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OBJECTIVE To explore the protective effect and mechanism of Longshengzhi capsules on cerebral ischemia- reperfusion injury in rats. METHODS The model of middle cerebral artery occlusion （MCAO） was established by using the improved thread occlusion method. The experiment was divided into six groups： sham surgery group （only separating blood vessels without inserting thread plugs， given the same volume of normal saline）， model group （modeling， given the same volume of normal saline）， nimodipine group （positive control， modeling， dose of 20 mg/kg）， and low-dose， medium-dose， and high-dose groups of Longshengzhi capsules （modeling， doses of 0.72， 1.44 and 2.88 g/kg， respectively）， with 10 mice in each group. Each group was given corresponding medication solution/normal saline by gavage， once a day， for 7 consecutive days. One hour after the last administration， the Zea Longa scoring method was used to score the neurological deficits in each group of rats， and the ABC enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in rats； TTC staining was used to observe the volume of cerebral infarction in rats and calculate the cerebral infarction volume ratio. Hematoxylin eosin staining was used to observe the pathological changes in the brain tissue of rats. Immunohistochemical staining was used to detect the positive expression of NLRP3 protein in the brain tissue of rats. Real-time fluorescence quantitative PCR was used to detect mRNA relative expressions of Toll-like receptor 4 （TLR4） and nuclear factor-κB （NF-κB） in the brain tissue of rats. Western blot assay was adopted to detect the relative expressions of TLR4， NLRP3 and phosphorylated NF-κB （p-NF-κB） protein in the brain tissue of rats and its intracellular NF-κB protein. RESULTS Compared with the sham surgery group， the neural dysfunction score， serum levels of TNF-α and IL-6， cerebral infarction volume ratio， relative expression levels of NF-κB and TLR4 mRNA， as well as protein relative expressions of TLR4， NLRP3 and p-NF-κB in the brain tissue， and relative protein expression of intracellular NF-κB were increased significantly in the model group （P＜0.01）； the enlarged gap and significant edema were observed in cortical nerve cells of brain tissue in rats， with a large amount of inflammatory cell infiltration； the positive expression of NLRP3 protein in brain tissue of rats obviously increased. Compared with the model group， the levels of the above indicators in the medium-dose and high-dose groups of Longshengzhi capsules， as well as the Nimodipine group， were reversed to varying degrees， and most differences were statistically significant （P＜0.05 or P＜0.01）； the pathological morphology observation showed a significant improvement， and the positive expression of NLRP3 protein in the brain tissue of rats was obviously reduced. CONCLUSIONS Longshengzhi capsules may inhibit TLR4/NF-κB/NLRP3 signaling pathway and neuroinflammatory response， thereby achieving a protective effect against cerebral ischemia-reperfusion injury in rats.
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Background The community is the main place for people's daily activities. A livable environment will improve the subjective well-being of residents. Objective To understand the current status of subjective well-being of residents in Pudong, Shanghai, and explore the impact of community environmental factors on residents' subjective well-being. Methods Using quota sampling, 6000 permanent residents from 12 sub-districts or towns in Pudong, Shanghai were selected to participate in an questionnaire survey. The questionnaire included three parts: participants' basic information, community environmental factors (neighborhood aesthetics, fitness environment, public service and security, natural environment), and subjective well-being. Using a multiple regression model, the influence of community environmental factors on the subjective well-being of residents was analyzed. Results A total of 5887 questionnaires were recovered, and the valid recovery rate was 98.1%. The subjective well-being score of the survey respondents was (7.03±1.61) points. There was no statistical difference in the subjective well-being score of study subjects of different gender and marital status groups; while those with different ages, education levels, occupations, and self-evaluated economic status showed statistical differences in their subjective well-being score (P<0.05). The multiple logistic regression analysis results showed that after controlling general demographic characteristics, with the low level as the control group (according predetermined cut-off values of 33.3% and 66.7%, the community environmental factors were divided into high-, medium-, and low-level groups), the OR values of subjective well-being of the high- and medium-level neighborhood aesthetics groups were 1.393 (95%CI: 1.173-1.654) and 1.235 (95%CI: 1.080-1.412); the OR values of the high- and medium-level fitness environment groups were 2.297 (95%CI: 1.929-2.734) and 1.349 (95%CI: 1.166-1.560); the OR values of the high- and medium-level public service and security groups were 1.101 (95%CI: 0.943-1.285) and 1.039 (95%CI: 0.905-1.193); the OR values of the high- and medium-level natural environment groups were 4.248 (95%CI: 3.321-5.434) and 1.652 (95%CI: 1.374-1.986), respectively. Conclusion Community environment factors could affect residents' subjective well-being, and good neighborhood aesthetics, fitness environment, natural environment have positive effects.
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Background Long working hours (LWH) and shift work are harmful to the physical and mental health of occupational groups. Objective To understand the status quo of LWH and shift work of migrant workers in Shanghai, and to analyze the influence of the above two factors on sleep of the population. Methods From July to September 2018, a cross-sectional survey using questionnaires was conducted among 3215 in-service employees at seven workplaces with more than 300 employees in six selected districts of Shanghai using multi-stage random sampling method. A total of 2976 valid questionnaires were collected, with a valid response rate of 92.6%. The questionnaires included general demographic characteristics, personal health behavior, work-related factors, weekly working hours, shift work, and sleep. Univariate analysis and logistic regression analysis were used to investigate the relationships of LWH and shift work with sleep, and an interaction item was included to evaluate potential interaction between LWH and shift work. Result The average age of the subjects was (30.98±9.49) years old, the male to female ratio was 1∶1.20, and 2382 workers were reported without local residency (80.0%). Among the migrant workers, the average weekly working hours was (57.23±13.14) h, the proportions of LWH (weekly working hours>40 h), extra LWH (weekly working hours>55 h), and shift work were 80.6% (1919/2382), 60.3% (1436/2382), and 25.4% (600/2366), respectively, all above were significantly higher than those of local workers. The prevalence rates of insomnia and lack of sleep among the migrant workers were 46.3% (1091/2356) and 25.4% (597/2354), respectively. The results of logistic regression model showed that after adjusting demographic characteristics such as gender, age, education level, and monthly income, as well as occupation and personal health behavior, compared with working hours ≤40 h per week, working 55-60 h per week was a risk factor for insomnia of migrant workers (OR=1.33, 95%CI: 1.02-1.72), while working >60 h per week was a risk factor for both insomnia (OR=1.37, 95%CI: 1.05-1.78) and insufficient sleep (OR=1.73, 95%CI: 1.28-2.35) of migrant workers. Shift work was only associated with insomnia (OR=1.37, 95%CI: 1.11-1.69). Meanwhile, working hours>60 h per week and shift work had an interaction effect on insomnia of migrant workers (OR=2.35, 95%CI: 1.20-4.60). Conclusion LWH and shift work are prominent among migrant workers, and there is an interaction between LWH and shift work with insomnia.
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Objective:To explore the surgical strategy of coronary artery bypass grafting(CABG) for moderate ischemic mitral regurgitation(IMR), and to clarify the impact of mitral valve surgical intervention(MVS) on the long-term prognosis of such patients.Methods:The clinical data of 234 consecutive patients with moderate IMR who received CABG from January 2013 to December 2018 were retrospectively included, with 184 males and 50 females. The age ranged from 29 to 78 years, with a mean of(61.5 ± 8.7) years old. According to whether MVS was performed at the same time, they were divided into CABG group(108 cases, CABG alone) and CABG+ MVS group(126 cases, CABG+ MVS at the same time). The long-term cardiac events, all-cause deaths, major cardiovascular and cerebrovascular adverse events(MACCE) and other end events were followed up. A matching queue was established by propensity matching score for statistical analysis.Results:After propensity matching score, a matching queue was established, including 78 pairs of patients. Survival analysis showed that the incidence of long-term cardiac events and postoperative new onset atrial fibrillation in CABG+ MVS group was significantly higher( P<0.05). However, there was no significant difference between the two groups in all-cause mortality, cardiogenic mortality, and the incidence of MACCE events( P>0.05). Cox regression analysis showed that simultaneous CABG+ MVS was a risk factor for long-term cardiac events and new postoperative atrial fibrillation. The results of subgroup studies showed that for patients without tricuspid regurgitation before operation, left ventricular end diastolic diameter>55 mm, and left ventricular ejection fraction(LVEF) ≤0.55, the probability of cardiac events after MVS at the same time of CABG was higher( P<0.05). However, patients with no tricuspid regurgitation before operation, left ventricular end diastolic diameter>55 mm, LVEF≤0.55, and left atrial diameter≥40 mm had a higher probability of atrial fibrillation after MVS at the same time of CABG( P<0.05). Conclusion:CABG can improve left ventricular remodeling in patients with moderate IMR, whether MVS intervention is performed at the same time or not, and the long-term survival rate of both is similar. CABG+ MVS in the same period can maintain a low residual reflux, but the incidence of long-term cardiac events and arrhythmias is high. The longer-term prognosis needs to be further studied. The surgical strategy of such patients should be selected individually according to the specific situation and the surgical quality in medical centers.
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@#Objective To summarize the pathological characteristics of primary left ventricular tumors and their influence on surgical treatment. Methods The clinical data of 32 patients with primary left ventricular tumor in Fuwai Hospital from January 2008 to March 2019 were retrospectively analyzed, including 17 males and 15 females with an average age of 33.88±17.89 years. The impact of different types of left ventricular tumor pathology on the surgical outcome was analyzed. Results Thirty-two patients with primary left ventricular tumors underwent surgery. Postoperative pathological biopsy results revealed benign tumor in 31 patients, including myxoma in 10 patients, lipomas in 7 patients, fibroma in 4 patients, hemangioma in 3 patients, rhabdomyoma in 2 patients, cyst in 2 patients, schwannoma in 1 patient, papillary fibroelastoma in 1 patient, cavernous hyperplasia of valvular lymphatic vessels in 1 patient. There was 1 patient of carcinoid (low-grade malignant tumor). Thirty patients underwent tumor resection surgery under hypothermic anesthesia and cardiopulmonary bypass followed by cardiac arrest while 2 patients without cardiopulmonary bypass. Nine patients received partial resection of the tumor, including lipomas in 6 patients, rhabdomyoma in 2 patients, schwannoma in 1 patient. Twenty-three patients received complete resection of the tumor. There were no in-hospital deaths, bleeding, secondary thoracotomy, low cardiac output, renal failure, postoperative embolism or other surgical complications. All the patients were normal before they were discharged out of the hospital. Their average postoperative hospital stay was 8.1±2.7 d. Within 6 months after the surgery, all 32 patients returned to the hospital for reexamination, and ultrasound results were all normal. Afterwards, the patients were followed up by telephone or in an outpatient clinic, and 3 patients were lost. The follow-up rate was 90.63%. During the follow-up of 3-120 (61.4±38.5) months, among the 9 patients whose tumors were partially resection, 2 patients recurred. One patient with schwannoma recurred 30 months after the surgery, and in the other patient lipomas grew 15 months later which resulted in massive regurgitation of the mitral valve. Conclusion Surgical resection is the first choice for the treatment of left ventricular benign tumors. For malignant left ventricular tumors, it is necessary to be cautious, and the surgical risk needs to be carefully evaluated. Most of the primary left ventricular tumors need to be operated as soon as possible. A surgeon should develop different surgical strategies according to different pathological types of tumors.
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Objective:To investigate the effect of epidermal growth factor receptor tyrosine kinase inhibitor on the radiosensitivity of human non-small cell lung cancer cells and its possible mechanism.Methods:Human non-small cell lung cancer cells H1299 were cultured in vitro. CCK-8 was used to detect the toxic effects of erlotinib on H1299 cells, IC 50 and IC 20 were calculated, and IC 20 was utilized as the drug concentration for subsequent experiments. The colony formation assay was performed to identifiy the effect of X-ray combined with erlotinib on H1299 cells, the radiosensitivity parameters were calculated, and the cell survival curves were delineated. Flow cytometry was conducted to detect the cell cycle distribution and apoptosis. Western blot analysis was used to detect the expression of EGFR/PI3K/AKT pathway and apoptosis-related proteins. Results:Erlotinib exerted inhibitory effect upon the proliferation of H1299 cells, IC 50 was calculated as 27.3 μmol/L, and 3.3 μmol/L for IC 20. X-ray combined with IC 20 concentration of erlotinib could reduce the cloning ability of H1299, increased the proportion of G 0/G 1 phase and G 2/M phase, decreased the proportion of S phase, aggravated cell apoptosis, down-regulated the expression of pEGFR and pAKT proteins, and up-regulated the expression of apoptosis-related proteins including Active Caspase 3 and Cleaved PARP. Conclusions:Erlotinib exerts a radiosensitizing effect on H1299. The possible mechanism is that erlotinib combined with radiation can suppress the EGFR/PI3K/AKT pathway, reduce the ability of repairing cell damage, change cell growth cycle and induce cell apoptosis.
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Based on the policy framework , the premarital healthcare policy of Guangxi was analyzed from four aspects including policy background , process, content and actors.We analyzed the factors influencing this policy and their interactions , and discussed the important impact of Thalassemia prevention , multi-sectoral consensus and appro-priate premarital healthcare measures to the policy building and implementation .Then the lessons such as strengthe-ning the multi-sector cooperation , specifically making clear the pre-marital screening projects and implementing the“one-stop” service model were summed up in Guangxi province .Finally, combined with existing major problems , some policy recommendations were put forward including clarify the funding criteria and strengthen the premarital healthcare publicity in order to promote the sustainable development of premarital healthcare services .
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Based on SWOT analysis and relevant information about the premarital healthcare services through on-site survey and literature research , this paper systematically analyzed the Strengths , Weaknesses , Opportunities and Threats of “one-stop” premarital healthcare services .It also puts forward some strategic suggestions on premarital healthcare services in China including enhancing communication and cooperation between the related national minis -tries and commissions , building a government-led multi-sectoral coordination mechanism , increasing the resource in-vestment , promoting the premarital health care service and pre-pregnancy physical examination integration , and strengthening publicity and mobilization of “one stop” service for premarital healthcare service policy recommenda-tions to provide a basis for decision-making in the promotion of the policy-related works .
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<p><b>OBJECTIVE</b>To evaluate the consistency between the clinical diagnostic criteria and the ascertained diagnostic criteria for diabetic peripheral neuropathy (DPN) in the Preventive and Treatment Guidelines of Diabetes in China (2013) and explore an economic, convenient, and accurate approach to DPN diagnosis.</p><p><b>METHODS</b>The patients with type 2 diabetes admitted in our department from April to June, 2014 were examined for nerve conduction velocity, 10 g nylon silk, vibration threshold value, sense of temperature and pain, and ankle reflex. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value were calculated to assess the diagnostic power of the two diagnostic criteria.</p><p><b>RESULTS</b>Of the 151 patients enrolled, 106 (70.2%) had a diagnosis of DPN consistent with the ascertained diagnostic criteria, as compared to 86 (56.95%) who were diagnosed according to the clinical diagnostic criteria; the latter patients accounted for 81.13% of former cases. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value of the clinical diagnostic criteria were 80.19%, 97.78%, 98.84%, 67.69%, 77.97%, and 0.69, respectively, which were highly consistent with those of the ascertained diagnostic criteria; the sensitivity to compression showed a poor consistency between the two diagnostic criteria. In the 5 screening tests, the combined test of temperature sensation, vibration perception, and ankle reflex showed the highest AUC value among their different combinations.</p><p><b>CONCLUSION</b>The clinical diagnostic criteria for DPN show good consistency with the ascertained diagnostic criteria, and for patients with clinical symptoms or with only one positive sign, combination of the two diagnostic criteria can achieve the maximum diagnostic power.</p>
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Humanos , China , Diabetes Mellitus Tipo 2 , Neuropatias Diabéticas , Diagnóstico , Exame Neurológico , Métodos , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
Cerebral ischemia-induced inflammatory cascade reaction may aggravate nerve tissue damage and destroy blood-braln barrier, and angiogenesis after ischemia can improve nerve function. Inhibiting inflammatory response after stroke, promoting angiogenesis and protecting blood-braln may reduce nerve tissue damage and promote recovery of neurological function. Monocyte chemotactic protein 1-induced protein inhibits inflammatory signaling pathways through degradating proinflammatory cytokine mRNA. Its unique biological characteristics also suggest that it has the potential protective effect in cerebral ischemia. This article focuses on the roles of monocyte chemotactic protein 1-induced protein in cerebral ischemia.
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Objective:To investigate effects of herbal compoundYiTangKang on the spleen deficiency metabolic syndrome.Methods:Forty maleWistar rats were randomly divided into two groups: the normal control group and theMS spleen deficiency syndrome group.The control group rats were fed with standard diet and water, whileMS spleen deficiency syndrome group with high fat diet and low dose intraperitoneal injection ofstreptozocin, which swam to the endurance limit. After12 weeks, theMS spleen deficiency syndrome group was randomly divided into two groups, with13 rats in each group.Rats in model group were fed with high fat diet and continuouly administered with daily saline, and rats in intervention group with high fat diet were trated with traditionalChinese medicinesYiTangKang by gavage,2 mL/200 g at the same time every day.10 weeks later, the expression of serum proteomics was investigated through abdominal aortic puncture and separation of serum, using isotope labeling technique, high performance liquid chromatography and four bar-Orbitrap mass spectrometer.Results:After treatment with traditionalChinese medicine yitangkang, in the model group, important carboxylesterase and retinal guanylatecyclase2 precursor were upregulated.As for intervention group, these indesxes were raised, but immunoglobulinIgG, carnitine acetyltransferase, tubulin beta -5, andGanLu sugar binding proteinC were down-regulated.At the same time, some new biological active substances, such as protein tyrosine kinase, beta glucosidase were also found.Conclusions:TraditionalChinese medicinesYiTangKang could regulate glucose and lipid metabolism in rats with spleen deficiency syndrome.
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The Theory of Change holds that the change in a project ’ s effectiveness can be derived from the changing process in the certain context .Only after analyzing changes caused by a project and the possible changing path or hypothesis can we determine the real cause of an effect .In 2012, the maternal, child and community health department of the former Ministry of Health began a comprehensive intervention project for children ’ s health in Nu-jiang Prefecture .The project was designed to explore modes and mechanisms for improving children ’ s health in the west, poverty and ethnic minority areas through cooperation at the national , provincial, and prefecture levels.Based on the Theory of Change , this article describes the logical framework of the comprehensive intervention project .In or-der to lay the foundation for improving the project design , ensuring the implementation of the project and conducting the follow-up monitoring and evaluation , we also expound the goals , implementation strategies , and intervention measures, project activities and output , implementation routes .
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In this paper , we summarize the theoretical models and research progress about program evaluation and practical situation of children ’ s health in Nujiang prefecture .We then develop a framework for comprehensively evaluating the intervention for children ’ s health based on program theory .This framework comprises the outside pro-gram environment , intervention action modules and change modules , and assessment techniques environment .The e-valuation mainly includes leading agencies , implementing agencies , coordinating agencies , coordination/implementa-tion personnel , intervention and service standards , the environment and atmosphere , target populations , interven-tions, determinants, outcome and effect .
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Objective:To determine children ’ s health status and influential factors in Nujiang prefecture , Yun-nan.Methods:Rickets morbidity rate , growth retardation rate , and low-weight rate were selected as the key indica-tors to calculate the sample size by using four-stage-sampling procedure .The data was collected through questionnaire survey, in-depth interviews, and focus-group discussions .χ2 test and qualitative analysis were used to analyze the quantitative and qualitative data .Results:The infant mortality rate was 13.14 %in 2011, which was 1.1 and 1.15 times more than the national and provincial average .The mortality rate of children under five was 16.35%in 2011, which was 1.05 and 1.13 times more than the national and provincial average .It was also 2.19 times more than the average in developed countries .The prevalence of medium and severe malnutrition in children under five was 2 .32%, which was 1 .54 times more than the national average .The incidence of low birth weight was 1 .41%.The research shows that the rates of rickets , growth retardation , and low-weight were 36.13%, 25.81%and 20.98%,and nutritional diseases are more serious .Conclusion:There are serious health problems for children in Nujiang pre-fecture, especially nutritional diseases .Influential factors include health policy and system , economic development, customs, geography, health service capacity , and parental health knowledge Suggestion:The government should im-prove top-level design , strengthen policy support , and develop the local economy in order to solve the social and poli-cy environment factors .Institutions and human capacity should be strengthened , access and quality of services should be improved , health education should be popularized , and health awareness and behaviors should be improved .
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ObjectiveTo investigate the hypersensitive C-reactive protein(hs-CRP),level in serum and the heart rate variability(HRV) in patients with dysthymic disorder,and explore the possible psychological and physiological mechanisms.MethodsPHI and short-term HRV were measured in 42 patients with dysthymic disorder( DD group),33 patients with major depressive disorder ( MD group)and 30 heathy controls( NC group),fasting blood samples were also analyzed with high-sensitivity C-reactive protein (hs-CRP).Results ( 1 ) DD group gained higher score in the somatization,anxiety,psychopathic deviate and hypomania than the MD group(P＜0.05 or P ＜ 0.01 ).(2)The standard deviation of differences between the consecutive RR intervals (SDNN),the percentage value of consecutive RR intervals that differ more than 50 ms(PNN50) and the high frequency band(HF) of DD group were lower significantly than MD and NC groups,the low frequency band(LF),and the ratio of LF to HF power(LF/HF) and hs-CRP level were higher than other two groups (P ＜ 0.05 or P＜0.01 ).(3)The somatization and anxiety were correlated with SDNN,the very low frequency band(VLF),LF and hs-CRP level ( r=-0.27,-0.29,r=0.38,0.33,r=0.41,0.31,r=0.34,0.23,P＜0.05 or P＜0.01).(4)The hs-CRP level in serum were correlated with SDNN,the root mean square of successive RR intervals (RMSSD),the standard deviation of differences between the consecutive RR intervals ( SDSD),VLF,LF,HF and LF/HF ( r =- 0.47,- 0.45,- 0.45,0.26,0.46,-0.51,0.10,P ＜ 0.05 or P ＜ 0.01 ).ConclusionThe patients with dysthymic disorder have significant somatization and anxiety,the personality character was mainly resulting in reducing HRV,which is related with the increasing serum hs-CRP level.
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Objective:To investigate the therapeutic role of topical, oral and combine of itraconazole treatment using a rabbit model of Aspergillus fumigatus keratitis. Methods: The epithelium was removed from the central cornea and the inoculum of Aspergillus fumigatus blastoconidia was placed on the corneal surface and covered with a contact lens. Forty-eight hours later the 32 rabbits were randomly divided into four groups. In topical group, rabbits were treated with topical itraconazole(1%,eight times daily); in oral group, rabbits received oral itraconazole (40 mg/kg,bid);in combine of group, rabbits were treated between topical itraconazole(1%,eight times daily) and oral itraconazole [40 mg/(kg?d)]. Untreated controls were also set. The eyes were examined and photographed with a slit-lamp 1,3,6, 10,15,20 and 25 days after inoculation, and an observer graded the corneas in a masked fashion. Corneal scraping, cultures were taken on days 3,6,15 and 25 for fungus growth. Results: At the beginning of treatment, with in 1 to 3 days, the slit-lamp scores did not differ among four groups. However, after days 6 the three treated groups had statistically significant lower scores compared to the untreated controls (P
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0 05). However, the gray of G cells were significantly enhanced( ?