[Reflections on integrating narrative medicine concepts into the development of pediatrics]. / å ³äºŽå„¿ç§‘å­¦å‘å±•èžå ¥å™äº‹åŒ»å­¦ç†å¿µçš„æ€è€ƒ.

Medicine is a continuously advancing science, characterized by the integration of multiple disciplines, ultimately focusing on the "human" aspect. Over the past half-century, there has been a global surge in efforts to reshape the humanistic spirit of medicine. Narrative medicine, a field that highly integrates medical professionalism with universal humanistic values, has developed rapidly in China from scratch over the past decade or so. This article introduces the development of narrative medicine both domestically and internationally, explains how to correctly understand the connotation of China's narrative medicine system and the significance of practicing narrative medicine. It analyzes current challenges in clinical practice, education and teaching, scientific research, doctor-patient consensus, and social recognition. Furthermore, it proposes directions for effort, namely, in the context of "greater health" and "new medical science", narrative medicine is empowered to help construct a harmonious medical narrative ecosystem, promote high-quality development in pediatrics, contribute to the innovation in medical education and talent training with humanistic strength and wisdom.

Mediation of serum albumin in the association of serum potassium with mortality in Chinese dialysis patients: a prospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#The clinical importance of hypokalemia is likely underrecognized in Chinese dialysis patients, and whether its clinical effect was mediated by serum albumin is not fully elucidated. This study aimed to explore the association between serum potassium and mortality in dialysis patients of a Chinese nationwide multicenter cohort, taking albumin as a consideration.@*METHODS@#This was a prospective nation-wide multicenter cohort study. Restricted cubic splines were used to test the linearity of serum potassium and relationships with all-cause (AC) and cardiovascular (CV) mortality and a subsequent two-line piecewise linear model was fitted to approach the nadir. A mediation analysis was performed to examine relations of albumin to potassium and mortalities.@*RESULTS@#A total of 10,027 patients were included, of whom 6605 were peritoneal dialysis and 3422 were hemodialysis patients. In the overall population, the mean age was 51.7 ± 14.8 years, 55.3%(5546/10,027) were male, and the median dialysis vintage was 13.60 (4.70, 39.70) months. Baseline serum potassium was 4.30 ± 0.88 mmol/L. After a median follow-up period of 26.87 (14.77, 41.50) months, a U-shape was found between potassium and mortality, and a marked increase in risk at lower potassium but a moderate elevation in risk at higher potassium were observed. The nadir for AC mortality risk was estimated from piecewise linear models to be a potassium concentration of 4.0 mmol/L. Interestingly, the significance of the association between potassium and mortality was attenuated when albumin was introduced into the extended adjusted model. A subsequent significant mediation by albumin for potassium and AC and CV mortalities were found ( P < 0.001 for both), indicating that hypokalemia led to higher mortality mediated by low serum albumin, which was a surrogate of poor nutritional status and inflammation.@*CONCLUSIONS@#Associations between potassium and mortalities were U-shaped in the overall population. The nadir for AC mortality risk was at a potassium of 4.0 mmol/L. Serum albumin mediated the association between potassium and AC and CV mortalities.

Effects of 0.05% cyclosporine eye drops(Ⅱ)on corneal nerves of patients with moderate to severe dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the efficacy of domestic cyclosporine A(CsA)in dry eye and its effect on sub-basal nerves(SBN)by observing quantitative and morphological changes in corneal SBN of patients with moderate to severe dry eye before and after the treatment with 0.05% CsA eye drops(Ⅱ).METHODS: In this prospective study, a total of 20 patients(20 eyes)with moderate to severe dry eye who admitted to the ophthalmology department of the Affiliated Eye Hospital of Nanchang University from December 2020 to January 2022 were selected. They were treated with domestic CsA and followed up for 3mo. Clinical evaluation was carried out at baseline and at 3mo after treatment. The changes in clinical symptoms, signs and morphology and quantity of SBN were observed.RESULTS: The ocular surface disease index(OSDI)score, the tear break-up time(TBUT), Schirmer Ⅰ, corneal fluorescein staining(CFS)score were significantly improved at 3mo after treatment. Confocal microscopy data analysis showed that SBN density increased from 13.49±5.43 mm/mm2 to 14.93±5.34 mm/mm2(P&#x0026;#x003C;0.001), nerve curvature scores decreased from 2.86±0.92 to 2.31±0.75(P&#x0026;#x003C;0.001), number of beaded structure decreased from 1.45±0.67/100μm to 1.07±0.45/100μm(P&#x0026;#x003C;0.001), and the number of dendritic cell(DC)decreased from 5.83±3.28 per frame to 3.67±2.24 per frame at 3mo after treatment(P&#x0026;#x003C;0.001). The number of DC was positively correlated with the number of branch nerves, the grade of nerve curvature and the number of nerve bead.(rs=0.27, P=0.045; rs=0.407, P&#x0026;#x003C;0.01; rs=0.486, P&#x0026;#x003C;0.01).CONCLUSIONS: Nerve injury was positively correlated with corneal inflammation caused by dry eye, and 0.05%CsA eye drops(II)could effectively inhibit inflammation and improve the morphology and quantity of corneal SBN. Observation of corneal SBN via in vivo confocal microscopy can be used as an effective method to evaluate the therapeutic effect of dry eye patients.

Palmitic acid hinders extracellular traps of neutrophil from postpartum dairy cow in vitro.

Peripartum dairy cows experience negative energy balance, characterized by high concentrations of blood free fatty acids (FFA) and immune dysfunction. Palmitic acid (PA), the most abundant saturated fatty acid in cow blood, is not only an energy precursor, but causes cellular dysfunction when in excess. Neutrophil extracellular traps (NET) are one of the arsenals of weapons neutrophils use to fight invading pathogens. However, given the marked increase in circulating PA during the peripartum period, it remains to be determined what effect (if any) PA has on NET release. Thus, the objective of this study was to evaluate the effect of PA on NET release and the underlying mechanism in vitro. Phorbol-12-myristate-13-acetate (PMA; 100 ng/mL, 3 h) was used to induce the release of NET in vitro. We isolated neutrophils from the peripheral blood of 5 healthy postpartum dairy cows with similar parity (median = 3, range = 2-4), milk yield (median = 27.84 kg/d per cow, range = 25.79-31.43 kg/d per cow), days in milk (median = 7 d, range = 4-10 d), and serum FFA <0.25 mM, ß-hydroxybutyric acid <0.6 mM, and glucose >3.5 mM. Inhibition of double-stranded DNA (dsDNA) level, a marker of NET release, in response to PA was used to determine an optimal incubation time and concentration for in vitro experiments. Cells were maintained in RPMI-1640 basic medium without phenol red, treated with 600 µM PA for different times (4, 5, 6, and 7 h) in the presence or absence of PMA. There was a decrease for dsDNA level in the supernatant due to increased duration of PA treatment, with a peak response at 6 h. Thus, 6 h was selected as the challenge time. Then, cells were treated with different concentrations of PA (100, 200, 400, and 600 µM) for 6 h in the presence or absence of PMA. There was a decrease for dsDNA level in the supernatant due to increased dose of PA, with a peak response at 400 µM. Finally, 400 µM PA for 6 h was selected as the treatment for subsequent experiments. Protein abundance of citrullinated histone in the presence or absence of PMA was markedly lower in response to incubation with PA. Morphological observations by laser confocal microscopy and scanning electron microscopy showed that the ratio of NET-releasing cells decreased in response to incubation with PA. Autophagy is a potential key intermediate process in the regulation of NET by PA. To investigate the effect of PA on autophagy, we used chloroquine to block lysosomal degradation. Exogenous PA led to accumulation of sequestosome-1 and microtubule-associated protein 1 light chain 3-II, and no further accumulation in the presence of chloroquine, all of which suggested an impairment of autophagic flux. To verify the role of autophagy in NET, we used rapamycin to promote autophagic flux; 100 nM rapamycin attenuated the suppressive effect of PA on NET release indicated by greater dsDNA levels, accumulation of citrullinated histone, and ratio of NET-releasing neutrophils. Overall, these data demonstrate PA inhibits NET release by suppressing autophagic flux, which provides information for understanding the immune dysfunction in postpartum cows.

Assessment of recycling methods and processes for lithium-ion batteries.

This review discusses physical, chemical, and direct lithium-ion battery recycling methods to have an outlook on future recovery routes. Physical and chemical processes are employed to treat cathode active materials which are the greatest cost contributor in the production of lithium batteries. Direct recycling processes maintain the original chemical structure and process value of battery materials by recovering and reusing them directly. Mechanical separation is essential to liberate cathode materials that are concentrated in the finer size region. However, currently, the cathode active materials are being concentrated at a cut point that is considerably greater than the actual size found in spent batteries. Effective physical methods reduce the cost of subsequent chemical treatment and thereafter re-lithiation successfully reintroduces lithium into spent cathodes. Some of the current challenges are the difficulty in controlling impurities in recovered products and ensuring that the entire recycling process is more sustainable.

Correlation of HMGB1, PON-1, MCP-1, and Periodontal P. gingivalis with Amniotic Fluid Fecal Dye.

BACKGROUND: This paper aims to investigate the correlation between high mobility group protein-1 (HMG-b1), antioxidant enzyme-1 (paraoxon-1, PON-1), monocyte chemoattractant protein-1 (monocyte chemoattractant protein-1, MCP-1), P. gingivalis, and MSAF. MATERIALS AND METHODS: The total sample size comprised of 73 cases in both groups. These patients were further subdivided into 2 groups: the MSAF group and the control group. 38 women were in the MSAF group and 35 women with term amniotic fluid serum were in the control group. The MSAF group was selected as a full-term singleton amniotic fluid fecal infection group. Clinical data were collected, and specimens were collected. Fecal staining of amniotic fluid and full-term amniotic fluid removes the placenta and umbilical cord blood. The expression of HMGB1 in the placenta was observed by immune-histochemical staining of MSAF and control groups. The content of PON-1 in cord blood was determined by ELISA. RESULTS: Correlation between maternal and neonatal clinical data and MSAF was done; MSAF group mean gestational age was 41.38 ± 1.40 weeks; control group mean gestational age was 39.20 ± 1.24 weeks. This study found no correlation between the birth weight, maternal age, sex, first/transmaternal, hyperthyroidism, hypothyroidism, and anemia between the MSAF and control group with nonsignificant P value (P > 0.05). However, the fatal age, gestational diabetes, gestational hypertension, umbilical cord abnormalities, placental abnormalities, and neonatal asphyxia factors were statistically different with a significant P value of <0.05 between both groups. HMGB1 and Periodontal P. gingivalis are mostly expressed in placental trophoblast, vascular endothelial cells, and amniotic epithelial and interstitial cells. After HE staining of 72 placentas by HE in MSAF and control, 6 had acute chorioamnionitis (5.1 control), 32 had chronic (23.9), 35 had abnormal placentas, and three in MSAF had chorionic columnar metaplasia. In immune-histochemistry experiments, the HMGB1 expression intensity of placental tissue was higher in the MSAF group (P < 0.05); however, the level of PON-1 was lower in the MSAF group as compared to the controls (P < 0.05). CONCLUSIONS: Gestational age and placental abnormalities are clinical high-risk factors for MSAF. HMGB1, PON-1, MCP-1, and Periodontal P. gingivalis may be involved in the development of MSAF, suggesting an oxidative/antioxidant imbalance with inflammation, and may be one of the mechanisms for MSAF development.

Expression and role of anti-oxidative damage factors in the placenta of preterm infants with premature rupture of membranes. / æŠ—æ°§åŒ–æŸä¼¤å› å­åœ¨èƒŽè†œæ—©ç ´æœªè¶³æœˆå„¿èƒŽç›˜ä¸­çš„è¡¨è¾¾åŠä½œç”¨.

OBJECTIVES: To study the association of the anti-oxidative damage factors nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and NAD(P)H:quinone oxidoreductase-1 (NQO1) with preterm premature rupture of membranes (PPROM). METHODS: A prospective study was conducted. The neonates who were hospitalized in Yanbian Hospital from 2019 to 2020 were enrolled as subjects, among whom there were 30 infants with PPROM, 32 infants with term premature rupture of membranes (TPROM), and 35 full-term infants without premature rupture of membranes (PROM). Hematoxylin and eosin staining was used to observe the inflammatory changes of placental tissue. Immunohistochemical staining was used to measure the expression of Nrf2, HO-1, and NQO1 in placental tissue. Western blot was used to measure the protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue. RESULTS: Compared with the PPROM group, the TPROM group and the non-PROM full-term group had significantly higher positive expression rates and relative protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue (P<0.05). There were no significant differences in the positive expression rates and relative protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue between the TPROM and non-PROM full-term groups (P>0.05). CONCLUSIONS: The low expression levels of Nrf2, HO-1, and NQO1 in placental tissue may be associated with PPROM, suggesting that anti-oxidative damage is one of the directions to prevent PPROM.

Expression and role of anti-oxidative damage factors in the placenta of preterm infants with premature rupture of membranes / 中国当代儿科杂志

OBJECTIVES@#To study the association of the anti-oxidative damage factors nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and NAD(P)H:quinone oxidoreductase-1 (NQO1) with preterm premature rupture of membranes (PPROM).@*METHODS@#A prospective study was conducted. The neonates who were hospitalized in Yanbian Hospital from 2019 to 2020 were enrolled as subjects, among whom there were 30 infants with PPROM, 32 infants with term premature rupture of membranes (TPROM), and 35 full-term infants without premature rupture of membranes (PROM). Hematoxylin and eosin staining was used to observe the inflammatory changes of placental tissue. Immunohistochemical staining was used to measure the expression of Nrf2, HO-1, and NQO1 in placental tissue. Western blot was used to measure the protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue.@*RESULTS@#Compared with the PPROM group, the TPROM group and the non-PROM full-term group had significantly higher positive expression rates and relative protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue (P<0.05). There were no significant differences in the positive expression rates and relative protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue between the TPROM and non-PROM full-term groups (P>0.05).@*CONCLUSIONS@#The low expression levels of Nrf2, HO-1, and NQO1 in placental tissue may be associated with PPROM, suggesting that anti-oxidative damage is one of the directions to prevent PPROM.

Molecular Mechanism of Nardostachyos Radix et Rhizoma-Agrimoniae Herba in Treatment of Arrhythmia Based on Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo explore the material basis and mechanism of Nardostachyos Radix et Rhizoma （NRER）-Agrimoniae Herba （AH）， the herbal pair effective in regulating the liver， invigorating Qi， and calming palpitations， in the treatment of premature ventricular contractions （PVCs） by network pharmacology and molecular docking. MethodThe chemical components and targets of NRER and AH were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） combined with relevant literature. GeneCards，Online Mendelian Inheritance in Man（OMIM），and DrugBank were used to predict the potential targets against PVCs. STRING platform was used for protein-protein interaction （PPI） analysis. Metascape platform was used for Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analysis. Cytoscape 3.8.0 was used to construct the NRER-AH component-potential target-signaling pathway network. The main target proteins underwent molecular docking to the active components of NRER-AH by AutoDock 4.2.6. ResultThe targets of nine active components in NRER-AH （such as quercetin，kaempferol，and acacetin） against PVCs mainly involved tumor necrosis factor （TNF），mitogen-activated protein kinase 1（MAPK1），and protein kinase B1（Akt1）. The potential targets were mainly enriched in 26 signaling pathways，such as pathways in cancer and the advanced glycosylation end product （AGE）-receptor of advanced glycosylation end product（RAGE） signaling pathway. The results of molecular docking showed that the majority of the active components （92.59%） of NRER-AH had good binding activities with the main target proteins TNF，MAPK1，and Akt1. ConclusionThe active components of NRER-AH can regulate cardiac ion channels，resist inflammation， and combat oxidative stress to treat PVCs through multi-target and multi-pathway interventions. They can also improve symptoms related to depression and anxiety by inhibiting monoamine oxidase activity and protecting nerves from damage. This study is expected to provide research ideas and the theoretical basis for further exploring the material basis and mechanism of NRER-AH in the treatment of PVCs.

Efficacy and safety of tea tree essential oil with different concentrations in the treatment of Demodex blepharitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the effectiveness and safety of different concentrations of tea tree essential oil in the treatment of Demodex blepharitis. <p>METHODS: The clinical data of 120 patients(240 eyes)with blepharitis caused by Demodex infection in our hospital from June 2017 to June 2019 were retrospectively analyzed. According to the use of tea tree essential oil concentrations of 10%, 15%, 20% and 25%, patients were divided into 4 groups(group A, group B, group C, group D), each group with 30 people. All patients were given meibomian gland massage, eyelid margin cleaning, and then scrubbed with different concentrations of tea tree oil to clean the eyelid margin. The number of demodex mites, clinical symptom score, clinical sign score, tear film break-up time(BUT), corneal fluorescein staining(FL)and SchirmerⅠtest(SⅠt)were compared before and 2, 4wk after treatment.<p>RESULTS: The number of Demodex mites, clinical symptom score, clinical sign score, BUT, FL and SⅠt were not statistically significant in the four groups before treatment(<i>P</i>>0.05). After treatment, the number of Dmodex mites, clinical symptom score, and clinical sign score in each group were lower than those before treatment, and the number of Demodex mites, clinical symptom score, and clinical sign score after 4wk of treatment in each group were lower than those after 2wk of treatment(all <i>P</i><0.008). After 2 and 4wk of treatment, the number, clinical symptom score and clinical signs score of Demodex mites in group A were the highest, while those in group D were the lowest(all <i>P</i><0.008). After treatment, the BUT of each group was higher than before treatment, and reached the peak in the 4wk. After 2 and 4wk of treatment, BUT among groups was highest in group D and lowest in group A(all <i>P</i><0.008). After treatment, FL and S I t of each group were lower than before treatment, and reached the lowest value in the 4wk. After 2 and 4wk of treatment, FL among the groups was the lowest in group D and the highest in group A(all <i>P</i><0.008). <p>CONCLUSION: Compared with 10% tea tree essential oil, 15% tea tree essential oil can effectively repel mites, relieve clinical symptoms and eye signs in patients with Demodex blepharitis, and is safer than 20% and 25% tea tree essential oils. As the preferred concentration of tea tree essential oil against Demodex blepharitis.

Comparison of the stability of different concentrations of fluorescein sodium on the detection of tear film rupture time / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the stability of different concentrations of fluorescein sodium solution on the detection of tear break-up time(TBUT).METHODS:A retrospective study. A total of 150 cases(150 eyes)who came to our dry eye clinic with good cooperation from August 2019 to September 2021 were selected for the study, and the subjects were randomly divided into five groups, which were fluorescein sodium(FLS, 0.5%), FLS(1.0%), FLS(1.5%), FLS(2.0%)and fluorescein sodium parallel(FLSP), with 30 patients in each group(all the right eyes were the subject eyes). Each group was dripped with the corresponding fluorescein sodium. The FLSP group was the fluorescent test strip detection group. The slit lamp image scores of different concentration groups were compared, the survival time of sodium fluorescein at the instant, 2, 5, 10, 15 and 30min points was observed in each group, and the mean value of TBUT in each group was recorded.RESULTS: The image score of FLS(0.5%)group was significantly higher than that of the other four groups(t=7.746, 21.483, 116.190, 38.730, all P&#x003C;0.01). The image score of FLS(1.0%)group was significantly higher than that of FLS(1.5%)and FLS(2.0%)group(t=10.742, 15.492, all P&#x003C;0.01). The survival time of fluorescein in FLS(0.5%)group was significantly shorter than that of the other four groups(t=8.226, 7.458, 9.159, 12.347, all P&#x003C;0.01). The survival time of fluorescein in FLS(1.5%)group was significantly longer than that of FLS(1.0%)and FLS(2.0%)group(t=15.428, 13.274, all P&#x003C;0.05). TBUT in FLS(0.5%)group was significantly higher than that of the other four groups at 2min(t=22.767, 22.345, 15.494, 17.213, all P&#x003C;0.01), and was significantly lower than that of the other four groups at 10min(t=23.266, 25.353, 10.183, 22.025, all P&#x003C;0.01). The mean first TBUT of FLS(1.5%)group was significantly shorter than that of the other four groups(t=25.236, 21.374, 19.658, 72.341, all P&#x003C;0.01), and the mean first TBUT of FLSP group was significantly longer than that of the other four groups(t=22.487, 30.267, 60.247, 40.857, all P&#x003C;0.01). There was no significant correlation between TBUT and ocular surface disease index(OSDI)and tear river height(rs=-0.072, 0.219, P=0.689, 0.112). TBUT was positively correlated with tear secretion(rs=0.674, P&#x003C;0.01).CONCLUSION: FLS(0.5%)had higher image quality but it was only suitable for observing staining within 5min, and the FLSP group was more suitable for clinical observation of corneal fluorescence staining for a longer period; FLS(1.5%)was the most stable and reliable concentration and dose for the detection of TBUT.

Transfusion rates and disease spectrum in neonates treated with blood transfusion in China.

This study aimed to investigate blood transfusion rates and spectrum of diseases in hospitalized neonates treated with blood transfusion in China to provide supporting data for future studies on neonatal blood transfusion.Data on hospitalized neonates were obtained from more than 100 experts from the Department of Neonatology of 55 hospitals in China between January 1, 2012 and December 31, 2016, using a standardized survey. A statistical analysis was conducted to evaluate the data collected, including the blood transfusion rates, blood component transfused, spectrum of diseases, and spectrum of major diseases.Between 2012 and 2016, 541,128 neonates were hospitalized in the 55 hospitals surveyed. There were 70,433 neonates who received blood transfusion, with an average transfusion rate of 13.02%. The rates of red blood cell transfusion, platelet transfusion, and plasma transfusion were 9.44%, 0.66%, and 4.77%, respectively. The neonatal blood transfusion rate was 17.99% in Northeast China, 9.74% in Northwest China, and between 10.60% and 16.22% in other regions. The neonatal blood transfusion rate was 12.3% in general hospitals and 13.8% in women and children's hospitals. The top 10 diseases identified in hospitalized neonates treated by blood transfusion were, in rank order, as follows:prematurity,pneumonia, hyperbilirubinemia, bacterial sepsis, respiratory distress syndrome, anemia, hemolytic disease, asphyxia, hemorrhage, and necrotizing enterocolitis.The neonatal blood transfusion rate in China is 13.03%.The rank order in the disease spectrum of the hospitalized neonates and that in hospitalized neonates treated with blood transfusion are different.

Correlation between cervical elastography parameters and time of the first stage of labor in late pregnancy by transvaginal ultrasound / 中华超声影像学杂志

Objective:To investigate the correlations between the labor process and the elastography parameters, and to explore the correlations among the elastography parameters.Methods:A total of 48 pregnant women in the late periods of pregnancy in Beijing Hospital from November 10, 2018 to January 30, 2019 were recruited prospectively. Elastography was performed to measure several elastographic parameters including the cervical length (CL), elasticity contrast index (ECI), hardness ratio (HR), internal orifice uterus(IOS) and external orifice uterus(EOS). They were followed up to delivery, and were divided into normal group and prolonged group according to the time duration of the first stage of labor. The correlation between the parameters and the time duration of the first stage of labor, as well as the relationships among the parameters were evaluated.Results:Among the 48 pregnant women, 35 cases were delivered by the vagina, 13 by cesarean section, 4 of whom were due to the prolongation of the first stage of labor and the other 9 cases for other reasons. The values of the CL and HR in normal group were significantly lower than that in prolonged group ( P=0.004, 0.02). The ECI in the normal group was significantly higher than that in the prolonged group ( P=0.046). Both the IOS and EOS in the normal group were higher than those in prolonged group without no significant difference( P>0.05). For the 35 women who underwent cervical elasticity assessment before labor and finally delivered vaginally, the duration of the first stage of labor was negatively correlated with cervical ECI ( r=-0.415, P<0.05). The ECI were negatively correlated with CL and HR ( r=-0.528, -0.374; P<0.05), and HR were negatively correlated with IOS and EOS ( r=-0.669, -0.558; P<0.01), whereas HR had no significant correlation with CL( P>0.05). Conclusions:The ECI of cervical tissue measured by cervical elastography can be used to semi-quantitatively evaluate the maturity of the cervix, it has potential value in predicting the labor duration and guiding clinical decision-making.

Mechanism of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma on Atrial Fibrillation Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To investigate the mechanism of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma in treatment of atrial fibrillation by predicting targets and signaling pathways based on network pharmacology.Method:The traditional Chinese medicine system platform (TCMSP) database was used to screen out active components of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma,predict targets,and construct the active component-predicted target network.Through the Online Mendelian Inheritance in Man (OMIM),Therapeutic Target Database (TTD),and Genecards databases,potential target information of atrial fibrillation was retrieved.STRING 11.0 database was used to obtain the protein-protein interaction data of relevant targets,and the results were visualized by Cytoscape 3.7.1 software to construct protein-protein interaction network relating to atrial fibrillation.The predicted targets of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma were mapped to the potential targets of atrial fibrillation.The intersection targets were the potential targets for the treatment of atrial fibrillation with Nardostachyos Radix et Rhizoma and Corydalis Rhizoma.Then,Visualization and Integrated Discovery (DAVID),a database for annotation,was used to analyze biological functions and pathways of the potential targets of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma in the treatment of atrial fibrillation.Finally,Cytoscape3.7.1 software was utilized to construct active component-potential target-signal pathway network of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma in treatment of atrial fibrillation.Result:Totally 51 active components of Nardostachyos Radix et Rhizoma and Corydalis Rhizoma were screened out,and 18 potential targets for the treatment of atrial fibrillation with Nardostachyos Radix et Rhizoma and Corydalis Rhizoma were predicted.The effect was mainly correlated with the regulation of interleukin-6 (IL-6),sodium channel protein type 5 subunit alpha (SCN5A),tumor necrosis factor (TNF),nitric-oxide synthase,endothelial (NOS3),potassium voltage-gated channel subfamily hmember 2 (KCNH2),collagen alpha-1(I) chain (COL1A1),retinoic acid receptor RXR-alpha (RXRA),tissue factor (F3),alpha-1B adrenergic receptor (ADRA1B) and other target proteins,cyclic guanosine monophosphate (cGMP)/cGMP-dependent protein kinase G (PKG) signaling pathway,phosphatidylinositol-3-kinases (PI3K)/protein kinase B (Akt) signaling pathway,transcriptional disorders in cancer,calcium signaling pathways,and adrenergic signals in cardiomyocytes.Conclusion:Nardostachyos Radix et Rhizoma and Corydalis Rhizoma treat atrial fibrillation based on multiple components,multiple targets and multiple channels,and provide a scientific basis for subsequent experimental studies for further explainning its mechanism of action.

[Concerns about neonates discharged against medical advice from the neonatal intensive care unit].

Discharge against medical advice (DAMA) conflicts with the purpose of disease treatment in children. Some research has shown that there are high proportions of extremely preterm infants and infants with asphyxia or congenital malformation in neonates with DAMA. This suggests that the sustainable development of neonatology needs cooperation and co-development with obstetrics, neonatal surgery, and radiology to reduce the rate of DAMA. With reference to the current status of research in both China and other countries, this article reviews the causes for DAMA and the strategies for reducing the rate of DAMA, in order to provide a theoretical basis for effectively reducing the rate of DAMA from the neonatal intensive care unit, improving treatment outcomes of the neonates, and increasing hospitals' comprehensive benefits.

Concerns about neonates discharged against medical advice from the neonatal intensive care unit / 中国当代儿科杂志

Discharge against medical advice (DAMA) conflicts with the purpose of disease treatment in children. Some research has shown that there are high proportions of extremely preterm infants and infants with asphyxia or congenital malformation in neonates with DAMA. This suggests that the sustainable development of neonatology needs cooperation and co-development with obstetrics, neonatal surgery, and radiology to reduce the rate of DAMA. With reference to the current status of research in both China and other countries, this article reviews the causes for DAMA and the strategies for reducing the rate of DAMA, in order to provide a theoretical basis for effectively reducing the rate of DAMA from the neonatal intensive care unit, improving treatment outcomes of the neonates, and increasing hospitals' comprehensive benefits.

Exogenous γ-Aminobutyric Acid Improves the Structure and Function of Photosystem II in Muskmelon Seedlings Exposed to Salinity-Alkalinity Stress.

Gamma-aminobutyric acid (GABA) is important in plant responses to environmental stresses. We wished to clarify the role of GABA in maintenance of photosynthesis in muskmelon seedlings (Cucumis melo L., cv. Yipintianxia) during saline-alkaline stress. To this end, we assessed the effect of GABA on the structure and function of the photosynthetic apparatus in muskmelon seedlings grown under saline-alkaline stress. These stresses in combination reduced net photosynthetic rate, gas-exchange, and inhibited photosystem II (PSII) electron transport as measured by the JIP-test. They also reduced the activity of chloroplast ATPases and disrupted the internal lamellar system of the thylakoids. Exogenous GABA alleviated the stress-induced reduction of net photosynthesis, the activity of chloroplast ATPases, and overcame some of the damaging effects of stress on the chloroplast structure. Based on interpretation of the JIP-test, we conclude that exogenous GABA alleviated stress-related damage on the acceptor side of PSII. It also restored energy distribution, the reaction center status, and enhanced the ability of PSII to repair reaction centers in stressed seedlings. GABA may play a crucial role in protecting the chloroplast structure and function of PSII against the deleterious effects of salinity-alkalinity stress.

[Effect of exogenous γ-aminobutyric acid on NO3--N assimilation in muskmelon under Ca(NO3)2 stress]. / 外源γ-æ°¨åŸºä¸é ¸å¯¹Ca(NO3)2胁迫下甜瓜幼苗NO3--N同化的影响.

The effect of exogenous γ-aminobutyric acid (GABA) on NO3--N assimilation in muskmelon under Ca(NO3)2 stress was investigated in ' Yipintianxia 208', a salt-sensitive melon variety cultured under deep flow hydroponics which simulated soil salinization. The results showed that under Ca(NO3)2 stress, the activities of nitrate reductase (NR), glutamate synthetase (GS) and glutamate amino transferase (GOGAT) in muskmelon seedlings were significantly reduced, while the activities of glutamate dehydrogenase (GDH), glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate aminotransferase (GPT) were enhanced, leading to increased contents of NH4+-N and total amino acids, and decreased contents NO3--N and soluble protein in muskmelon, which further severely inhibited plant growth and photosynthesis of muskmelon seedlings. Exogenous GABA effectively improved the absorption of NO3--N in muskmelon roots and its transportation from root to shoot under Ca(NO3)2 stress, and improved NH4+-N assimilation by enhancing NR, GS and GOGAT activities in muskmelon seedlings. Exogenous GABA also reduced NH4+ release by limiting GDH deamination, thus further alleviated the toxication of NH4+-N induced by Ca(NO3)2 stress. In addition, foliage spraying of GABA could regulate amino acids metabolic pathways and promote protein synthesis. The results suggested that exogenous GABA could improve NO3--N assimilation and regulate amino acids metabolism to alleviate Ca(NO3)2 stress damage in muskmelon seedlings.

[Effect of insulin-like growth factor-1 on hyperoxia-induced apoptosis in A549 cells].

OBJECTIVE: To investigate the effect of insulin-like growth factor-1 (IGF-1), which can promote cell differentiation and inhibit cell apoptosis, on hyperoxia-induced apoptosis in A549 cells and its anti-apoptotic mechanism. METHODS: A549 cells were sub-cultured, exposed to hyperoxic conditions and were then treated with different concentrations of IGF-1 (1, 10, and 100 ng/mL) for 48 hours. Cell viability was measured by MTT assay. Cell apoptosis was evaluated by Annexin V-FITC/PI double-staining flow cytometry. Expression levels of Bax and Bcl-2 were measured by flow cytometry. RESULTS: The middle-dose and high-dose IGF-1 intervention groups had higher cell viabilities than the hyperoxic exposure group [(64±3)% and (88±4)% vs (51±3)%; P<0.05]. Compared with the air control group, the hyperoxic exposure group had a significantly higher apoptotic rate [(38.3±5.4)% vs (2.4±0.9)%; P<0.05], a significantly lower expression level of Bcl-2 [(72±5)% vs (91±4)%; P<0.05], and a significantly higher expression level of Bax [(54±6)% vs (3±2)%; P<0.05]. Compared with the hyperoxic exposure group, the low-dose, middle-dose, and high-dose IGF-1 intervention groups had significantly lower apoptotic rates [(16.1±4.7)%, (9.2±2.8)%, and (6.9±2.5)% vs (38.3±5.4)%; P<0.05], significantly higher expression level of Bcl-2 [(79±4)%, (94±4)%, and (100±5)% vs (72±5)%; P<0.05], and significantly lower expression level of Bax [(26±4)%, （5±2)%, and (4±2)% vs (54±6)%; P<0.05]. CONCLUSIONS: Hyperoxia significantly inhibits proliferation and promotes apoptosis in A549 cells. IGF-1 may promote cell proliferation and inhibit hyperoxia-induced apoptosis in A549 cells by regulating the expression of Bcl-2 and Bax.

Relationship of iron overload to bone mass density and bone turnover in postmenopausal women with fragility fractures of the hip / 中华外科杂志

<p><b>OBJECTIVE</b>To study relationships between serum ferritin and bone metabolism in patients with hip fragility fractures.</p><p><b>METHODS</b>This cross-sectional study included 76 postmenopausal women with hip fracture from Feburary 2011 to June 2012. The mean age of the women was (73 ± 10) years (range, 55-93 years) and the mean duration of menstruation was (22 ± 10)years (range, 5-50 years). Serum concentrations of ferritin, transferrin, alkaline phosphatase (ALP), amino-terminal extension peptide of type I collagen (P1NP), C-terminal telopeptides of type I collagen (β-CTX)and femoral and lumbar bone mineral density by dual-energy X-ray absorptiometry were measured. Bone metabolism was compared between normal and elevated ferritin groups with t-test, Pearson linear, partial correlation and multiple regression analysis examined associations between iron- and bone-related markers.</p><p><b>RESULTS</b>Serum ferritin concentration raised to (230 ± 146)µg/L, transferrin concentration reduced to (1.89 ± 0.33)g/L. P1NP concentration raised to (61 ± 32) ng/L when the concentration of serum ALP and β-CTX were in the normal range. T-scores for bone mineral density in the femoral neck (-2.0 ± 1.1) and lumbar (-2.1 ± 1.2) were below the normal ranges(-1.0-1.0). The subjects were divided into two groups according to serum ferritin concentration, normal group(serum ferritin concentration ≤ 150 µg/L, n = 25) and elevated group(serum ferritin concentration > 150 µg/L, n = 51). Patients of elevated group had lower bone mineral density in femoral neck and lumbar than normal group(t = 3.13,2.89, P < 0.01), and higher P1NP, β-CTX concentration (t = -2.38, -3.59, P < 0.05) . In partial correlation analysis adjusted for confounders, serum ferritin concentration was correlated negatively with bone mineral density in both femoral neck and lumbar (r = -0.335,-0.295, P < 0.05), and positively with P1NP and β-CTX (r = 0.467,0.414, P < 0.05), but not correlated with ALP (r = 0.188, P > 0.05). Transferrin concentration tended to be correlated positively with bone mineral density in both femoral neck and lumbar (r = 0.444, 0.262, P < 0.05) and negatively with ALP, P1NP and β-CTX(r = -0.326,-0.285,-0.278, P < 0.05).</p><p><b>CONCLUSIONS</b>Iron overload has a high prevalence in postmenopausal women with fragility fracture. Increased iron stores, which might lead to bone loss and lower bone mineral density by enhancing the activity of bone turnover, could be an independent factor to take effects on bone metabolism on postmenopausal women.</p>