Sampling data of fresh frozen plasma, cryoprecipitates and leukocyte-free platelet quality monitoring in Hebei Province from 2015 to 2021: a retrospective analysis / 中国输血杂志

【Objective】 To form the sampling data interval by retrospectively analyzing the sampling data of quality monitoring of fresh frozen plasma, cryoprecipitates and leukocyte-free platelets in all blood stations in Hebei Province during the past 7 years. 【Methods】 The data of blood component sampling from 12 blood station quality control laboratories in Hebei from 2015 to 2021 were collected. The FⅧ content and plasma protein content of fresh frozen plasma, the FⅧ content and fibrinogen content of cryoprecipitates, and the leukocyte residuals, red blood cell mixed and platelet content of leukocyte-free platelets were taken as the objects for discrete point and fitted curve analysis. 【Results】 The FⅧ level of fresh frozen plasma: (1.36±1.1) IU/mL, 5 blood stations showed a representative overall high or low or fluctuated characteristics; Fresh frozen plasm-plasma protein items: overall mean ±SD: (61.13±16.7) g/L, four blood stations showed scattered distribution or continuous high value scattered points; Cryoprecipitates FⅧ: the overall mean ±SD: (134.25±58.7) IU/mL, four blood stations showed the differentiation characteristics of continuous high, low or stable in the middle; Cryoprecipitates-fibrinogen items: the overall mean ±SD: (215.27±83.5) mg, five blood stations showed the overall high or low and fluctuated. Leukocyte-free apheresis platelet-to-leukocyte residual items: overall mean ±SD: 0.37±0.96 (×106/bag), two blood stations showed a relatively high representative overall characteristics, and the rest were concentrated between 0 and 1; The total mean ±SD of platelet-to-red blood cell mixture without leukocyte was 2.45±2.82 (×109/bag), with obvious segmented concentrated distribution, and scattered distribution in 3 blood centers. Platelet content: the overall mean ±SD was 3.14±1.55 (×1011/bag), many deviations were noticed in 3 blood stations, and 1 blood station showed representative overall high characteristics. 【Conclusion】 This analysis shows that the distribution status of each blood station in different items is similar. The distribution status of discrete point groups and the change trend of the concentrated part of the fitting curve show that there are some differences in the monitoring level between the quality control laboratories of each blood station, and the update of detection instruments and reagents and the selection of detection methods greatly affect the test results. The summary data presented the index interval framework formed in the past 7 years, which helped to understand the difference between the results of each laboratory, correct the accuracy of the test results, better play the guiding role of quality monitoring in the blood preparation process, and continue to enhance the standardization of the whole process of blood collection and supply in the province.

Current situation and main problems of blood quality control in Hebei province / 中国输血杂志

【Objective】 To investigate the status quo and existing problems of quality control laboratory of blood stations in Hebei province, and to provide reference for the capacity building of quality control laboratory in the future. 【Methods】 The data of routine blood collection and supply, blood component preparation, blood sampling ratio/frequency, and sampling results among 12 blood stations in Hebei in 2020 were collected. The monitoring effect of blood component quality in Hebei province, combined with the indicator changes of main blood components, were analyzed. 【Results】 Blood component preparation from blood stations in Hebei are different. The requirements for the number and frequency of routine sampling in each apartment are not standardized, and retrospective analysis was not conducted basically. Although the frequency and sampling of blood component quality monitoring can meet the minimum requirements of the Quality Monitoring Guidelines of Whole Blood and Blood Components 2017 and Technical Operating Regulations of Blood Stations (2019 Edition), but does not match the actual collection and preparation units. The qualification rate and reliability are unstable due to the small sample size. Monthly quality inspection can result in judgment errors, which is not conducive to systematic analysis and continuous improvement of blood collection and supply process. 【Conclusion】 In the context of continuous enhancement of blood collection and supply standardization in Hebei Province, the blood quality monitoring mechanism based on intra-province consistency can be further studied to standardize intra-province homogenization of blood quality monitoring in multiple links including sampling rules, statistical analysis and data comparison calibers.

Gentiopicroside targets PAQR3 to activate the PI3K/AKT signaling pathway and ameliorate disordered glucose and lipid metabolism

The obstruction of post-insulin receptor signaling is the main mechanism of insulin-resistant diabetes. Progestin and adipoQ receptor 3 (PAQR3), a key regulator of inflammation and metabolism, can negatively regulate the PI3K/AKT signaling pathway. Here, we report that gentiopicroside (GPS), the main bioactive secoiridoid glycoside of Gentiana manshurica Kitagawa, decreased lipid synthesis and increased glucose utilization in palmitic acid (PA) treated HepG2 cells. Additionally, GPS improved glycolipid metabolism in streptozotocin (STZ) treated high-fat diet (HFD)-induced diabetic mice. Our findings revealed that GPS promoted the activation of the PI3K/AKT axis by facilitating DNA-binding protein 2 (DDB2)-mediated PAQR3 ubiquitinated degradation. Moreover, results of surface plasmon resonance (SPR), microscale thermophoresis (MST) and thermal shift assay (TSA) indicated that GPS directly binds to PAQR3. Results of molecular docking and cellular thermal shift assay (CETSA) revealed that GPS directly bound to the amino acids of the PAQR3 NH2-terminus including Leu40, Asp42, Glu69, Tyr125 and Ser129, and spatially inhibited the interaction between PAQR3 and the PI3K catalytic subunit (P110α) to restore the PI3K/AKT signaling pathway. In summary, our study identified GPS, which inhibits PAQR3 expression and directly targets PAQR3 to restore insulin signaling pathway, as a potential drug candidate for the treatment of diabetes.

Genetic analysis of 21 cases of methylmalonic acidemia / 中华医学遗传学杂志

OBJECTIVE@#To carry out genetic analysis for 21 patients with methylmalonic acidemia (MMA) and provide genetic counseling for their families.@*METHODS@#Next generation sequencing (panel) was used to detect the pathogenic variants underlying the disease.@*RESULTS@#In total 29 variant sites of MMUT, MMAA, MMUT were identified in the 21 patients, with common variants including c.323G>A (10%), c.917C>T (10%), c.984delC (10%) of MMUT gene, and c.609G>A (45%), c.80A>G (10%) , c.567dupT (10%) of MMACHC gene. Among these, c.2000A>G of MMUT, c.298G>T of MMACHC and c.734-7A>G of MMAA gene were unreported previously.@*CONCLUSION@#Genetic testing for MMA patients can clarify the cause of the disease and provide a basis for the clinical diagnosis. Discovery of novel variants has enriched the mutational spectrum of MMA.

The characteristics of gastrointestinal symptoms in patients of Parkinson′s disease / 中华神经科杂志

Objective:To investigate the characteristics of gastrointestinal (GI) symptom spectrum in patients with Parkinson′s disease (PD), and to help the early identification of gastrointestinal symptoms and management of PD.Methods:One hundred PD patients in the Department of Neurology, Peking Union Medical College Hospital from January 2017 to August 2017 were enrolled in this study. They were assessed by face-to-face GI dysfunction questionnaire, including eight common symptoms involved in oropharynx, upper and lower digestive tract. The Spearman correlation analysis was performed.Results:The age of PD patients was (61.9±10.5) years, the ratio of male to female was 53∶47 and the disease duration was 4.0 (2.0, 6.0) years. There were 42 cases of Hoehn-Yahr (H-Y) stage 1, 30 cases of H-Y stage 2 and 28 cases of H-Y stage 3 and above (24 cases of H-Y stage 3, three cases of H-Y stage 4 and one case of H-Y stage 5). Totally 58% (58/100) of PD patients had one or more GI symptoms. Constipation (42%, 42/100), dysdefecation (38%, 38/100) and salivation (28%, 28/100) were the top three of most common GI symptoms. Lower GI symptoms were the most common (57%, 57/100), followed by oropharyngeal symptoms (33%, 33/100), and upper GI symptoms (27%, 27/100). GI symptoms could appear in H-Y stage 1 patients, 26.1% (11/42) of which had 1-2 kinds of GI symptoms and over 20% of which had more than three kinds of GI symptoms. A total of 39.3% (11/28) of PD patients with H-Y stage ≥3 had more than three kinds of GI symptoms. The Gastroparesis Cardinal Symptom Index (GCSI) score in patients with upper GI symptoms was 3.0 (2.0,6.5). The constipation symptom score in patients with constipation and dysdefecation was 19.0 (12.0,27.3). As for the clinical type of constipation, 66.7% (38/57) of them were mixed, 21.0% (12/57) were slow transit and 12.3% (7/57) were dysdefecation. In 38.6% (22/57) of the constipated patients, constipation symptoms occurred earlier than PD motor symptoms. Correlation analysis showed that H-Y stage was positively correlated with the course of PD, the number of GI symptoms, salivation, constipation, dysdefecation and constipation symptom scores.Conclusions:Constipation, dysdefecation and salivation were the most common GI symptoms in PD patients. PD patients had at least one GI symptom in the early stage (H-Y stage 1). Lower GI symptoms were more common than oropharyngeal symptoms and upper GI symptoms. With the development of PD, the number of GI symptoms, salivation, constipation and dysdefecation were aggravated, which were important for early symptomatic identification and disease management.

Effects of endoscopic and surgical treatment for distal early gastric cancer on long-term quality of life and function / 中华消化内镜杂志

Objective@#To study the effects of endoscopic submucosal dissection(ESD) on long-term quality of life (QOL) and gastric function of patients with distal early gastric cancer (EGC), compared with those of surgery.@*Methods@#Patients with EGC who received ESD or surgical resection in Peking Union Medical College Hospital over 1 year ago were selected to be followed up. QLQ-C30, SF-36, EQ-5D and dyspeptic symptom rating scale were used to evaluate QOL. Five-hour gastric emptying rate was used to evaluate distal gastric function. Electronic gastroscopy was used to observe whether the anastomotic stoma was stenotic. According to the age at resection, 1 to 1 matching was performed between the distal 1/3 gastric ESD (EP) group and the distal subtotal gastrectomy (SP) group, and then the QOL and gastric function between the two groups were compared.@*Results@#Twenty-five patients were included in group EP and group SP respectively. According to QLQ-C30, the scores of cognitive function were 83.3 (83.3, 83.3) in group EP and 83.3 (83.3, 100.0) in group SP (P=0.056). The proportion of patients with symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) between the two groups were not statistically different. There was no statistical difference in the scores of EQ-5D and SF-36 between the two groups. According to dyspeptic symptom rating scale, 56.0% patients in group EPhad burning sensation, but only 28.0% in group SP had this symptom (P=0.054). 20.0% of patients in group SPreported nausea, while only 4.0% in group EP had this symptom (P=0.084). Gastric emptying results showed that the proportion of patients with abnormal 5-hour gastric emptying rate was 31.8% in group EP, while there was no abnormal emptying in group SP (P=0.003). Gastroscopy results showed that one patient in group EP had pyloric stenosis, but 5-hour gastric emptying rate was normal. All anastomotic stomas in group Sp were unobstructed.@*Conclusion@#ESD and surgical resection for distal EGC show similar long-term effects on QOL of patients. But the long-term gastric emptying function may decrease after distal gastric ESD.

Related factors of sarcopenia in hospitalized elderly patients with coronary heart disease / 中华心血管病杂志

Objective@#To explore the incidence and clinical characteristics of sarcopenia in hospitalized elderly patients with coronary heart disease and search for the related factors.@*Methods@#This study was a single-center observational study. According to the inclusion criteria, elderly patients hospitalized with coronary heart disease from Peking Union Medical College Hospital between December 2017 and December 2018 were enrolled. The patients were divided into sarcopenic group and non-sarcopenic group according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Activities of daily living of the patients were assessed (including ADL and IADL) . Comorbidity of the patients was evaluated by the Charlson comorbidity index (CCI). Long-term medication use of the patients was recorded to assesse whether there was polypharmacy. The nutritional status of the patients was examined by the mini nutritional assessment-short form (MNA-SF). The full tandem stance time of the patients was evaluated. The history of falls over the previous year, urinary incontinence, and living conditions of the patients were also recorded. Multivariate logistic regression was used to analyze the related factors for sarcopenia of elderly patients with coronary heart disease.@*Results@#A total of 364 patients were enrolled in the study. The patients were aged 65-96 (74.6±6.5) years and there were 218 (59.9%) male patients. There were 264 cases of stable coronary heart disease and 100 cases of acute coronary syndrome. The median number of long-term used medication was 7. One hundred and fifty-two (41.8%) patients were complicated with type 2 diabetes, 38 (10.4%) patients were complicated with anxiety/depression, and 98 (26.9%) patients had the history of falls over the previous year. Eighty-two (22.5%) patients were complicated with urinary incontinence, 12 patients (3.3%) were complicated with malnutrition and 33 patients (9.2%) were living alone. There were 81 (22.3%) sarcopenic patients and 283 (77.7%) non-sarcopenic patients among all the hospitalized elderly patients with coronary heart disease. The sarcopenic patients were more older, with lower body mass index(BMI)(both P<0.001), higher CCI and more long-term used medication (both P<0.05), higher proportions of malnutrition, urinary incontinence, history of falls, and living alone (all P<0.05) compared to non-sarcopenic patients. ADL and IADL scores of sarcopenic patients were significantly lower than those of non-sarcopenic patients (both P<0.001). There was also a higher proportion of unable to accomplish full tandem stance among sarcopenic patients compared to non-sarcopenic patients (P<0.001). Moreover, higher hs-CRP level (P=0.047) , lower albumin level (P=0.004) and significantly lower prealbumin level (P<0.001) were observed in sarcopenic patients compared to non-sarcopenic patients. Stepwise multivariate binomial logistic regression analysis revealed that male (OR=5.036, 95%CI 1.782-14.230, P=0.002), low BMI (OR=0.883, 95%CI 0.796-0.980, P=0.019), as well as low prealbumin level (OR=0.990, 95%CI 0.980-1.000, P=0.045) were related factors for sarcopenia among elderly patients with coronary heart disease.@*Conclusions@#Sarcopenia is a geriatric condition commonly seen in hospitalized elderly patients with coronary heart disease. Male, low BMI, and low prealbumin level were the factors related to sarcopenia for older adults with coronary heart disease.

Effects of endoscopic and surgical treatment for distal early gastric cancer on long-term quality of life and function / 中华消化内镜杂志

Objective To study the effects of endoscopic submucosal dissection(ESD) on long-term quality of life ( QOL) and gastric function of patients with distal early gastric cancer ( EGC) , compared with those of surgery. Methods Patients with EGC who received ESD or surgical resection in Peking Union Medical College Hospital over 1 year ago were selected to be followed up. QLQ-C30, SF-36, EQ-5D and dyspeptic symptom rating scale were used to evaluate QOL. Five-hour gastric emptying rate was used to evaluate distal gastric function. Electronic gastroscopy was used to observe whether the anastomotic stoma was stenotic. According to the age at resection, 1 to 1 matching was performed between the distal 1/3 gastric ESD ( EP ) group and the distal subtotal gastrectomy ( SP ) group, and then the QOL and gastric function between the two groups were compared. Results Twenty-five patients were included in group EP and group SP respectively. According to QLQ-C30, the scores of cognitive function were 83. 3 (83. 3, 83. 3) in group EP and 83. 3 (83. 3, 100. 0) in group SP(P=0. 056). The proportion of patients with symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) between the two groups were not statistically different. There was no statistical difference in the scores of EQ-5D and SF-36 between the two groups. According to dyspeptic symptom rating scale, 56. 0％patients in group EPhad burning sensation, but only 28.0％ in group SP had this symptom (P=0.054).20. 0％ of patients in group SP reported nausea, while only 4. 0％ in group EP had this symptom ( P=0. 084) . Gastric emptying results showed that the proportion of patients with abnormal 5-hour gastric emptying rate was 31. 8％ in group EP, while there was no abnormal emptying in group SP(P=0. 003). Gastroscopy results showed that one patient in group EP had pyloric stenosis, but 5-hour gastric emptying rate was normal. All anastomotic stomas in group Sp were unobstructed. Conclusion ESD and surgical resection for distal EGC show similar long-term effects on QOL of patients. But the long-term gastric emptying function may decrease after distal gastric ESD.

Regional Brain Activity During Rest and Gastric Water Load in Subtypes of Functional Dyspepsia: A Preliminary Brain Functional Magnetic Resonance Imaging Study

BACKGROUND/AIMS: Functional dyspepsia (FD) remains a great clinical challenge since the FD subtypes, defined by Rome III classification, still have heterogeneous pathogenesis. Previous studies have shown notable differences in visceral sensation processing in the CNS in FD compared to healthy subjects (HS). However, the role of CNS in the pathogenesis of each FD subtype has not been recognized. METHODS: Twenty-eight FD patients, including 10 epigastric pain syndrome (EPS), 9 postprandial distress syndrome (PDS), and 9 mixed-type, and 10 HS, were enrolled. All subjects underwent a proximal gastric perfusion water load test and the regional brain activities during resting state and water load test were investigated by functional magnetic resonance imaging. RESULTS: For regional brain activities during the resting state and water load test, each FD subtype was significantly different from HS (P < 0.05). Focusing on EPS and PDS, the regional brain activities of EPS were stronger than PDS in the left paracentral lobule, right inferior frontal gyrus pars opercularis, postcentral gyrus, precuneus, insula, parahippocampal gyrus, caudate nucleus, and bilateral cingulate cortices at the resting state (P < 0.05), and stronger than PDS in the left inferior temporal and fusiform gyri during the water load test (P < 0.05). CONCLUSIONS: Compared to HS, FD subtypes had different regional brain activities at rest and during water load test, whereby the differences displayed distinct manifestations for each subtype. Compared to PDS, EPS presented more significant differences from HS at rest, suggesting that the abnormality of central visceral pain processing could be one of the main pathogenesis mechanisms for EPS.

Learning curve characteristics of Mckeown-type minimally invasive esophagectomy and effects of the pararecurrent laryngeal nerve lymphadenectomy on efficacy / 中华消化外科杂志

Objective To explore the learning curve characteristics of Mckeown-type minimally invasive esophagectomy and effects of the para-recurrent laryngeal nerve lymphadenectomy on efficacy.Methods The retrospective cohort study was conducted.The clinicopathological data of 163 patients with esophageal squamous cell carcinoma (ESCC) who underwent Mckeown-type minimally invasive esophagectomy in the Affiliated Tumor Hospital of Xinjiang Medical University between January 2011 and December 2015 were collected.According to the para-recurrent laryngeal nerve lymphadenectomy in the different learning curve stages (early,medium and later stages),49 patients who didn't undergo right para-recurrent laryngeal nerve lymphadenectomy were allocated into the group A,65 who underwent para-recurrent laryngeal nerve lymphadenectomy were allocated into the group B,and 49 underwent bilateral para-recurrent laryngeal nerve lymphadenectomy were allocated into the group C.Observation indicators:(1) comparisons of intra-and post-operative recovery among groups;(2) comparisons of follow-up and survival among groups;(3) correlation analysis between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to April 2017.Measurement data with normal distribution were represented as-x±s.Comparison among groups was analyzed using the ANOVA,and pairwise comparison was done using the independent-sample t test.Measurement data with skewed distribution were described as M (range),and comparison of count data was done using the chi-square test.The survival time was calculated by the Kaplan-Meier method,and Log-rank test was used for survival analysis.Correlation analysis was done by Spearman rank correlation.Results (1) Comparisons of intra-and post-operative recovery among groups:patients in the 3 groups underwent successful Mckeown-type minimally invasive esophagectomy of ESCC,without conversion to open surgery.The operation time,total number of lymph node dissected,number of thoracic lymph node dissected and volume of intraoperative blood loss were respectively (395±94) minutes,14.7±6.9,9.6±5.4,(175± 100) mL in the group A and (329±67) minutes,20.4±9.1,11.4±7.3,(117±49) mL in the group B and (301±51)minutes,25.8±11.0,14.8±10.1,(115±50) mL in the group C,with statistically significant differences in above indicators among groups (F=21.962,1.992,5.775,12.744,P＜0.05),between group A and group B (t =3.135,3.741,4.324,4.375,P＜0.05) and between group A and group C (t=5.120,3.415,5.712,6.130,P＜0.05).There was no statistically significant difference in operation time and volume of intraoperative blood loss between group B and group C (t =2.325,2.459,P＞0.05).There were statistically significant differences in total number of lymph node dissected and number of thoracic lymph node dissected between group B and group C (t =2.751,3.245,P＜0.05).Cases with unilateral recurrent laryngeal nerve injury,anastomotic leakage and pneumonia were respectively 7,8,7 in the group A and 17,19,10 in the group B and 11,15,10 in the group C,with no statistically significant differences (x2 =0.968,3.292,0.773,P＞0.05).Number of lymph node dissected at right and left para-recurrent laryngeal nerve were respectively 0,0 in the group A and 1.9±1.8,0 in the group B and 2.6±2.1,1.1±0.8 in the group C.Of 35patients with unilateral recurrent laryngeal nerve were treated with symptomatic and supportive treatment of neuro nutrition,18 encountered permanent hoarseness and 17 recovered well.Patients with anastomotic fistula and pneumonia were improved by sufficient drainage and antibiotic therapy.(2) Comparisons of follow-up and survival among groups:149 of 163 patients were followed up for 17-65 months,with a median time of 32 months,including 43 in the group A,61 in the group B and 45 in the group C.Survival time of patients who received follow-up was recpectively (31.3±2.6) months,(32.2± i.6) months and (25.5±2.5) months in group A,B and C,with no statistically significant differences (x2=4.412,P＞0.05).(3) Correlation analysis between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy:results of correlation analysis showed that there was a significant negative correlation between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy (r=-0.632,-0.451,P＜0.05),showing a decreasing trend in operation time and volume of intraoperative blood loss with increasing surgical cases.Conclusions The operation time and volume of intraoperative blood loss are gradually declining with learning curve process of Mckeown-type minimally invasive esophagectomy.Para-recurrent laryngeal nerve lymphadenectomy cannot increase the incidence of recurrent laryngeal nerve injury,with more completely lymphadenectomy.

Design and application of slide support nursing bed / 医疗卫生装备

Objective To design a slide support nursing bed for the patient after cross leg flap transplant operation.Methods The bed was designed based on the principle of four-link-type mechanism slide,which was composed of a bed body,slide support,sliding rails,locking bolt,connector bar for sliding rails,extension arm,leg support and etc.Accurate localization of leg support was executed by zero setting,readjustment and etc.Results The bed could be adjusted up and down,back and forth or at different angles so as the compression on the cross leg flap was avoided to enhance the comfort of the patient after cross leg flap transplant operation.Conclusion The bed gains advantages in convenience,safety,effect and etc,and is worthy promoting clinically for the patient after cross leg flap transplant operation.

Inhibitory effect of north-Schisandra chinensis polysaccharide on neutrophil inflammation induced by lipopolysaccharide / 吉林大学学报(医学版)

Objective:To investigate the effect of Manchu medicine north-Schisandra chinensis polysaccharide (NSCP) on the human neutrophils treated by lipopolysaccharide (LPS) cultivated in vitro,and to elucidate its anti inflammatory mechanism.Methods:The neutrophilic inflammatory cell model was established with LPS.The experiment included control group,LPS group (1.0 mg · L-1) and NSCP group (1.25,2.50 and 5.00 g · L-1),the cells in NSCP group were first treated with LPS for 60 min,and then treated with different concentrations of NSCP.The levels of TNF-α in neutrophils were measured with ELISA and the apoptotic rates were detected by flow cytometry.Results:The level of TNF-a in LPS group was increased compared with control group (P＜0.05).The level of TNF-α in NSCP group was decreased compared with LPS group (P＜0.05).The apoptotic rate in LPS group was decreased compared with control group (P＜0.05);the apoptotic rates in NSCP group were increased with the increasing of time and dose,and the best effect was found 16 h after treatment with 5 g · L-1NSCP:the apoptotic rate in NSCP group was significantly increased compared with LPS group (P＜0.05).Conclusion:NSCP can perform the anti-inflammation effect through the suppression of LPS-induced TNF-α secretion in neutrophils and the promotion of neutrophils apoptosis.

Application of clinical pathway teaching model in new nurses pre-job training / 中国实用护理杂志

Objective To observe the role of clinical pathway method of teaching in the new nurses pre-job standardization training, and provide evidence for the exploration of scientific teaching methods. Methods Make training manual for new nurses on the basis of clinical path model. New nurses were assigned randomly to clinical pathway group (29 cases) and control group (28 cases). The clinical pathway and effective quality supervision were adopted in clinical pathway group, and the traditional teaching method were adopted in control group. The level of theory, basic skills, professional skills were evaluated, and satisfaction of teaching method and self-assessment were collected and analyzed. Results The results of theory, basic skills, and professional skills in clinical pathway group were (89.41 ± 5.07), (95.28 ± 2.96), (93.10 ± 2.86) points, and those in control group were (80.92 ± 7.64), (89.82 ± 3.77), (85.57 ± 5.33) points, the differences were significant (t=4.792, 6.083, 6.682, P=0.000).The number of satisfaction of teaching method was 28 cases in clinical pathway group and 22 cases in control group, the difference was significant (Z=38.316, P=0.000). Learning motivation, the ability of autonomous learning, communication, problem analyzing and solving, critical thinking, and the nursing behavior standardization in the self-assessment part in clinical pathway group were all better than those in the control group, the differences were significant (Z=-3.938~-2.143, P<0.01 or 0.05). Conclusions The application of clinical pathway method in new nurses pre-job training could effectively improve the level of theory, basic skills and professional skills, increase their satisfaction of teaching method and self-assessment.

Application of clinical pathway teaching model in new nurses pre-job training / 中国实用护理杂志

Objective To observe the role of clinical pathway method of teaching in the new nurses pre-job standardization training, and provide evidence for the exploration of scientific teaching methods. Methods Make training manual for new nurses on the basis of clinical path model. New nurses were assigned randomly to clinical pathway group (29 cases) and control group (28 cases). The clinical pathway and effective quality supervision were adopted in clinical pathway group, and the traditional teaching method were adopted in control group. The level of theory, basic skills, professional skills were evaluated, and satisfaction of teaching method and self-assessment were collected and analyzed. Results The results of theory, basic skills, and professional skills in clinical pathway group were (89.41 ± 5.07), (95.28 ± 2.96), (93.10 ± 2.86) points, and those in control group were (80.92 ± 7.64), (89.82 ± 3.77), (85.57 ± 5.33) points, the differences were significant (t=4.792, 6.083, 6.682, P=0.000).The number of satisfaction of teaching method was 28 cases in clinical pathway group and 22 cases in control group, the difference was significant (Z=38.316, P=0.000). Learning motivation, the ability of autonomous learning, communication, problem analyzing and solving, critical thinking, and the nursing behavior standardization in the self-assessment part in clinical pathway group were all better than those in the control group, the differences were significant (Z=-3.938~-2.143, P<0.01 or 0.05). Conclusions The application of clinical pathway method in new nurses pre-job training could effectively improve the level of theory, basic skills and professional skills, increase their satisfaction of teaching method and self-assessment.

Inhibitory effect of north-Schisandra chinensis polysaccharide on neutrophil inflammation induced by lipopolysaccharide / 吉林大学学报(医学版)

Objective:To investigate the effect of Manchu medicine north-Schisandra chinensis polysaccharide (NSCP) on the human neutrophils treated by lipopolysaccharide (LPS) cultivated in vitro,and to elucidate its anti inflammatory mechanism.Methods:The neutrophilic inflammatory cell model was established with LPS.The experiment included control group,LPS group (1.0 mg · L-1) and NSCP group (1.25,2.50 and 5.00 g · L-1),the cells in NSCP group were first treated with LPS for 60 min,and then treated with different concentrations of NSCP.The levels of TNF-α in neutrophils were measured with ELISA and the apoptotic rates were detected by flow cytometry.Results:The level of TNF-a in LPS group was increased compared with control group (P＜0.05).The level of TNF-α in NSCP group was decreased compared with LPS group (P＜0.05).The apoptotic rate in LPS group was decreased compared with control group (P＜0.05);the apoptotic rates in NSCP group were increased with the increasing of time and dose,and the best effect was found 16 h after treatment with 5 g · L-1NSCP:the apoptotic rate in NSCP group was significantly increased compared with LPS group (P＜0.05).Conclusion:NSCP can perform the anti-inflammation effect through the suppression of LPS-induced TNF-α secretion in neutrophils and the promotion of neutrophils apoptosis.

Emergency decontamination technology and equipment against chemical agents:research advances / 军事医学

As an important measure to reduce casualties and prevent secondary pollution, decontamination is an impor-tant link in the process of emergency response during chemical accidents.The decontamination effect is closely related to decontamination technology and equipment.Decontamination agent selection and development are an important part of a decontamination technology.In this paper, the development and use of cleaning agents, such as alkaline, oxidation and chlorination, adsorption (degradation), metal oxide and oxygen acid salt, chemical compounds, biological (enzymatic), and individual disinfection package, light decontamination equipment, multifunctional integrated large-scale decontamination equipment at home or abroad, are reviewed.By laying bare the gap between China and advanced countries in the related field, we hope to raise the concern of relevant professional counterparts and promote the development of domestic decontami-nation technology and equipment with decontaminant agents at the core.

The 453rd case:diarrhea, weight loss and diabetes mellitus / 中华内科杂志

Chronic diarrhea is a common complaint in gastroentology department,which is classified into a variety of types.While as eosinophilic gastroenteritis is a rare cause.A 50-year-old male patient was admitted with a 2-year history of diarrhea worsened for 10 months.Fasting could alleviate the diarrhea.Laboratory findings demonstrated anemia,low vitamins and minerals,fat malabsorption and abnormal D-xylose absorption test,delayed gastric emptying.According to the endoscopic biopsy of gastrointestinal mucosa,the diagnosis of eosinophilic gastroenteritis was made.Diabetic neuropathy may aggravate the symptom.The diarrhea resolved after the administration of steroids.

Changes in Enteric Neurons of Small Intestine in a Rat Model of Irritable Bowel Syndrome with Diarrhea

BACKGROUND/AIMS: Physical and/or emotional stresses are important factors in the exacerbation of symptoms in irritable bowel syndrome (IBS). Several lines of evidence support that a major impact of stress on the gastrointestinal tract occurs via the enteric nervous system. We aimed to evaluate histological changes in the submucosal plexus (SMP) and myenteric plexus (MP) of the distal ileum in concert with the intestinal motor function in a rat model of IBS with diarrhea. METHODS: The rat model was induced by heterotypic chronic and acute stress (CAS). The intestinal transit was measured by administering powdered carbon by gastric gavage. Double immunohistochemical fluorescence staining with whole-mount preparations of SMP and MP of enteric nervous system was used to assess changes in expression of choline acetyltransferase, vasoactive intestinal peptide, or nitric oxide synthase in relation to the pan neuronal marker, anti-Hu. RESULTS: The intestinal transit ratio increased significantly from control values of 50.8% to 60.6% in the CAS group. The numbers of enteric ganglia and neurons in the SMP were increased in the CAS group. The proportions of choline acetyltransferase- and vasoactive intestinal peptide-immunoreactive neurons in the SMP were increased (82.1 ± 4.3% vs. 76.0 ± 5.0%, P = 0.021; 40.5 ± 5.9% vs 28.9 ± 3.7%, P = 0.001), while nitric oxide synthase-immunoreactive neurons in the MP were decreased compared with controls (23.3 ± 4.5% vs 32.4 ± 4.5%, P = 0.002). CONCLUSIONS: These morphological changes in enteric neurons to CAS might contribute to the dysfunction in motility and secretion in IBS with diarrhea.

Decontamination properties of nanoscale metal oxides against chemical warfare agents / 国际药学研究杂志

Objective To elevated the decontam ination properties of commercial nanoscale metal oxides against chemical warfare agents (CWA), and provide more foundation for the satisfactory materials of CWA decontamination. Methods Some nanocrystals of commercial metal oxides such an MgO, TiO2, ZnO and zinc nickel ferrite compound had been chosen to compare their decontamination properties. The nanocrystals were mixed with three representative compounds, sulfur mustard (HD), soman (GD) and S-(2-diisopropylaminoethyl) O-ethyl methylphosphonothioate (VX) at room temperature and natural light. The analogous experiments were conducted without addition of nanocrystals as negative control. After a fixed time, the samples were then analyzed by the methods of T-135, Schoeneman reaction and conversion method to determine the content of CWA. The decontamination properties of nanocrystals were compared with negative control. Results The chosen nanoscale metal oxides excepted nanoscale MgO had good decontamination properties against HD, and they all could decontaminate GD quickly. Nanoscale TiO2 had superior decontamination properties against GD and HD. At the room temperature and natural light, HD was completely decontaminated within 20 hours and GD was completely decontaminated within 4 hours by nanoscale TiO2. The nanocrystals of metal oxides didn′t decontaminate VX effectively. Compared to the activated clay group, nanoscale MgO had superior decontamination properties against VX over other nanocrystals (P<0.05), but the percentage of degradation was lower than 20% within 7 h. Conclusion The chosen nanoscale TiO2 has superior decontamination properties against GD and HD than others in natural condition, but it isn′t a promising agent for the decontamination of VX.