Analysis of Ethical Dilemmas in the Practice of Informed Consent of Critical Care Physicians in a Region of Beijing / 中国医学伦理学

【Objective:】 To explore the ethical dilemmas faced by the critical care physicians in the process of practicing the right to informed consent in a region of Beijing. 【Methods:】 14 doctors in the critical care unit from 5 medical institutions in a certain region of Beijing were interviewed in depth face-to-face by qualitative research method. The data obtained were analyzed through coding, classification, and extraction of subjects. 【Results:】 The lack of trust in doctor-patient communication leads to the instrumentalization of the right to know. When the decision of family members is inconsistent with the patient’s right to life and health, doctors are faced with the dilemma of choice and its impact. 【Conclusions:】 Faced with such ethical dilemmas, it is suggested to rebuild doctor-patient trust through multiple measures, and make appropriate restrictions on the agent-executing of the right of informed consent.

A review: extraction, phytochemicals, and biological activities of rambutan (Nephelium lappaceum L) peel extract.

Rambutan (Nephelium lappaceum L.) peels are produced during application process. Drying methods of rambutan peel, including open sun, oven, oven vacuum, and freeze-drying, have been describes in this study. The extraction technologies of dried rambutan peels were reviewed, such as maceration and hot extraction, microwave-assisted extraction, ultrasonic-assisted extraction, and supercritical fluid extraction. The phytochemicals of rambutan peel extracts were analyzed, and the purification and stability of geraniin was reviewed. Rambutan peel extracts exhibit wide bioactivities in vitro and in vivo, and these bioactivities depend chiefly on the phenolic contents and profiles in the different extracts. The safety of rambutan peel extracts was analyzed. In addition, rambutan peel extracts could be used as important components to make different products, which are potentially applied in food, medicine, and cosmetic. However, the extracts efficiency must be further increased using some emerging technologies. Furthermore, the bioactive mechanism and bioavailability of the extract in human system should be further evaluated.

Identification of in vitro angiotensin-converting enzyme and dipeptidyl peptidase IV inhibitory peptides from draft beer by virtual screening and molecular docking.

BACKGROUND: Hypertension and diabetes are two kinds of senile diseases which often occur simultaneously. The commonly used drugs in clinic may produce certain side effects. Food-derived polypeptide is a kind of polypeptide with great development potential, which has many functions of regulating human physiological function. Beer is rich in nutrition but there are few researches on bioactive peptides in beer. RESULTS: In this study, a rapid virtual screening method was established to obtain bioactive peptides from Tsingtao draft beer. The peptide sequence was analyzed by ultra-performance liquid chromatography-quadrupole-Orbitrap-tandem mass spectrometry (UPLC-Q-Orbitrap-MS2 ), and 50 peptides were identified. Eight peptides with potential biological activities were screened by using Peptide Ranker software and previous literature references. On the basis of absorption prediction, toxicity prediction, and molecular docking analysis, LNFDPNR and LPQQQAQFK were finally confirmed. The molecular docking results showed that two peptides could bind angiotensin-converting enzyme (ACE) and dipeptidyl peptidase IV (DPP-IV) tightly by hydrogen bonding and hydrophobic interaction. The in vitro activity evaluation results showed that two peptides had obvious ACE and DPP-IV inhibitory activity. CONCLUSION: This study established a method for rapidly screening bioactive peptides from Tsingtao draft beer, screened two ACE and DPP-IV inhibitory peptides in beer and analyzed their active action mechanism. This article may have great theoretical significance and practical value to further explore the health function of beer. © 2021 Society of Chemical Industry.

Changes of volatile components and their content determination of Olibanum after processing / 中国药房

OBJECTIVE To analyze the changes of volatile co mponents in Olibanum and its processed products ，and to determine the contents of 4 components as octyl acetate. METHODS The volatile oil of Olibanum ，fried Olibanum and Olibanum stir-baked with vinegar were extracted. The components of volatile components were identified by GC-MS. The structure identification and data analysis of the chemical components with similarity ≥80％ were performed by using Xcalibur 4.0 software and NIST 2.0 mass spectrum database. The peak area normalization method was used to calculate the relative content of each component. GC method was adopted to simultaneously determine and compare the contents of limonene ，octyl acetate ，linalool and n-octanol in volatile components of Olibanum and its processed products. RESULTS Thirteen components were identified from volatile components of Olibanum ，fried Olibanum and Olibanum stir-baked with vinegar ，mainly including alcohols ，olefins and esters；among them ，relative contents of octyl acetate in Olibanum ，fried Olibanum and Olibanum stir-baked with vinegar were higher，which were 23.86％ ，37.80％ and 53.86％ respectively. The linear ranges of limonene ，octyl acetate ，linalool and n-octanol were 0.006 6-0.066 4，0.179 2 -1.792 0，0.003 7-0.037 0 and 0.032 8-0.328 0（r＞0.999 5）respectively；RSDs of precision，repeatability and stability （24 h）tests were all less than 2％；average recoveries were 98.56％，100.02％，99.13％ and 98.66％，respectively（RSD≤2.16，n＝6）. Average contents of 4 components in Olibanum were 0.15％，16.27％，0.36％ and 2.26％，while those of fried Olibanum were 0.85％，17.58％，0.66％ and 3.47％，respectively；those of Olibanum stir-baked with vinegar were 0.50％，19.75％，0.58％ and 3.34％，respectively. Compared with Olibanum ，average contents of octyl acetate ， linalool，n-octanol and limonene in volatile components of fried Olibanum and Olibanum stir-baked with vinegar were increased significantly（P＜0.05 or P＜0.01）. Compared with fried Olibanum ，average contents of limonene ，linalool and n-octanol were decreased significantly ，while those of octyl acetate were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS After fried and stir-baked with vinegar ，the volatile components in Olibanum are similar ，but the relative contents are different ，and the contents of octyl acetate and other components are increased.

Novel umami peptides from tilapia lower jaw and molecular docking to the taste receptor T1R1/T1R3.

This study aimed to isolate and identify peptides with intense umami taste from tilapia lower jaw. The aqueous extract was separated using ultrafiltration and Sephadex G-15 gel filtration chromatography. The peptide fraction with an intense umami taste was selected by sensory evaluation. The five novel peptides with strong umami taste were VADLMR, STELFK, FVGLQER, DALKKK, and VVLNPVARVE. Electronic tongue analysis and sensory evaluation showed that five peptides had obvious umami taste characteristics, and the recognition thresholds of umami peptides were in the range 0.125-0.250 mg/mL. Molecular docking was used to study the interaction of the peptides and umami taste receptor T1R1/T1R3. The five peptides could perfectly be inserted into the binding pocket of the Venus flytrap domain in the T1R3 subunit. Hydrogen bonding and hydrophobic interaction were the important interaction forces. The five peptides may bind with Asp219, Glu217, and Glu148 in T1R1/T1R3 receptor and produce the umami taste.

HIV antibody screening and confirmative tests of voluntary blood donors in a hospital in Beijing: A retrospective analysis / 中国输血杂志

【Objective】 To retrospectively analyze the epidemiological characteristics and regularity of HIV among voluntary blood donors in our hospital, so as to provide help for the formulation of effective coping strategies for voluntary blood donation, reduce the incidence of blood transmitted diseases, and improve blood safety. 【Methods】 HIV infection and population characteristics of voluntary blood donors in our hospital from January 2010 to December 2019 were statistically analyzed. 【Results】 A total of 330 000 blood donations occurred during 2010 to 2019, and 1 024 HIV-infected blood donors were screened out, with a positive rate of 0.31%. The detection rate was the highest in 2016, with 158 cases infected(158/35 889, 0.44%), followed by 151 in 2015(151/37 586, 0.40%), and 42 in 2010(42/20 824, 0.20%). The difference was statistically significant (χ2=88.754, P<0.001). Among the 1 024 HIV-infected patients, 876 were males and 148 females, with a gender ratio close to 6∶1. The majority were aged between 18~35 years old, accounting for 86.13%. 【Conclusion】 The HIV infection rate among voluntary blood donors had been increasing year by year in recent years. Major blood centers should strengthen the health information before blood donation, carry out HIV screening strictly, select blood donors appropriately, establish a stable blood donation team, so as to reduce the discarding rate of blood.

Relationship between high mobility group protein box-1 level in peripheral blood and no-reflow in patients with acute myocardial infarction after interventional therapy / 中国基层医药

Objective:To investigate the relationship between high mobility group protein box-1 (HMGB1) level in peripheral blood and no-reflow in patients with acute myocardial infarction after interventional therapy.Methods:120 patients with acute myocardial infarction patients who received interventional treatment in Liuzhou People's Hospital, China between October 2019 and October 2020 were included in this study. They were divided into normal blood flow group ( n = 78) and no-reflow group ( n = 42) according to the situation of coronary reflow after interventional treatment. The clinical data and laboratory test results were compared between the two groups. The level of HMGB1 in peripheral blood was detected using enzyme-linked immunosorbent assay and compared between the two groups. The diagnostic value of HMGB1 in no reflow was analyzed by the receiver operating characteristic (ROC) curve. Results:There were no significant differences in age, gender, history of hypertension, history of smoking, history of coronary heart disease, and peak value of creatine kinase MB between no reflow and normal flow groups (all P > 0.05). The number of patients developing diabetes mellitus, the proportion of patients developing lesions of multiple vessels, C-reactive protein level and brain natriuretic peptide level in no-reflow group were significantly higher than those in the normal blood flow group (all P < 0.05). Enzyme-linked immunosorbent assay results revealed that there was significant difference in HMGB1 level between no reflow and normal flow groups [(5.2 ± 0.85) mg/L vs.(3.2 ± 0.9) mg/L, t = -2.38, P = 0.02). The ROC curve was used to compare the diagnostic values of HMGB1, brain natriuretic peptide and C-reactive protein for no reflow. The results showed that the area under the ROC curve values of HMGB1, brain natriuretic peptide and C-reactive protein were 0.746 (0.661-0.830), 0.605 (0.504-0.705) and 0.688 (0.595-0.781), respectively. The area under the ROC curve value of HMGB1 was the highest. Conclusion:The level of HMGB1 is obviously increased in patients with acute myocardial infarction presenting with no reflow, which has a high diagnostic value for no reflow.

HPLC Fingerprint Establishment ，Content Determination and Multivariate Statistical Analysis of Qinlian Runfei Decoction / 中国药房

OBJECTIVE：To establish the f ingerprint of Qinlian runfei decoction，determine the contents of 11 components， and conduct cluster analysis and orthogonal partial least squares discriminant analysis （OPLS-DA）. METHODS ：HPLC method was used. The determination was performed on ZORBAX Eclipse Plus C 18 column with mobile phase consisted of acetonitrile- 0.05％ phosphoric acid solution （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was set at 260 nm， and column temperature was 30 ℃. The sample size was 10 μL. Using wogonoside as reference，HPLC fingerprints of 10 batches of Qinlian runfei decoction were drawn and the similarity evaluation was conducted with Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition），the common peaks were also confirmed ；the contents of 11 components in Qinlian runfei decoction were determined by the same method. SPSS 21.0 software was used for clus ter analysis ，and SIMCA 14.0 software was used for OPLS-DA to screen marker components affecting quality. RESULTS ：There were 21 common peaks in 10 batches of Qinlian runfei decoction ，and the similarity with control fingerprint was greater than 0.98. A total of 11 common peaks were identified ， which were rutin ， forsythiaside A ， forsythiaside B ， iris， irigenin， baicalin， forsythiaside， wogonoside， baicalein， irisflorentin and wogonin. The line ar ranges of 11 components were 9.960 0-49.800 0，1.974 0-9.870 0，0.672 0-3.360 0，0.960 0-4.800 0，0.549 0- 2.745 0，5.040 0-25.200 0，1.374 0-6.870 0，0.615 0-3.075 0，0.759 9-3.795 0，0.162 0-0.810 0，0.042 0-0.210 0 μg（all r＞ 0.999）； RSDs of precision ， stability （48 h） and repeatability tests were less than 2％ ； the average recoveries were 95.81％-100.29％ with RSDs of 0.43％-1.73％（n＝6）；the contents were 8.924 4-12.820 8，0.352 2-0.868 7，0.435 6-0.711 2， 0.389 8-1.309 0，0.335 8-0.530 1，1.680 5-4.542 3，0.701 8-1.584 2，2.240 2-5.442 5，2.351 0-5.558 9，0.106 0-0.182 2，0.076 8- 0.128 9 mg/g，respectively. The results of cluster analysis showed that when class spacing was 10，it could be divided into two groups，S1-S3 and S 4-S10；when the class spacing was 5，the second class could be divided into two categories ，S6，S7，S9 were clustered into one category ，and S 4，S5，S8，S10 were clustered into one category. The results of OPLS-DA analysis showed that S6，S7 and S 9 were at the top of the figure ，S4，S5，S8 and S 10 were at the lower left side of the figure ，and S 1-S3 were at the lower right side of the figure ，which was consistent with the cluster analysis results ；VIP values of baicalin ，iris，forsythiaside A ， baicalein and wogonoside were all greater than 1. CONCLUSIONS ：Established fingerprint and content determination methods have high precision and good stability. Combined with multivariate statistical analysis ，it can be used for the quality control of Qinlian runfei decoction. Five components as baicalin are the marker components affecting the quality of Qinlian runfei decoction.

UPLC-Q-Orbitrap-MS2 analysis of Moringa oleifera leaf extract and its antioxidant, antibacterial and anti-inflammatory activities.

Moringa oleifera leaf acetone extract (MLE) was prepared. Phytochemicals of MLE and their antioxidant, antibacterial, and anti-inflammatory activities were evaluated. Results showed that MLE contained total phenolic content of 20.16 mg gallic acid equivalents/g dry weight. A total of 39 compounds were identified by mass spectrometry. The contents of acetyl-glucomoringin, caffeoylquinic acid, feruloylquinic acid, and coumarylquinic acid were high. MLE had high DPPH· and ABTS•+ scavenging activities and reducing powder. In addition, MLE could effectively inhibit S. aureus and B. subtilis, but little effect on E. coli was found. The anti-inflammatory effect of MLE was evaluated using a lipopolysaccharide (LPS) -induced RAW 264.7 cell model. MLE significantly inhibited nitric oxide (NO) production and inducible NO synthase (iNOS) mRNA levels in LPS-induced RAW 264.7 cells. The inhibitory activity increased in a dose-dependent manner. The bioactivities of MLE were related to its phenolic content and phenolic profiles.[Figure: see text].

Identification and characterization of the peptides with calcium-binding capacity from tilapia (Oreochromis niloticus) skin gelatin enzymatic hydrolysates.

The aim of this study was to isolate and identify the peptides with calcium-binding capacity from the different tilapia skin gelatin enzymatic hydrolysates. The complex protease was selected and its hydrolysates were further separated using gel filtration chromatography (Sephadex G-25) and reverse phase high-performance liquid chromatography. Two purified peptides with strong calcium-binding capacity were identified as Tyr-Gly-Thr-Gly-Leu (YGTGL, 509.25 Da) and Leu-Val-Phe-Leu (LVFL, 490.32 Da). The calcium-binding capacities of YGTGL and LVFL reached 76.03 and 79.50 µg/mg, respectively. The structures of the complex of purified peptides and calcium (YGTGL-Ca and LVFL-Ca) were characterized by ultraviolet-visible spectroscopy (UV-VIS), scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and mass spectrometry (LC-MS/MS). The results of UV-VIS, SEM, and XRD indicated that YGTGL-Ca and LVFL-Ca were formed as new compounds. The results of FTIR and LC-MS/MS indicated the nitrogen atom of the amino group and the oxygen atom of the carboxyl group in terminates of the peptides provided primary binding sites. Moreover, the hydrophobic amino acids in purified peptides could provide more chelating spaces. This study was of great significance for the development of calcium supplement foods. PRACTICAL APPLICATION: Compared with inorganic calcium and organic calcium, the bioactive gelatin peptide chelated calcium has the characteristics of high utilization rate, high solubility, and high absorption rate. The raw materials are extracted from the tilapia processed waste, which reduce the cost, make full use of resources, and improve the bioavailability. The tilapia skin gelatin peptide calcium chelate can be directly absorbed by the human body, and the absorption efficiency is high, further improving the resource utilization rate and having high economic benefits, which is a comprehensive supplement that can also be used as a functional food.

Analysis of the correlation between IL-23, IL-17and β-cell function in latent autoimmune diabetes in adult patients / 中国医师杂志

Objective@#To determine interleukin (IL)-23 and IL-17 level in latent autoimmune diabetes in adult (LADA) patients, and to explore the relationship of IL-23, IL-17and β-cell function in these patients.@*Methods@#Forty LADA patients from 2011 to 2016 in our hospital were selected as LADA group, and forty participants were as normal control group. Clinical and biochemical data was collected and the level of the IL-23 and IL-17 was measured with the enzyme linked immunosorbent assay (ELISA). The differences in interleukin levels among the two groups were compared. Pearson correlation analysis was used for investigating the relationship between the dependent of statistical significant interleukins and the independent data in the LADA patients, all closely related variables then were included in a stepwise multiple linear regression analysis.@*Results@#The levels of serum IL-23 , IL-17 and IL-23/IL-17 were significantly higher in LADA group than those in control groups [3.54(2.88~5.24)μg/L vs 1.98(1.62~2.18)μg/L, P<0.05], [22.42(17.71~26.07)ng/L vs 17.97(17.15~20.70)ng/L, P<0.05], (175.79±38.67 vs 105.22±19.08, P<0.01). IL-23 and IL-17 in the LADA group were negatively correlated with fasting C peptide (FCP) (r=-0.42, r=-0.48, P<0.05), and the ratio of IL-23/IL-17 was positively correlated with fasting plasma glucose (FPG) (r=0.44, P=0.00). Stepwise multiple liner regression analysis showed that serum IL-23 and IL-17 level were independently associated with the FCP in LADA group.@*Conclusions@#IL-23 and IL-17 were possibly important proinflammatory factor in LADA patients, and can provide the new immunodiagnosis markers for LADA.

MicroRNA-200c-3p inhibits proliferation of nephroblastoma cells by targeting CCNE2 / 南方医科大学学报

OBJECTIVE@#To predict and verify the target gene of miR-200c-3p and evaluate the inhibitory effect of miR-200c-3p on the proliferation of nephroblastoma cells.@*METHODS@#The putative target genes of miR-200c-3p were predicted by bioinformatics approach. Nephroblastoma cell models with miR-200c-3p overexpression or knockdown were established in SK-NEP-1 and G401 cells with corresponding control groups. The expressions of CCNE2 in SK-NEP-1 and G401 cells in different groups were detected by RT-PCR and Western blotting. A luciferase reporter assay was used to determine the targeting relationship between miR-200c-3p and CCNE2. The effects of miR-200c-3p overexpression or knockdown on cell proliferation was detected by cell counting kit-8 (CCK-8) assay and soft agarose assay.@*RESULTS@#CCNE2 was one of the target genes of miR-200c-3p as predicted by bioinformatics methods. Transfection of the two nephroblastoma cell lines with miR-200c-3p mimic resulted in significantly lowered CCNE2 mRNA and protein expressions ( < 0.05). The results of dual-luciferase assay confirmed that miR-200c-3p bound to the 3'UTR of CCNE2. CCK-8 assay and soft agarose assay demonstrated that overexpression of miR-200c-3p significantly inhibited the proliferation of the nephroblastoma cells ( < 0.01), and knocking down miR-200c-3p in the cells produced the opposite effects.@*CONCLUSIONS@#miR-200c-3p overexpression inhibits the proliferation of nephroblastoma cells by down-regulating its target gene CCNE2.

Pregnancy with pre-excitation syndrome influence on pregnancy outcomes / 中华妇产科杂志

Objective:To investigate the characteristics of pregnancy with pre-excitation syndrome and its influence on pregnancy outcomes.Methods:A retrospective analysis was made on the clinical data of 62 cases of pregnancy complicated with pre-excitation syndrome in Beijing Anzhen Hospital from Jan. 2008 to Dec. 2008. According to whether there was a supraventricular tachycardia (SVT) in pregnancy, they were divided into two groups. There were 16 pregnant women in the SVT seizure group during pregnancy, and 46 pregnant women in no SVT seizure group, with a multi-disciplinary comprehensive diagnosis and treatment model. SPSS software was used to analyze the data and compare the gestational age, age and weight of the newborn, and then compare the pregnancy outcomes.Results:(1) The total number of deliveries in Beijing Anzhen Hospital during the study period was 21 786, and the patients with pregnancy combined with pre-excitation syndrome account for 0.28% (62/21 786). (2) Totally 44 patients (71%, 44/62) were diagnosed with pre-excitation syndrome before pregnancy, and 18 patients (29%, 18/62) were diagnosed for the first-time during pregnancy. Among patients diagnosed with pre-excitation syndrome before pregnancy, 16 patients (36%, 16/44) had seizures before pregnancy, 28 patients (64%, 28/44) had asymptomatic before pregnancy, and 4 of asymptomatic patients had SVT during pregnancy. (3) Of the 16 pregnant women in the SVT seizure group during pregnancy, 2 patients (2/16) had SVT episodes in the first trimester, 5 patients (5/16) had SVT episodes in the second trimester, 9 patients (9/16) had SVT episodes in the third trimester. In the SVT seizure group, 8 patients (8/16) had SVT episodes before pregnancy, and 8 patients (8/16) had no SVT episodes before pregnancy. There were 46 patients in the SVT seizure-free group during pregnancy, including 9 patients with SVT attacks before pregnancy and 37 patients without SVT before pregnancy. (4) Compared with the pregnant women in the SVT seizure group, the age, weight gained during pregnancy, delivery gestation week, newborn weight, and the time of the first and second labors were not statistically different between the two groups of pregnant women (all P>0.05). However, the total duration of labor in the SVT seizure group during pregnancy was shorter and pre-pregnancy weight was lower (all P<0.05). The rate of cesarean section in pregnant women with SVT attack was 12/16, and the rate of cesarean section in pregnant women without SVT was 50% (23/46; P=0.051). No pregnant woman had an arrhythmia during delivery. Conclusions:SVT episode in patients during pregnancy most occurs in the third trimester. Patients who are asymptomatic before pregnancy may also have SVT during pregnancy. Pre-excitation syndrome patients with SVT attacks during pregnancy increase adverse pregnancy outcomes. Multidisciplinary comprehensive management could effectively control pregnant women with pre-excitation syndrome, effectively reduce the occurrence of serious arrhythmia risk events during pregnancy, so that most patients could get good pregnancy outcomes.

Analysis of the correlation between IL-23, IL-17and β-cell function in latent autoimmune diabetes in adult patients / 中国医师杂志

Objective To determine interleukin (IL)-23 and IL-17 level in latent autoimmune diabetes in adult (LADA) patients,and to explore the relationship of IL-23,IL-17and β-cell function in these patients.Methods Forty LADA patients from 2011 to 2016 in our hospital were selected as LADA group,and forty participants were as normal control group.Clinical and biochemical data was collected and the level of the IL-23 and IL-17 was measured with the enzyme linked immunosorbent assay (ELISA).The differences in interleukin levels among the two groups were compared.Pearson correlation analysis was used for investigating the relationship between the dependent of statistical significant interleukins and the independent data in the LADA patients,all closely related variables then were included in a stepwise multiple linear regression analysis.Results The levels of serum IL-23,IL-17 and IL-23/IL-17 were significantly higher in LADA group than those in control groups [3.54 (2.88 ～ 5.24) μg/L vs 1.98 (1.62 ～ 2.18) μg/L,P ＜0.05],[22.42 (17.71 ～ 26.07) ng/L vs 17.97 (17.15 ～ 20.70) ng/L,P ＜ 0.05],(175.79 ± 38.67 vs 105.22 ± 19.08,P ＜0.01).IL-23 and IL-17 in the LADA group were negatively correlated with fasting C peptide (FCP) (r =-0.42,r =-0.48,P ＜ 0.05),and the ratio of IL-23/IL-17 was positively correlated with fasting plasma glucose (FPG) (r =0.44,P =0.00).Stepwise multiple liner regression analysis showed that serum IL-23 and IL-17 level were independently associated with the FCP in LADA group.Conclusions IL-23 and IL-17 were possibly important proinflammatory factor in LADA patients,and can provide the new immunodiagnosis markers for LADA.

Clincal value of different MRI sequences in the diagnosis of elbow trauma in children / 中国基层医药

Objective:To analyze the clinical value of different MRI sequences in the diagnosis of elbow trauma in children.Methods:From March 2015 to March 2019, 78 children with elbow joint injury were studied.All patients were examined by X-ray and MRI, including 3D-DESS, TSETIWI, T1-TIRM and FS-PDWI.The differences between the two methods were analyzed.Results:A total of 62 cases of epiphyseal fracture were confirmed by MRI.According to the distribution of Salter Harris fracture: 23 cases of type Ⅱ (37.10%)>17 cases of type Ⅲ (27.42%)>12 cases of type Ⅳ (19.35%)>10 cases of type Ⅰ (16.13%)>0 case of type Ⅴ (0.00%), the difference was statistically significant (χ 2=6.126, P=0.025). Among 78 children of elbow joint injury, 73 cases had bone marrow edema, of which 62 cases were within 1 cm from epiphyseal plate, 11 cases were outside 1 cm from epiphyseal plate, 5 cases were without bone marrow edema, and there was a correlation between bone marrow edema and epiphyseal fracture ( r=0.174, P=0.006). Type Ⅰ-Ⅳ epiphysis injury of elbow joint in children could be accompanied with articular cartilage injury, and 3D-DESS had good effect on articular cartilage injury. Conclusion:Different sequences of MRI have high accuracy in the diagnosis of elbow joint injury in children, which is of great significance in reducing misdiagnosis and missed diagnosis rate of epiphyseal fracture, bone marrow edema and articular cartilage injury in children.

Preparation and identification of novel inhibitory angiotensin-I-converting enzyme peptides from tilapia skin gelatin hydrolysates: inhibition kinetics and molecular docking.

Tilapia skin gelatin was hydrolyzed by successive simulated gastrointestinal digestion, and the hydrolysates were further separated by transport across a Caco-2 cell monolayer. Angiotensin-I-converting enzyme inhibitory (ACEI) peptides were separated by successive chromatographic steps from the transport hydrolysates. We have identified two key ACEI peptides, namely VGLPNSR (741.4133 Da) and QAGLSPVR (826.4661 Da) with IC50 values of ACEI activity of 80.90 and 68.35 µM, respectively. Lineweaver-Burk plots indicated that the inhibitory ACE kinetics of the two peptides were noncompetitive. Molecular docking simulation showed that the two peptides could interact with the ACE site via hydrogen bonds with high binding power. However, the hydrogen bonds were not formed with the key amino acid residues in the active site of ACE. This finding was in accordance with the noncompetitive inhibition. This study established a novel approach to identify key ACEI peptides and suggested the use of tilapia peptides as functional food ingredients to prevent hypertension.

Purification and Characterization of Peptides Inhibiting MMP-1 Activity with C Terminate of Gly-Leu from Simulated Gastrointestinal Digestion Hydrolysates of Tilapia (Oreochromis niloticus) Skin Gelatin.

Tilapia skin gelatin hydrolysates (TSGHs) were prepared by simulated gastrointestinal digestion and separated by gel filtration and semi-preparative reversed-phase high-performance liquid chromatography. The anti-photoaging effects were evaluated using an ultraviolet radiation B (UVB)-induced mouse embryonic fibroblast (MEF) photoaging model in vitro. Three fractions from TSGHs with high inhibitory intercellular matrix metalloproteinase-1 (MMP-1) activities and reactive oxygen species (ROS) production were obtained. Three key peptides, GYTGL, LGATGL, and VLGL, were identified, and their C terminate was Gly-Leu. Three peptides were synthesized and exhibited a significant inhibition of intercellular MMP-1 activity and ROS production. Furthermore, three peptides inhibiting MMP-1 activities were evaluated through their docking of S1' and S3' active pockets of MMP-1. Hydrogen bonds and C terminate Gly-Leu played important roles. Finally, the protective effects of three peptides on intercellular collagen in UVB-induced MEFs were compared. Our results indicated that tilapia gelatin peptides exhibited potential activities to prevent and regulate photoaging.

Qualitative Research on Ethical Justification of Reducing Sedation in Intensive Care Unit / 中国医学伦理学

Objective: To explore the ethical justification of reducing sedation in ICU based on the need of medical treatment but the increase of patient's discomfort and the solution of this ethical conflict. Methods: Quali-tative research was used to conduct the in - depth interview among 15 senior medical staffs. We analyzed the ob-tained information, refined the research contents and formed the research report. Results: In ethics, it was a chal-lenge to achieve a satisfactory balance between the guarantee of the patient's comfortable experience and medical demand for reducing sedation. Conclusions: When making a sedation therapy program, the clinicians should pay more attention to the patient's own comfortable experience, that is, try to minimize the discomfort of patients in the pursuit of the most satisfactory treatment outcome.

Dose-effect Relationship of Yuning Ointment and its Decomposed Recipes on Acne in Mice / 中国药师

Objective: To study the dose-effect relationship of Yuning ointment and its decomposed recipes in the treatment of oleic acid induced acne in mice. Methods: Oleic acid was administrated to the back (2 cm ×2 cm) of the mice (once a day) for 21 days to induce acne. At d22, the gradient dosage of Anemone flaccida crude drug (1. 06-1 060. 23 mg?kg-1?d-1,k=3. 16), Yuning oint-ment without Anemone flaccida crude drug (4. 73-1 767. 75 mg?kg-1?d-1, k=3. 16) and Yuning ointment (2. 84-2 827. 28 mg?kg-1?d-1, k=3. 16) was respectively administrated to the back of mice for 14 days. The pathological changes of skin were observed by hematoxylin-eosin (HE) staining. The diameter of sebaceous glands and the ratio of follicular keratinization area were morphomet-rically analyzed. The serum levels of IL-1, IL-6 and TNF-α were detected by ELISA assay. The median effective dosages (ED50) of A-nemone flaccida in the three prescriptions were regressed by Prism 5. 01 software to determine the prescription dose-effect. Results: All the therapy groups were with significantly relieved pathological changes of sebaceous glands hypertrophy and follicular keratinization, and decreased serum levels of IL-1, IL-6 and TNF-α in a dose-dependent manner. The dose-response curves showed an "S" shape. A-mong the three therapy groups, the effect of Yuning ointment was the best. The ED50of Yuning ointment regressed by Anemone flaccida dose was 0. 28-fold for improving sebaceous glands hypertrophy, 0. 14-fold for inhibiting follicular keratinization, and 0. 15-, 0. 49-and 0. 24-fold for decreasing serum levels of IL-1, IL-6 and TNF-α. . Regressed by Yuning ointment without Anemone flaccida, the ED50of Yuning ointment was lower than Yuning ointment without Anemone flaccid in terms of improving pathological changes and inhibiting the secretion of cytokines. Conclusion: Yuning ointment can prevent and treat acne through regulating immune function. And the prescrip-tion compatibility can enhance the effects of Anemone flaccida.

Dose-effect Relationship of Xianfu Ointment and its Decomposed Recipes on Chronic Eczema / 中国药师

Objective:To investigate the dose-effect relationship of Xianfu ointment and its decomposed recipes the 1-chloro-2,4-dini-trochlorobenzene(DNCB) induced chronic eczema in mice, and confirm the median effective dose (ED50) of each formula and the synergetic effect by compatibility. Methods:DNCB was used to induce chronic eczema in C57 mice. The mice were treated with gradient dosages of the Xianfu ointment (11.71-11 662.50 mg?kg-1?d-1,k = 0.316), Anemone flaccid (0.53-530.12 mg?kg-1?d-1,k = 0.316), Xianfu ointment without Anemone flaccid (11.18-11 132.40 mg?kg-1?d-1,k =0.316),respectively. The pathological features were observed after hematoxylin-eosin staining. The volume ratio of epidermides and the number of lymphocyte infiltrated in dermis were analyzed with morphometry. The serum levels of IL-2,IFN-γ,IL-4,and IL-13 were detected by ELISA assay. The ED50was calculated by non-linear regression with various slope using Prism-5.0 software.Results:The effects of Xianfu ointment and its decomposed recipes on chronic eczema showed a dose-dependent tendency. The dose-response curves showed"S"shape. The efficacy of Xianfu ointment on chronic eczema was the most significant among the three formulas, which was demonstrated by decreased epidemical thicknes (ED50= 377.90 mg?kg-1?d-1), reduced infiltrated lymphocyte number(ED50= 153.20 mg?kg-1?d-1), increased serum IL-2(ED50=608.90 mg?kg-1?d-1) and IFN-γ (ED50= 205.50 mg?kg-1?d-1) levels, and decreased serum IL-4(ED50= 198.70 mg?kg-1?d-1) and IL-13 levels (ED50= 117.60 mg?kg-1?d-1). And the dose-effect curves of Anemone flaccid and Xianfu ointment without Anemone flaccid groups were both right shift when compared with that of Xianfu ointment. Conclusion:Xianfu ointment and its decomposed recipes can effectively treat chronic eczema. Anemone flaccid has obvious compatibility synergy in the whole formula. The effects of Xianfu ointment is most significant.