The effects of quality improvement program on the incidence of bronchopulmonary dysplasia in very preterm infants / 中国新生儿科杂志

Objective:To evaluate the effects of quality improvement (QI) program on the incidence of bronchopulmonary dysplasia (BPD) in very preterm infants (VPIs) [gestational age (GA)<32 weeks].Methods:From July to December 2017,VPIs admitted to the Department of Neonatology of Yancheng Maternity and Child Health Care Hospital were retrospectively enrolled and were assigned into pre-quality improvement program group (Pre-QI group).From July to December 2018, VPIs were assigned into post-quality improvement program group (Post-QI group). QI program included delayed umbilical cord clamping (DCC), early postnatal nasal continuous positive airway pressure ventilation (nCPAP) and minimally invasive pulmonary surfactant therapy (MIST). The clinical data and prognostic indicators of the two groups of VPIs and their mothers were compared. Independent sample t-test or continuity-adjusted Chi-square test (or Fisher's exact test) and Logistic regression were used for statistical analysis. Results:A total of 204 VPIs were enrolled, including 96 cases in Pre-QI group and 108 cases in Post-QI group. 1 min Apgar score and hematocrit on admission to the neonatal intensive care unit (NICU) in the Post-QI group were significantly higher than the Pre-QI group( P<0.05). The incidence of delivery room resuscitation, endotracheal intubation at birth and endotracheal intubation in NICU in the Post-QI group were significantly lower than the Pre-QI group( P<0.05). The application of pulmonary surfactant and mechanical ventilation, the incidence of neonatal respiratory distress syndrome and BPD in the Post-QI group were lower than the Pre-QI group ( P<0.05). After adjusting for confounding factors, Logistic regression analysis showed that DCC ( aOR=0.261,95% CI 0.091~0.718, P=0.023), nCPAP ( aOR=0.284,95% CI 0.123~0.667, P=0.015), MIST ( aOR=0.276,95% CI 0.114~0.627, P=0.011) were protective factors of BPD, and MV ( aOR=2.023,95% CI 1.048~3.918, P=0.036) was risk factor of BPD. Conclusions:The QI program consisting of DCC, early nCPAP and MIST for VPIs can reduce the incidence of BPD.

Surveillance on pinworm infection among rural children in Anhui Province from 2017 to 2021 / 中国学校卫生

Objective@#To understand the status of pinworm infection in rural children aged 3-9 years in Anhui Province, and to provide scientific basis for the prevention and control strategy of pinworm disease.@*Methods@#According to the National Surveillance Program of Liver Fluke Disease and Soil Transmitted Nematodiasis(Trial), no less than 10% counties(cities and districts) in Anhui Province were selected as mobile surveillance sites every year. Each surveillance site was divided into 5 areas on the basis of geographical location(east, west, south, north and middle), from each of the areas, one administrative village was selected from one township(town, community) for conducting surveillance. Children at age 3-9 years from each site were examined for pinworm infection with the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method. Chi square test was used to compare the infection rate.@*Results@#From 2017 to 2021, the 5 year average infection rate of pinworm in rural Anhui was 1.34%(128/9 557), and there was no significant difference in the infection rate over the years( P >0.05). The detection rates of the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method were 0.28% and 1.23%, respectively, the difference was statistically significant( χ 2=72.97, P <0.01). In different regions, the 5 year average infection rate of Fuyang City was the highest(4.27%), and the rate of each city was positively correlated with the number of local resident population( r =0.54, P <0.05). There was no significant sex difference in the 5 year average infection rates( P >0.05). The 5 year average infection rate of children aged 3 to 9 years in rural areas were 0.62%, 1.10%, 1.44%, 1.57%, 0.94%, 2.09% and 1.57%, respectively, showed an increasing trend with the increase of age( χ 2=14.41, χ 2 trend =6.70, P <0.05). There was no significant difference in the average infection rate between scattered children and collectively living children( P >0.05).@*Conclusion@#From 2017 to 2021, the infection rate of pinworm among children in rural Anhui province remains at a low level. In the future, health education and monitoring should be strengthened.

Association of maternal emotional symptoms and childhood adverse experiences with children s emotional and behavioral problems / 中国学校卫生

Objective@#To explore the mediating effect of maternal emotional symptoms on maternal adverse experiences and children s emotional behavior problems, so as to provide a scientific basis for family intervention of children with emotional behavior problems.@*Methods@#A multi stage sampling method was used to select 12 kindergartens in 3 districts and counties of Wuhu City. The questionnaire star method was used to investigate the love of homosexuality in families and children, children s emotional behavior development questionnaire, mother s life experience questionnaire, mother s emotional symptoms questionnaire, etc. SPSS 23.0 software was used for general descriptive analysis and Spearman correlation analysis. GLS method was used to evaluate the mediating effect of maternal mental health level between maternal adverse experiences and childrens emotional and behavioral problems.@*Results@#The difficulty factor score in the Strength and Difficulty Questionnaire (SDQ) of preschool children in Wuhu City was (10.08±4.05) points, the abnormal detection rate of the total difficulty score was 6.6%, and the abnormal detection rate of prosocial behavior was 16.5%, the total score of mother s adverse experience was positively correlated with the total score of mother s SDQ difficulties and the scores of mother s depression, anxiety and stress symptoms. The total score of children s SDQ difficulties was positively correlated with the scores of mother s depression, anxiety and stress emotions( r=0.17-0.71, P < 0.01). The results of mediating effect analysis showed that the intermediate effect coefficients of maternal depression, anxiety, stress and other emotions between the total score of maternal adverse experience and the total score of children s SDQ difficulties were statistically significant( P <0.05), and the mediating effect accounted for 22.6%, 15.2% and 17.1% of the total effect, respectively.@*Conclusion@#The relationship between maternal adverse childhood experiences and children s emotional behavior problems was influenced by maternal emotional symptoms. Attention to mothers early life experience and mental health is beneficial to the prevention and control of children s emotional and behavioral problems.

Association of Ego-depletion level with glycemic control and quality of life among adolescents with type 1 diabetes / 中国实用护理杂志

Objective:To investigate the ego-depletion level of adolescents with type 1 diabetes mellitus (T1DM) and to explore its association with glycemic control and quality of life.Methods:This was a cross-sectional survey study. A total of 195 adolescents with T1DM were recruited from the First Affiliated Hospital of Nanjing Medical University from March to September 2022 by convenient sampling method. The Self-Regulatory Fatigue Scale (SRF-S) and Short Form of the Chinese version Diabetes Quality of Life for Youth Scale (C-DQOLY-SF) and the general information questionnaire were collected and the glycated hemoglobin (HbA 1c) value was detected. Results:The total score of self-regulatory fatigue for 195 adolescents with T1DM was (42.23 ± 9.94) points, with a scoring rate of 52.79%, which was at a medium level. Pearson correlation analysis showed that the total score of self-regulatory fatigue was positively correlated with HbA1c ( r = 0.25, P<0.01), and negatively correlated with quality of life ( r = -0.61, P<0.01). The hierarchical linear regression results showed that after controlling for demographic sociolagy and disease variables, ego-depletion had a positive predictive effect on HbA1c ( t = 3.69, P<0.01), while ego-depletion had a negative predictive effect on Quality of life ( t = -8.48, P<0.01). Conclusions:Ego-depletion of adolescents with T1DM may affect their blood glucose control and quality of life, which should be noticed by medical workers.

Status and Prospect of Management Policy and System for High-level Pathogenic Microorganism Laboratories in China / 中山大学学报(医学科学版)

High-level pathogenic microorganism laboratories are strategic scientific and technological forces of national biosafety， so it is significant to improve the policy and system management and strengthen the safety supervision. This paper reviewed the current status of management policy and system of high-level pathogenic microorganism laboratories， summarized the problems and challenges in terms of safety laws and regulations， supervision mechanism， hierarchical and classified management， standards and norms， legal person responsibility system， occupational access system and personnel training system. This paper also proposed targeted policy suggestions that might underlie the biosafety management of high-level pathogenic microorganism laboratories in China.

A new form of familial platelet disorder caused by germline mutations in RUNX1 in a pedigree / 中华内科杂志

Objective: To investigate the clinical and biological characteristics of familial platelet disorder (FPD) with germline Runt-related transcription factor (RUNX) 1 mutations. Methods: Patients diagnosed with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with RUNX1 mutations from February 2016 to December 2021 in Wuhan No.1 Hospital underwent pedigree analysis and were screened for gene mutations (somatic and germline). Patients diagnosed with FPD with germline RUNX1 mutations were enrolled and evaluated in terms of clinical characteristics and biological evolution. Bioinformatics analysis was used to assess the pathogenicity of mutations and to analyze the effect of mutated genes on the function of the corresponding protein. Results: Germline RUNX1 mutations were detected in three out of 34 patients suffering from MDS/AML who had RUNX1 mutations. A pedigree of FPD with RUNX1 (RUNX1-FPD) c.562A>C and RUNX1 c.1415T>C mutations was diagnosed, and the mutations were of patrilineal origin. Bioinformatics analysis indicated that the locus at positions 188 and 472 in the AML-1G type of RUNX1 was highly conserved across different species, and that variations might influence functions of the proteins. The mutations were evaluated to be highly pathogenic. Of the nine cases with germline RUNX1 mutations: two patients died due AML progression; one case with AML survived without leukemia after transplantation of hemopoietic stem cells; four patients showed mild-to-moderate thrombocytopenia; two cases had no thrombocytopenia. During the disease course of the proband and her son, mutations in RUNX1, NRAS and/or CEBPA and KIT appeared in succession, and expression of cluster of differentiation-7 on tumor cells was enhanced gradually. None of the gene mutations correlated with the tumor were detected in the four cases not suffering from MDS/AML, and they survived until the end of follow-up. Conclusions: RUNX1-FPD was rare. The mutations c.562A>C and c.1415T>C of RUNX1 could be the disease-causing genes for the family with RUNX1-FPD, and these mutations could promote malignant transformation. Biological monitoring should be carried out regularly to aid early intervention for family members with RUNX1-FPD.

A cohort study of incidence of club drug abuse in men who have sex with men in Qingdao / 中华流行病学杂志

Objective: To understand and analyze the incidence of club drug abuse and influencing factors in men who have sex with men (MSM) in Qingdao, and provide reference for the AIDS prevention and intervention in this population. Methods: From March 2017 to July 31, 2022, MSM who did not abuse club drug were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every 6 months. The survey collected the information about the MSM's demographic characteristics, sexual characteristics, club drug abuse and others. The incidence of club drug abuse was the outcome dependent variable and the interval between the recruitment into the cohort and the incidence of club drug abuse was the time dependent variable. Cox regression analysis was conducted to identify the influencing factors for club drug abuse. Results: A total of 509 MSM were recruited at baseline survey, and 369 eligible MSM were enrolled in this cohort. A total of 62 MSM began to abuse club drug during the study period, and the cumulative follow-up time was 911.54 person-years, the incidence of club drug abuse was 6.80/100 person-years. All the club drug abusers shared drugs with others in the first club drug abuse, and 16.13% (10/62) had mix-use of club drugs. The multivariate Cox proportional risk regression analysis showed that being students (aHR=2.17, 95%CI: 1.15-4.10), receiving no HIV testing or receiving 1 HIV testing during past 6 months (aHR=4.57, 95%CI:1.80-11.60; aHR=5.15, 95%CI: 2.83-9.36), having sex only with regular sexual partners during past 6 months (aHR=4.75,95%CI:2.32-9.75), having more than 4 homosexual partners (aHR=1.70, 95%CI:1.01-2.87) and abuse of club drug of sexual partners during past 6 months (aHR=12.78, 95%CI:3.06-53.35) were significantly associated with club drug abuse in the MSM. Conclusions: The incidence of club drug abuse was at a high level in the MSM cohort in Qingdao, indicating a high risk for HIV infection. Being student, receiving less HIV testing, having sex only with regular sexual partners, having more homosexual partners and abuse of club drug of sexual partners during past 6 months were risk factors for the incidence of club drug abuse in the MSM. Targeted surveillance and intervention measures should be strengthened to reduce the risk of club drug abuse in MSM.

Analysis of HIV-1 subtypes and pretreatment drug resistance in newly reported HIV/AIDS cases in Hangzhou, 2020-2022 / 中华微生物学和免疫学杂志

Objective:To analyze the HIV-1 subtypes and drug resistance among newly reported HIV/AIDS cases before antiretroviral therapy (ART) in Hangzhou.Methods:Blood samples were collected from newly diagnosed HIV-1/AIDS cases not receiving ART in Hangzhou from 2020 to 2022. HIV-1 pol gene was amplified and then sequenced. A phylogenetic tree was construct using MEGA7.0 software to analyse the HIV-1 subtypes, The sequences were submitted to the Stanford University drug resistance database to identify drug resistance mutation sites and drug sensitivity. Results:A total of 2 700 sequences were obtained. Twelve subtypes were identified, and the predominant subtypes were CRF07_BC (46.8%, 1 263/2 700) and CRF01_AE (34.6%, 933/2 700). The overall drug resistance rate before ART was 8.1% (220/2 700) and the resistance rates to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 2.8% (75/2 700), 1.3% (36/2 700) and 4.4% (119/2 700), respectively. Among the 220 drug-resistant cases, mutations conferring resistance to PIs (Q58E), NRTIs (M184V/I) and NNRTIs (K103N/S and E138A/G/K/Q) were detected in 47 (21.4%), 13 (5.9%), 42 (19.1%) and 41 (18.6%) patients, respectively.Conclusions:HIV-1 genotypes were highly complex in newly reported HIV/AIDS cases in Hangzhou from 2020 to 2022. There were cases showing moderate or high resistance to backbone drugs before ART, indicating that HIV-1 monitoring should be strengthened to avoid treatment failure and reduce the spread of drug-resistant strains.

Analysis of the relationship between management capability of general practice team leaders and the team performance in community health service centers based on structural equation model / 中华全科医师杂志

Objective:To analyze the relationship between capacity of general practice team leaders and the team performance in community health service centers.Methods:This study was a cross-sectional study. A questionnaire survey was conducted between November and December 2022, among general practice team leaders and general practitioners (GPs) from 18 community health service centers in the urban and suburban areas of shanghai selected by stratified sampling method. The personal information questionnaire, leadership of general practice team leader questionnaire,and work performance scale of general team members were used for the survey. The relationship between leadership of general practice team leaders and team performance was analyzed based on structural equation model (SEM).Results:A total of 944 questionnaires were distributed and 856 valid ones were returned with a response rate of 91.0%, including 110 general practice team leaders and 749 were GPs. The SEM analysis showed that some dimensions of the management ability of the general practice team leader had significant effect on the employee organization loyalty (organizational management: β=0.37, teaching and research management: β=-0.29, strategy and cultural construction: β=0.23, personal quality: β=0.11) and work performance (special business management: β=0.95, organizational management: β=0.54) (all P<0.05); and employee organization loyalty played a partial mediator role in relationship between leadership of general practice team leaders and work performance with a mediating effect of 39.50%. Conclusion:The management ability of the general practice team leader directly affect or indirectly affect the work performance of team members through team members′ organizational loyalty.

Status quo of management capabilities of general practice team leaders in community health service centers in Shanghai / 中华全科医师杂志

Objective:To survey on the status quo of the management capabilities of general practice team leaders in community health service centers in Shanghai.Methods:Using stratified sampling method, 18 community health service centers in the urban and suburban areas of Shanghai were selected, then the general practice team leaders and general practitioners (team members) in the centers were selected as the study participants. The questionnaire survey on the management capabilities of general practice team leaders was conducted among selected participants from November to December 2021. The self-assessment by general team leaders and the other-assessment by team members were carried out, and the total scores was calculated according to the weight of self-evaluation score (30%) and other-evaluation score(70%).Results:A total of 110 general practice team leaders and 749 team members participated in the survey. Among the team leaders, 63.64% (70/110) were females, 82.73% (91/110) were bachelor degree holders, 71.82% (79/110) had intermediate professional title, and 50.91% (56/110) worked for more than 9 h per day. The total score of general practice team leaders was (87.15±10.76) points, the other-assessment score was significantly higher than self-assessment score ((88.62±9.34) vs.(83.71±14.08), t=2.22, P<0.05). The average score of the 5 dimensions was 4.41 for special business management, 4.39 for organizational management, 4.38 for personal quality, 4.27 for teaching and research management and 4.22 for strategy and cultural construction, respectively. Conclusion:The overall management capabilities of Shanghai community general practice team leaders are at the upper-middle level, however, the capabilities in scientific research and team planning are relatively weak.

Treatment of vascular paralysis syndrome with methylene blue during kidney transplantation: one case report / 中华器官移植杂志

The report described one case of vascular paralysis syndrome during kidney transplantation to provide references for clinical practice.After intraoperative opening of kidney artery and vein, the recipient developed vascular paralysis syndrome.However, the efficacy is not obvious after dosing of norepinephrine.After an intravenous infusion of methylene blue, the recipient has a successful removal of tracheal intubation and recovered well.

Impact of insulin injection induced lipohypertrophy on multidimensional glucose variability in patients with type 1 diabetes mellitus / 中华内分泌代谢杂志

Objective:This study aimed to investigate the effect of lipohypertrophy induced by insulin injection on blood glucose fluctuation in patients with type 1 diabetes mellitus.Methods:A total of 80 patients with type 1 diabetes mellitus were recruited between June 2021 and December 2021 from the First Affiliated Hospital of Nanjing Medical University. And these patients all received insulin injection more than six months. Lipohypertrophy was assessed by ultrasound scanning, and blood glucose fluctuation was evaluated using the flash glucose monitoring system(FGM). Univariate analysis and multivariate linear regression were used to analyze the relationship of lipohypertrophy and and core indicators of blood glucose fluctuation.Results:Compared with patients without lipohypertrophy, patients with lipohypertrophy had higher mean amplitude of glycemic excursions(MAGE), coefficient of variation(CV), mean of daily differences(MODD), standard deviation(SD) of blood glucose, time above range(TAR), and high blood glucose index(HBGI; all P<0.05), while time in range(TIR) of glucose markedly become lower( P<0.01). Moreover, multivariate linear regression analysis showed that lipohypertrophy detected by ultrasound was an independent influencing factor of TIR( β=-9.423, P=0.032), MAGE( β=1.114, P=0.039), CV( β=4.304, P=0.041), MODD( β=0.717, P=0.046) after adjusting for age at diagnosis, duration of insulin injection, fasting C-peptide, and daily dose of insulin per unit weight. Conclusion:Lipohypertrophy increases glycemic variability and imposes negative impact on glycemic control rate in patients type 1 diabetes mellitus.

Recent research on neurodevelopmental disorders in children / 中国当代儿科杂志

Neurodevelopmental disorders (NDDs) in children are a group of chronic developmental brain disorders caused by multiple genetic or acquired causes, including disorders of intellectual development, developmental speech or language disorders, autism spectrum disorders, developmental learning disorders, attention deficit hyperactivity disorder, tic disorders, and other neurodevelopmental disorders. With the improvement in the research level and the diagnosis and treatment techniques of NDDs, great progress has been made in the research on NDDs in children. This article reviews the research advances in NDDs, in order to further improve the breadth and depth of the understanding of NDDs in children among pediatricians.

Inhibition of Sonic Hedgehog signaling inhibits fibrous scar formation and adversely affects functional outcome after ischemic brain injury in rats / 南方医科大学学报

OBJECTIVE@#To investigate the effects of inhibiting Sonic Hedgehog (Shh) signaling on fibrous scar formation and functional outcome after ischemic brain injury.@*METHODS@#Adult SD rats were randomized into sham-operated group, middle cerebral artery occlusion (MCAO) and reperfusion (I/R) group, I/R with intraventricular empty adenoviral vector (rAd-NC) injection group, and I/R with adenovirus-mediated Shh knockdown (rAd-ShShh) group. After the treatments, the neurological deficits of the rats were assessed, and the protein and mRNA expressions of fibronectin (Fn), α-SMA, and Shh in the ischemic hemisphere were detected with immunofluorescence assay and qPCR; TUNEL staining was used for detecting neural cell apoptosis. In the cell experiment, primary meningeal fibroblasts isolated from neonatal SD rats were pretreated for 24 h with TGF-β1 or TGF-β1 plus cyclopamine (CYC) before oxygen-glucose deprivation for 150 min followed by reoxygenation for 72 h (OGD/R). CCK-8 assay and scratch test were performed to examine the changes in cell proliferation and migration, and immunofluorescence assay, qPCR and Western blotting were used for detecting cell transformation and the expressions of Shh, α-SMA, and Fn.@*RESULTS@#Cerebral I/R injury significantly increased the protein and mRNA expressions of Shh, α-SMA, and Fn in the ischemic hemisphere of the rats, but their expression levels were significantly lowered by intraventricular injection of rAd-Shshh (P < 0.05), which obviously increased cell apoptosis in the ischemic hemisphere (P < 0.05) and improved modified mNSS and modified Bederson scores of the rats (P < 0.05). In the cell experiment, pretreatment with TGF-β1 and TGF-β1+CYC both increased the viability of the primary meningeal fibroblasts after OGD/R. TGF-β1 significantly enhanced the migration ability and induced obvious transformation of the exposed cells (P < 0.05), but these effects were significantly attenuated by co-treatment with CYC (P < 0.05). The expressions of Shh, α-SMA and Fn in the TGF-β1 group were all significantly higher in TGF-β1-treated cells (P < 0.05) and were obviously lowered by co-treatment with CYC (P < 0.05).@*CONCLUSION@#Inhibition of Shh signaling may inhibit fibrous scar formation and functional recovery in rats after ischemic brain injury.

Effect of Siwutang on Diminished Ovarian Reserve in Rats Based on 16S rRNA Sequencing of Intestinal Flora / 中国实验方剂学杂志

ObjectiveTo study the effect of Siwutang （SWT） on intestinal flora in rats with diminished ovarian reserve （DOR） induced by Tripterygium wilfordii polyglycoside （TWP） based on 16S rRNA sequencing. MethodTwenty 8-week-old female SD rats were randomly assigned into four groups： blank group， model group， SWT high-dose group， and SWT low-dose group. Except the blank group， the other three groups were underwent intragastric administration of TWP tablets at a dose of 50 mg·kg-1 for 14 days. On day 15， the high-dose group was administrated at 3 times of the human dosage （40 g/person/day）， the low-dose group at 1.5 times of the human dosage， and the model group and the blank group with the same volume of normal saline for 18 days. Then， feces were collected for 16S rRNA sequencing. One hour after administration， blood was sampled from abdominal aorta after anesthesia for the measurement of hormone levels by radioimmunoassay， and ovaries were sampled， embedded， sliced， and stained with haematoxylin-eosin （HE） for pathological observation. ResultThe model group had higher level of luteinizing hormone （LH， P<0.05） and lower level of estradiol （E2， P<0.05） than the blank group. The SWT high-dose group and low-dose group had lower LH levels （P<0.05） and higher E2 levels than the model group （P<0.05）. SWT reversed the elevation in follicle-stimulating hormone （FSH） and LH levels and the decline in E2 and progesterone （P） levels caused by TWP to some extent. There were a large number of follicles at different developmental stages in the blank group， while atretic follicles increased significantly in the model group. A large number of mature follicles， secondary follicles， and primary follicles were observed in the high-dose SWT group， and primordial follicles， secondary follicles， and increased corpus luteum in the low-dose SWT group. Compared with that in the blank group and the administration group， the abundance of Verrucomicrobia and Epsilonbacteraeota in the model group significantly reduced. Compared with the blank group， the model group had different intestinal flora in phylum， class， order， family， and genus levels. Specifically， the model group had increased proportions of Firmicutes and Bacteroidetes. After TWP modeling， the abundance of Lachnospiraceae decreased significantly while that of Ruminococcaceae UCG-005 increased significantly. SWT groups， blank group， and model group can be clearly distinguished， and SWT groups had a tendency to approach the blank group. ConclusionSWT may improve the ovarian function of rats with TWP-induced DOR by regulating intestinal flora diversity.

Practice of applying the growth research index performance model to improve the discipline competitiveness of prefecture-level hospitals / 中华医学科研管理杂志

Objective:Build a research index performance model with discipline growth evaluation, to evaluate the scientific research performance level of various disciplines in hospital more objectively, fairly and dynamically.Methods:Take the research projects, papers, patents and achievements as the main evaluation indicators and establish the hierarchical and classified scoring standards, to form the weight index evaluation model for the total score, per capita score and growth of the discipline research.Results:Using the growth research index to evaluate the scientific research performance of departments and individual researcher between January 2018 and December 2020. Excellent departments were selected for the top 10% of the scientific research index, those whose scientific research scores increased by more than 20% compared with the previous year were selected as the progressive departments, and the top 1% of individual scientific research scores were selected as the advanced researchers, which were commended and encouraged. For the departments ranked in the bottom 5% or whose scientific research index significantly declined compared with previous year, early warning, guidance and supervision were implemented. Since the implementation of the evaluation system, the research performance of disciplines has been significantly improved, and many achievements were made.Conclusions:This evaluation mode can stimulate the enthusiasm of the disciplines and scientific researchers for entrepreneurship and innovation to set up the standards and promote the continuous improvement of the research capacity of the whole hospital.

The Hammersmith Infant Neurological Examination for following-up the gross motor development of high-risk infants / 中华物理医学与康复杂志

Objective:To explore the ability of the Hammersmith Infant Neurological Examination (HINE) to predict the gross motor development of high-risk infants.Methods:A total of 207 high-risk infants were assessed with the HINE and the Gesell Developmental Schedule (GDS) at the ages of 3, 6, 9 and 12 months. They were then divided into a normal development group and a delayed group according to their gross motor development at 12 months old. The validity of the HINE′s discrimination was quantified retrospectively as the difference in the total HINE score at each follow-up month between the two groups. Spearman coefficients relating the total HINE score with the gross motor development quotient from the GDS were calculated at each follow-up month. The HINE′s total score threshold for predicting gross motor retardation at 12 months was determined from a receiver operating characteristics curve, and the predictive validity, sensitivity and specificity were evaluated by calculating the area under the curve.Results:At each time point the average total HINE score of the delayed group was significantly lower than the normal group′s average. The correlation between the HINE total scores and the GDS gross motor development quotients was strongest at 6 months old, and weakest at 3 months. The threshold total HINE score for predicting gross motor retardation at 12 months old was 60 at 3 months, 67 at 6 months, and then 71. The instrument′s sensitivity and specificity were very good at all four time points.Conclusion:The HINE can usefully predict gross motor retardation in the first year of life for high-risk infants. The critical value of the total score can be used as an auxiliary diagnostic reference for neuromotor development in such infants.

Role of Sirt3 expression in peritoneal macrophages in dexmedetomidine-induced inhibition of inflammatory responses in septic mice / 中华麻醉学杂志

Objective:To evaluate the role of nicotinamide adenine dinucleotide-dependent deacetylase Sirtuin3 (Sirt3) expression in peritoneal macrophages in dexmedetomidine-induced inhibition of inflammatory responses in septic mice.Methods:Sixty-four healthy male C57BL/6 mice, aged 7 weeks, weighing about 20 g, were divided into 4 groups ( n=16 each) using a random number table method: sham operation group (S group), sepsis group (Sep group), dexmedetomidine group (DEX group), and dexmedetomidine plus Sirt3 inhibitor 3-TYP group (TYP group). Sepsis was induced by cecal ligation and puncture.In group DEX, normal saline 0.25 ml was intraperitoneally injected at 1 h before development of the model, and 30 min later dexmedetomidine 50 μg/kg (in 0.25 ml of normal saline) was intraperitoneally injected.In group S and group Sep, the equal volume of normal saline was intraperitoneally injected at 1 h and 30 min before development of the model, respectively.In group S, laparotomy and cecal extraction were performed without ligation and perforation.Peritoneal lavage was obtained at 24 h after operation, and peritoneal macrophages were cultured for 1 h. The expression of Sirt3, interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) mRNA in peritoneal macrophages was detected using quantitative real-time polymerase chain reaction.Western blot was used to detect the expression of Sirt3 in peritoneal macrophages.The concentrations of IL-1β and TNF-α in peritoneal fluid were measured by enzyme-linked immunosorbent assay.The 10-day survival of mice in each group was observed, and the survival rates were calculated. Results:Compared with group S, the expression of Sirt 3 protein and mRNA in peritoneal macrophages was significantly down-regulated, the expression of IL-1β and TNF-α mRNA was up-regulated, the concentrations of IL-1β and TNF-α in peritoneal lavage were increased, and the 10-day survival rates were decreased in Sep, DEX and TYP groups ( P<0.05). Compared with group Sep, the expression of Sirt3 protein and mRNA in peritoneal macrophages was significantly up-regulated, the expression of IL-1β and TNF-α mRNA was down-regulated, the concentrations of IL-1β and TNF-α in the peritoneal lavage were decreased, and the 10-day survival rate was increased in group DEX ( P<0.05). Compared with group DEX, the expression of Sirt3 protein and mRNA and IL-1β and TNF-α mRNA in peritoneal macrophages was significantly up-regulated, the concentrations of IL-1β and TNF-α in peritoneal lavage were increased, and the 10-day survival rate was decreased in group TYP ( P<0.05). Conclusions:Up-regulation of Sirt3 expression in peritoneal macrophages is involved in the process of dexmedetomidine-induced inhibition of inflammatory responses in septic mice.

A qualitative study of the expectations and value of patients with malocclusion for participation in shared decision making in orthognathic surgery options / 中国实用护理杂志

Objective:To explore the expectations and values of patients with malocclusion on participation in shared decision-making of orthognathic surgical protocols, and to provide references for further development of clinical shared decision-making models.Methods:Based on the expected value theory and descriptive qualitative research methods, using purposive sampling, 13 patients with malocclusion in the Ninth People's Hospital of Shanghai Jiao tong University School of Medicine from May to August in 2021 were selected for semi-structured interviews. The interview data were sorted, classified and refined by traditional content analysis.Results:Two themes were extracted: patients' ability beliefs about their ability to participate in shared decision making for orthognathic surgery(decision support ability, psychological coping ability and environmental adaptability), and task values for shared decision making for orthognathic surgery(interest value, acquisition value).Conclusions:Low level of patients′ ability beliefs in shared decision-making, active physician guidance facilitates patient participation, but the depth of patient participation is influenced by factors such as information support, cultural climate, and physical space for shared decision making. It is suggested that the magnetic role of physicians should be actively played, the shared decision-making team should be strengthened, at the same time, hospital manager should enhance shared decision making propaganda to increase the acceptance and participation of patients in shared decision making so as to improve the quality of shared decision-making.

Transforming growth factor-β1 induces transformation of rat meningeal fibroblasts into myofibroblasts by upregulating Shh signaling / 南方医科大学学报

OBJECTIVE@#To investigate the effect of TGF-β1 on Shh signaling pathway during the transformation of meningeal fibroblasts into myofibroblasts.@*METHODS@#Primary meningeal fibroblasts were isolated from neonatal (24 h) SD rats and purified using type Ⅳ collagenase. The isolated cells were treated with 10 ng/mL TGF-β1 alone or in combination with 20 μmol/L SB-431542 (a TGF-β1 receptor inhibitor) for 72 h, and the changes in proliferation and migration abilities of the fibroblasts were assessed with CCK-8 assay and cell scratch test. The expression of fibronectin (Fn) was detected with immunofluorescence assay, and Western blotting was performed to examine the expressions of Fn, α-SMA and Shh protein in the cells; the expression of Shh mRNA was detected with real-time fluorescence quantitative PCR.@*RESULTS@#TGF-β1 treatment obviously enhanced the proliferation and migration of primary meningeal fibroblasts (P < 0.05), and promoted the transformation of meningeal fibroblasts into myofibroblasts and the secretion of Fn (P < 0.05). TGF-β1 treatment also upregulated the expression of Shh at both protein and mRNA levels (P < 0.05). Treatment with SB-431542 partially blocked the effect of TGF-β1 on the transformation of meningeal fibroblasts (P < 0.05).@*CONCLUSION@#TGF-β1 can induce the transformation of meningeal fibroblasts into myofibroblasts by up-regulating Shh expression in Sonic Hedgehog signaling pathway.