Strategies for scientific and technological innovations in provincial maternal and child health care insti-tution based on PEST-SWOT model / 现代医院

Objective To investigate the internal and external factors of scientific and technological innovations in pro-vincial maternal and child health care institutions and propose effective strategies for facilitating the innovations.Methods The PEST-SWOT model was used to analyze the internal strengths and weaknesses,external opportunities,and threats of the scientific and technological innovations in a provincial maternal and child health care institution from the perspectives of political,econom-ic,social,and technical environment.Results The institution has advantages and opportunities in policy support,scientific re-search management and investment,and disciplinary characteristics.However,it faces some threats and has disadvantages in tal-ent team,information-oriented level,and industrial competition.Conclusion The development of scientific and technological in-novation in provincial maternal and child health care institutions is affected by internal and external factors.It is necessary to firmly seize opportunities and comprehensively promote scientific and technological innovations from the aspects of medical treat-ment,teaching and research collaboration,discipline layout,talent team,and information-oriented construction.

Influencing factors of the TEG maximum amplitude reduction in emergency trauma patients / 中国输血杂志

【Objective】 To investigate the causes of abnormal decrease in maximum amplitude(MA) of thromboelastography(TEG) and its effect on prognosis by monitoring the changes of coagulation-related indexes in emergency trauma patients. 【Methods】 A total of 319 cases of trauma patients admitted to our hospital from September 2020 to September 2023 were retrospectively analyzed, and the coagulation-related indexes of 0 h and 24 h after admission were observed. According to the MA results, they were divided into normal MA group(>50 mm) and reduced MA group(≤50 mm) to compare the hemoglobin(Hb), platelets count(Plt), activated partial thromboplastin time(APTT), prothrombin time(PT), fibrinogen(Fib), thrombin time(TT), D-dimer(D-D), coagulation reaction time(R), clot formation kinetics(Angle), 30 min clot dissolution rate(Ly30), MA, thrombine-antithrombin complex(TAT) and plasminase-α2 plasminase inhibitor complex(PIC). The correlation between MA and fibrinolysis indexes in 319 trauma patients was analyzed. According to whether tranexamic acid(TXA) was used, the reduced MA group was divided into a TXA group and a non-drug group. The differences in the change of the above coagulation-related indexes, mortality rate and changes in blood product dosage were compared between the two groups. 【Results】 Compared with the normal MA group, Hb, Plt, Fib, diastolic blood pressure and GCS scores decreased, while heart rate, ISS score and mortality increased significantly in the reduced MA group(P0.05). The mortality rate in the TXA group was reduced significantly(P<0.05). 【Conclusion】 Hyperfibrinolysis may be an important factor in the abnormal decrease of MA in emergency trauma patients. Treatment with TXA can improve its effect on MA, and reduce the transfusion of blood products and the patient mortality.

Maternal betaine supplementation ameliorates fatty liver disease in offspring mice by inhibiting hepatic NLRP3 inflammasome activation

BACKGROUND/OBJECTIVES@#Previous research has shown maternal betaine supplementation alleviates fetal-derived hepatic steatosis. Therefore, this study examined the anti-inflammatory effect of maternal betaine intake in offspring mice and its mechanism.MATERIALS/METHODS: Female C57BL/6J mice and their offspring were randomly divided into 3 groups according to the treatment received during gestation and lactation: control diet (CD), fatty liver disease (FLD), and fatty liver disease + 1% betaine (FLD-BET). The FLD group was given a high-fat diet and streptozotocin (HFD + STZ), and the FLD-BET group was treated with HFD + STZ + 1% betaine. After weaning, the offspring mice were given a normal diet for 5 weeks and then dissected to measure the relevant indexes. @*RESULTS@#Compared to the CD group, the offspring mice in the FLD group revealed obvious hepatic steatosis and increased serum levels of alanine aminotransferase, interleukin (IL)-6, and tumor necrosis factor (TNF)-α; maternal betaine supplementation reversed these changes. The hepatic mRNA expression levels of IL-6, IL-18, and Caspase-1 were significantly higher in the FLD group than in the CD group. Maternal betaine supplementation reduced the expression of IL-1β, IL-6, IL-18, and apoptosis-associated speck-like protein containing C-terminal caspase recruitment domain (ASC). Maternal betaine supplementation also reversed the increasing protein expressions of nitric oxide dioxygenase-like receptor family pyrin domain containing 3 (NLRP3), ASC, Caspase-1, IL-1β, and IL-18 in offspring mice exposed to HFD + STZ. Maternal betaine supplementation decreased the homocysteine (Hcy) and s-adenosine homocysteine (SAH) levels significantly in the livers. Furthermore, the hepatic Hcy concentrations showed significant inverse relationships with the mRNA expression of TNF-α, NLRP3, ASC, and IL-18. The hepatic SAH concentration was inversely associated with the IL-1β mRNA expression. @*CONCLUSIONS@#The lipotropic and anti-inflammatory effect of maternal betaine supplementation may be associated with the inhibition of NLRP3 inflammasome in the livers of the offspring mice.

Clinical characteristics and endoscopic diagnosis and treatment for colorectal mucosa associated lymphoid tissue lymphoma / 中华消化内镜杂志

Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.

Novel compound FLZ alleviates rotenone-induced PD mouse model by suppressing TLR4/MyD88/NF-

Parkinson's disease (PD) is the second most common neurodegenerative disease, but none of the current treatments for PD can halt the progress of the disease due to the limited understanding of the pathogenesis. In PD development, the communication between the brain and the gastrointestinal system influenced by gut microbiota is known as microbiota-gut-brain axis. However, the explicit mechanisms of microbiota dysbiosis in PD development have not been well elucidated yet. FLZ, a novel squamosamide derivative, has been proved to be effective in many PD models and is undergoing the phase I clinical trial to treat PD in China. Moreover, our previous pharmacokinetic study revealed that gut microbiota could regulate the absorption of FLZ

Comparison of the clinical efficacy of icotinib and gefitinib in the treatment of stage Ⅳ lung adenocarcinoma patients with EGFR sensitive gene mutation / 中国基层医药

Objective@#To compare the clinical efficacy of icotinib and gefitinib in the treatment of advanced(stage Ⅳ) lung adenocarcinoma patients with epidermal growth factor receptor(EGFR) sensitive gene mutation.@*Methods@#Fifty-four advanced(stage Ⅳ) lung adenocarcinoma patients with EGFR sensitive gene mutation were selected.According to the random number table method, the patients were divided into two groups, with 27 cases in each group.The icotinib group received icotinib hydrochloride targeted therapy, and the gefitinib group was orally given gefitinib.The clinical efficacy, quality of life score, adverse reactions, progression free survival(PFS) were compared between the two groups.@*Results@#There were no statistically significant differences in clinical curative effect between the two groups[complete remission(0 cases vs.0 cases), partial remission(9 cases vs.8 cases), stable(12 cases vs.14 cases), progress disease(6 cases vs.5 cases), objective response rate(33.3% vs.29.6%), disease control rate(77.8% vs.81.5%), Z=1.060, χ2=0.143, 0.100, all P>0.05]. After treatment, the differences of body function, social function, psychological function, common symptoms and side effects, specific modules in the gefitinib group were not statistically significant compared with those before treatment(t=1.402, 1.199, 1.840, 1.860, 1.275, all P>0.05). The icitinib group had better body function, psychological function, common symptoms, side effects and specific modules than before treatment(t=2.525, 3.335, 4.477, 3.778, all P<0.05). The psychological function, common symptoms and side effects, specific module life quality scores in the icotinib group were (39.72±4.23)points, (38.84±4.67)points, (38.94±4.56)points, respectively, which were higher than (37.08±5.14)points, (35.48±5.02)points, (35.85±4.97)points in the gefitinib group(t=2.061, 2.546, 2.380, all P<0.05). The incidence rate of Ⅰ-Ⅱ grade adverse reactions between the two groups had no statistically significant difference (χ2=4.667, P>0.05). The incidence rate of Ⅲ-Ⅳ grade adverse reactions of the icotinib group was 7.4%, which was lower than 25.9% of the gefitinib group(χ2=9.000, P<0.05). The total incidence rate of adverse reactions of the icotinib group was 40.7%, which was significantly lower than 70.4% of the gefitinib group(χ2=25.694, P<0.05). There was no statistically significant difference in mean PFS between the two groups in the 19delete mutation of EGFR gene(t=0.795, P>0.05). The average PFS of the icotinib group under EGFR gene 21L858R mutation was (14.62±3.85)months, which was longer than (10.73±5.61)months of the gefitinib group(t=2.971, P<0.05).@*Conclusion@#Icotinib, gefitinib in the treatment of advanced(stage Ⅳ) lung adenocarcinoma patients with EGFR sensitive gene mutation has similar clinical effect, but icotinib has higher safety, better tolerability, and can significantly improve the quality of life of patients, prolong the EGFR mutation of the 21L858R gene under the survival of patients.