Pulmonary artery dissection secondary to ventricular septal defect and pulmonary valve stenosis.

The aortic short axis view demonstrated the widening of the pulmonary artery and the membrane-like echo in the pulmonary artery divided it into true lumen and false lumen. And the flow of the ruptured openings on the band-like echo was clearly revealed by Color Doppler.

Glutathione S-transferase templated copper nanoclusters as a fluorescent probe for turn-on sensing of chlorotetracycline.

Hereby, facile-green copper nanoclusters templated by glutathione S-transferase (GST-CuNCs) have been innovatively synthesized via a simple one-pot stirring method at room temperature. The as-prepared nanoclusters exhibited uniform size with satisfactory fluorescence intensity, good stability and low cytotoxicity. Significantly, the fluorescence of the obtained GST-CuNCs could be considerably enhanced by the addition of chlorotetracycline (CTC) rather than other analogues of CTC, which was ascribed to the aggregation-induced enhancement caused by the interaction between CTC and GST. The enhanced fluorescence intensity demonstrated a good linear correlation with the CTC concentration in the range of 30-120 µM (R2 = 0.99517), and the low detection limit was 69.7 nM. Furthermore, the proposed approach showed favorable selectivity and anti-interference toward CTC among prevalent ions and amino acids. Additionally, this nanoprobe was also applied to the quantitative detection of CTC in serum samples with satisfactory outcomes, which demonstrated excellent prospects for practical applications.

Polysaccharides in contact lenses: From additives to bulk materials.

As the number of applications has increased, so has the demand for contact lenses comfort. Adding polysaccharides to lenses is a popular way to enhance comfort for wearers. However, this may also compromise some lens properties. It is still unclear how to balance the variation of individual lens parameters in the design of contact lenses containing polysaccharides. This review provides a comprehensive overview of how polysaccharide addition impacts lens wear parameters, such as water content, oxygen permeability, surface wettability, protein deposition, and light transmittance. It also examines how various factors, such as polysaccharide type, molecular weight, amount, and mode of incorporation into lenses modulate these effects. Polysaccharide addition can improve some wear parameters while reducing others depending on the specific conditions. The optimal method, type, and amount of added polysaccharides depend on the trade-off between various lens parameters and wear requirements. Simultaneously, polysaccharide-based contact lenses may be a promising option for biodegradable contact lenses as concerns regarding environmental risks associated with contact lens degradation continue to increase. It is hoped that this review will shed light on the rational use of polysaccharides in contact lenses to make personalized lenses more accessible.

The aptamer-based RNA-PROTAC.

RNA-binding proteins (RBPs) dysfunction has been implicated in a number of diseases, and RBPs have traditionally been considered to be undruggable targets. Here, targeted degradation of RBPs is achieved based on the aptamer-based RNA-PROTAC, which consists of a genetically encoded RNA scaffold and a synthetic heterobifunctional molecule. The target RBPs can bind to their RNA consensus binding element (RCBE) on the RNA scaffold, while the small molecule can recruit E3 ubiquitin ligase to the RNA scaffold in a non-covalent manner, thereby inducing proximity-dependent ubiquitination and subsequent proteasome-mediated degradation of the target protein. Different RBPs targets, including LIN28A and RBFOX1, have been successfully degraded by simply replacing the RCBE module on the RNA scaffold. In addition, the simultaneous degradation of multiple target proteins has been realized by inserting more functional RNA oligonucleotides into the RNA scaffold.

Ras Inhibitor Lonafarnib Rescues Structural and Functional Impairments of Synapses of Aß1-42 Mice via α7nAChR-Dependent BDNF Upregulation.

Alzheimer's disease (AD) is characterized pathologically by the structural and functional impairments of synapses in the hippocampus, inducing the learning and memory deficiencies. Ras GTPase is closely related to the synaptic function and memory. This study was to investigate the effects of farnesyl transferase inhibitor lonafarnib on the synaptic structure and function in AD male mice and explore the potential mechanism. Our results showed 50 mg/kg lonafarnib (intraperitoneal) rescued the impaired spatial memory and improved the damaged synaptic transmission and plasticity of Aß1-42 mice. In addition, lonafarnib ameliorated the morphology of synaptic dendrites and spines in Aß1-42 mice. Furthermore, lonafarnib enhanced α7nAChR cell surface expression and phosphorylation of downstream Akt and CaMKII in Aß1-42 mice, which were inhibited by α7nAChR antagonist methyl lycaconitine (MLA), and increased the phosphorylation of CREB in a CaMKII- but not ERK-dependent way. Lonafarnib enhanced hippocampal brain-derived neurotrophic factor (BDNF) concentration in Aß1-42 mice, which was sensitive to MLA and KN93 (an inhibitor of CaMKII), but not related to ERK and Akt pathways. H-Ras, but not Rhes, was related to the lonafarnib induced improvement of α7nAChR cell surface expression and BDNF content. Interestingly, lonafarnib induced improvement of synaptic transmission, plasticity and spatial cognition in Aß1-42 mice was abolished by BDNF deprivation with TrkB/Fc chimera protein. Our results indicate that lonafarnib can rescue the structural and functional impairments of synapses in the Aß1-42 mice, which may be related to the improvement of BDNF content through the H-Ras-α7nAChR-dependent CaMKII-CREB pathway, leading to the improvement of spatial cognition.SIGNIFICANCE STATEMENT Alzheimer's disease (AD) is characterized pathologically by the structural and functional impairments of synapses in the hippocampus, inducing the learning and memory deficiencies. However, no effective drugs have not been developed for the treatment of AD synaptic. This study for the first time reported the beneficial effects of Ras inhibitor lonafarnib on the synaptic structure and function in AD mice, providing an alternative way for the treatment of "synaptic disease" in AD patients.

The development and effect evaluation of training program of clinical teaching ability enhancement for clinical nurse specialists based on Cone of Learning / 中华医学教育探索杂志

Objective:To explore the method and effect of training program of clinical teaching ability enhancement for geriatric clinical nurse specialists based on Cone of Learning.Methods:A one-week clinical teaching ability enhancement training program based on Cone of Learning for geriatric clinical nurse specialists was designed and provided for a total of 70 trainees in three sessions, which mainly covered 8 items, including the design and management of training program for clinical nurse, case-based teaching method, clinical application of Workshop method, the implementation and evaluation of nursing teaching rounds, and the making of multi-media courseware. The comprehensive effect evaluation was carried out through the examination of trainees' trial teaching, the self-evaluation of teaching ability, the degree of teaching satisfaction and the feedback of teaching practice in all trainees. SPSS 22.0 was used for t-test. Results:Twenty trainees were rated as excellent with (87.32±3.26) points, and 35 rated as good with (81.75±5.19) points; the self-evaluation of integrative teaching ability scored (1.54±0.66) points before the training and (3.69±0.52) points after the training. The ability was enhanced compared with that before the training ( P < 0.001). The degree of satisfaction of the training program was 97.43% (341/350). After returning to the unit, 64.29% (45/70) of geriatric clinical nurse specialists completed the assignments. Conclusion:The training program for geriatric clinical nurse specialists can effectively improve their clinical teaching ability and is worthy of further promotion and application.

Comparative study on gerontological advanced practice nurses training between China and America / 中华医学教育探索杂志

Objective:To compare the differences between China and America in gerontological advanced practice nurses training, and to improve the quality of the training programs in China from the mature experience of America.Methods:Relative literature were retrieved from CNKI, Wanfang Database, Weipu Database, PubMed, Clinical Key Nursing and official websites of Chinese and American Nursing Associations, and the retrieved literature were screened and the contents were extracted. Then the training status of gerontological advanced practice nurses in China and America were analyzed and summarized.Results:The similarities and differences of seven elements of gerontological advanced practice nurses in China and America were introduced and compared, namely, classification and training mode, curriculum provision, core competence and faculty, qualification authentication and scope of practice.Conclusion:Drawing lessons from from America, we should explicit training target, set phased long training mechanism, strengthen the construction of teaching staff, and establish practice standards to propel and improve the nursing training program in China.

Lanthanide Polyoxometalate Based Water-Jet Film with Reversible Luminescent Switching for Rewritable Security Printing.

Luminescent security printing is of particular importance in the information era. However, the use of conventional paper still carries a lot of economic and environmental issues. Therefore, developing new environmentally friendly security printing material with a low cost is imperative. To achieve the aforementioned goals, novel lanthanide polyoxometalate doped gelatin/glycerol films with high transparency, high strength, and good flexibility have been developed via a solution-casting method. The electrostatic interaction between zwitterionic gelatin and polyoxometalate was confirmed by attenuated total reflection Fourier transform infrared spectroscopy. Luminescent spectra and digital images indicated that the films exhibited reversible luminescent switching properties through association and dissociation of hydrogen bonds between glycerol and water molecules, allowing its potential application as water-jet rewritable paper for luminescent security printing. Furthermore, the printed information can be conveniently "erased" by heating, and the film can be reused for printing. The film exhibited excellent ability to be both rewritten and re-erased. A QR code pattern and hybrid printing were employed to improve the security of information. In addition, the rewritable films possessed excellent regeneration ability and low toxicity, as well as good stability against UV irradiation and organic solvents. The water-jet rewritable film based on lanthanide polyoxometalate for luminescent security printing, to the best of our knowledge, has not yet been reported up to date. This work provides an attractive alternative strategy on fabricating rewritable films for luminescent security printing in terms of cutting down the cost, simplifying the preparation process, and protecting the environment.

Catalytic asymmetric synthesis of N-substituted tetrahydroquinoxalines via regioselective Heyns rearrangement and stereoselective transfer hydrogenation in one pot.

N-Substituted tetrahydroquinoxalines (37 examples) were step-economically obtained in good yield (<97%) and ee (<99%) with readily available substrates. The reaction proceeds through an interesting regioselective Heyns rearrangement/enantioselective transfer hydrogenation in one pot. The substrate scope and the reaction mechanism were systematically investigated.

Dynamic Observation of the Effect of Maternal Caries on the Oral Microbiota of Infants Aged 12-24 Months.

Aim: To provide a dynamic description of the oral microbial composition in mothers with and without dental caries and their children aging 12-24 months. Methodology: A total of 20 pairs of mothers and their children aged 12 months were included and followed up at 18 and 24 months of age. Ten mothers with dental caries(MEG) and their children(CEG) were in the exposure group, and ten caries-free mothers(MCG) and their children(CCG)in control group. Supragingival plaque biofilm samples were collected and DNA was extracted for bacterial 16S rRNA gene sequencing. Results: A total of 18 pairs completed follow-ups. At a 3% divergence level, the number of common operational taxonomic units found between the mothers and children increased as the children aged. Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Actinobacteria accounted for more than 80% phyla of each group. A microbial community structure analysis showed that the differences between mothers and children were significant in all groups except for the MEG24 and CEG24 groups. Conclusions: Oral microbiota of children was more like their mothers' with increasing age, regardless of whether the mothers had dental caries. Mothers with dental caries may have a greater influence on the oral microbiota of children's than those without dental caries as children age.

Stimuli-activatable nanomaterials for phototherapy of cancer.

Phototherapy including photothermal therapy (PTT) and photodynamic therapy (PDT), as non-invasive therapy approaches, have gained accumulated attention for cancer treatment in past years. PTT and PDT can generate local hyperthermia effects and reactive oxygen species (ROS) respectively, for tumor eradication. To improve the therapeutic performance while minimizing the reverse side effects of phototherapy, extensive efforts have been devoted to developing stimuli-activatable (e.g. pH, redox, ROS, enzyme, etc) nanomaterials for tumor-specific delivery/activation of the phototherapeutics. In this review, we first overviewed the recent advances of the engineered stimuli-responsive nanovectors for the phototherapy of cancer. We particularly summarized the progress of stimuli-activatable nanomaterials-based combinatory therapy strategies for augmenting the performance of phototherapy. We further discuss challenges for the clinical translation of nanomaterials-based phototherapy.

Regioselective, Diastereoselective, and Enantioselective One-Pot Tandem Reaction Based on an in Situ Formed Reductant: Preparation of 2,3-Disubstituted 1,5-Benzodiazepine.

The 1,5-benzodiazepines are important skeletons frequently contained in medicinal chemistry. Herein, we described an unexpected tandem cyclization/transfer hydrogenation reaction for obtaining chiral 2,3-disubstituted 1,5-benzodiazepines. The enolizable aryl aldehydes were chosen as substrates to react with symmetric and unsymmetric o-phenylenediamines. The unforeseen tandem reaction occurred among many possible latent side reactions under chiral phosphoric acid catalysis and affords the corresponding products in moderate yields and regioselectivities, good diastereoselectivities, and enantiomeric ratio (up to 99:1).

Rescue of male infertility through correcting a genetic mutation causing meiotic arrest in spermatogonial stem cells / 亚洲男科学杂志(英文版)

Azoospermia patients who carry a monogenetic mutation that causes meiotic arrest may have their biological child through genetic correction in spermatogonial stem cells (SSCs). However, such therapy for infertility has not been experimentally investigated yet. In this study, a mouse model with an X-linked testis-expressed 11 (TEX11) mutation (Tex11

Combined use of transversus abdominis plane block and laryngeal mask airway during implementing ERAS programs for patients with primary liver cancer: a randomized controlled trial.

The incidence and mortality of primary liver cancer are very high and resection of tumor is the most crucial treatment for it. We aimed to assess the efficacy and safety of combined use of transversus abdominis plane (TAP) block and laryngeal mask airway (LMA) during implementing Enhanced Recovery After Surgery (ERAS) programs for patients with primary liver cancer. This was a prospective, evaluator-blinded, randomized, controlled parallel-arm trial. A total of 96 patients were enrolled (48 in each group). Patients in the control group received general anesthesia with endotracheal intubation, while patients in the TAP + LMA group received general anesthesia with LMA and an ultrasound-guided subcostal TAP block. The primary end-point was postoperative time of readiness for discharge. The secondary end-points were postoperative pain intensity, time to first flatus, quality of recovery (QoR), complications and overall medical cost. Postoperative time of readiness for discharge in the TAP + LMA group [7 (5-11) days] was shorter than that of the control group [8 (5-13) days, P = 0.004]. The postoperative apioid requirement and time to first flatus was lower in the TAP + LMA group [(102.8 ± 12.4) µg, (32.7 ± 5.8) h, respectively] than the control group [(135.7 ± 20.1) µg, P = 0.000; (47.2 ± 7.6) h, P = 0.000; respectively]. The QoR scores were significantly higher in the TAP + LMA group than the control group. The total cost for treatment in the TAP + LMA group [(66,608.4 ± 6,268.4) CNY] was lower than that of the control group [(84,434.0 ± 9,436.2) CNY, P = 0.000]. There was no difference in complications between these two groups. The combined usage of a TAP block and LMA is a simple, safe anesthesia method during implementing ERAS programs for patients with primary liver cancer. It can alleviate surgical stress, accelerate recovery and reduce medical cost.

Strong red-emitting gold nanoclusters protected by glutathione S-transferase.

Glutathione S-transferase (GST) is distributed widely in tissues and has been proven to be vital in the body. For example, it catalyzes reduced glutathione (GSH) to a variety of electrophilic substances and thus protects cells against many toxic chemicals. Therefore, GST-related investigations have always been significant for medical and/or life sciences. In the present study, a new material of gold nanoclusters (Au-NCs) protected by GST, Au-NCs@GST, was fabricated via an improved one-step heating method. The products were fully characterized by X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS), and Fourier transform infrared (FT-IR) and circular dichroism (CD) spectra. The results confirmed that around 10 gold atoms are encapsulated in one intact GST, forming Au-NCs@GST with strong (QY = 13.5%) red emission at 670 nm. Therefore, a new nanomaterial possessing both strong luminescence and bio-functions of GST was developed, and it has great potential in GST-related investigations. To prove the concept, Au-NCs@GST was successfully applied to detect metronidazole (MNZ) both in solution and in living cells. Therefore, in the present study, we report not only a new nanomaterial of Au-NCs@GST but also a feasible fluorescence probe for antibiotic detection. Both the improved synthetic method and the design concept can be extended to the fabrication of other kinds of metal nanoclusters using different functional proteins for various purposes.

Hybrid Assembly toward Enhanced Thermal Stability of Virus-like Particles and Antibacterial Activity of Polyoxometalates.

In an effort to improve both the stability of virus-like particles (VLPs) and the medical activity of polyoxometalates (POMs), a new hybrid assembly system between human papillomavirus (HPV) capsid protein L1 and a europium-containing POM (EuW10) has been constructed, for the first time, via the electrostatic interactions between them. The co-assembly of EuW10 and HPV 16 L1-pentamer (L1-p) in buffer solution resulted in the encapsulation of POMs in the cavity of VLPs, which was further confirmed by cesium chloride (CsCl) gradient ultracentrifugation, SDS-PAGE, dynamic light scattering, and transmission electron microscopy, whereas the post-assembly of EuW10 with the as-prepared VLPs leads to the adsorption of POMs only on the external surface of particles, and both cases improved the thermal and storage stabilities of VLPs obviously. Particularly, the encapsulation of POMs in VLPs largely improved the antibacterial activity of EuW10, and thereby, the present study will be significant for both the stability improvement of protein vaccines and the development of POM medicine.

Bibliometric analysis of studies on medical teaching case library construction in China / 中国实用护理杂志

Objective To analyze current situation and development tendency of medical teaching case library construction and to provide information for medical teaching reform. Methods Bibliometrics was used to retrieve and analyze literatures on the subject of medical teaching case library construction from China National Knowledge Infrastructure, CBMdisc, VIP and Wanfang Data from construction to June 20th,2017. Results Totally 116 articles published in 71 journals were included.A gradual growth was found in the number of publication and funded articles. The average citation count was 2.05. A majority of articles were produced in Beijing, Guangdong and Shanghai. Medical teaching case library covered 9 majors and 42 courses and applied in class teaching (50.00%, 58/116), clinical practice (37.07%, 43/116), refresher training (2.59%, 3/116), assessment and evaluation (0.86%, 1/116). Satisfaction investigate,examination score analysis and expert review were commonly used to evaluate the quality of case library. Conclusions Researches in China on medical teaching case library construction were increasing in recent years.Case library were applied in various aspects of medical teaching,however, there still remained some problems.Articles on the subject of case library were not highly-cited.There was no core author group yet. The subject on medical case library still needed deep and further exploration. There′s suggestion that we should attach importance to medical case library construction and related study to push medical education reform.

Impact of different analgesic depths and abdominal trauma of different severities on stress and recovery of rats undergoing total intravenous anesthesia.

A number of animal models have been developed to examine the pathophysiological consequences of surgical procedures, but anesthetic methods, monitoring, and management measures in these models are very different from those used in humans. This study was designed to create a rat model of abdominal surgery using anesthetic methods and perioperative treatment similar to those used in the clinic and to investigate the effects of different injury severities and depths of anesthesia and analgesia on surgical stress and postoperative recovery. Abdominal skin/muscle incision was compared with exploratory laparotomy in rats under propofol intravenous anesthesia, accompanied by perioperative measures such as oxygen inhalation, fluid infusion, warmth, blood gas analysis, and infection prevention. Stress indices (mean arterial pressure, heart rate, blood glucose, and plasma corticosterone) were monitored during anesthesia and surgery, and recovery indicators (body weight, food consumption, and pain) were measured after surgery. In addition, animals undergoing laparotomy were subjected to low and high dosages of propofol and sufentanil, in order to examine the relationship between anesthetic and analgesic depth and stress on recovery. Exploratory laparotomy induced a greater stress response and caused slower postoperative recovery as measured than somatic injury. High-dose sufentanil downregulated plasma corticosterone and improved postoperative recovery more effectively than high-dose propofol (P<0.05). Taken together, a rat model of abdominal surgery using anesthetic methods and perioperative treatment similar to those used in the clinic was successfully developed. It showed a positive correlation between severity of surgical trauma and stress response and postoperative recovery and a significant role of adequate analgesia in reducing surgical stress and improving postoperative recovery.

Biocompatible supramolecular dendrimers bearing a gadolinium-substituted polyanionic core for MRI contrast agents.

Two cationic dendrons bearing terminal groups of triethylene glycol monomethyl ether in different generations were used to encapsulate a paramagnetic polyoxometalate cluster K13[Gd(ß2-SiW11O39)2], in which the Gd3+ ion was sandwiched by the coordination of two lacunary [ß2-SiW11O39]8- sub-clusters, through electrostatic interaction. Benefiting from the surface covering of cationic dendrons and ionic complexation, both inorganic polyanionic core and the complexes formed maintained chemical stability in a physiological environment. In addition, the formed charge-neutralized supramolecular complex dendrimers with biocompatible periphery had low cytotoxicity but high relaxivity for in vitro and in vivo magnetic resonance imaging (MRI) in the self-assembled state. Because of the branched structure of organic components on the cluster surface and the disordered packing of complexes in aggregations, a reasonable communication of cluster core with the bulk environment was concluded. Importantly, due to the assembled particle size and molecular weight, the complex dendrimers were a suitable model for liver-specific MRI contrast agents. The results obtained showed that the dendritic supramolecular hybrid complexes represent potential MRI contrast agents in the development of new biomedical materials.

Potential applications of polyoxometalates for the discrimination of human papillomavirus in different subtypes.

The binding-induced luminescence enhancement of an Eu-containing polyoxometalate (POM), EuSiWMo, by the arginin/lysine-rich cationic peptides supplied a platform to detect the capsid proteins of human papillomaviruses (HPVs). However, the strong binding affinity between them makes it very difficult to be differentiated among peptides from different subtypes of HPVs. Therefore, several strategies to monitor the binding affinity of POM-peptide are performed and finally the discriminations on representative peptides from different subtypes of HPV capsid proteins are achieved in the present study. The results show that an Eu-containing POM, EuW10, with nine negative charges is sufficient to discriminate different subtypes of HPV peptides based on the specific sequence and basic charge differences. The discrimination mechanisms between them explored at sub-molecular level using time-resolved fluorescence spectra and isotherm titration calorimetric (ITC) reveal both the driving force and binding model accordingly. Therefore, this study reports a simple, low-cost and efficient fluorescence enhanced method to discriminate the peptides from different subtypes of HPV capsid proteins, which would be possible after further optimization.