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Objective:To investigate the current status of research on the construction of leadership indicator system in the medical field at home and abroad, and to analyze the characteristics of the indicator system therein.Methods:This was a bibliometric study. The group applied subject keywords to search relevant literature on the construction of leadership indicator system in the medical field at home and abroad on English websites PubMed, Web of Science, Google Scholar, CINAHL, Scopus and Chinese websites Baidu Academic, CNKI, CQVIP, Wanfang Data Knowledge Service Platform, with a time frame of 2016-2023. The basic characteristics of the literature, the theoretical framework of the research application and the research theme were extracted, and the content of the indicator system in the literature was reviewed and summarized.Results:A total of 21 literatures were included, including 7 Chinese literatures and 14 English literatures. Of these literatures, 10 focused on physician leadership, 5 on medical manager leadership, and 2 on general practitioner leadership. Among 16 research literatures, 9 informed the theoretical basis of leadership, and 4 literatures were applied research. Five main themes were identified: leadership studies of individual healthcare administrators, leadership development in healthcare, interest and attitudes of healthcare workers towards leadership learning, applications of leadership in healthcare, and the impact of leadership in healthcare on patients and healthcare organizations.Conclusions:At present, research on the construction of the leadership indicator system in the medical field presents is diverse, with differences in theoretical basis and content. The original and empirical research is still insufficient.
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In order to understand the current status of the knowledge, attitude and practice (KAP) about prevention and control of COVID -19 in college students, and to provide theoretical basis for prevention and control work in college campus. This study investigated the KAP of COVID -19 of 1 847 college students in Shaanxi province by questionnaire using the convenience sampling method. Chisquare test and multivariate logistic regression analysis were used to analyze the influencing factors for the KAP of COVID -19. The results demonstrated that 48.3% of the students had a higher knowledge level of COVID -19, 11.7% had a fear attitude and 39.6% had good protective practices. Logistic regression results showed that female and urban household college students had higher cognitive level of COVID -19. The college students with anxiety state were more likely to have fear attitude. Students of female, urban household, anxiety, higher cognition and fear attitude showed better protective practices. The above results indicated that the knowledge level of COVID -19 in college students are not enough, and the attitude and protective practices need to be further improved. Therefore, relevant departments should follow the rules of KAP, carry out targeted propaganda and education on COVID -19 for college students, to improve their ability to cope with public health emergencies.
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Objective:To investigate the prognostic value of the ratio of veno-arterial carbon dioxide partial pressure difference to arterio-venous oxygen content difference (Pv-aCO 2/Ca-vO 2) in children with primary peritonitis-related septic shock. Methods:A retrospective study was conducted. Sixty-three children with primary peritonitis-related septic shock admitted to department of intensive care unit of the Children's Hospital Affiliated to Xi'an Jiaotong University from December 2016 to December 2021 were enrolled. The 28-day all-cause mortality was the primary endpoint event. The children were divided into survival group and death group according to the prognosis. The baseline data, blood gas analysis, blood routine, coagulation, inflammatory status, critical score and other related clinical data of the two groups were statistics. The factors affecting the prognosis were analyzed by binary Logistic regression, and the predictability of risk factors were tested by the receiver operator characteristic curve (ROC curve). The risk factors were stratified according to the cut-off, Kaplan-Meier survival curve analysis compared the prognostic differences between the groups.Results:A total of 63 children were enrolled, including 30 males and 33 females, the average age (5.6±4.0) years old, 16 cases died in 28 days, with mortality was 25.4%. There were no significant differences in gender, age, body weight and pathogen distribution between the two groups. The proportion of mechanical ventilation, surgical intervention, vasoactive drug application, and procalcitonin, C-reactive protein, activated partial thromboplastin time, serum lactate (Lac), Pv-aCO 2/Ca-vO 2, pediatric sequential organ failure assessment, pediatric risk of mortality Ⅲ in the death group were higher than those in the survival group. Platelet count, fibrinogen, mean arterial pressure were lower than those in the survival group, and the differences were statistically significant. Binary Logistic regression analysis showed that Lac and Pv-aCO 2/Ca-vO 2 were independent risk factors affecting the prognosis of children [odds ratio ( OR) and 95% confidence interval (95% CI) were 2.01 (1.15-3.21), 2.37 (1.41-3.22), respectively, both P < 0.01]. ROC curve analysis showed that the area under curve (AUC) of Lac, Pv-aCO 2/Ca-vO 2 and their combination were 0.745, 0.876 and 0.923, the sensitivity were 75%, 85% and 88%, and the specificity were 71%, 87% and 91%, respectively. Risk factors were stratified according to cut-off, and Kaplan-Meier survival curve analysis showed that the 28-day cumulative probability of survival of Lac ≥ 4 mmol/L group was lower than that in Lac < 4 mmol/L group [64.29% (18/28) vs. 82.86% (29/35), P < 0.05]. Pv-aCO 2/Ca-vO 2 ≥ 1.6 group 28-day cumulative probability of survival was less than Pv-aCO 2/Ca-vO 2 < 1.6 group [62.07% (18/29) vs. 85.29% (29/34), P < 0.01]. After a hierarchical combination of the two sets of indicator variables, the 28-day cumulative probability of survival of Pv-aCO 2/Ca-vO 2 ≥ 1.6 and Lac ≥ 4 mmol/L group significantly lower than that of the other three groups (Log-rank test, χ2 = 7.910, P = 0.017). Conclusion:Pv-aCO 2/Ca-vO 2 combined with Lac has a good predictive value for the prognosis of children with peritonitis-related septic shock.
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Objective:To investigate the related risk factors affecting the prognosis of hemorrhagic fever with renal syndrome(HFRS) in children.Methods:A retrospective study was carried out.We selected 182 pediatric patients who met the diagnostic criteria for pediatric HFRS while hospitalized in the Intensive Care Department of the Affiliated Children′s Hospital of Xi′an Jiaotong University between July 2014 and December 2021 as the research objects.The severe and critical patients were taken as the observation group(24 cases), and the mild and moderate pediatric patients were taken as the control group(158 cases). The demographic, epidemiological data and clinically relevant indicators within 8 hours of pediatric patients after admission were collected.The 28-day death was the primary endpoint.Renal failure and pulmonary edema were secondary endpoint.The differences of clinically relevant indicators between the two groups were observed.Logistic regression was used to analyze the risk factors and receiver operating characteristic(ROC) curve was used to determine the predictive efficacy of different outcome prediction models.Results:There were no statistically significant differences in age, gender, and BMI between the two groups (all P>0.05). Compared the control group with the observation group, coagulation function indicators such as activated partial thromboplastin time (APTT)[(134±21)s vs.(164±34)s], D-dimer [(6.31±3.20)mg/L vs.(12.43±5.67)mg/L], von Willebrand factor (vWF)[(352±45)μg/L vs.(465±103)μg/L], and platelet(PLT)[(87±35)×10 9/L vs.(45±24)×10 9/L], Lactate(Lac)[(2.6±1.1)mmol/L vs.(6.0±2.0)mmol/L]were different significantly(all P<0.05). Additionally, the lymphocyte characteristic analysis indicator lymphocytes [(2 749±686)×10 6/L vs.(2 374±851)×10 6/L], CD3 + [(1 821± 487)×10 6/L vs.(1 065±539)×10 6/L], CD4 + /CD8 + (1.65±0.73)vs.(1.00±0.25), CD19 + [(559±105)×10 6/L vs.(487± 133)×10 6/L]were different significantly(all P<0.05). The inflammatory index procalcitonin(PCT) [(22±15)ng/L vs.(56±21)ng/L, P<0.05]was different significantly in two groups.The rate of continuous renaly replacement therapy, ventilator-assisted ventilation, vasoactive drugs and other treatment measures increased significantly in observation group than those in control group(all P<0.05). Multivariate logistic regression analysis was performed on the included indicators.With death as the primary endpoint, Lac, CD8 + , D-dimer, vWF and PCT were significantly associated with mortality, which were risk factors for death, while PLT and CD4 + /CD8 + were protective factors.With renal failure and pulmonary edema as secondary endpoint, CD8 + , D-dimer, Lac and PCT were risk factors for secondary endpoint.ROC curve analysis showed that the sensitivity, specificity and AUC of the risk factor prediction model related to the primary endpoint variables were 77.91%, 81.22% and 0.769, and which related to secondary endpoint variables were 87.61%, 77.59% and 0.891, respectively. Conclusion:The combinations of CD8 + , D-dimer, Lac, PCT and vWF have good predictive value for poor prognosis in children with HFRS.
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Background There is a lack of research evidence on the association between sugar-sweetened beverage (SSB) consumption and gestational diabetes mellitus (GDM) in China. Objective To explore the association between frequency of SSB consumption before pregnancy and risk of GDM in pregnant women in Shaanxi Province, and to provide a scientific basis for targeted interventions to control maternal blood glucose. Methods The recruitment to the China Birth Cohort study started in October 2020. Pregnant women at 6-16 weeks who had their first prenatal examination at five hospitals in Shaanxi Province were recruited. A maternal health questionnaire was used to collect basic information about pregnant women. A semi-quantitative food frequency questionnaire was used to collect the consumption of carbonated beverages, fruit and vegetable juice beverages, coffee beverages, and milk tea beverages in one year before pregnancy, which were summed to obtain the SSB consumption. Pregnant women were divided into three groups according to SSB consumption, namely <1 serving·week−1, 1-4 servings·week−1, and ≥5 servings·week−1. GDM was confirmed by oral glucose tolerance test (OGTT) between 24-28 weeks of gestation. A binary logistic regression model was applied to explore the association between SSB consumption and risk of GDM. Multiple linear regression was applied to investigate the associations between SSB consumption (per 1-serving·d−1 increase) and OGTT fasting plasma glucose, 1-hour glucose, and 2-hour glucose. Results A total of 3811 pregnant women were finally enrolled in this study, of which 752 developed GDM, with an incidence rate of 19.7%. The incidence rates of GDM in pregnant women with SSB consumption frequency of <1 serving·week−1, 1-4 servings·week−1, and ≥5 servings·week−1 were 18.0%, 21.1%, and 26.8%, respectively. After adjusting for maternal age, pre-pregnancy body mass index (BMI), education, number of children born, family history of diabetes, smoking, alcohol consumption, physical activity level, and total energy intake, the risk of GDM increased by 26% (OR=1.26, 95%CI: 1.05, 1.50) in the 1-4 servings·week−1 group and by 76% (OR=1.76, 95%CI: 1.31, 2.38) in the ≥5 servings·week−1 group compared to the <1 serving·week−1 SSB consumption group, respectively. Further stratified analysis revealed no interaction effect (Pinteraction>0.05) between SSB consumption and maternal age, pre-pregnancy BMI, or first labor or not. For each additional SSB consumption per day, the risk of GDM increased by 94% (OR=1.94, 95%CI: 1.37, 2.75); and the maternal OGTT 1-hour glucose and 2-hour glucose increased by 0.33 mmol·L−1 and 0.18 mmol·L−1, respectively (P<0.05), and no significant increase in fasting plasma glucose was found (P>0.05). Conclusion Higher SSB consumption before pregnancy increases the risk of GDM in pregnant women.
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Objective: To explore the value of modified RANSON score in predicting mortality from severe acute pancreatitis (SAP). Methods: In this retrospective study, 461 SAP patients hospitalized from January 2016 to January 2020 were enrolled. AP (acute pancreatitis) patients from our hospital were employed as the training set. In addition, AP patients from the affiliated hospital of Nantong University were set as the validation set. The clinical characteristics of patients were compared between the two sets. The independent risk factors for SAP were determined through logistic regression. Moreover, the risk factors were derived for various prediction models by logistic regression. Multiple methods were adopted to assess the predictive ability of various models. Results: A total of 338 patients were assigned into the training set, while 123 patients were assigned into the validation set. The patients in the training and validation sets showed the consistent distribution trends (P>0.05). In the training set, significant differences between patients in the non-survival and survival groups were BMI, PCT, platelets (PLT), direct bilirubin (DBil) and RANSON scores (P<0.05). In further multivariate analysis, BMI, PCT and RANSON score were found as the independent risk factors for the mortality of SAP (OR=1.12, 1.25, 1.28, 95% CI:1.06-1.19, 1.08-1.44, 1.12-1.47, P<0.05). In the training set and validation set, ROC curve analysis showed that AUC of BMI+RANSON score was 0.778 and 0.789, respectively. In the calibration curve, the fitting degree of RANSON score+BMI and ideal assessment model was 0.975 and 0.854, respectively. The decision curve suggested that the net benefit per patient increased with the lengthening of the RANSON score+ BMI model curve. As revealed by the results of NRI and IDI indicators, RANSON score+BMI was optimized based on RANSON score (P<0.05). Conclusion: BMI+RANSON was confirmed as a modified model effective in predicting the mortality from SAP.
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Objective:To explore the teaching effect of standardized training physicians in department of hematology through the tutor responsibility system combined with case-based learning (CBL teaching method), and to provide new ideas for the formulation of the teaching plan of standardized training physicians in the future.Methods:A total of 52 residents trained in the Department of Hematology, The First Affiliated Hospital of Army Medical University from January to December 2017 were selected in the study. And they were randomly divided into observation group and control group, with 26 cases in each group. The control group received the CBL teaching method, and the observation group received the tutor responsibility system combined with the CBL teaching method, both of which were taught for 3 years. Our hospital's self-made assessment form was used to assess the operating skills, theoretical knowledge and teaching quality of the two groups' residents before and after 3 years of teaching. SPSS 24.0 was used for t test and chi-square test. Results:After 3 years of teaching, the scores of bone marrow aspiration, bone marrow biopsy, lumbar puncture, and intrathecal injection, the basic theories of specialists, standardized diagnosis and treatment of common diseases, analysis of difficult cases, and rescue scores of critically ill patients, the scores of medical knowledge, clinical thinking, professional ethics, doctor-patient communication, theoretical connection with practice of both groups were all increased than before teaching ( P<0.05), and the above scores of the observation group were higher than those of the control group, with statistical differences ( P<0.05). Conclusion:The tutor responsibility system combined with CBL teaching method is conducive to improving the training effect and teaching quality of hematology.
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Objective:To compare the diagnostic values of different diagnostic criteria of prostate specific membrane antigen (PSMA) PET/CT for primary prostate cancer (PCa).Methods:From May 2019 to May 2021, 2-(3-(1-carboxy-5-((6- 18F-fluoro-pyridine-3-carbonyl)-amino)-pentyl)-ureido)-pentanedioic acid ( 18F-DCFPyL) PET/CT images of 78 patients (age: (68.5±1.4) years) with clinically suspected PCa in Shanxi Bethune Hospital were retrospectively collected and blind diagnosed by the three criteria of SUV max, PSMA reporting and data system (PSMA-RADS) score and molecular imaging PSMA (miPSMA) score. The diagnostic efficacy for PCa, the correlation between the diagnostic results and disease risk, and the consistency of the diagnostic results of the three criteria were compared. Delong test, Spearman rank correlation analysis, and intra-class correlation coefficient (ICC) were used to analyze data. Results:The sensitivities of SUV max, PSMA-RADS score and miPSMA score for PCa were all 93.75%(60/64) and the specificities were 12/14, 10/14 and 12/14 respectively; AUCs of the three criteria were 0.951, 0.862 and 0.951, with no significant difference between SUV max and miPSMA score ( z=0.00, P=1.000), while there were significant differences between PSMA-RADS score and SUV max or miPSMA score ( z values: 2.71, 2.93, P values: 0.007, 0.030). There were positive correlations between the diagnostic results of the three criteria and the disease risk (International Society of Urological Pathology (ISUP) grading: rs values: 0.66, 0.62, 0.63, all P<0.001; D′Amico grouping: rs values: 0.67, 0.64, 0.67, all P<0.001). The diagnostic results of the three criteria were highly consistent (ICC=0.941, 95% CI: 0.903-0.967). Conclusion:The SUV max and miPSMA score have higher diagnostic efficiency and correlation of disease risk, which are more suitable for clinical application.
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In order to understand the current status of the knowledge, attitude and practice (KAP) about prevention and control of COVID -19 in college students, and to provide theoretical basis for prevention and control work in college campus. This study investigated the KAP of COVID -19 of 1 847 college students in Shaanxi province by questionnaire using the convenience sampling method. Chisquare test and multivariate logistic regression analysis were used to analyze the influencing factors for the KAP of COVID -19. The results demonstrated that 48.3% of the students had a higher knowledge level of COVID -19, 11.7% had a fear attitude and 39.6% had good protective practices. Logistic regression results showed that female and urban household college students had higher cognitive level of COVID -19. The college students with anxiety state were more likely to have fear attitude. Students of female, urban household, anxiety, higher cognition and fear attitude showed better protective practices. The above results indicated that the knowledge level of COVID -19 in college students are not enough, and the attitude and protective practices need to be further improved. Therefore, relevant departments should follow the rules of KAP, carry out targeted propaganda and education on COVID -19 for college students, to improve their ability to cope with public health emergencies.
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Objective:To establish an in vivo diffusion model of Treponema pallidum (Tp) in New Zealand rabbits. Methods:A standard strain of Tp (Nichols strain) was recovered in the testes of New Zealand rabbits, and isolated and passaged continuously. The suspensions of the second-passage Tp were collected and inoculated onto the dorsal skin of New Zealand rabbits. After 21-day infection, the New Zealand rabbits were anesthetized and sacrificed, blood samples were collected, and skin tissues at the infection site as well as liver, spleen, testes and lymph nodes were aseptically resected. Real-time fluorescence-based quantitative PCR was performed to detect the spread of Tp in different tissues and organs.Results:On day 21 after infection with Tp, skin lesions such as indurations and ulcers were seen at all inoculated sites of New Zealand rabbits. Pathological examination showed a lot of inflammatory cells in the infected lesions, mainly including plasma cells, macrophages and lymphocytes. Real-time fluorescence-based quantitative PCR revealed a large number of Tp in tissues and organs, such as liver, spleen and testes.Conclusion:After inoculation with Tp in the dorsal skin of New Zealand rabbits, Tp could spread to the liver, spleen, testes and other tissues and organs through blood and lymph nodes, and the in vivo diffusion model of Tp strains in New Zealand rabbits was successfully constructed.
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BACKGROUND@#The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas.@*METHODS@#The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China.@*RESULTS@#The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences.@*CONCLUSIONS@#Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.
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Adult , Female , Humans , Male , Young Adult , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Exercise , Mental Health/statistics & numerical data , Screen Time , Students/psychology , Time Factors , UniversitiesABSTRACT
Breast cancer is a major chronic disease threatening women's health. It has topped the global cancers as the diagnosed cases outnumbered lung cancer patients in 2020. Internal damage due to the seven emotions is an important cause of breast cancer and the disorders of hypothalamic-pituitary-adrenal(HPA) axis and endocrine system and the abnormal immune defense mechanism in response to psychological stress all affect the occurrence and development of breast cancer. It is noteworthy that the theory of seven emotions in traditional Chinese medicine and the psychological stress theory of modern medicine have something in common in some aspects. Therefore, this study explored the correlation between internal damage due to the seven emotions and psychological stress and analyzed the molecular biological mechanisms of psychological stress influencing breast cancer from the perspective of modern medicine, which is helpful to reasonably prevent breast cancer and other related tumors and improve the prognosis of breast cancer patients through emotion regulation.
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Female , Humans , Breast Neoplasms/genetics , Emotions , Hypothalamo-Hypophyseal System , Medicine, Chinese Traditional , Pituitary-Adrenal System , Stress, PsychologicalABSTRACT
Gastric cancer is one of the most common malignant tumors in the digestive system， and precancerous lesion of gastric cancer （PLGC） represents a long-term stage in the process of malignant development of normal gastric mucosa into gastric cancer. Gastric cancer and precancerous lesions are difficult to cure clinically， leaving poor prognosis and a serious negative impact on the quality of daily life of patients. In recent years， studies on cell autophagy have been at the forefront of the natural life science. Regulating autophagy to treat precancerous lesions and prevent gastric cancer has become nowadays a hot topic. Autophagy is a process in which cells enclose some redundant or damaged cytoplasm， proteins and organelles to form autophagosomes， and bind to lysosomes to degrade the contents. Autophagy has bidirectional effect on different cells and different stages of the same cell. Autophagy at a lower level can kill cancer cells， while autophagy can promote the growth and proliferation of cancer cells under stress conditions such as hypoxia， hunger and infection， or when autophagy clears damaged proteins in cells and organelle function is abnormal. Traditional Chinese medicine（TCM）， which has low toxicity and easy acceptance by patients， has a positive effect on the treatment of gastric cancer and PLGC. At present， studies on the prevention and treatment of gastric cancer and PLGC by TCM have been carried out in depth with cell autophagy as the breakthrough point. More and more research results have confirmed that TCM can regulate the autophagy process of gastric cancer cells and play an anti-tumor role by interfering with various autophagy related genes， signal pathways and organelles. This paper summarizes the studies on the regulation of cell autophagy by TCM in the treatment of gastric cancer and precancerous lesions， so as to provide references for future studies on the regulation of autophagy by TCM.
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Objective:Kawasaki disease shock syndrome(KDSS) is a serious complication of Kawasaki disease(KD). The main manifestations are low blood pressure and decreased blood perfusion at the acute stage of onset, which is life-threatening.The purpose of this study was to provide early intervention and reduce the complications and mortality of this disease by analyzing clinical features and expression level of interleukin-6(IL-6)of children with KDSS.Methods:In this study, a total of 25 children with KDSS in Nanjing Children′s Hospital were collected, and their clinical characteristics, relevant laboratory indicators and IL-6 expression levels were analyzed by retrospective case-control study.Results:Compared with ordinary KD children, KDSS children were more common in older children, with prolonged fever, severe skin rash, high inflammatory indicators, and more likely to be associated with coronary dilatation.The level of IL-6 in children with KDSS in the acute phase was significantly higher than that in children with KD[(28.5±39.2) ng/mL vs.(226.8±102.9) ng/mL, P<0.05], while the level of IL-6 in children with KDSS in the convalescent period was significantly lower than that in the acute phase of KDSS[(226.8±102.9) ng/mL vs.(5.6±1.7)ng/mL, P<0.05], and the difference was statistically significant. Conclusion:The systemic inflammatory response of KDSS is more obvious, IL-6 plays an important role in it, and the therapeutic effect of IL-6 blocker in KD and its complications needs further study.
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Objective:To evaluate the efficacy of Liangxue-Xiaofeng Decoction combined with acitretin A capsule in the treatment of psoriasis vulgaris. Methods:A total of 80 patients with psoriasis vulgaris from March 2015 to June 2019 in our hospital, who met the inclusion criteria, were divided into two groups according to the random number table method, 40 patients in each group. The control group was given acitretin A capsules on the basis of conventional western medicine treatment, and the study group was given Liangxue-Xiaofeng Decoction on the basis of the control group. Both groups were treated for 2 months and followed up for 6 months. The skin lesion area and Psoriasis Area and Severity Index (PASI) scores were performed before and after treatment. The levels of IL-8, IL-6 and TNF-α were detected by real time PCR amplification, and the levels of histone acetyltransferase (HATs) and histone deacetylase (HDACs) by ELISA. The adverse reactions and recurrence during the follow-up period were recorded and the clinical efficacywas evaluated. Results:The total effective rate of the study group was 82.5% (33/40) and that of the control group was 62.5% (25/40). The difference between the two groups was statistically significant ( χ2=4.012, P=0.045). After treatment, the PASI score of the study group was significantly lower than that of the control group ( t=7.921, P<0.01), and the serum levels of IL-8, IL-6 and TNF-α were significantly lower than those in the control group ( t=12.749, 13.933, 10.856, all Ps<0.01); the activity of HATs [(35.03 ± 3.79) g/L vs. (29.26 ± 2.41) g/L, t=8.125] of the study group was significantly higher than that of the control group ( P<0.01), and HDACs activity [(31.00 ± 2.71) g/L vs. (37.55 ± 3.08) g/L, t=10.098] of the study group was significantly lower than that of the control group ( P<0.01). Conclusions:Acitretin A capsule combined with Liangxue-Xiaofeng Decoction can reduce the level of inflammatory cytokines in patients with psoriasis vulgaris, and prevent the disease progression. The mechanism may be related to the regulation of homeostasis balance in acetylation.
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The soaking and fermentation of Baphicacanthus cusia( Nees),the important intermediate link of Indigo Naturalis processing,facilitates the synthesis of indigo and indirubin precursors and the dissolution of endogenous enzymes and other effective components,while the role of microorganisms in the fermentation is ignored. The present study investigated the changes of microbial community structure in Indigo Naturalis processing based on 16 S amplicon sequencing and bioinformatics. Meanwhile,the contents of indigo,indirubin,isatin,tryptanthrin,indole glycoside,etc. were determined to explore the correlation between the microorganisms and the alterations of the main components. As demonstrated by the results,the microbial diversity decreased gradually with the fermentation,which bottomed out after the addition of lime. Proteobacteria,Bacteroidetes,and Firmicutes were the main dominant communities in the fermentation. The relative abundance of Proteobacteria declined gradually with the prolongation of fermentation time,and to the lowest level after the addition of lime. The relative abundance of Firmicutes increased,and that of Bacteroidetes decreased first and then increased. The contents of effective substances in Indigo Naturalis also showed different variation tendencies. As fermentation went on,indole glycoside decreased gradually; indigo first increased and then decreased; indirubin and isatin first decreased and then increased; tryptanthrin gradually increased. Those changes were presumedly related to the roles of microorganisms in the synthesis of different components. This study preliminarily clarified the important role of microorganisms in the soaking and fermentation and provided a scientific basis for the control of Indigo Naturalis processing and the preparation of high-quality Indigo Naturalis.
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Fermentation , Indigo Carmine , Indigofera , Indoles , MicrobiotaABSTRACT
Indigo Naturalis has a long history of medicinal use with particularity and complexity in its processing. Before the Ming dynasty,Indigo Naturalis was extracted from the top layer of zymotic fluid,called " purified Indigo Naturalis". In modern processing,the precipitate " crude Indigo Naturalis" is dried to produce Indigo Naturalis after impurity removal. The form of Indigo Naturalis slices has undergone significant changes in ancient and modern times. In view of this,the quality comparison between crude Indigo Naturalis and purified Indigo Naturalis was conducted in this study with modern analytical techniques. Firstly,chemical composition was analyzed with UPLC-Q-TOF-MS,and the chemical composition of scent with HS-SPME/GC-MS/MS. The content of indigo,indirubin,total ash,and water-soluble extract was determined as well as the inorganic composition in crude Indigo Naturalis and purified Indigo Naturalis. Then,their microscopic morphology was observed and the surface element composition was investigated. Finally,the antipyretic activities of crude Indigo Naturalis and purified Indigo Naturalis were compared in the fever rat model induced by lipopolysaccharide and 2,4-dinitrophenol. The results demonstrated that the purified Indigo Naturalis had a faster and more lasting antipyretic effect,while the crude Indigo Naturalis had almost no antipyretic effect. This study is of great significance to the research on processing technology of Indigo Naturalis and provides reference for the formulation of its quality standards,production specifications and calibration procedures.
Subject(s)
Animals , Rats , Indigo Carmine , Indigofera , Plant Extracts , Tandem Mass SpectrometryABSTRACT
BackgroundLittle is known about the risk factors for critical-ill events (intensive care, invasive ventilation, or death) in patients with COVID-19. MethodsPatients with laboratory-confirmed COVID-19 admitted to the Wuhan Leishenshan Hospital from February 13 to March 14 was retrospectively analyzed. Demographic data, symptoms, laboratory values at baseline, comorbidities, treatments and clinical outcomes were extracted from electronic medical records and compared between patients with and without critical-ill events. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression models were developed to explore the risk factors for critical-ill events. A risk nomogram was established to predict the probability for the critical-ill events. Survival analysis of patients with critical-ill events was performed by the Kaplan-Meier method. Results463 COVID-19 patients were included in this study, of whom 397 were non-critically ill and 66 were critically ill (all from the intensive care unit). The LASSO regression identified four variables (hypersensitive cardiac troponin I, blood urea nitrogen, haemoglobin, and interleukin-6) contributing to the critical-ill events. Multivariable regression showed increasing odds of in-hospital critical-ill events associated with hypersensitive cTnI greater than 0.04 ng/mL (OR 20.98,95% CI 3.51-125.31), blood urea nitrogen greater than 7.6 mmol/L (OR 5.22, 95% CI 1.52-17.81, decreased haemoglobin (OR 1.06, 95% CI 1.04-1.10), and higher interleukin-6 (OR 1.05, 95% CI 1.02-1.08) on admission. ConclusionsHypersensitive cTnI greater than 0.04 ng/mL, blood urea nitrogen greater than 7.6 mmol/L, decreased haemoglobin, and high IL-6 were risk factors of critical-ill events in patients with COVID-19. Main pointHypersensitive cTnI greater than 0.04 ng/mL, BUN greater than 7.6 mmol/L, decreased haemoglobin, and high IL-6 were risk factors of critical-ill events (intensive care, invasive ventilation, or death) in patients with COVID-19.
ABSTRACT
Fatigue is a widespread and complex physiological phenomenon. Chronic fatigue can lead to cardiovascular dysfunction, mental disorders and other serious pathological reactions. Therefore, how to relieve fatigue accurately and effectively is an important proposition to implement the concept of "Healthy China" in the new era. As an important part of Chinese medicine health industry, Chinese medicine health food has been developing rapidly in recent years. At present, there are 1 157 kinds of anti-fatigue health food on the market in China, most of which are single Chinese medicine and its compound. However, their functions are generally labeled as "anti-fatigue", and their function positioning is too extensive and unclear. With the deepened understanding of fatigue classification and its physiological and pathological basis, it is urgent to be combined with the progress of modern chemical and pharmacological stu-dies to differentiate and precisely position the anti-fatigue health effects of traditional Chinese medicine. For this purpose, the classifications of fatigue were summarized in this paper, and the mechanism of fatigue was explained from the aspects of energy metabolism, accumulation of metabolites, oxidative stress, inflammation, hypothalamus pituitary adrenal axis and so on. We selected 10 traditional Chinese medicines which are most frequently used in health food, analyzed their anti-fatigue effect mechanisms, and summarized the best types of anti-fatigue food, so as to promote the scientific development of anti-fatigue health food industry, expand the market application scope of anti-fatigue health food, better respond to the construction of a healthy China and serve for people's health.
Subject(s)
China , Drugs, Chinese Herbal , Food , Medicine, Chinese Traditional , Plants, MedicinalABSTRACT
Objective:To investigate the different effects of different treatment regimens in resistant Kawasaki disease (KD) and to provide evidence for clinical treatment.Methods:Forty-nine inpatient children with resistant KD from July 2017 to June 2019 in Children's Hospital of Nanjing Medical University were enrolled into this study. Treatment and follow-up were still in progress. Rank sum test and χ2/Fisher test were used for statisic. Results:The incidence of resistance in infliximab group was significantly lower than that of intravenous immunoglobulin (IVIG) retreated group ( P<0.05). Sixteen cases were treated with 5 mg/kg infliximab (IFX), and 33 cases received methylprednisolone and an additional dose of IVIG. Nine cases who were resistant to IVIG and methylprednisolone were treated with IFX, 6 patients responded to IFX, 3 of them were treated with cyclosporine. Coronary artery changes were followed up. Coronary artery lesions (CALs) were improved in the IFX group, CALs occurred in 12(36%) patients received IVIG and methylprednisolone, 4 of them were improved( χ2=0.633 , P=0.426). Patients were followed up for 3-24 months, the incidence of CALs persistence was statistically significantly different between the two groups (0 vs 24%, P=0.021]. Conclusion:IFX might be an effective and tolerable treatment for resistant KD.