A qualitative research on supportive care needs of patient with inflammatory bowel disease / 中国实用护理杂志

Objective:To deeply explore the supportive care needs of patients with inflammatory bowel disease, in order to provide reference for the development of supportive care strategies.Methods:A qualitative description was conducted based on the supportive care needs framework. Objective sampling method was used to select 17 patients with inflammatory bowel disease from the First Affiliated Hospital with Nanjing Medical University from August to November 2021 for semi-structured in-depth interview and directed content analysis was used to analyze the interview data.Results:The final analysis yielded a total of 5 categories. These were physiological need, information need, practical (daily life) need, emotional and social support need, psychological and spiritual needs. They were all within the framework of supporting care needs.Conclusions:In the future, targeted education and diversified social support should be implemented based on the needs of patients with inflammatory bowel disease and from the perspectives of hospital, family members and peers.

Diagnosis and treatment of pediatric cervical bronchogenic cyst / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the clinical characteristics and surgical treatment outcomes of children with cervical bronchogenic cysts. Methods:A retrospective study of 6 pediatric patients with bronchogenic cysts in the neck region treated in our hospital during 2014 to 2020 was performed. All children underwent complete resection of cervical mass under general anesthesia. Results:There were 6 children, aged from 1 to 5 years, with a median of 2.25 years. There were 3 males and 3 females. The lesions were located on the left neck in 3 cases, the midline neck in 2 cases and the right neck in 1 case. The clinical manifestations were painless mass in 5 cases and recurrent neck infection in 1 case. The size of the mass ranged from 2.1 to 7.5 cm. There was no characteristic clinical or imaging features of bronchogenic cysts. Misdiagnosed as lymphangioma in 3 cases, thyroglossal cyst in 2 cases and piriform fistula in 1 case. The follow-up ranged from 1.50 to 7.75 years, with a median of 4.13 years. All 6 children had no recurrence or complications. Conclusion:Although rare, bronchogenic cysts should be considered in the differential diagnosis of cervical cystic masses in children. Surgery is the most effective way to treat cervical bronchogenic cyst, and histopathological examination is the gold standard for diagnosis.

Tendency of road traffic injuries among different age groups in China from 2004 to 2018 / 中华创伤杂志

Objective:To analyze the tendency of road traffic injuries (RTIs) among different age groups in China from 2004 to 2018 so as to provide a reference for targeted prevention of RTIs.Methods:Based on the annual traffic accident report data from the Ministry of Public Security of China and the China Statistical Yearbook, the age was divided into four groups: 0-14 years, 15-34 years, 35-59 years and ≥60 years. The total number of accidents, number of fatalities, number of injuries and age composition ratio of RTIs in different age groups were calculated from 2004 to 2018, and the mortality and disability rates of RTIs in different age groups were also calculated. The annual percent change (APC) and average annual percent change (AAPC) of the total number of accidents, number of fatalities, mortality rate, number of injuries and disability rate of RTIs among different age groups in China were measured by Joinpoint regression so as to analyze development trend of RTIs.Results:From 2004 to 2018, the age distribution concerning the number of accidents, deaths and injuries of RTIs were mainly among 15-34 years and 35-59 years, with the composition ratio greater than 40%. The composition ratio of people aged ≥60 years was small, but was increased gradually. The fitted value of the segmented regression model had a small relative error with the actual value, showing good fitting effect. From 2004 to 2018, the total number of accidents, number of fatalities, mortality rate, number of injuries and disability rate of RTIs in China were all statistically descended (AAPC=-5.53， P<0.01；AAPC=-3.64， P<0.01；AAPC=-4.19, P<0.01; AAPC=-5.13, P<0.01, AAPC=-5.65, P<0.01). Total number of accidents, number of fatalities and mortality rate of RTIs in China showed a notable upward trend instead after 2016 (APC=8.15, P=0.03; APC=2.10, P<0.01, APC=1.55, P<0.05). From 2004 to 2018, the total number of accidents, number of fatalities, mortality rate，number of injuries and disability rate of RTIs among people aged 15-34 years and 35-59 years were statistically descended (AAPC<0, P<0.05), while the total number of accidents, number of fatalities, mortality rate, number of injuries, and disability rate of RTIs among people aged ≥ 60 years showed a notable upward trend instead (AAPC=7.13, P<0.01; AAPC=6.64, P<0.01; AAPC=3.37, P<0.05; AAPC=8.85, P<0.01; AAPC=5.83, P<0.01). Conclusions:From 2004 to 2018, the total number of accidents, number of fatalities, mortality rate, number of injuries and disability rate of RTIs present a decrease trend in China and among people aged 15-34 years and 35-59 years, while an upward trend in those aged ≥60 years. In particular, the RTIs among people aged ≥60 years in China show an increase significantly since 2016, so the education of traffic safety awareness for the elderly should be strengthened to prevent their occurrence of RTIs.

Hydrogen production and phosphorus recovery via supercritical water gasification of sewage sludge in a batch reactor.

In this study, gasification of sewage sludge in supercritical water using a batch reactor was investigated. The effects of temperature, retention time, and the oxidation coefficient on gas composition, gas yield, total organic carbon removal efficiency (XTOC), gasification efficiency (GE), carbon gasification efficiency (CE), and phosphorus release rate (Xp) were investigated. The experimental results indicated that the yields for hydrogen, methane, and carbon dioxide increased with the increase in temperature from 380 °C to 460 °C. A maximum hydrogen molar fraction of 55.72% and a yield of 19.86 mol/kg were obtained at 460 °C and 27 MPa after 6 min. The GE, CE, XTOC, and Xp also increased with the increase in temperature. An extension of the retention time promoted the gasification of sludge, thereby resulting in an increase in the hydrogen and methane molar fraction, yield, GE, CE, XTOC, and Xp. Under the conditions of 420 °C and 27 MPa after 6 min, with an increase in the oxidation coefficient from 1.5 to 2.5, the oxidation reaction became dominant in the supercritical water. Hydrogen and methane were converted to carbon dioxide and water with an excess of hydrogen peroxide, which resulted in a lower hydrogen yield. However, the decomposition of organic compounds in the sludge was promoted with the addition of hydrogen peroxide, thereby resulting in an increase in the GE, CE, XTOC, and Xp. When the oxidation coefficient reached 2.5, a maximum GE of 131.6% and Xp of 98.74% were obtained.

Iodinated thyroglobulin and autoimmune thyroiditis / 中华地方病学杂志

Iodinated thyroglobulin (TG) can reflect the storage of thyroid hormones and iodine in the thyroid, which has an important influence on thyroid function. However, the study on iodinated TG and autoimmune thyroiditis has yet to be further conducted. This paper reviews the formation of iodinated TG, the measuring method of TG, and the molecular mechanism of iodinated TG function, including the relationships between iodinated TG and thyroid peroxidase adjustment, the expression of thyrotropin receptor, thyroid transcription factor 1, paired box gene 8, and iodine and sodium transporter, last but not least, we aim to investigate the immune and autophagy mechanisms of high iodinated TG-induced autoimmune thyroiditis.

Supercritical water gasification of landfill leachate for hydrogen production in the presence and absence of alkali catalyst.

Gasification of landfill leachate in supercritical water using batch-type reactor is investigated. Alkali such as NaOH, KOH, K2CO3, Na2CO3 is used as catalyst. The effect of temperature (380-500 °C), retention time (5-25 min), landfill leachate concentration (1595 mg L-1-15,225 mg L-1), catalyst adding amount (1-10 wt%) on hydrogen mole fraction, hydrogen yield, carbon gasification rate, COD, TOC, TN removal efficiency are investigated. The results showed that gaseous products mainly contained hydrogen, methane, carbon dioxide and carbon monoxide without addition of catalyst. However, the main gaseous products are hydrogen and methane with addition of NaOH, KOH, K2CO3, Na2CO3. In the absence of alkali catalyst, the effect of temperature on landfill leachate gasification is positive. Hydrogen mole fraction, hydrogen yield, carbon gasification ratio increase with temperature, which maximum value being 55.6%, 107.15 mol kg-1, 71.96% is obtained at 500 °C, respectively. Higher raw landfill leachate concentration leads to lower hydrogen production and carbon gasification rate. The suitable retention time is suggested to be 15 min for higher hydrogen production and carbon gasification rate. COD, TOC and TN removal efficiency also increase with increase of temperature, decrease of landfill leachate concentration. In the presence of catalyst, the hydrogen production is obviously promoted by addition of alkali catalyst. the effect of catalysts on hydrogen production is in the following order: NaOH ＞ KOH ＞ Na2CO3 ＞ K2CO3. The maximum hydrogen mole fraction and hydrogen yield being 74.40%, 70.05 mol kg-1 is obtained with adding amount of 5 wt% NaOH at 450 °C, 28 MPa, 15 min.

Comparative Study on the Policies of Generic Drug Consistency Evaluation in China,America and Japan / 中国药房

OBJECTIVE:To study the consistency policies of generic drugs in China,America and Japan comparatively,and provide reference for perfecting quality and efficacy consistency evaluation of generic drugs in China. METHODS:Generic drugConsistency evaluationQuality evaluationDESIwere used as keywords to search the related literatures or information of ge-neric drugs published or reported in CNKI,Web of Science,Elsevier,Springer database and USA FDA website during Jan. 1st, 1950-Jun. 30th,2016. And comparative analysis was conducted for the historical background,evaluation methods and policy influ-ences of consistency policies of generic drugs in China,America and Japan. RESULTS:There were differences in the historical background,evaluation methods,major participants and policy influences of consistency policies of generic drugs in China,Ameri-ca and Japan. The evaluation for generic drugs in USA was reevaluation of the drugs effectiveness under the history of drug registra-tion regulation was imperfect. With experts'review,it was evaluated based on FDA,enterprises,scientific literature evidence and experts review. Main evaluation method was in vitro dissolution test in Japan. The consistency evaluation of generic drug in China focused on the generic drug marketing authorization,mainly using in vivo bioequivalence. And the standards of reference prepara-tions were from the basically similar drugs to the original drugs. CONCLUSIONS:Compared with innovation-based countries like America and Japan,the availability of reference preparations in China is low,and policy environment is more complex. China should further improve the laws and regulations,giving reasonable buffer period,considering the diversity of evaluation methods, exemptions in special circumstances and current situation of pharmaceutical industry,paying attention to the balance between techni-cal supervision and system supervision.

The analysis of modified hamstring post surgery for the treatment of spastic cerebral palsy with knee flexion deformity / 中华骨科杂志

Objective To explore the curative effect of knee flexion deformity on spastic cerebral palsy treatment method.Methods All of 30 patients with spastic cerebral and knee flexion deformity were randomly divided into two groups:traditional operation group and modified operation group,using the commonly used operation (In 15 cases,with traditional hamstring post surgery) and) modified operation (In 15 cases,with modified hamstring post surgery),two groups of patients were treated with Ilizarov external fixation drafting device in the correction of knee flexion deformity after soft tissue release.Adjustment began 7 days after the soft tissue release operation of external fixation,and stretched approximately 0.2 degrees each time,3 times/d,until knee flexion deformity was corrected to hyperextension for 10 degree and maintained for 3 weeks,and the flexion contracture degree of knee joint was measured every 2 weeks;then the Ilizarov external fixation drafting device was removed.Then wear a walking straight leg brace for more than 3 months,until the knee walking function is good.Clinical evaluation included the joint pain index,walking function index,knee flexion deformity degree and range of joint motion score of Dimeglio standard.Results Flexion contracture deformity of knee joint in 30 cases (60 knees) was corrected when Ilizarov external fixator was removed,knee extension to 0 degrees-5 degrees.The two groups of patients had the knee flexion angle range of-1.2 degrees to 13.3 degrees,with an average of (7.32°±3.41°) after removed of the walking straight leg brace,in which 4 cases (8 joints) got recurrent deformity of 10°-15° at the time of removing of the walking straight leg brace.Knee activity significantly was improved at the end of treatment.60 cases of knee joint activity were close to normal,with flexion of 100 degrees to 135 degrees,extension of 0 degrees to 10 degrees.Two groups of patients were statistically significantly improved before and after surgery.Curative effect comparison:The walking function index of the modified operation group was obviously superior to that of the traditional operation group,there was significant statistical difference.There were no statistically significant differences in pain index,knee flexion,and range of joint motion.Conclusion For the treatment of flexion deformity of the knee joint in spastic cerebral palsy,traditional surgery using the semitendinosus and gracilis,post and semimembranosus lysis,combined with the Ilizarov draft external fixation could improve the walking function of the patients,simplify the surgical incision and reduce trauma.As a result,modified hamstring post surgery is an ideal,effective treatment method.

Research on the Payment Pricing Mechanism of Medicare Drugs / 中国药房

OBJECTIVE:To provide suggestions for the government decision of payment price of medicare drugs. METHODS:Investigation was conducted for the beginning of payment price policy of medicare drugs,effect of the implementation of policy in other countries and the encountered problems. The payment pricing mechanism was explored based on the combination of new medi-cal reform with theoretical analysis and empirical research. RESULTS:The reform of payment pricing mechanism of medicare drugs will have effect on current drug price,especially for R&D oriented pharmaceutical industries. The policy can decrease drug expendi-ture in medicare expenditure,and it is not sure whether it can decrease total medicare expenditure. CONCLUSIONS:It is suggest-ed to notice the related measures and government should keep balance between drug availability and encouraging R&D innovation.

[Changes in chemokine receptor 4, interleukin-6, and collagen X expression in the ATDC5 cell line stimulated by cyclic tensile strain and stromal cell-derived factor-1].

OBJECTIVE: This study further explores the stromal cell-derived factor-1 (SDF-1)/chemokine receptor 4 (CXCR4) signaling axis mechanism in temporomandibular joint osteoarthritis (OA) by detecting the changes in CXCR4, interleukin (IL)-6, and collagen X expression in the ATDC5 cell line stimulated by the cyclic tensile strain and SDF-1. METHODS: Insulin-transferrin-selenium (ITS) was used to induce ATDC5 cells to differentiate into chondrocyte-like cells. After three weeks, the cells were divided into two groups: those with and without cyclic tensile strain. These groups were further divided into the negative control and SDF-1 groups. Strain force of 20% was applied. After 12 h, the total proteins were extracted from cells of the four groups, and Western blot analysis was used to detect the changes in CXCR4, IL-6, and collagen X expression. RESULTS: SDF-1 could enhance CXCR4, IL-6, and collagen X expressions in the chondrocytes, and 20% tensile strain force could further upregulate the three factors. CONCLUSION: Under abnormal tensile force, SDF-1 can upregulate its specific receptor CXCR4, thus increasing its-binding efficiency and resulting in the activation of the SDF-1/CXCR4 axis. This condition enhances the expressions of IL-6 and other inflammatory factors and directly damages to cartilage tissue. Such damage directly promotes chondrocyte hypertrophy, which enhances collagen X expression.

Changes in chemokine receptor 4, interleukin-6, and collagen X expression in the ATDC5 cell line stimulated by cyclic tensile strain and stromal cell-derived factor-1 / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study further explores the stromal cell-derived factor-1 (SDF-1)/chemokine receptor 4 (CXCR4) signaling axis mechanism in temporomandibular joint osteoarthritis (OA) by detecting the changes in CXCR4, interleukin (IL)-6, and collagen X expression in the ATDC5 cell line stimulated by the cyclic tensile strain and SDF-1.</p><p><b>METHODS</b>Insulin-transferrin-selenium (ITS) was used to induce ATDC5 cells to differentiate into chondrocyte-like cells. After three weeks, the cells were divided into two groups: those with and without cyclic tensile strain. These groups were further divided into the negative control and SDF-1 groups. Strain force of 20% was applied. After 12 h, the total proteins were extracted from cells of the four groups, and Western blot analysis was used to detect the changes in CXCR4, IL-6, and collagen X expression.</p><p><b>RESULTS</b>SDF-1 could enhance CXCR4, IL-6, and collagen X expressions in the chondrocytes, and 20% tensile strain force could further upregulate the three factors.</p><p><b>CONCLUSION</b>Under abnormal tensile force, SDF-1 can upregulate its specific receptor CXCR4, thus increasing its-binding efficiency and resulting in the activation of the SDF-1/CXCR4 axis. This condition enhances the expressions of IL-6 and other inflammatory factors and directly damages to cartilage tissue. Such damage directly promotes chondrocyte hypertrophy, which enhances collagen X expression.</p>

The pathology morphology changes of contracture achilles tendon under Ilizarov technology / 中华骨科杂志

ObjectiveTo study the histologic changes of contracture Achilles tendon under Ilizarov distraction technique.MethodsEighteen dogs were installed ilizarov external fixation frames on the right hind leg in a neutral position.Pull traction started 1 week postoperatively with speed of 1 mm/day for 3 weeks.After 15 degrees of foot drop,the fixation was still maintained for 3 weeks.Nine animals were randomly selected and put to death(Contracture group),other animals corrected for 3 weeks with the same speed and methods,then put to death(Force group),health specimens as control group.(1)Observe tendon cells arranged distribution and collagen fiber form with HE dyeing,and analysis of tendon retinal thickness with image analysis software.(2)Observe collagen Ⅰ and Ⅲ with picrosirius red dying,and analyzed both content changes with image analysis software.(3)Determination of protein contents of polysaccharide with phloroglucinol spectrophotometry.Results (1)In the contracture group,the collagenous fibre gap was not obvious,the tendon cell assumes spindle-shaped,saccate,the collagen fibrous bundle distortion,the arrangement was scattered in disorder,difficult to see the intercellular substance.Tendon retinal thickness showed obvious differences with the health side (Control group).In the force group,the tendon cells were round or oval,located in collagen bundles in a string of alignment,inflammatory cells were seen.Tendon retinal thickness showed no differences with the health side.(2)With polarized light microscopy,the collagen Ⅰ and collagen Ⅲ composition proportion in the contracture group showed obvious differences with the control group,force group had not obvious differences with health side.(3)The content of polysaccharide in the contracture group were obviously reduced,while force group returned to normal level.ConclusionThe tissue form of contracture Achilles tendon can recovered to normal with the Ilizarov technology.