving ICU ventilator-assisted therapy and ventilator bundle treatments for more than 3 days in the First Department of Critical Care Medicine of the Second Hospital of Lanzhou University from January 2013 to December 2014 were enrolled. The patients were randomly divided into two groups for sedative treatment. The patients in dexmedetomidine group (n = 42) were given dexmedetomidine 0.2-0.7μg·kg-1·h-1 to achieve a goal of satisfactory sedation [Richmond agitation-sedation scale (RASS) score 0 to - 2 during the day, and -1 to -3 at night). The patients in midazolam group (n = 48) were given midazolam 2-3 mg intravenously first, and then 0.05 mg·kg-1·h-1 for maintenance. The drug dose was adjusted according to RASS every 4 hours to maintain the appropriate sedation depth. The patients in both groups received continuous intravenous infusion of fentanyl for analgesia. Ventilator bundle treatments included the head of a bed up 30°to 45°, awaken and extubation appraisal, daily use of proton pump inhibitors for peptic ulcer prevention, prevention of deep vein thrombosis (DVT), chlorhexidine mouth nursing, and removal of sputum by suction from subglottic area. When the patients in both groups obtained satisfactory target sedation, daily awakening was conducted, and spontaneous breathing test (SBT) was carried out to determine optional weaning time. When the condition was optimal, weaning was conducted, otherwise ventilator bundle treatments were continued. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), respiratory frequency (RR) were monitored before and 15, 30, 60, 120, 180 minutes after the treatment, and at the moment of extubation and 30 minutes after extubation. The duration of mechanical ventilation, extubation time, length of ICU stay, and the incidence of adverse events were also recorded. Results Both dexmedetomidine and midazolam could give rise to sedation with same score of analgesia in patients in both groups, and similar effect of sedation and analgesia could be achieved. Compared with midazolam, dexmedetomidine could significantly reduce the duration of mechanical ventilation (hours: 108.33±21.96 vs. 119.85±20.29,t = -2.586, P = 0.011), earlier extubation time (hours: 112.95±22.20 vs. 128.58±26.18,t = -3.031,P = 0.003), length of ICU stay (hours: 149.21±20.47 vs. 163.88±33.59,t = -2.457,P = 0.016), the incidence of delirium [9.5% (4/42) vs. 31.2% (15/48),χ2 = 6.349,P = 0.012], but it would elevate the incidence of severe hypotension [28.6% (12/42) vs. 8.3% (4/48),χ2 = 6.277,P = 0.012] and severe bradycardia [19.0% (8/42) vs. 8.3% (4/48),χ2 = 2.225,P = 0.136]. Both drugs could lower SBP, DBP, MAP, and HR, and the effect in dexmedetomidine group was more significant from 60 minutes after treatment [SBP (mmHg, 1 mmHg = 0.133 kPa): 113.12±14.42 vs. 124.40±15.79, DBP (mmHg): 69.02±9.62 vs. 76.94±10.41, MAP (mmHg): 83.76±10.50 vs. 92.77±11.87, HR (bpm): 79.19±12.28 vs. 87.42±17.77,P< 0.05 orP< 0.01]. Both sedatives could significantly lower the rate of spontaneous breathing, and the effect of midazolam group was more significant from 60 minutes after treatment compared with dexmedetomidine group (times/min: 18.27±4.29 vs. 20.07±4.11,P< 0.05).Conclusions The sedative effects of dexmedetomidine in the ICU patients treated with ventilator bundle treatment are satisfactory, and it can shorten the duration of mechanical ventilation, extubation time and length of ICU stay, reduce the incidence of delirium. However, monitoring should be strengthened in order to prevent and control the adverse effects such as severe hypotension and severe bradycardia.