Effect of improved management of placenta accreta spectrum disorders on maternal and infant outcomes / 中华围产医学杂志

Objective:To evaluate the role of improved management procedures in placenta accreta spectrum disorders (PAS) and its impact on maternal and infant outcomes.Methods:This retrospective study involved 164 pregnant women who were diagnosed with PAS complicated with placenta previa and delivered at Nanjing Drum Tower Hospital, Nanjing University Medical School from January 2019 to December 2022. All subjects were allocated to pre-improvement group (January 2019 to December 2020, n=96) and post-improvement group (January 2021 to December 2022, n=68). The management was improved in the following five aspects: (1) The time for scheduled delivery was postponed to 37 weeks from 34-36 weeks;(2) Intraoperative cell salvage was encouraged despite autologous blood donation during pregnancy;(3) Original surgical incision was utilized instead of mid-longitudinal incision in the lower abdomen to reduce operative trauma; (4) A lower segment incision of the uterus was not prohibited based on pre-operative PAS classification and intra-operative situation to enter the uterine cavity, even through the placenta instead of pass-by;(5) The interface between lower uterine segment and bladder was dissected before instead of after the baby was born and uterine blood supply was stopped by tourniquet or Scharr forceps. Statistical methods such as t-test, Chi-square test or Fisher exact probability method were used to compare the difference in maternal and infant outcomes between the two groups. Results:After the improvement, the delivery rate beyond 37 weeks decreased significantly [83.3% (80/96) vs 69.1% (47/68), χ 2=4.60, P=0.038]. There was no significant difference in the distribution of elective, subemergency and emergency surgeries before and after the improvement ( χ 2=0.36, P=0.834). Compared to the pre-improvement group, the proportion of women who underwent cesarean section through previous abdominal incisions increased significantly [74.0% (71/96) vs 91.1% (64/68), χ 2=11.11, P=0.001] in the post-improvement group, while the proportion of application of abdominal longitudinal incision and classical cesarean section decreased significantly [84.3% (81/96) vs 57.3% (39/68), χ 2=14.81, P<0.001; 83.3% (80/96) vs 61.8% (42/68), χ 2=9.72, P=0.003]. No significant difference was found between the two groups in terms of the transfusion rate of allogeneic red blood cell, platelet and other blood components, pre-discharge hemoglobin level, subtotal hysterectomy rate, bladder injury, thrombus event, the admission rate of intensive care unit and unplanned reoperation rate (all P>0.05). The incidence of admission in neonatal intensive care unit (NICU) and necrotizing enterocolitis decreased significantly after improvement [24.7% (24/97) vs 11.8% (8/68), χ 2=4.31, P=0.038; 4.1% (4/97) vs 0.0% (0/68), χ 2=58.06, P<0.001]. The incidence of respiratory distress syndrome, mechanical ventilation, and neonatal septicemia also decreased, but without statistical difference. Conclusions:After adopting a series of improvement measures, such as delaying planned delivery to 37 weeks of gestation, individualized cesarean section plan, and changing the method of obtaining autoblood, the number of premature infants and the NICU admission rate decreased significantly without increasing the risk of maternal complications and emergency operation. Furthermore, the incidence of adverse events such as maternal organ injury, unplanned reoperation, and re-admission remains at a low level. Therefore, this improved management is feasible.

Effect and mechanism of sodium cantharidate on proliferation,migration and invasion of esophageal cancer EC9706 Cells / 新乡医学院学报

Objective To investigate the effect and mechanism of sodium cantharidate on the proliferation,migration and invasion of esophageal carcinoma EC9706 cells.Methods Esophageal cancer EC9706 cells were randomly divided into blank control group,low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium canthari-date group and cisplatin group.The EC9706 cells in the low-,medium-and high-dose sodium cantharidate groups were given fi-nal mass concentration of 1.0,2.5 and 5.0 mg·L-1 sodium cantharidate intervention,respectively.The EC9706 cells in the cisplatin group were treated with the final mass concentration of 140 mg·L-1 cisplatin,and the cells in the control group was cultured in Dulbecco's modified Eagle's medium.The cell proliferation rate in each group was detected by cell counting reagent-8 method,the mobility of EC9706 cells in each group was detected by scratch test,the invasion rate of EC9706 cells in each group was detected by Transwell method,and the levels of Wnt3a and β-catenin mRNA in EC9706 cells in each group were detected by real-time quantitative polymerase chain reaction method,and the levels of Wnt3a and β-catenin protein in EC9706 cells in each group were detected by Western blot.Results At 24,48 and 72 h of cultivation,the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium canthari-date group and cisplatin group was significantly lower than that in the blank control group(P＜0.05);the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group and medium-dose of sodium cantharidate group was significantly higher than that in the high-dose sodium cantharidate group and cisplatin group(P＜0.05);the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group was significantly higher than that in the medium-dose sodium cantharidate group(P＜0.05);there was no significant difference in the proliferation rate of EC9706 cells between the high-dose sodium cantharidate group and cisplatin group(P＞0.05);the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium cantharidate group and cisplatin group was significantly decreased with the extension of culture time(P＜0.05).The mobility rate and invasion rate of EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium cantharidate group and cisplatin group were significantly lower than those in the blank control group(P＜0.05);the mobility rate and invasion rate of EC9706 cells in the low-dose sodium cantharidate group and medium-dose sodium cantharidate group were significantly higher than those in the high-dose sodium cantharidate group and cisplatin group(P＜0.05);the migration rate and invasion rate of EC9706 cells in the low-dose sodium cantharidate group were significantly higher than those in the medium-dose sodium cantharidate group(P＜0.05);there was no significant difference in the mobility rate and invasion rate of EC9706 cells between the high-dose sodium cantharidate group and cisplatin group(P＞0.05).The relative expression levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium cantharidate group and cisplatin group were significantly lower than those in the blank control group(P＜0.05);the relative expression levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells in the low-dose sodium cantharidate group and medium-dose sodium cantharidate group were significantly higher than those in the high-dose sodium cantharidate group and cisplatin group(P＜0.05);the relative expressions levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells in the low-dose sodium cantharidate group were significantly higher than those in the medium-dose sodium cantharidate group(P＜0.05);there was no significant difference in the relative expression levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells between the high-dose sodium cantharidate group and cisplatin group(P＞0.05).Conclusion Sodium cantharidate can significantly inhibit the proliferation,migration and invasion of esophageal carcinoma EC9706 cells,and its mechanism may be related to the inhibition of the Wnt3a/β-catenin pathway.

Guanxin V Relieves Ventricular Remodeling by Inhibiting Inflammation: Implication from Virtual Screening, Systematic Pharmacology, Molecular Docking, and Experimental Validation / 中国结合医学杂志

OBJECTIVE@#To reveal the anti-inflammatory mechanism of Guanxin V, which is prescribed for ventricular remodeling in clinical practice.@*METHODS@#Guanxin V-, ventricular remodeling-, and inflammation-related targets were obtained through an integrated strategy of virtual screening and systematic pharmacology, and then the shared targets were visualised with a Venn diagram. Guanxin V network and the protein-protein interaction network were drawn, and enrichment analysis was conducted. Finally, the main results obtained from the integrated strategy were validated by molecular docking and in vivo experiments.@*RESULTS@#A total of 251, 11,425, and 15,246 Guanxin V-, ventricular remodeling-, and inflammation-related targets were acquired, respectively. Then, 211 shared targets were considered to contribute to the mechanism of ventricular remodeling treated by Guanxin V. Guanxin network and the protein-protein interaction network were drawn, and enrichment analysis showed some cardiovascular-related biological processes and signaling pathways. Molecular docking revealed that the Guanxin V-derived compounds could align with key targets. Final in vivo experiments proved that Guanxin V reverses ventricular remodeling by inhibiting inflammation.@*CONCLUSION@#Guanxin V relieves ventricular remodeling by regulating inflammation, which provides new ideas for the anti-ventricular remodeling mechanism of Guanxin V.

Thoughts on teaching reform of Biologicology / 生物工程学报

With the rapid development of modern biotechnology, the cultivation of high-quality biotechnology talents has received more and more attention. The course of Biologicology is a core subject that students majoring in biology should master. However, Biologicology is a new subject, and its teaching content and teaching methods are at the exploratory stage. Based on the current teaching status and existing problems of the Biologicology course, we propose teaching reforms in terms of teaching content, teaching methods and assessment methods, to lay a firm foundation for the further teaching efficacy of Biologicology course and increasing students' interest in learning.

Intrauterine balloon tamponade combined with temporary abdominal aortic balloon occlusion in the management of women with placenta accreta spectrum:a randomized controlled trial / 中华妇产科杂志

Objective:To access the effectiveness and safety of the intrauterine balloon tamponade verse gauze packing combined with temporary abdominal aortic balloon occlusion in the management of placenta accreta spectrum (PAS).Methods:This was an open-label, randomized controlled trial conducted in Nanjing Drum Tower Hospital. The patients suspected with PAS for uterine preservation surgery under the multidisciplinary team care were recruited between Aug 2015 and Jan 2018. When bleeding could not be achieved after fetus delivered, and a temporary abdominal aortic balloon occlusion and the compression sutures as needed, the women were randomly allocated 1∶1 into balloon tamponade ( n=81) or gauze packing ( n=80) group. The primary outcome was successful bleeding arrests by avoiding second line surgeries. The secondary outcomes included the volume of blood loss during and after cesarean section, the rate of PPH, incidence and amount of blood transfusion, hysterectomy, postpartum pain, ICU admission, need for re-laparotomy, and the length of hospital stay, readmission, and interventional radiology complications. Results:All the women [100% (81/81)] in the balloon group were obtained hemostasis without further intervention, significantly higher than 88% (70/80) in the gauze group ( P=0.001). Before uterine tamponade, blood loss were 820 ml (620-1 230) ml and 850 ml (605-1 442) ml, while placenta bed were sutured in 96%（78/81, 77/80） respectively ( P>0.05).The proportion of blood loss≥1 000 ml was higher in the gauze group than that in the balloon group ( P=0.006). Maternal adverse events involving total blood loss, puerperal morbidity and postpartum pain occurred more frequently in the gauze group ( P<0.05). The following outcome showed no statistically significant difference between the two groups: the vascular occlusion time, the dose of radiation, and interventional radiology complication ( P>0.05). The median volume infused into the lower and upper balloons is 70 ml (50-100 ml) and 180 ml (100-240 ml). Conclusions:Incrauterine balloon tamponade is as effective as gauze packing in hemostasis following the placenta delivery in PAS. Compared with gauze packing, the uterine balloon tamponade is more effective.

Construction of engineered exosomes with high loading efficiency of cellular endogenous proteins / 生物工程学报

Exosomes have many advantages as natural drug delivery carriers, but their application is limited by the inefficient loading of intracellular drugs (such as proteins and nucleic acids). In this study, mCherry, a red fluorescent protein, was used as the endogenous cargo target. Through gene modification of donor cells and fusion expression of membrane localization elements (PB, CAAX, Palm and CD63), mCherry was specifically sorted into exosomes through biogenesis. Results show that CD63 had the highest sorting efficiency, followed by Palm. PB and CAAX led enrichment of mCherry on the plasma membrane, but not in exosomes. The approach provides an alternative to facilitate packaging of cargo by exosomes and thus to increase the efficient delivery of endogenous protein drugs.

Clinical audit of intensive care unit admission relating to hypertensive disorders of pregnancy / 中华围产医学杂志

Objective To assess the current practice in managing hypertensive disorders of pregnancy (HDP) and provide possible interventions to improve the quality of care.MethodsA checklist was developed based on Chinese Medical Association's guideline on HDP. A criteria-based audit was conducted on 66 HDP patients who were admitted to the Intensive Care Unit (ICU) of Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School between January 1, 2014 and December 31, 2016. The quality of care during antepartum and hospitalized period were evaluated, and patient factors were also considered. We also collected data on patients' demographics, complications of HDP, acute physiology and chronic health evaluation (APACHE)Ⅱ score and duration of hospital stay.T or Mann-WhitneyU test orChi-square test was performed. Results(1) From 2014 to 2016, the number of deliveries in Nanjing Drum Tower Hospital was 18573, with 1561 cases (8.4％) of HDP. Among the 66 cases being audited, 44 (66.7％) were preeclampsia; 16 (24.2％) were preeclampsia complicated by chronic hypertension; six (9.1％) were eclampsia; no maternal death was reported. (2) Complications of HDP in this study included heart failure (17 cases, 25.8％), hemolysis, elevated liver enzyme levels, low platelet count (HELLP) syndrome (15 cases, 22.7％), anemia and/or thrombopenia requiring transfusion (12 cases, 18.2％), renal dysfunction (seven cases, 10.6％), eclampsia (six cases, 9.1％), pulmonary edema/acute respiratory distress syndrome (five cases, 7.6％), placenta abruption (four cases, 6.1％), cerebral venous and sinus thrombosis (two cases, 3.0％), cerebral hemorrhage (one case, 1.5％) and hepatic rupture (one case, 1.5％). Their APACHEⅡ score was 9.0±3.9. The duration of ICU and hospital stay was 2 (1-30) d and 8 (4-32) d, respectively. (3) Compared with the gravidas who registered during antenatal care, those without registrations were older [(33.0±6.0) vs (29.1±5.4) years old,t=-2.616], having less antenatal visits [2 (0-4) vs 5 (2-10) times, Z=110.000] and higher blood pressure on admission [(177.0±24.1) vs (155.5±24.6) mmHg of systolic blood pressure (t=-3.322), and (116.4±14.6) vs (108.0±18.7) mmHg of diastolic blood pressure (t=-3.013, 1 mmHg=0.133 kPa)], and only a few of them were nulliparas [23.8％(5/21) vs 71.1％(32/45),χ2=13.006] (all P<0.05). (4) Among the 66 cases, seven (10.6％) had preeclampsia history, but none of them received aspirin for HDP prevention; 21 (31.8％) did not have regular testing of blood pressure during antenatal check; 24 (36.4％) did not receive proper antenatal evaluation when hypertension was identified. (5) After excluding 20 cases directly admitted upon the first diagnosis of HDP, the rest 46 were managed in the outpatient department. Eighteen of them (39.1％) did not have blood pressure monitoring and 26 of them (56.5％) did not have a regular test of hemoglobin, platelet, urine protein, liver or renal function. (6) Twenty-nine gravidas (43.9％) suffered a delay in referral or admission. (7) All gravidas received magnesium sulphate administration. Thirty-three cases with severe hypertension (systolic blood pressure≥160 mmHg or diastolic blood pressure≥110 mmHg) were given antihypertensive drugs with satisfactory blood pressure control. Thirty-six cases with living fetus (26-34+6 gestational weeks) received antenatal dexamethasone. Termination of pregnancy was delayed in three cases after admission.ConclusionsThe management of HDP is not good enough in patients' education, screening for high-risk population, early diagnosis and antenatal care. Quality improvement efforts should be focused on strengthening patient education, training of doctors in primary and secondary hospitals, implementing protocols on antepartum care of preeclampsia and establishing a referral system for patients with severe obstetric complications.

Based on sequencing of 16 S rRNA gene elaborate effect of Coptis chinensis on intestinal microbial diversity in type 2 diabetes mellitus / 中草药

Objective To explore the effect of Coptis chinensis on the intestinal microflora diversity of rats with type 2 diabetes mellitus and further elucidate the mechanism of C. chinensis in treatment of type 2 diabetes mellitus. Methods SD rats were randomly divided into control group (CON), model group (M), C. chinensis group (HL), and positive control group (POS), 10 in each group respectively. Type 2 diabetes mellitus model was caused by special diet fed and ip injection of STZ together. CON with M, HL, and POS was respectively given gavage volume 0.5% CMC-Na, 4.36 g/kg C. chinensis water extract and 0.097 g/kg of metformin. The body weight and blood glucose were monitored once a week separately. After four weeks of administration, the oral glucose tolerance and insulin level were measured. After four weeks of administration, the contents of rectum were collected and sequenced by a 16 S rRNA gene sequencing. Results A total of 951OTU, 15 Phylum, 25 Class, 43 Order, 69 Family, 182 Genus and 357 Species were obtained. At the level of Phylum, the content of Actinobacteria in M was significantly higher than that in CON and HL (P < 0.05), while Deferribacteres was only detected in M. In M, Firmicutes, Spirochaetae, Tenericutes, and Elusimicrobia were higher than CON. Interestingly, they were all reduced after giving C. chinensis, meanwhile the abundance of Proteobacteria, Fusobacteria and Verrucomicrobia in HL were slightly higher than that in CON and M. Conclusion Actinobacteria and Deferribacteres were probably potential markers in type 2 diabetes mellitus. After administrating C. chinensis, the change of intestinal microflora diversity revealed C. chinensis could improve the intestinal microflora disorder of type 2 diabetes mellitus.

Up-regulation effect of neureglin1β on extracellular signal-regulated kinase 5 signaling pathway in rats with cerebral ischemia reperfusion injury / 中华神经医学杂志

Objective To explore the regulating mechanism ofneuregulin1β (NRG1β) on extracellular signal-regulated kinase 5 (ERK5) signaling pathway in rats with cerebral ischemia reperfusion injury.Methods Fifty male Wistar rats were divided randomly into sham-operated group,model group,treatment group,inhibitor group,and inhibitor combined with treatment group (n=10).Focal cerebral ischemic models were established by inserting a monofilament thread to achieve middle cerebral artery occlusion (MCAO).The rats were injected 5 μL (2 μg/kg) NRGlβ to the internal carotid artery.This inhibitor BIX02189 was injected into the internal carotid artery before ischemia.The neurobehavioral functions were evaluated by modified neurological severity scale (mNSS).The apoptotic cells were counted by terminal deoxynucleotidyl transferase dUTP nick-end labeling,and the expressions of phosphorylated (p-) mitogen activated proteins kinase kinase 5 (MEKK5),ERK5 and myocyte enhancer-binding factor 2C (MEF2C) were determined by immunohistochemical assay and Western blotting.Results The rats in the model group appeared neurobehavioral dysfunction,the number of apoptotic cells in the cortex was increased,and the expressions of p-MEKK5,p-ERK5 and p-MEF2C showed compensable enhancement,which were significantly different as compared with those in the sham-operated group (P＜0.05).As compared with those in the model group and inhibitor combined with treatment group,the expressions of p-MEKK5,p-ERK5 and p-MEF2C were further significantly enhanced,the number of apoptotic cells was significantly decreased and the neurobehavioral functions were significantly improved in treatment group (P＜0.05).As compared with those in the model group and inhibitor combined with treatment group,the number of apoptotic cells was significantly increased,and the expressions ofp-MEKK5,p-ERK5 and p-MEF2C were significantly decreased in the inhibitor group (P＜0.05).Conclusion NRG1β could play a neuroprotective role by activating the MEKK5-ERK5-MEF2C signaling pathway and further up-regulating the expressions of p-MEKK5,p-ERK5 and p-MEF2C to inhibit the inflammation induced by cerebral ischemia reperfusion injury in rats.

Fetal Hemodynamics and Fetal Growth Indices by Ultrasound in Late Pregnancy and Birth Weight in Gestational Diabetes Mellitus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The offspring of women with gestational diabetes mellitus (GDM) are prone to macrosomia. However, birth weight is difficult to be correctly estimated by ultrasound because of fetal asymmetric growth characteristics. This study aimed to investigate the correlations between fetal hemodynamics, fetal growth indices in late pregnancy, and birth weight in GDM.</p><p><b>METHODS</b>A total of 147 women with GDM and 124 normal controls (NC) were enrolled in this study. Fetal hemodynamic indices, including the systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of umbilical artery (UA), middle cerebral artery (MCA), and renal artery (RA), were collected. Fetal growth indices, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length, were also measured by ultrasound. Birth weight, newborn gender, and maternal clinical data were collected.</p><p><b>RESULTS</b>The independent samples t-test showed that BPD, HC, and AC were larger in GDM than in NC (P < 0.05). Fetal hemodynamic indices of the UA and MCA were lower (P < 0.05), but those of the RA were higher (P < 0.001) in GDM than in NC. Birth weight was higher in GDM than in NC (P < 0.001). Pearson's correlation analysis showed that hemodynamic indices of the UA were negatively correlated with birth weight, BPD, HC, and AC in both groups (P < 0.05). MCA (S/D, PI, and RI) was negatively correlated with birth weight, HC, and AC in GDM (r = -0.164, -0.206, -0.200, -0.226, -0.189, -0.179, -0.196, -0.177, and - 0.172, respectively, P< 0.05), but there were no correlations in NC (P > 0.05). RA (S/D, PI, and RI) was positively correlated with birth weight in GDM (r = 0.168, 0.207, and 0.184, respectively, P< 0.05), but there were no correlations in NC (P > 0.05).</p><p><b>CONCLUSION</b>Fetal hemodynamic indices in late pregnancy might be helpful for estimating newborn birth weight in women with GDM.</p>

Acupuncture combined with medication for blood-stasis in unstable angina patients with different thrombolysis in myocardial infarction risk stratification / 中国针灸

<p><b>OBJECTIVE</b>To observe the intervention effects of acupuncture combined with standardized treatment of western medicine on blood-stasis syndrome in unstable angina (UA) patients with different thrombolysis in myo-cardial infarction (TIMI) risk stratification.</p><p><b>METHODS</b>According to TIMI risk score, a total of 72 UA patients were included, 24 cases in low-risk (0 to 2 points) group, 24 cases in moderate-risk (3 to 4 points) group and 24 cases in high-risk (5 to 7 points) group. Based on routine standardized treatment of western medicine, acupuncture was applied at Xinshu (BL 15), Xuehai (SP 10), Geshu (BL 17), Danzhong (CV 17), Jueyinshu (BL 14), Ximen (PC 4) and Neiguan (PC 6) in three groups. Acupuncture was given once a day, 14 days as a session. After one session, each symptom score and total score of blood stasis syndrome were observed.</p><p><b>RESULTS</b>One patient dropped out respectively, and 23 patients in each group were included in the analysis. After treatment, the score of angina symptom and total score of blood stasis syndrome were significantly improved in three groups (all<0.01). The improvements of each score and total score of blood stasis syndrome in the high-risk group were superior to those in the low-risk group and moderate-risk group (<0.05,<0.01).</p><p><b>CONCLUSIONS</b>With the higher TIMI scores, the blood stasis syndrome is aggravated accordingly. Acupuncture combined with standardized treatment of western medicine could effectively intervene blood stasis syndrome, especially for the score of blood stasis syndrome of patients in high-risk group.</p>

Comparison of Pain Thresholds and Analgesic Effects of Parecoxib Sodium in Surgical Patients of Different Racial and Religious Backgrounds / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the differences of the thresholds of pain and analgesic effects of parecoxib sodium among patients with different racial and religious backgrounds.</p><p><b>METHODS</b>A total of 48 male patients aged 18 to 38 years who had undergone elective laparoscopic appendectomy under general anesthesia in our centers were enrolled in our study and then divided into 6 groups(n=8 in each group)based on their racial backgrounds(three levels:Mongoloid,Negroid,and Europoid)and religious backgrounds(two levels:without religion background,with religion background).All subjects received the same anesthesia,surgical procedure,and postoperative analgesia with parecoxib sodium. The temperature pain threshold and electrical pain threshold were detected 1h before and after analgesia.</p><p><b>RESULTS</b>The threshold of pain was higher in Europoids than in Negroids and Mongoloids before and after treatment. The temperature pain threshold and electrical pain threshold were not significantly different between subjects with or without religious background(before analgesic therapy:F=251.119,P=0.130,F=275.861,P=0.059;after analgesic therapy:F=308.531,P=0.086,F=180.062,P=0.078). Also,there was no interaction between the racial and religious backgrous in terms of temperature pain threshold and electrical pain threshold(F=13.553,P=0.091,F=22.001,P= 0.089;after analgesic therapy:F=4.624,P=0.089,F=15.935,P=0.094).</p><p><b>CONCLUSIONS</b>The threshold of pain differs among individuals with different racial background:it is highest in Europoids,followed by Negroids and Mongoloids. It shows no obvious difference in people with different religious backgrounds.</p>

Disinfection efficacy of different disinfectants on dental unit waterlines / 中国感染控制杂志

Objective To compare the disinfection efficacy of different disinfectants on dental unit waterlines (DUWLs). Methods 18 sets of DUWLs were randomly divided into 4 groups,and disinfected or treated with hydrogen peroxide (H2 O2 )disinfectant,sodium hypochlorite (NaClO)disinfectant,hydrogen peroxide silver ion disinfectant(Sanosil),and distilled water (DW)respectively.Water specimens from triple syringes and high-speed handpieces were taken,bacterial count before and after disinfection were compared.Results Before disinfection,no significant differences in bacterial counts were found among four groups (all P >0.05),bacterial counts of DUWLs of all groups severely exceeded the standard(all>3 000 CFU/mL).After disinfection,except DW group,bacterial counts of DUWLs of the other groups declined dramat-ically (all <100 CFU/mL),bacterial count after disinfection were all obviously lower than before disinfection (all P <0.001 ).One week after disinfection,bacterial counts among three disinfectant groups in different time periods were statisti-cally different (triple syringes:Day1—Day5,all P <0.05;high-speed handpieces:Day2,Day3 and Day5,all P <0.05). Day3 after disinfection of triple syringes by H2 O2 and NaClO,Day4 after disinfection of high-speed handpieces by H2 O2 and NaClO,and Day5 of triple syringes and high-speed handpieces by Sanosil all exceeded the standard of Center for Disease Control and Prevention of America.One week after disinfection,bacterial counts of three disinfection groups all exceeded or approximated to that before disinfection.Conclusion Three types of disinfectants can all effectively reduce bacterial load in DUWLs.Compared with other disinfectants,Sanosil has advantage of inhibiting bacterial growth after disinfection.

2-deoxy-D-glucose modified supermagnetic iron oxide nanoparticles enhance the contrasting effect on MRI of human lung adenocarcinoma A549 tumor in nude mice / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the role of 2-deoxy-D-glucose (2-DG) modified supermagnetic iron oxide nanoparticles (SPIO) (γ-Fe2O3@DMSA-DG NPs) in tumor detection as a magnetic resonance imaging (MRI) contrast agent.</p><p><b>METHODS</b>γ-Fe2O3@DMSA-DG NPs was prepared. The degree of A549 cells targeted absorption of γ-Fe2O3@DMSA-DG NPs was detected by Prussian blue staining, colorimetric assay, T2W and multi-echo sequence MRI. γ-Fe2O3@DMSA NPs was used as a control agent, and free D-glucose as a competitive inhibitor. Human lung adenocarcinoma A549 xenograft tumor was prepared in nude mice. Sterile aqueous suspension of γ-Fe2O3@DMSA NPs or γ-Fe2O3@DMSA-DG NPs was injected into the tail vein of nude mice. Before and 6, 12, 24, 48 h after injection, MRI imaging of the mice was performed. T2 signal intensity of the tumor, brain, liver and thigh skeletal muscles, and T2 values of the tumors were measured.</p><p><b>RESULTS</b>The average diameter of the particles was about 10 nm, and there were no significant differences between the diameters of γ-Fe2O3@DMSA NPs and γ- Fe2O3@DMSA-DG NPs. The IR spectra showed the C-N retractable vibration peak at γ-Fe2O3@DMSA-DG NPs surface, indicating that 2-DG was conjugated to the γ-Fe2O3@DMSA NPs. The Prussian blue staining, colorimetric assay, MRI T2 signal intensity and T2 values revealed that γ-Fe2O3@DMSA-DG NPs were significantly more absorbed by A549 cells at growth peak than γ-Fe2O3@DMSA NPs, and the absorption of γ-Fe2O3@DMSA-DG NP was inhibited by free D-glucose. The results of in vivo examination showed that before and at 6, 12, 24, 48 h after injection of γ-Fe2O3@DMSA-DG NPs, the mean T2 signal intensities of the tumors were (326.00 ± 16.26)s, (276.40 ± 5.13)s, (268.40 ± 30.58)s, (240.40 ± 25.93)s, (262.20 ± 30.04)s, respectively, and the T2 values of the tumors were (735.80 ± 20.93) ms, (645.80 ± 69.58) ms, (615.00 ± 124.61) ms, (570.60 ± 67.78) ms, and (537.80 ± 105.29) ms, respectively. However, before and at 6, 12, 24, 48 h after injection of γ-Fe2O3@DMSA NPs, the mean T2 signal intensities of the tumors were (335.60 ± 4.93)s, (290.80 ± 5.93)s, (273.40 ± 15.08)s, (327.40 ± 16.65)s, and (313.20 ± 20.45)s, respectively, and T2 values were (686.00 ± 21.44)ms, (617.80 ± 69.93)ms, (645.20 ± 85.89)ms, (669.40 ± 13.72)ms, and (608.80 ± 61.90)ms, respectively. The T2 signal intensity and T2 value of the tumors were not declined generally after injection. The liver T2 signal intensity was decreased after injection of both γ-Fe2O3@DMSA-DG NPs and γ-Fe2O3@DMSA NPs, and T2 signal intensity of the brain and muscle did not show significant changes.</p><p><b>CONCLUSIONS</b>γ-Fe2O3@DMSA-DG NPs has an ability to target glucose receptors overexpressed in tumors, and may serve as a MRI contrast agent for tumor detection.</p>

Atorvastatin Attenuates TNF-alpha Production via Heme Oxygenase-1 Pathway in LPS-stimulated RAW264.7 Macrophages / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To assess the effect of atorvastatin on lipopolysaccharide (LPS)-induced TNF-α production in RAW264.7 macrophages.</p><p><b>METHODS</b>RAW264.7 macrophages were treated in different LPS concentrations or at different time points with or without atorvastatin. TNF-α level in supernatant was measured. Expressions of TNF-α mRNA and protein and heme oxygenase-1 (HO-1) were detected by ELISA, PCR, and Western blot, respectively. HO activity was assayed.</p><p><b>RESULTS</b>LPS significantly increased the TNF-α expression and secretion in a dose- and time-dependent manner. The HO-1 activity and HO-1 expression level were significantly higher after atorvastatin treatment than before atorvastatin treatment and attenuated by SB203580 and PD98059 but not by SP600125, suggesting that the ERK and p38 mitogen-activated protein kinase (MAPK) pathways participate in regulating the above-mentioned effects of atorvastatin. Moreover, the HO-1 activity suppressed by SnPP or the HO-1 expression inhibited by siRNA significantly attenuated the effect of atorvastatin on TNF-α expression and production in LPS-stimulated macrophages.</p><p><b>CONCLUSION</b>Atorvastatin can attenuate LPS-induced TNF-α expression and production by activating HO-1 via the ERK and p38 MAPK pathways, suggesting that atorvastatin can be used in treatment of inflammatory diseases such as sepsis, especially in those with atherosclerotic diseases.</p>

Effect of labetalol for mild to moderate hypertension during pregnancy on maternal and fetal outcomes: a meta-analysis / 中华围产医学杂志

Objective To review outcomes in randomized controlled trials comparing labetalol with other anti hypertensives/placebo/no drug for mild to moderate hypertension in pregnancy.Methods We searched PubMed,China Knowledge Resource Integrated Database and VIP Database and performed a meta analysis of randomized controlled trials of labetalol for hypertension in pregnancy.Data were entered into RevMan software for analysis [relative risk (RR) and its 95％ confidence interval (CI)].Results Seven studies were included in the meta-analysis.Four trials (553 women) compared labetalol with methyldopa for mild to moderate hypertension in pregnancy.Labetalol reduced the risk of severe hypertension (RR=0.52,95％CI:0.31-0.88) and proteinuria (RR=0.57,95％CI:0.36 0.91).The incidence of preterm birth and small-for-gestational-age infants was similar between these two groups.Five trials (720 women) compared labetalol with placebo/no drug for mild to moderate hypertension in pregnancy.Labetalol reduced the risk of severe hypertension (RR=0.29,95％CI:0.16-0.53) and proteinuria (RR-0.73,95％CI:0.56-0.95) and showed no effect on preterm birth and small-for-gestational-age infants.Conclusions The results support the use of labetalol for mild to moderate hypertension in pregnancy.Labetalol is more effective in treating hypertension than methyldopa.However,due to the quality of the included studies,clinical effects of labetalol need to be evaluated in high quality randomized controlled trials.

Study on Intervention Effect of Sang-Ji Mixture in TLR-4 Expression on Peripheral Blood Monocytes in Hypertensive Patients with Overabundant Liver-fire and Phlegm Syndrome / 世界科学技术-中医药现代化

This study was aimed to observe the effect of Sang-Ji (SJ) mixture in the treatment of Toll-like receptor 4 (TLR-4) expression on peripheral blood monocytes (PBMCs) in hypertensive patients. A total of 60 cases of hyper-tensive cases with overabundant liver-fire and phlegm syndrome were randomly divided into the treatment group and the control group with 30 cases in each group. Both groups received Felodipine and/or Benazapril treat-ment. The treatment group was added with SJ mixture. The observation duration was 28 days. The detection was made on indicators such as blood pressure , traditional Chinese medicine ( TCM ) syndrome scores and TLR-4 ex-pression on PBMCs before and after treatment. The results showed that after treatment, the blood pressure, TCM syndrome scores and TLR-4 expression on PBMCs of both groups decreased compared with that of the pretreat-ment . Changes on TCM syndrome scores and TLR-4 expression of the treatment group were more significant than that of the control group ( P < 0 . 05 ) . It was concluded that SJ mixture improved clinical symptoms in pa-tients with overabundant liver-fire and phlegm syndrome , decreased TLR-4 expression on PBMCs , in order to inhibit the immune response to a certain extent .

Feasibility and safety of preoperative autologous blood donation for pregnant patients / 医学研究生学报

Objective Preoperative autologous blood donation ( PABD) may reduce the need for allogeneic blood , but it may also cause a short massive blood loss in pregnant women , and its fetal and maternal safety has to be adequately assessed .This study was to evaluate the feasibility and safety of PABD for pregnant women and their fetuses . Methods A prospective observational study was conducted among the women who met the inclusion criteria and gave birth in Nanjing Drum Tower Hospital between January and December 2013 .According to the clinical validation of risk stratification criteria for peripartum hemorrhage of California 2013 , the ca-ses were classified into a low-, a medium-, and a high-risk group.Data on blood donation procedures , obstetric outcomes, and blood transfusions were collected after delivery for analysis . Results Totally, 92 pregnant women accomplished 115 blood donations .The median volumes of the donated blood were 300, 300, and 400 mL in the low-, medium-, and high-risk groups, respectively ( P>0.001).There were no significant changes in HR , SBP and SpO2 during the blood donation procedures (P>0.05) except for the fall of diastolic blood pressure by an average of 3.4 mmHg (P0.05), which were similar to those in the cases who donated twice , with no significant differences before and after the donation (P>0.05). Homologous blood transfusion was performed for 5 cases (17.9%) in the high-risk group, with the volume of blood loss >2000 mL in all the cases.All the newborns survived without asphyxia and there was no perinatal death . Conclusion PABD can provide timely autologous whole blood donation for pregnant women .Under strict management , PABD is feasible and safe for pregnant patients who are at a high risk for massive blood loss during delivery or have a rare type of blood no readily available .

Recent development in preparation and application of drug-loaded magnetic nanoparticle-modified microcapsules / 中国肿瘤临床

Coupled magnetic nanoparticles in the microcapsule structure, such as magnetic microcapsules, can be delivered in specific organism or tissues under magnetic field exposure. Thus, the microcapsules can achieve active targeting functions by manipulat-ing the magnetic field. Based on the magnetic microcapsules, the antitumor drugs can also be loaded to realize magnetic response, which gives microcapsules sustained and controlled release advantages. To date, the drug microcapsules carrying magnetic nanoparti-cles have become promising novel delivery carriers for the treatment of tumor diseases. This paper mainly reviews the method of prepa-ration of the magnetic nanoparticle-coupled microcapsules, including liposomes, polyelectrolyte microcapsules, and polymer micro-spheres. The basic research progress of these microcapsules as anticancer drug carriers for the tumor therapy was also reviewed.

miR-370 is stage-specifically expressed during mouse embryonic development and regulates Dnmt3a.

MicroRNAs (miRNAs) are small non-coding RNAs that participate in a large variety of biological processes. In this paper, the spatiotemporal expression pattern of miR-370 was characterized during mouse embryonic development, and was found to be stage- and tissue-specifically expressed. In addition, through luciferase reporter assays and western blot analyses, DNA methyltransferase 3A (Dnmt3a) was identified as a directly regulated target of miR-370. Altogether, our results indicate that miR-370 may play important roles in the morphogenesis of diverse organs, especially brain and adrenal glands, by mediating Dnmt3a expression during mouse development.