Effects of different early sedation levels on clinical outcomes of ICU patients with mechanical ventilation / 中国实用护理杂志

Objective:To investigate the current sedation level of patients with mechanical ventilation in ICU, and to explore the influence of early different sedation levels on clinical outcomes, so as to provide theoretical basis for better guidance of clinical sedation evaluation and implementation of sedation strategy management.Methods:This study was a retrospective longitudinal study. The 201 patients with invasive mechanical ventilation who underwent sedation in the Department of Intensive Care Medicine of the First Affiliated Hospital of Guangxi Medical University from January to December 2021 were selected by convenience sampling method. According to the results of Richmond Agitation-Sedation Scale(RASS), the patients were divided into deep sedation group (98 cases) and shallow sedation group (103 cases). The influencing factors of endotracheal intubation retention time and outcome were investigated by Cox multifactor analysis.Results:In the early sedation ≤48 h after the start of mechanical ventilation, 63.2%(2 143/3 389) of patients with invasive mechanical ventilation had a RASS score of shallow sedation, 35.2%(1 194/3 389) of patients with deep sedation, and 1.5%(52/3 389) of patients with insufficient sedation. Cox multivariate regression analysis showed that age, sedation level, duration of invasive mechanical ventilation and continuous renal replacement therapy were the factors influencing the indentation time of tracheal insertion ( χ2 values were 4.73 to 74.31, all P<0.05); early deep sedation was a risk factor for delayed extubation ( HR=0.499, 95% CI 0.276-0.903, P<0.05); gender, sedation level, invasive mechanical ventilation duration, acute physiology and chronic health evaluation Ⅱ scores, admission mode, continuous renal replacement therapywere the influencing factors of patient outcomes ( χ2 values were 4.41 to 26.20, all P<0.05). The deeper the sedation, the worse the patient outcomes ( HR=0.568, 95% CI 0.335-0.963 all P<0.05) . Conclusions:The early sedation level is related to the retention time and outcome of tracheal intubation in ICU patients with mechanical ventilation, and different sedation levels affect the clinical outcome of patients. The retention time of tracheal intubation in patients with shallow sedation was shortened, which was beneficial to the outcome of patients.Therefore, sedation evaluation should be strengthened in clinical work, and sedation methods should be selected according to the needs of patients. In the absence of contraindications, the shallow sedation strategy should be implemented as soon as possible. This study provides some reference and theoretical basis for the formulation and management of clinical sedation strategies.

Dose-response relationships of resistance exercise intensity in frail elderly: a systematic review / 中国实用护理杂志

Objective:To systematically evaluate the dose-response relationships of resistance exercise intensity in frail elderly.Methods:A comprehensive search of randomized controlled trials on the dose-response relationships of resistance exercise for frail elderly in PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database. The documents that met the conditions were screened out, and after the data were extracted and the quality of the documents were evaluated, the RevMan 5.3 software was used for Meta analysis.Results:A total of 10 eligible randomized controlled trials were included in this study. The subjects of the study were 454 cases of frail and pre-frail elderly. After Meta analysis, there was a dose-response relationships between the training intensity of resistance exercise and the muscle strength, muscle endurance, and physical function of frail elderly. Both low-intensity and high-intensity resistance exercises can significantly increase the leg muscle strength of frail elderly people ( MD=4.58, 95% CI 3.34-5.82, P<0.05) and muscle endurance ( MD=12.27, 95% CI 6.54-17.99, P<0.05). Compared with low-intensity resistance exercise, high-intensity resistance exercise increased leg muscle strength of frail elderly people ( MD=7.97, 95% CI 0.85-15.09, P<0.05) and muscle endurance ( MD=6.94, 95% CI 5.21-8.66, P<0.05) showed more obvious advantages. The analysis of the results of the chair sitting test and the stairs climbing test shows that low-intensity resistance exercise has no obvious advantage in improving the physical function of frail elderly people, while high-intensity resistance exercise can significantly improve the physical function of frail elderly people ( MD=-5.8, 95% CI -7.3--4.29, P<0.05; MD=-1.20, 95% CI-2.17--0.23, P<0.05). Conclusions:Resistance exercise can significantly improve the muscle strength, muscle endurance and physical function of the frail elderly. High-intensity resistance exercise is more effective than low-intensity resistance exercise.

A study on personalized nutritional intervention based on nutritional assessment in long-term continuous nursing for elderly postoperative colorectal cancer patients / 中华临床营养杂志

Object:To explore the role of personalized nutritional intervention based on nutritional assessment in long-term continuous nursing of elderly postoperative colorectal cancer patients.Methods:Elderly patients with colorectal cancer who received radical surgery in a tertiary hospital in Beijing were screened from January 2021 to January 2022 and a total of 100 patients at nutritional risk (defined as with a Nutritional Risk Screening 2002 [NRS 2002] score ≥ 3) were included in the study. Patients were stratified by age and then divided into control and intervention groups with 50 cases in each. The control group received regular health guidance and follow-up visits at postoperative outpatient clinics while the intervention group received personalized nutritional intervention based on nutritional assessment additionally. The intervention period was 12 months. Nutritional indicators including body mass index (BMI), upper arm circumference, grip strength and hemoglobin, as well as albumin and quality of life (QoL), are compared between the two groups.Results:Compared with the control group, the intervention group showed significantly better results of BMI [(18.46±0.53) vs (16.9±0.77)], upper arm circumference [(25.09±1.41)cm vs (23.49±1.45)cm], grip strength [(28.34±8.00)kg vs (23.97±7.19)kg], HGB [(135.10±9.27)g/L vs (106.40±8.73)g/L] and ALB [(41.62±3.41)g/L vs (28.62±2.38)g/L, all P < 0.01]. The intervention group also had significantly higher scores in physical [(20.96±2.03) vs (15.66±0.82)], emotional [(21.48±1.64) vs (15.76±1.00)], social [(23.44±1.67) vs (15.96±0.99)], and functional [(20.74±1.74) vs (5.46±0.97)] domains of QoL (all P<0.01). Conclusion:In elderly patients with colorectal cancer after radical resection, personalized nutritional intervention based on nutritional assessment can effectively control nutritional indicators, help reduce the incidence of malnutrition, improve postoperative quality of life, and inform the establishment of standardized process in nutrition management.

Molecular evolutionary analysis reveals Arctic-like rabies viruses evolved and dispersed independently in North and South Asia

Background@#Arctic-like (AL) lineages of rabies viruses (RABVs) remains endemic in some Arctic and Asia countries. However, their evolutionary dynamics are largely unappreciated. @*Objectives@#We attempted to estimate the evolutionary history, geographic origin and spread of the Arctic-related RABVs. @*Methods@#Full length or partial sequences of the N and G genes were used to infer the evolutionary aspects of AL RABVs by Bayesian evolutionary analysis. @*Results@#The most recent common ancestor (tMRCA) of the current Arctic and AL RABVs emerged in the 1830s and evolved independently after diversification. Population demographic analysis indicated that the viruses experienced gradual growth followed by a sudden decrease in its population size from the mid-1980s to approximately 2000.Genetic flow patterns among the regions reveal a high geographic correlation in AL RABVs transmission. Discrete phylogeography suggests that the geographic origin of the AL RABVs was in east Russia in approximately the 1830s. The ancestral AL RABV then diversified and immigrated to the countries in Northeast Asia, while the viruses in South Asia were dispersed to the neighboring regions from India. The N and G genes of RABVs in both clades sustained high levels of purifying selection, and the positive selection sites were mainly found on the C-terminus of the G gene. @*Conclusions@#The current AL RABVs circulating in South and North Asia evolved and dispersed independently.

Circular RNA HIPK3 is a Prognostic and Clinicopathological Predictor in Malignant Tumor Patients.

Objectives: Circular RNA Homeodomain Interacting Protein Kinase 3 (circHIPK3) is one of the most researched circRNAs in recent 5 years. Many individual studies confirmed that aberrantly expression of circHIPK3 held prognostic value in various tumors. Thus, the aim of this meta-analysis is to assess its prognostic potentials and functions in malignant tumors. Materials and methods: Multiple databases were carefully searched for articles published about circHIPK3 over the past 10 years. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to demonstrate prognostic value of circHIPK3 using Stata 15.0 software. Results: 8 studies including 1175 patients were ultimately enrolled in this meta-analysis. Pooled results showed that abnormal expression of circHIPK3 was significantly correlated with unfavorable OS (pooled HR=2.12, 95% CI: 1.69-2.66) and DFS/PFS (HR=2.28, 95% CI: 1.67-3.10) in cancer patients. Additionally, abnormal expression of circHIPK3 was also related to the distal metastasis of the tumors (OR: 3.27, 95%CI: 2.16-4.97, p<0.001). Conclusions: Abnormal expression of circHIPK3, no matter high or low expression, was associated with poor clinical outcomes in multiple cancer types. More comprehensive studies were required to verify and strengthen the clinical value of circHIPK3 in human malignant diseases.

PM2.5 in poultry houses synergizes with Pseudomonas aeruginosa to aggravate lung inflammation in mice through the NF-κB pathway

Background@#High concentrations of particulate matter less than 2.5 μm in diameter (PM2.5) in poultry houses is an important cause of respiratory disease in animals and humans. Pseudomonas aeruginosa is an opportunistic pathogen that can induce severe respiratory disease in animals under stress or with abnormal immune functions. When excessively high concentrations of PM2.5 in poultry houses damage the respiratory system and impair host immunity, secondary infections with P. aeruginosa can occur and produce a more intense inflammatory response, resulting in more severe lung injury. @*Objectives@#In this study, we focused on the synergistic induction of inflammatory injury in the respiratory system and the related molecular mechanisms induced by PM2.5 and P. aeruginosa in poultry houses. @*Methods@#High-throughput 16S rDNA sequence analysis was used for characterizing the bacterial diversity and relative abundance of the PM2.5 samples, and the effects of PM2.5 and P. aeruginosa stimulation on inflammation were detected by in vitro and in vivo. @*Results@#Sequencing results indicated that the PM2.5 in poultry houses contained a high abundance of potentially pathogenic genera, such as Pseudomonas (2.94%). The lung tissues of mice had more significant pathological damage when co-stimulated by PM2.5 and P. aeruginosa, and it can increase the expression levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α through nuclear factor (NF)-κB pathway in vivo and in vitro. @*Conclusions@#The results confirmed that poultry house PM2.5 in combination with P. aeruginosa could aggravate the inflammatory response and cause more severe respiratory system injuries through a process closely related to the activation of the NF-κB pathway.

A modified gentamicin protection assay for detecting invasive phenotype of Salmonella enterica serovar Enteritidis / 生物工程学报

Salmonella enterica serovar Enteritidis (SE) is one of the most important zoonotic pathogens that cause enteritis and systemic infection in animals and human. Understanding invasive capacities of SE isolates is of vital importance to elucidate pathogenesis of Salmonella infection. To improve the throughput capacity and repeatability of classical gentamicin protection assay (GPA), a modified PGA was developed by taking high-throughput advantage of 96-well cell plates and multichannel pipettes. In addition, drop plate technique rather than spread plate method was applied in the modified GPA protocol for bacterial enumeration. The modified GPA protocol was evaluated by phenotyping intracellular replication of a high virulent and a low virulent SE isolates, JL228 and LN248, in a phagocytic cell line RAW264.7. The protocol was then applied in invasive phenotype determination of 16 SE strains to non-phagocytes (HT-29) and the intracellular replication of 43 SE strains to phagocytes (RAW264.7). Significant lower intra-group and inter-group coefficient of variations of the modified GPA was observed, implying good repeatability and reproducibility over traditional protocol. Further, replication phenotypes were also correlated with those from direct observation by confocal microscopy. Collectively, the improved GPA protocol had advantages of high throughput capacity, good repeatability and reliability, it was also noticed that the protocol also represented a fast and labor-saving alternative scheme for the invasive phenotype determination of Salmonella Enteritidis, and providing reliable phenotype profiles for Salmonella-host interplay interpretation.

Percutaneous Endoscopic C2-C3 Medial Branches Neurotomy for Cervicogenic Headache.

BACKGROUND: Cervicogenic headache (CEH) is characterized by unilateral posterior head and neck pain originating from cervical structures and may be improved or resolved by successful treatment of the causative cervical disorder or lesion. Cervical medial branch radiofrequency (RF) lesion therapy is effective in some CEH patients with no significant pathologic abnormalities that can be surgically corrected. However, patients with refractory CEH are often encountered clinically. CASE DESCRIPTION: Here we describe the case of a 68-year-old female with an 18-year history of CEH who did not respond to a series of treatments including nonsteroidal antiinflammatory drugs, anticonvulsants, medial branch diagnostic block, medial branch RF lesion, and spinal cord stimulation. After careful examination, we performed percutaneous endoscopic right C2-C3 medial branch neurotomy under local anesthesia and neuroleptanalgesia. The patient's constant pain was ultimately relieved. CONCLUSIONS: For patients with refractory CEH who failed medial branch RF lesion, which could be relieved briefly by diagnostic medial branch injection, percutaneous endoscopic C2-C3 medial branches neurotomy may alleviate their pain under the premise of full informed consent, accurate localization, careful intraoperative exploration, and stimulation testing.

Dorsal Root Entry Zone Lesion for Neuropathic Pain Due to Thoracolumbar Spine Fracture: Long-Term Result.

OBJECTIVE: To retrospectively evaluate long-term efficacy and safety of dorsal root entry zone (DREZ) lesion for treatment of neuropathic pain within the lower extremities and perineal region after thoracolumbar spine fracture. METHODS: Forty-two patients were treated with posterior laminectomy under general anesthesia. The DREZ regions of the spinal cord segments were ablated under a microscope. Data regarding pain relief, pain variation over time, and postoperative complications were collected. The relationship between injured spinal column segment, spinal cord, nerve root, and pain territory were analyzed retrospectively. RESULTS: Spinal column injury segments were located between T12 and L4. Pain territories were distributed between the T11 and S5 dermatomes with varying ranges, at an average of 2-6 segments higher than the spinal cord injury segments. Pain relief rate was 100% in 21 patients (50.0%) and was over 50% in 14 patients (33.3%). Eighteen patients (42.9%) developed temporary tingling in the upper edge of the spinal cord lesion segment after surgery. Of the 4 patients with unilateral lower extremity pain, 2 developed postoperative persistent pain in the contralateral lower extremity. CONCLUSIONS: For patients with neuropathic pain of the lower extremities and/or the perineal region after thoracolumbar spine fracture, pain within the lower extremities was mostly because of nerve root injury. Pain in the perineal region caused by L1 fracture was attributed to spinal cord injury segmental pain. Nerve root injury pain had a good prognosis after DREZ lesion; the effect of DREZ lesion for spinal cord injury segmental pain may be uncertain.

Evaluation on the confidence of refusing unprotected sex behavior and related factors among college students in Zhejiang province / 中华流行病学杂志

Objective@#To understand the confidence-related factors of refusing unprotected sex behavior among college students in Zhejiang province.@*Methods@#Stratified cluster random sampling method was conducted among college students from 13 colleges and universities in Zhejiang province, from October to November, 2018. A total of 3 718 students who self-reported "ever having had sexual contacts" were enrolled. Chi-square test was used to compare the confidence of rejecting unprotected sex under different demographic characteristics, sexual attitude/behaviors and different intervention approaches. Multivariate logistic regression model was used to analyze the related factors.@*Results@#A total of 3 718 college students were involved in this study with average age as (20.17±1.38) years old and 70.5% (2 620/3 718) were male. The proportions of having confidence to refuse unprotected sex behavior were 74.9% (1 963/2 620) of male and 77.9% (896/1 098) of female students, respectively. According to the results from multivariate logistic regression analysis, factors that related to the confidence of refusing unprotected sex behavior in male students would include, did not accept casual sex behavior (compared with accepted students, OR=2.247, 95%CI: 1.828-2.762), did not accept homosexual behavior (compared with accepted students, OR=1.810, 95%CI: 1.302- 2.516), having casual sex behavior in the past one year (compared with having no sex behavior, OR=1.345, 95%CI: 1.051-1.721), aware of the availability of HIV self-test reagents service in college (compared with did not knew, OR=1.381, 95%CI: 1.011-1.887), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.707, 95%CI: 1.374-2.121). In female students, the factors would include: being urban resident (compared with rural residence, OR=1.816, 95%CI: 1.225-2.693), 21 years old or above (compared with 20 years old or below, OR=1.469, 95%CI: 1.075-2.007), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.597, 95%CI: 1.093-2.333), etc.@*Conclusions@#Both male and female college students had higher confidence in refusing unprotected sex behavior. For male students, refusing casual or homosexual contacts, having casual sex in the recent year, knowing HIV self-test reagents service and having had HIV-related risk self-assessment in college as related factors. However, for female students; city residence, 21 years old and above, and having a HIV infection risk self- assessment in college appeared as related factors. Sexual health education should be strengthened to reduce unprotective sex behavior and to promote HIV infection risk self-assessment among the college students.

Fluid structure interaction analysis of transcatheter aortic valve implantation / 中国组织工程研究

BACKGROUND: Cardiac valve replacement provides an effective therapeutic means for valvular heart disease. Compared with thoracotomy surgery, interventional treatment, typified by transcatheter aortic valve implantation, has the advantages of minor trauma and rapid recovery. At present, the transcatheter aortic valve replacement is rarely applied in clinical practice. Existing studies mainly focus on the changes of physiological conditions after surgery, while little is reported on the transcatheter aortic valve models. OBJECTIVE: To explore the deformation and stress distribution features of the transcatheter aortic valve, and to verify its working performance. METHODS: The finite element geometric model and mathematical model of the aortic valve, including the aortic valve, blood vessel wall, blood and stent, were established. The fluid structure interaction analysis was carried out by the immersion boundary method, and the effective orifice area index was calculated to verify the performance of the model. RESULTS AND CONCLUSION: During the course of blood shock, the valve leaflets were curl, and the maximum deformation occurred at 1/4 and 3/4 of the valve leaflet free edge. The largest equivalent stress of the aortic valve model was on the stent, but it is almost unformed. The stress concentration of the valve leaflets was located at the curved site of the free edge and the suture points of the leaflets and stents, where a damage easily occurred. The dynamic flow experiments show that the process of the simulation model deformation and effective orifice area index are close to the experimental results. Therefore, the simulation model is reasonable and effective.

Dynamic changes of serum COR and PCT levels in patients with sepsis after burn and analysis of its clinical application / 国际检验医学杂志

Objective To explore the clinical value of Dynamic testing of serum cortisol (COR) and procalcitonin (PCT) in the prediction and prognosis of sepsis after burn.Methods 122adult patients with severe burns who were treated by our unit from September 2014to November 2017were selected and retrospective analyzed.According to the diagnosis criteria of sepsis and the prognosis, the patients were divided into nonsepsis group, sepsis survival group and sepsis death group.The serum COR and PCT level in 1-20days after burn were continuously and dynamically monitored and measured using an automated electrochemical method and immunofluorescence method respectively.Results The serum COR levels in sepsis patients were significantly higher than those in non-sepsis group from the sixth day after burns (P<0.05) , and the serum PCT levels were significantly higher than those in the non-sepsis group from the 7th day after burn (P<0.05) .From the 11th day after burn, the serum COR and PCT levels in the sepsis death group were significantly higher than those in the sepsis survival group (P<0.05);the serum PCT levels in the sepsis death group were significantly higher than those in the sepsis survival group from the 15th day after the burn (P<0.05) .The serum COR levels in the sepsis-dead group decreased linearly, and the serum COR levels were significantly lower than those in the sepsis survival group (P<0.05) .Conclusion The combined testing of serum COR and PCT can be used as an early predictor of post burn sepsis, The Dynamic testing of serum COR and PCT levels in the important clinical application value in the evaluation of prognosis of sepsis after burn.

The effect of resistance training on the rehabilitation of hand in rheumatoid arthritis patients / 中国实用护理杂志

Objective To investigate the effect of resistance training on the rehabilitation of hand joint in patients with rheumatoid arthritis. Methods Selecting 66 cases of the stable phase of rheumatoid arthritis (ra) patients in a rheumatoid immunology outpatient of a general hospital in Beijing during October 2016 to March 2017 ,33 patients were randomly divided into control group and 33 patients into intervention group by using random number. Exercise instruction of routine finger operation in control group;The intervention group was guided by trained nurses with finger exercises and resistance training. Two groups of patients were tested before and after 3 months of exercise, and both hands were tested and the patients were recorded with their hands. The patients were evaluated by the Signals of Functional Impairment(SOFI). Results Before exercise, the grip strength, morning stiffness time, SOFI score in the control group were:60.0(43.0,100.5) mmHg(1 mmHg=0.133 kPa), 45.0(30.0,60.0)min,2.0(1.0,3.0),and in the intervention group they were:85.0(49.3,108.7) mmHg,45.0(30.0,60.0) min,2.0(1.0,3.0),the differences between two groups of had no statistical significance (Z=-1.488,-0.609,-0.118, P>0.05). After three months of exercise, the grip strength, morning stiffness time, SOFI score in the control group were:60.0 (40.5,102.7) mmHg,30.0(10.0,45.0) min,1.0(1.0,2.0),and in the intervention group they were:89.5(56.0, 119.0) mmHg,10.0(5.0,15.0) min,1.0(0.0,1.0),the differences between two groupshad statistical significance (Z=-2.412,-3.668,-2.998,P<0.05).This showed that the grip strength was significantly increased compared with the control group,while the morning stiffness of the intervention group was significantly lower than the control group, and SOFI was significantly reduced compared with the control group, and all the differences were statistically significant. The results also showed that in the control group, the grip force did not change significantly three months later, and the difference was not statistically significant ( P>0.05), but in the intervention group, the grip strength was significantly higher three months later, and the morning stiffness and SOFI were significantly reduced in the group, and the differences were statistically significant (Z=-4.865,-5.508,-4.711, P<0.05). Conclusions The effect of anti-resistance training on the function of hand joint in rheumatoid arthritis patients is better than that of conventional finger operation, especially in improving the grip strength.

Evidence of two genetically different lymphotropic herpesviruses present among red deer, sambar, and milu herds in China

Herpesvirus infections in Cervidae are a serious threat affecting some deer species worldwide. In our attempt to identify malignant catarrhal fever-associated herpesviruses in deer herds, ten gammaherpesviral DNA fragments were identified in five species of deer in herds in China by using a pan-herpesvirus polymerase chain reaction assay targeting viral DNA polymerase. Notably, in sambar (Rusa unicolor), a novel gamma-2 herpesvirus was identified that showed a close relationship with fallow deer lymphotropic herpesvirus (LHV), while the other fragments were phylogenetically grouped together with Elk-LHV. Determination of whether these viruses have any clinical implication in these deer species should be undertaken urgently.

Antophagy inhibition can decrease AR42J cell apoptosis induced by exendin-4 / 中华肝胆外科杂志

Objective To explore whether exendin-4 inhibits AR42J cells and its mechanism.Methods AR42J cells were treated with exendin-4 under multiple concentrations(1,5,10 pmol/L) at 24,48,72,96,120 h to assess its cell viability by MTT assay and got the IC-50 and time points.Then checking whether exendin-4 could induce the AR42Jcells apoptosis by setting normal control (NC) group,exendin-4 (Ex-4) group and Ex-4+ z-VAD-fmk (apoptosis inhibitor) group,and exploring whether 3-MA which is autophagy inhibitor could inhibit the AR42J cells apoptosis induced by exendin-4 by setting NC group,Ex-4 group and Ex-4+3-MA group.Cell viability was analyzed by MTT and the cells apoptosis was detected by flow cytometry and the protein levels of caspase-3,LC3 and p62 were studied by Western blot.Results Concentration of 10 pmol/L exendin-4 and and time point 72 h were selected for the further study.z-VAD-fmk pretreatment can significantly inhibit the cell viability of exendin-4 by (81.2±3.3)％ vs.(49.4±3.0)％ (P＜0.05).Flow cytometry showed that exendin-4 could induce the AR42J cells apoptosis by (28.2± 1.4)％ vs.(3.6±0.8)％,and increased the caspase-3 level by Western blot,which both can be reversed by (79.1 ±2.3) ％ vs.(49.8±2.5)％ (P＜0.05) when the cells were treated for 72 h,as was apoptosis ratio by (14.5±2.1)％ vs.(29.2±3.2)％.Western blot showed that exendin-4 can upregulate protein levels of LC3B-Ⅱ,p62 和 caspase-3 and 3-MA,and pretreatment can inhibit the upregulation of LC3B-Ⅱ and caspase-3 but further increased the upregulation of p62 induced by exendin-4.Conclusions Exendin-4 can induce AR42J cells apoptosis and 3-MA pretreating can inhibit exendin-4 cytotoxicity through downregulating autophagy.So auto phagy inhibitor 3-MA could potentially extenuate the cytotoxicity of exendin-4 in pancreatic acinar cells.

Expression and significance of autophagy-related genes in acute pancreatitis / 中华胰腺病杂志

Objective To examine the expression and analyze the significance of autophagy-related gene microtubule-associated protein 1 light chain 3 (MAP1-LC3,LC3),p62 and lysosorne-associated membrane protein 2 (LAMP-2) in pancreatic tissues of mice with acute pancreatitis (AP).Methods Twenty mice were randomized into AP group and control group,and the number of mice was equal between two groups.AP group was intra-peritoneally injected by 20％ L-arginine solution (two injections of 4 g/kg body weight,every 1 h) in the dosage of 4 g/l kg twice every 1 hour to establish AP model,while control group was administered with equal volume of normal saline by intra-peritoneal injection.All the mice were euthanized at 24 hour after the last injection.Pancreatic histopathological changes were measured.In addition,the protein expressions of LC3,p62 and LAMP-2 were detected by Western blot.Results No obvious pathological changes were observed in control group.Pancreatic acinar edema,structure destruction,missing,the obvious widening of interlobular septum,small interlobular septum and acinar septum,and the necrosis of acinar cells at different degrees were observed in AP group.The pathological score for tissue edema,hemorrhage,necrosis and inflammation in AP group was 3.13 ± 0.50,2.83 ± 0.32,3.25 ± 0.46 and 3.16 ± 0.47,respectively,which was all 0 in control group.The differences were statistically significant between AP group and control group (P ＜ 0.01).In AP group,the ratio of LC3-Ⅱ/LC3-Ⅰ,p62 and LAMP-2 protein in pancreatic tissue were 1.16 ± 0.08,0.94 ± 0.04 and 0.35 ± 0.04,respectively,which were 0.24 ± 0.02,0.34 ± 0.03 and 0.95 ± 0.03 in control group.The ratio of LC3-Ⅱ/LC3-Ⅰ and p62 protein in pancreatic tissue in AP group were much higher than those in control group,while LAMP-2 in AP group was lower than that in control group,and there was statistically significant difference between two groups (all P ＜0.01).Conclusions Intraperitoneal injection of L-arginine could induce acute pancreatitis,and autophagy is impaired,which was associated with decreased LAMP-2 protein expression.

Effect of finger exercises and cognitive training in elderly patients with mild cognitive impairment / 现代临床护理

Objective To explore the effect of finger exercises and cognitive training on cognitive function, ability of daily living and quality of life of elderly patients with mild cognitive impairment. Methods About 90 elderly patients with mild cognitive impairment were randomly divided into experimental group and control group. In the experimental group finger exercises and cognitive training were implemented, and the control group was given routine care and health education. 3 months and 6 months after the intervention, the two groups were compared in respect of the cognitive function, ability of daily living and quality of life. Results The difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between the two groups 3 month and 6 month after the intervention (P<0.05). Pairwise comparison done at three time points (before intervention, 3 months and 6 months after intervention) in the experimental group showed that the difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between before intervention and 3 months after intervention, before intervention and 6 months after intervention. Conclusion The finger exercises and cognitive training in elderly patients with mild cognitive impairment can effectively strengthen the cognitive function and ability of daily living, and improve the quality of life.

Regulatory effect of microRNA-141 on synthesis of high mobility group protein B1 in mouse carcinoma cell line hepal-6 / 中南大学学报(医学版)

OBJECTIVE@#To explore the regulatory effect of microRNA-141 (miR-141) on expression of high mobility group protein B1 (HMGB1) in mouse hepatoma carcinoma cell line (hepal-6 cells).
@*METHODS@#The hepal-6 cells were divided into 4 groups: a miR-141 mimic group, a miR-141 mimic control group, a miR-141 inhibitor group and a miR-141 inhibitor control group. The miR-141 was transfected into hepal-6 cells with lipofectamine 2000. The levels of miR-141 and HMGB1 mRNA in the hepal-6 cells were detected by quantitative real-time PCR (qRT-PCR), and then HMGB1 protein was examined by Western blot. The regulatory effect of miR-141 on 3'-UTR of candidate target gene (HMGB1) was determined by dual-luciferase reporter assay.
@*RESULTS@#Compared with the control group, the level of miR-141 was up-regulated in the miR-141 mimic group, while down-regulated in the miR-141 inhibitor group. Moreover, the levels of HMGB1 mRNA and protein decreased in the miR-141 mimic group, while increased in the miR-141 inhibitor group. The dual-luciferase reporter assay showed that miR-141 could target the 3'-UTR of HMGB1 gene.
@*CONCLUSION@#MiR-141 can up-regulate the expression of HMGB1 protein at the post-transcriptional level by targeting to the specific sequence of 3'-UTR of HMGB1 gene, which suggests that HMGB1 gene may be a target gene of miR-141.

Analysis of outpatient prescription evaluation of western medicine in Yanqing District Hospital of Beijing from 2011 to 2015 / 中国基层医药

Objective To explore the writing quality and rational use of drugs for outpatient prescription of western medicine in Yanqing District Hospital of Beijing.Methods From January 2011 to December 2015, 12 000 prescriptions of western medicine were selected randomly.The prescriptions were analyzed by Excel and the Pareto diagram analysis was used to find out the main reasons of irrational prescription.Results From 2011 to 2015, the basic indicators of prescription of western medicine were reasonable:the average number of drugs on each pre-scription was 2.31,the utilization rate of injections was 15.91%,the utilization rate of essential drugs was 38.00%, the utilization rate of antibacterial was 14.56%.The unreasonable rate of prescription was 6.32%,and the main irra-tional reason were dosage inappropriate,indications inappropriate,inappropriate selection of drugs and combination therapy was not suitable.Conclusion By prescription review,we have listed the problems,and provide the basis for rational drug use and improvement measures.