Mediating role of stressful life events between sleep chronotype and depressive mood in adolescents / 中国学校卫生

Objective@#A longitudinal mediating model was designed to explore the relationship between sleep chronotype and depressive mood with stressful life events as the mediating variable, so as to provide reference basis for preventing depression in adolescents.@*Methods@#From March (T1) to October (T2) 2022, the Munich Chronotype Questionnaire, and Adolescent Self-rating Life Events Checklist and Center for Epidemiologic Studies Depression Scale were administered in 1 251 middle school students in the first and second grades of a middle school in Meishan, Sichuan Province for a follow up study. Two wave of date on sleep time type, stressful life events, and depressive moods were collected.@*Results@#At T1, the detection rate of depressive mood was 22.5% in adolescents but 27.0% at T2.At the same time point, there were significant positive correlations between chronotype, stressful life events and depressive mood ( r=0.06-0.69, P <0.05). Cross lagged model results showed that early sleep chronotype could significantly predict later depressive mood ( β=0.53, P <0.05), and early depressive mood could significantly predict later sleep chronotype ( β=0.01, P <0.01). Longitudinal mediation model analysis showed that T1 sleep chronotype not only directly affected T2 depressive mood (direct effect value=1.421, 95% CI =0.985- 1.858 , P <0.01), but also affect T2 depressive mood through the partial mediating effects of T2 stressful life events (indirect effect value=1.268, 95% CI =0.810-1.726, P <0.05). Although T1 depressive mood was a direct predictor of T2 sleep chronotype (direct effect value=0.025, 95% CI =0.017-0.032), it was not a direct predictor of T2 sleep chronotype by partial intermediate action of T2 stressful life events (indirect effect value=-0.001, 95% CI = -0.006- 0.004, P >0.05).@*Conclusions@#Sleep chronotype can not only directly predict depressive mood of adolescents, but also indirectly affect depressive mood of adolescents through the longitudinal mediating effect of stressful life events. To prevent depression and improve mental health in this population, adolescents should develop the habit of early sleep schedule, and improve their ability to cope with stressful life events.

Analysis of 50 cases of bloodstream infection with Listeria monocytogenes / 中国热带医学

@#Abstract: Objective　To analyze the characteristics of bloodstream infection of Listeria monocytogenes and provide basis for the diagnosis and treatment of the disease. Methods　We retrospectively analyzed the cases of Listeria monomyrhosi bloodstream infection in Peking Union Medical College Hospital (PUMCH) from April 2012 to April 2022. The age, sex, onset time, underlying disease, symptoms, diagnosis, treatment and prognosis of the patients were analyzed, as well as the changes of white blood cells (WBC), neutrophils, lymphocytes, and C-reactive protein (CRP) before and after anti-infection treatment. Results　Fifty cases of Listeria monocytogenes bloodstream infection confirmed by blood culture were involved. The age of patients ranged from 0 to 82 (43.7±20.0) years old, among whom 20.0% were over 60 years old. The onset time of patients was the highest in spring (44.0%), followed by winter (24.0%), and relatively fewer in summer and autumn (14.0%-18.0%). The median diagnosis time was 3 days (1-60 days). After the etiological diagnosis, 45 patients (90.0%) had underlying diseases or pregnancy status, and 45 patients were adjusted to the target antibacterial treatment mainly with carbapenems (48.9%) and penicillins (44.4%). The level of WBC, neutrophils, lymphocytes, monocytes, and CRP after treatment were significantly lower than those pre-treatments (P<0.05). Among all patients, 36 cases (72.0%) were treated according to the Antimicrobial Treatment Guidelines for Fever Sanford, of which 26 cases (72.2%) were discharged from the hospital, two cases died, one case was transferred to other hospitals, and 7 cases had a poor prognosis. Conclusions　Autoimmune diseases, tumor diseases, pregnant patients are susceptible to Listeria monocytogenes infection. Penicillins are the first choice for effective empiric therapy. For the patients allergic to penicillins, trimethoprim/sulfamethoxazole or meropenem could be used.

Advances in basic research on choline and central nervous system development and related disorders / 中华预防医学杂志

Choline is an essential nutrient that plays an integral role in all stages of the life cycle, with increasing interest in the relationship between choline and neurodevelopment. Choline is a major component in the synthesis of phospholipids, phosphatidylcholine and sphingolipids, and is an essential nutrient for methyl metabolism, acetylcholine synthesis and cell signaling. Choline plays an important role in neurogenesis and neural migration during fetal development, potentially influencing the development and prognosis of neurological disorders, but its mechanism of action is not yet clear. This article reviews the source and metabolism of choline, the effects and mechanism of choline on neurodevelopment and central nervous system related disorders.

Inhibition of LAMP3 mediates the protective effect of vitamin D against hypoxia/reoxygenation in trophoblast cells

Inadequate invasion and excessive apoptosis of trophoblast cells are associated with the development of preeclampsia. Vitamin D deficiency in pregnant women may lead to an increased risk of preeclampsia. However, the underlying mechanisms by which vitamin D is effective in preventing preeclampsia are not fully understood. The objectives of this study were to investigate the role of lysosome-associated membrane glycoprotein 3 (LAMP3) in the pathogenesis of preeclampsia and to evaluate whether vitamin D supplementation would protect against the development of preeclampsia by regulating LAMP3 expression. Firstly, the mRNA and protein levels of LAMP3 were significantly upregulated in the placentas of preeclampsia patients compared to normal placentas, especially in trophoblast cells (a key component of the human placenta). In the hypoxia/reoxygenation (H/R)-exposed HTR-8/Svneo trophoblast cells, LAMP3 expression was also upregulated. H/R exposure repressed cell viability and invasion and increased apoptosis of trophoblast cells. siRNA-mediated knockdown of LAMP3 increased cell viability and invasion and suppressed apoptosis of H/R-exposed trophoblast cells. We further found that 1,25(OH)2D3 (the hormonally active form of vitamin D) treatment reduced LAMP3 expression in H/R exposed trophoblast cells. In addition, 1,25(OH)2D3 treatment promoted cell viability and invasion and inhibited apoptosis of H/R-exposed trophoblast cells. Notably, overexpression of LAMP3 abrogated the protective effect of 1,25(OH)2D3 on H/R-exposed trophoblast cells. Collectively, we demonstrated trophoblast cytoprotection by vitamin D, a process mediated via LAMP3.

Burden of lung cancer attributable to household air pollution in the Chinese female population: trend analysis from 1990 to 2019 and future predictions / Carga de doença devida a câncer de pulmão atribuível à poluição do ar domiciliar na população feminina chinesa: análise de tendências de 1990 a 2019 e previsões futuras / Carga de morbilidad del cáncer de pulmón atribuible a la contaminación del aire doméstico en la población femenina china: análisis de tendencias de 1990 a 2019 y predicciones futuras

This study analyzes the long-term trend of the burden of lung cancer attributable to household air pollution in the Chinese female population, from 1990 to 2019, and make predictions for the next decade. Based the data from the 2019 Global Burden of Diseases (GBD 2019), the joinpoint regression model was used to reflect the temporal trend of the burden of lung cancer attributable to household air pollution, and an autoregressive integrated moving average (ARIMA) model was used to predict the burden of disease over the next decade. From 1990 to 2019, the age-standardized mortality and disability-adjusted life years (DALYs) rates of the Chinese female population were higher than the global rates, and the gap due to residential radon increased over time. The burden of lung cancer attributable to solid fuels has shown a significant downward trend while that due to residential radon has increased slightly overall, but remains lower than the former. The burden of lung cancer increased with age, and the peak age of DALYs rates changed from 70 < 75 years in 1990 to 75 < 80 years in 2019. The model predicted that the burden of lung cancer attributable to solid fuels will gradually decrease over the next decade, whereas the burden of lung cancer due to residential radon will gradually increase and surpass the burden due to solid fuels in 2023. Residential radon will become a more important factor of household air pollution than solid fuels in the next decade for the Chinese female population. Future interventions targeted at household air pollution are needed to reduce the burden of lung cancer.

O objetivo do texto foi analisar a tendência a longo prazo da carga da doença devida a câncer de pulmão atribuível à poluição atmosférica domiciliar na população feminina chinesa de 1990 a 2019 e fazer previsões para a próxima década. Com base nos dados da Carga Global de Doenças 2019 (GBD 2019), o modelo de regressão joinpoint foi utilizado para refletir a tendência temporal da carga da doença devida a câncer de pulmão atribuível à poluição atmosférica domiciliar e um modelo autorregressivo de média móvel integrada (ARIMA), para prevê-la na próxima década. Entre 1990 e 2019, as taxas de mortalidade padronizada por idade e esperança de vida corrigida pela incapacidade (DALYs) da população feminina chinesa foram maiores do que as taxas globais e a diferença devido à exposição residencial a radônio aumentou ao longo do tempo. A carga da doença atribuível a combustíveis sólidos mostrou uma tendência significativa à queda, enquanto aquela devida à exposição residencial a radônio aumentou ligeiramente no geral, mas permanece menor que a primeira. A carga da doença aumentou com a idade, e a idade máxima das taxas de DALYs passou de 70 < 75 anos em 1990 para 75 < 80 anos em 2019. Nosso modelo previu que a carga da doença atribuível aos combustíveis sólidos diminuirá gradualmente na próxima década, enquanto a carga da doença devida ao radônio aumentará paulatinamente e superará a carga devida aos combustíveis sólidos em 2023. A exposição residencial ao radônio se tornará um fator mais importante à poluição atmosférica domiciliar para a população feminina chinesa do que os combustíveis sólidos na próxima década. Futuras intervenções direcionadas à poluição atmosférica domiciliar são necessárias para reduzir a carga do câncer de pulmão.

El objetivo fue analizar la tendencia a largo plazo de la carga de morbilidad del cáncer de pulmón atribuible a la contaminación del aire doméstico en la población femenina china de 1990 a 2019 y hacer predicciones para la próxima década. Según los datos de la Carga Global de Enfermedad de 2019 (GBD 2019), se utilizó el modelo de regresión joinpoint para reflejar la tendencia temporal de la carga de morbilidad pulmonar atribuible a la contaminación del aire doméstico y un modelo autorregresivo integrado de media móvil (ARIMA) para predecir la carga de morbilidad durante la próxima década. De 1990 a 2019, las tasas de mortalidad estandarizadas por edad y años de vida ajustados por discapacidad (AVAD) de la población femenina china fueron más altas que las tasas mundiales, y la brecha debida al radón residencial aumentó con el tiempo. La carga de morbilidad atribuible a los combustibles sólidos mostró una significativa tendencia decreciente, mientras que la del radón residencial aumentó ligeramente, pero en niveles inferiores a la anterior. La carga de morbilidad aumentó con la edad, y las tasas de edad máxima de AVAD cambiaron de 70 < 75 años en 1990 a 75 < 80 años en 2019. El modelo predijo que la carga de morbilidad atribuible a los combustibles sólidos disminuirá gradualmente durante la próxima década, mientras que la carga de morbilidad por radón residencial aumentará gradualmente y superará la carga debida a los combustibles sólidos en 2023. El radón residencial se convertirá en un factor más importante de contaminación del aire doméstico que los combustibles sólidos en la próxima década para la población femenina china. Se necesitan intervenciones futuras dirigidas a la contaminación del aire doméstico para reducir la carga del cáncer de pulmón.

Correlation between circadian rhythm,emotion regulation and depressive symptoms among adolescents / 中国学校卫生

Objective@#To investigate association between adolescent depressive symptoms with circadian rhythm and emotion regulation strategies, and to provide the basis for mental health education for depression.@*Methods@#CES-D, Morning and Evening Questionnaire-5 (MEQ-5) and Emotion Regulation scale (ERS) were administered to 2 398 students from 6 middle schools in Chengdu, Langzhong and Leshan of Sichuan Province. SPSS 21.0 was used to data processing and anlysis.@*Results@#About 37.9% (909/2 398) of adolescents reported depressive symptoms. Prevalence of depressive symptom was higher in female students( χ 2= 25.15 , P <0.01), rural adolescents( χ 2=15.45, P <0.01), adolescents aged 15-18 compared to aged 12-14( χ 2=187.24, P < 0.01 ). There was significant difference in rate of depressive symptoms among adolescents with different circadian rhythms( χ 2= 55.19 , P < 0.01 ), with definite evening rhythm preference was the highest(57.1%). Prevalence of depressive symptoms significantly varied by sleep duration( χ 2=141.99, P <0.01), and were highest in adolescents with sleep duration <6 h(69.4%). The scores of suppression dimension in depressed adolescents were significantly higher than that of non depressive group, while the scores of reappraisal dimension were significantly higher in non depressive group than that of depressive group. Multivariate Logistic regression analysis showed that gender( OR =1.60), age( OR=2.29), suppression( OR = 1.13 ), sleep duration <6 h( OR =5.17), sleep duration 6-8 h ( OR =2.88) were positively associated with depressive symptoms in adolescents. Moderate type( OR =0.53), morning type ( OR =0.55) and cognitive reappraisal ( OR =0.90) were associated with lower rate of depressive symptoms( P <0.05).@*Conclusion@#Sleep rhythm delay, lack of sleep and emotion suppression in adolescents are associated with higher risk for depression. Regular sleep habits and reasonable emotion regulation might help to prevent adolescent depression.

Effect of Vitamin D3 to Platelet Activation Mediated by Tumor Cell Culture Medium / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of vitamin D3 to platelet activation by tumor cell culture medium.@*METHODS@#The peripheral blood platelets of BALB/c mice were isolated. The platelets were activated in 4T1 culture fluid for 24 h. The platelets were divided into 7 groups: control group, activation group, 1 nmol/L vitamin D3 group, 10 nmol/L vitamin D3 group, 50 nmol/L vitamin D3 group, 100 nmol/L vitamin D3 group, and positive drug (0.1 μmol/L eptifibatide) group. CCK-8 assay was used to detect the platelet proliferation at 24, 48 and 72 h. Flow cytometry was used to detect the expression of CD61 and CD62p and receptor for advanced glycation end products (RAGE) at 24, 48 and 72 h. ELISA was used to detect the level of platelet-endothelial cell adhesion molecule-1 (PECAM-1) at 24, 48 and 72 h.@*RESULTS@#The CD41@*CONCLUSION@#Vitamin D3 shows antiplatelet effect and can inhibit platelet proliferation and activation.

Responses to child sexual assaults and associated factors among parents of young children / 中国学校卫生

Objective@#To analyze the possible responses of parents of young children to Child sexual assault (CSA) and the potential influencing factors, so as to provide evidence for prevention programs of CSA.@*Methods@#Part of the data from "2016-2020 Child Injury Prevention Project" was used to analyze responses to CSA among parents of children younger than 3rd grade in primary school by chi square test and Logistic regression analysis.@*Results@#A total of 4 072 parents were included in the analysis. Among them, 86.8% of parents chose "to solve problems together", 51.0% of parents taking children to a "psychologist", 4.9% of parents "scolding children for being too careless", 2.9% of parents "letting child not disclose abuse" and 6.5% of parents chose "other" coping methods. Parents with foreign nationality [OR(95%CI)=2.58(1.25-5.15)] and lower education level (OR=0.26-0.64) tend to "blame" their children. Mothers [(OR(95%CI)=0.54(0.33-0.90)], higher parental education level (OR=0.27-0.72) were more reluctant to encourage their children to keep quiet. Mothers [OR(95%CI)=1.73(1.32-2.27)], older children (OR=1.33-1.78) and parents with higher education level (OR=1.65-2.99) tend to "accompany". Parents aged 30 or more, and from high school/technical school/technical secondary school tend to take their children to see a "psychologist" [OR(95%CI)=1.39(1.14-1.71), 1.79(1.26-2.53)].@*Conclusion@#Parents universally pay attention to the physical and mental health of children after CSA, but some parents still take negative coping methods, e.g. "blame" and "not disclose". Parenting educational level, duration of parent-child communication and age of children are primary factors associated with parental responses to child sexual assault. This study suggests that prevention secondary injury following child sexual assault should be farther strengthened, while fully considering the characteristics of the educated objects.

Expert consensus on Tongsaimai Tablets/Capsules in treatment of peripheral vascular diseases in clinical practice / 中国中药杂志

Tongsaimai Tablets/Capsules are composed of Lonicerae Japonicae Flos, Angelicae Sinensis Radix, Achyranthis Bidentatae Radix, Codonopsis Radix, Dendrobii Caulis, Astragali Radix, Scrophulariae Radix, and Glycyrrhizae Radix et Rhizoma, and are effective in promoting blood circulation, removing blood stasis, supplementing Qi, and nourishing Yin. It is widely used in the treatment of peripheral vascular diseases. With 40 years of clinical application, it has accumulated substantial research data and application experience. Its good clinical efficacy and pharmacoeconomic benefits in improving the clinical symptoms of peripheral vascular diseases have been confirmed by relevant research. Meanwhile, this drug has also been recommended by many expert consensus, guidelines, and teaching materials, serving as one of the most commonly used Chinese patent medicines in clinical practice. To further improve the understanding of the drug among clinicians and properly guide its clinical medication, the China Association of Chinese Medicine took the lead and organized experts to jointly formulate this expert consensus. Based on the questionnaire survey of clinicians and the systematic review of research literature on Tongsaimai Tablets/Capsules with clinical problems in the PICO framework, the consensus, combined with expert experience, concludes recommendations or consensus suggestions by GRADE system with the optimal evidence available through the nominal group technique. This consensus defines the indications, usage, dosage, course of treatment, medication time, combined medication, and precautions of Tongsaimai Tablets/Capsules in the treatment of peripheral vascular diseases, and explains the safety of its clinical application. It is recommended for clinicians and pharmacists in the peripheral vascular department(vascular surgery), traditional Chinese medicine surgery(general surgery), and endocrinology department of hospitals at all levels in China.

Flavonoid Luteolin Enhances Calcium Overload in Mouse Photoreceptors

Background Calcium overload is one of the main reasons that cause photoreceptor apoptosis during theirdegeneration. Our recent data show that flavonoid luteolin protects mouse retinal photoreceptors in diseasedmodel. Aim To explore how luteolin affects the calcium overload in mouse retinal photoreceptors. Methods Fluo4 AM was loaded into retinal slices of wild type mice. Fluorescent images were taken every 5s to monitor thechanges of calcium signal in the soma of photoreceptor. Tissue was perfused with Ringer’s solution as control,then luteolin for 10 min and then Ringer’s as washout. During the perfusion of each solution, high K+ solution wasapplied to elicit calcium overload in photoreceptors. Fluorescent intensity of the photoreceptor soma wasmeasured and compared between control and luteolin solution. Results The high K+ induced-peak fluorescentintensity of Fluo-4 after luteolin treatment was significant higher than that perfused with control solution.Conclusion Luteolin enhances calcium overload in mouse retinal photoreceptors.

Influence of warming needling technique on gastrointestinal reaction after hyperthermic intrape-ritoneal chemotherapy in patients with postoperation of colon cancer / 针刺研究

OBJECTIVE: To observe the effect of warming needling therapy on gastrointestinal reaction after hyperthermic intraperitoneal chemotherapy (HIPEC) in patients of spleen and stomach deficiency syndrome after colon cancer surgery. METHODS: A total of 120 cases of HIPEC were randomized into observation group and control group, 60 cases in each. The patients of the two groups all received HIPEC. In the observation group, 1 h before HIPEC, warming needling technique was applied to Zusanli (ST36), Sanyinjiao (SP6) and Yinlingquan (SP9) and the even-needing technique of acupuncture was applied to Neiguan (PC6) for 30 min, and then the intravenous injection with Ondansetron was given 30 min before HIPEC. In the control group, The intravenous injection with Ondansetron was given 30 min before HIPEC. In the two groups, the changes in nausea, vomiting, abdominal distention, diarrhea, total bilirubin (TB), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and KPS score, as well as the average hospitalization length of stay were observed. RESULTS: The total effective rates in the treatment of nausea, vomiting, abdominal distention and diarrhea were 91.67%(55/60), 93.33%(56/60), 80.00%(48/60) and 88.33%(53/60) in the observation group and were 78.33%(47/60), 78.33%(47/60), 63.33%(38/60) and 70.00%(42/60) in the control group respectively, and the total effective rate in the treatment of gastrointestinal reaction of HIPEC in the observation group was obviously higher than that in the control group(P0.05). CONCLUSION: The warming needling technique of acupuncture and moxibustion alleviates the gastrointestinal reaction, improves KPS score and reduces the hospitalization length of stay in HIPEC patients after the surgery of colon cancer and differentiated as the spleen and stomach deficiency in traditional Chinese medicine.

Effect of RNA N6-methyladenosine on immunoregulation / 上海交通大学学报（医学版）

N6-methyladenosine (m6A) is the most prevalent and abundant post-transcriptional RNA modification in eukaryotes. m6A is a dy-namic and reversible process catalyzed by m6A methyltransferase complex and demethylase. m6A is involved in the regulations of gene expres-sion and biological processes. Recently, researches have discovered that m6A plays a vital role in the differentiation and regulation of immune cells, which could provide a new idea for the research and therapy of immune-related diseases. The present article reviews the recent progresses of m6A in immunoregulation.

Clinical effect of Guanggu Jisheng decoction in treatment of recovery stage coronavirus disease 2019 / 第二军医大学学报

Objective To observe the clinical effect of Guanggu Jisheng decoction on the treatment of coronavirus disease 2019 (COVID-19) during recovery stage. Methods A total of 122 convalescent COVID-19 patients in Guanggu Branch of Maternity and Child Healthcare Hospital of Hubei Province were treated with Guanggu Jisheng decoction for 3 consecutive courses, each course lasting 3 days. The changes of traditional Chinese medicine (TCM) syndromes before and after treatment were compared. Scores were recorded according to the laboratory testing and the severity of symptoms (no symptom, mild, common and severe) to investigate the clinical curative effect of Guanggu Jisheng decoction on the treatment of convalescent COVID-19. Results According to the TCM syndrome scores, after one course of treatment (3 days), the total effective rate was 75.41% (92/122), with the effective rate being 31.97% (39/122), the significant efficiency being 21.31% (26/122), and the clinical recovery rate being 22.13% (27/122). After two courses of treatment (6 days), the total effective rate was 86.89% (106/122), with the effective rate being 32.79% (40/122), the significant efficiency being 28.69% (35/122), and the clinical recovery rate being 25.41% (31/122). After three courses of treatment (9 days), the total effective rate was 88.52% (108/122), with the effective rate being 16.39% (20/122), the significant efficiency being 31.15% (38/122), and the clinical recovery rate being 40.98% (50/122). The symptoms of cough, fatigue, shortness of breath and sweating were significantly improved. No patients turned positive again from negative of respiratory pathogen nucleic acid. Conclusion Guanggu Jisheng decoction has a good clinical effect on convalescent COVID-19 patients. It can significantly improve the clinical symptoms.

Comparable effects of Jiedu Granule, a compound Chinese herbal medicine, and sorafenib for advanced hepatocellular carcinoma: A prospective multicenter cohort study / 中西医结合学报

OBJECTIVE@#Sorafenib has been extensively used for the treatment of advanced hepatocellular carcinoma (HCC), and Chinese herbal medicine has also been used to manage advanced HCC. The present work evaluates the effectiveness and safety of Jiedu (JD) Granule, a compound of traditional Chinese herbal medicine, side-by-side with sorafenib for the treatment of advance HCC.@*METHODS@#Patients with advanced HCC receiving treatment with JD Granule or sorafenib were enrolled from December 2014 to March 2018. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS) and safety. Propensity score matching (PSM) analysis was used to control for possible selection bias from the study group allocation process.@*RESULTS@#Of the 325 patients included, 161 received JD Granule and 164 received sorafenib. No significant differences were found in OS or PFS among patients receiving JD Granule compared to sorafenib (P > 0.05). Median OS of the two study groups was 6.83 months (95% confidence interval [CI]: 5.83-9.47) in the group receiving JD Granule and 8 months (95% CI: 6.67-9.80) in the group receiving sorafenib, with half-, 1- and 2-year survival rates of 53.6%, 31.2% and 13.2% vs 60.1%, 35.5% and 14.2%, respectively. Even after PSM, the median survival time did not differ between the JD Granule group (9.03 months; 95% CI: 6.37-14.2) and the sorafenib group (7.93 months; 95% CI: 6.5-9.97), with comparable half-, 1- and 2-year survival rates. The most common adverse events (AEs) were diarrhea (13.7%) and fatigue (5.6%) in the JD Granule group, and hand-foot skin reaction (46.3%) and diarrhea (36.6%) in the sorafenib group. The JD Granule was more cost-effective than sorafenib treatment for advanced HCC.@*CONCLUSION@#Compared to sorafenib, JD Granule was more cost-effective and caused fewer AEs for the treatment of Chinese patients with advanced HCC.

Awareness of palliative care and its influencing factors in community residents in Hangzhou / 预防医学

Objective@# To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service.@*Methods@#By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors.@*Results @#A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old（OR = 0.467,95% CI：0.285-0.767）,primary school education and below（OR = 2.248,95%CI：1.239-4.079）and experience of caring for dying patients（OR = 1.551,95% CI：1.094-2.199）were the influencing factors for the awareness of palliative care. @*Conclusion@#The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.

Based on PI3K/Akt/mTOR Signaling Pathway to Explore Mechanism of Zhigancao Tang Against MIRI-induced Ventricular Tachycardia and Ventricular Fibrillation in Rats / 中国实验方剂学杂志

Objective:Through phosphatidylinositol 3-kinase（PI3K）/protein kinase B （Akt）/mammalian rapamycin target protein （mTOR） signaling pathway， explore the effect of Zhigancao Tang on myocardial ischemia-reperfusion injury（MIRI）The role and mechanism of arrhythmia（ventricular tachycardia and ventricular fibrillation）. Method:The 72 SD rats were randomly divided into sham operation group，model group， Zhigancao Tang low，medium and high dose group（11.43，22.86，45.72 g·kg-1），Wenxin granule group（2.43 g·kg-1），continuous drug intervention for 10 days. Two hours after the last administration，the MIRI model of rat was prepared by ligating the left anterior descending coronary artery，and the changes of electrocardiogram were recorded. After successful modeling，blood and heart tissue were collected to detect the content of creatine creatine（CK），lactate dehydrogenase（LDH）and aspartate aminotransferase（AST）in the serum, the enzyme-linked immunoassay（ELISA） method was used to detect cardiac troponin（CtnI）content, immunohistochemical detection of myocardial PI3K，Akt，mTOR expression. Western blot was used to detect the myocardial autophagy-related protein microtubule-associated protein 1 light chain 3（LC-3），autophagy markers Beclin1 and PI3K/Akt/mTOR signaling pathway related protein expression and phosphorylated p-PI3K，p-Akt，p-mTOR levels. Result:In model group， 100% of ventricular tachycardia and 91.67% of ventricular fibrillation occurred. Compared with sham operation group， the serum levels of CK，LDH，AST，and CtnI in the model group were significantly increased（P<0.01），PI3K，Akt，mTOR AOD values in myocardial tissue were significantly increased （P<0.01），the relative expression of the ratio of LC3-Ⅱ/LC3-Ⅰ and Beclin1 was significantly increased（P<0.01），p-PI3K/PI3K，p-Akt/Akt，and p-mTOR/mTOR were significantly reduced （P<0.01）. Compared with model group， the incidence of ventricular tachycardia and ventricular fibrillation in the high-dose Zhigancao Tang group was significantly reduced （P<0.01），and the duration was the shortest compared with other administration groups（P<0.01）， CK，LDH，AST level and CtnI content were significantly reduced（P<0.01）， the expression of PI3K，Akt and mTOR of Zhigancao Tang group was significantly decreased with increasing dose（P<0.01）， the expression of LC-3 and Beclin1 was accompanied by Zhigancao Tang increase of each dose group of soup had different degrees of decrease （P<0.01），while the expression ratio of PI3K/Akt/mTOR-related protein was significantly increased （P<0.05，P<0.01）. Conclusion:Pretreatment of Zhigancao Tang can reduce the abusually elevated cardiac enzymes CK, LDH, AST and CtnI, inhibit excessive autophagy of cells, and up-regulate the expression of PI3K, Akt and mTOR, indicating that the anti-MIRI arrhythmia effect of Zhigancao Tang may be related to the PI3K/Akt/mTOR signaling pathway.

Influence of childhood abuse on implicit and explicit self-esteem among children in Sichuan / 中国学校卫生

Objective@#To investigate association between childhood abuse and self-esteem among children in Sichuan.@*Methods@#A total of 700 students aged 10-16 years from four cities of Sichuan were selected through stratified random sampling method. All the participants were investigated with Screen Questionnaire of Child Abuse(SQCA), the Self-esteem Scale (SES) and the E-Prime based Implicit-Association Test(IAT).@*Results@#The prevalence of childhood abuse in Sichuan is 11.3%(65/574). Among them, 55.4% reported one type of abuse experience, 29.2% reported two types and 15.4% reported 3 or more types of abusive experiences. The average level of explicit self-esteem for the total sample children (x〖TX-*3〗=28.92, higher than 26) was in the medium level. For children with abuse experiences, explicit (t=-2.56, P<0.05) and implicit self-esteem (t=-2.40, P<0.05) was significantly lower than average level of the total sample. Educational background of primary caregivers was positively associated with explicit self-esteem(P<0.05). Gender and childhood abuse entered in the final regression model for implicit self-esteem(F=6.11, P<0.01), and childhood abuse negatively correlated with implicit self-esteem(t=-2.83, P<0.01).@*Conclusion@#Children with abuse experiences are more likely to have low implicit self-esteem.

Chronic wound biofilms: diagnosis and therapeutic strategies / 中华医学杂志(英文版)

OBJECTIVE@#To review the diagnosis of chronic wound biofilms and discuss current treatment approaches.@*DATA SOURCES@#Articles included in this review were obtained from the following databases: Wanfang, China National Knowledge Infrastructure, PubMed, and the Web of Science. We focused on research published before August 2019 with keywords including chronic wound, biofilm, bacterial biofilms, and chronic wound infection.@*STUDY SELECTION@#Relevant articles were selected by carefully reading the titles and abstracts. Further, different diagnosis and clinical treatment methods for chronic wound biofilm were compared and summarized from the selected published articles.@*RESULTS@#Recent guidelines on medical biofilms stated that approaches such as the use of scanning electron microscopy and confocal laser scanning microscopy are the most reliable types of diagnostic techniques. Further, therapeutic strategies include debridement, negative pressure wound therapy, ultrasound, antibiotic, silver-containing dressing, hyperbaric oxygen therapy, and others.@*CONCLUSION@#This review provides the identification and management of biofilms, and it can be used as a tool by clinicians for a better understanding of biofilms and translating research to develop best clinical practices.

Chronic wound biofilms: diagnosis and therapeutic strategies / 中华医学杂志(英文版)

Objective@#To review the diagnosis of chronic wound biofilms and discuss current treatment approaches.@*Data sources@#Articles included in this review were obtained from the following databases: Wanfang, China National Knowledge Infrastructure, PubMed, and the Web of Science. We focused on research published before August 2019 with keywords including chronic wound, biofilm, bacterial biofilms, and chronic wound infection.@*Study selection@#Relevant articles were selected by carefully reading the titles and abstracts. Further, different diagnosis and clinical treatment methods for chronic wound biofilm were compared and summarized from the selected published articles.@*Results@#Recent guidelines on medical biofilms stated that approaches such as the use of scanning electron microscopy and confocal laser scanning microscopy are the most reliable types of diagnostic techniques. Further, therapeutic strategies include debridement, negative pressure wound therapy, ultrasound, antibiotic, silver-containing dressing, hyperbaric oxygen therapy, and others.@*Conclusion@#This review provides the identification and management of biofilms, and it can be used as a tool by clinicians for a better understanding of biofilms and translating research to develop best clinical practices.

The traditional Chinese medicine formulation Ruanjian Sanjie Decoction regulates the tumor matrix and improves the anti-tumor efficacy of TP-PEG-LPs

The Ruanjian Sanjie Decoction (RSD) is a traditional Chinese medicine (TCM) formulation consisting of Spica Prunellae, Pseudobulbus Cremastrae Seu Pleiones, Concha Ostreae and Semen Coicis, and widely used as an adjuvant in anti-cancer therapy. The aim of this study was to determine the effects of RSD on the extracellular matrix (ECM) of tumors, and on the efficacy of anti-cancer nano-formulations in a tumor-bearing mouse model. The mice were treated with triptolide encapsulated in PEG-modified liposomes (TP-PEG-LPs), either alone or in combination with RSD. The combination treatment significantly retarded tumor growth relative to the untreated controls, indicating the potent adjuvant effect of RSD in targeted anti-cancer therapy. In addition, RSD also reduced the amount of total collagen and collagen I and increased that of collagen III in the tumor ECM, along with decreasing the expression of the pro-angiogenic VEGF. Finally, even high doses of RSD did not significantly affect the liver and kidney function or body weight, indicating low toxicity.