BACKGROUND:Pueraria decoction is a famous prescription of traditional Chinese medicine,which has good anti-inflammatory and analgesic effects.The mechanism of Pueraria decoction in osteoarthritis was analyzed using network pharmacology to obtain the main therapeutic components of Pueraria decoction. OBJECTIVE:To analyze the mechanism of Pueraria decoction in the treatment of osteoarthritis through network pharmacology and animal experiments. METHODS:First,the active ingredients of Pueraria decoction were screened through the Chinese Herbal Medicine Analysis platform(TCMSP)and the genes related to osteoarthritis were collected in the GeneCards database.Second,Cytoscape software was used to construct the"active ingredient-target-disease"network diagram,explore hub genes and analyze gene expression differences.Subsequently,the therapeutic effect of luteolin,one of the main components of Pueraria decoction,was verified in a mouse model of osteoarthritis.Finally,the Kyoto Encyclopedia of Genes and Genomes(KEGG)and the gene ontology(GO)enrichment analyses of the target genes were conducted to further explore the relevant mechanisms. RESULTS AND CONCLUSION:115 active ingredients and 147 target genes related to osteoarthritis were identified.GO and KEGG analyses found that Pueraria decoction could affect osteoarthritis through a variety of reaction mechanisms and metabolic pathways.Six hub genes and compounds acting on these genes were determined.Luteolin,the main component of Pueraria decoction,could better promote cartilage repair,accelerate the decrease of typy II collagen and inhibit the expression of matrix metalloproteinase 1 and cyclooxygenase 2 in animal experiments.To conclude,Pueraria decoction contains various active ingredients to prevent the progression of osteoarthritis through oxidative stress and metabolic pathways.

Objectives Comparative analysis on epidemiological characteristics of measles in Minhang District before and after Large scale supplementary immunization activities of measles containing vaccine(MCV) in 2010. Methods Measles incidence data of MCV-SIA in 2010 and the first five years before 2010 (from January 1, 2005 to December 31, 2009), the next five years (from January 1, 2011 to December 31, 2015) and the second five years (from January 1, 2016 to December 31, 2020) after were collected. Descriptive epidemiological method was used for comparative analysis. Results The incidence rate of measles in Minhang District, Shanghai after MCV-SIA in 2010 showed a significant downward trend, The average annual incidence (per 100 0000) in the first 5 years before 2010 was 155.96, SIA was 30.08,The next five years was 29.52, The second five years was 2.84,There was statistical difference in the annual incidence rate between the four groups.（χ²=3165.821，P<0.01）. The annual incidence rate between registered residence and non registered residence population were not statistically different after second SIA years after the SIA（χ²=1.646，P=0.223）The proportion of 8-month-old children under the age of MCV decreased from 15.46% in the first five years of MCV-sia to 5.88%,In the second five years after MCV-sia, the proportion of 10-14 age group increased from 7.81% to 13.83%, The susceptible population of measles before MCV-SIA was less than 8 month old and under the age of MCV initial immunization, no migrant workers with no history of immunization and adults with registered residence. Once there is a source of infection, it is easy to cause the spread of the epidemic. After MCV-SIA, foreign students in international schools and nonworking population became the focus of measles. Of the 95 cases in which measles virus genotypes were available in the next five years, 2 (2.11%) were A genotype, and 93 (97.89%)were the indigenous H1 genotype ; Of the 7 cases in which measles virus genotypes were available in the second five years,7 (100%)were the indigenous H1 genotype . Conclusions After MCV-SIA, the comprehensive measles prevention and control measures can effectively control the incidence and prevalence of measles in Minhang District. But circulation of the indigenous H1 genotype was not interrupted, the work of normalization measures to eliminate measles also needs to cooperate with many departments to strengthen the prevention and control measures of measles in foreign schools and the nonworking population.

Objective: To explore the turnover intention of nurses in Quzhou and its influential factors. Methods: From July to August in 2017 cross-sectional study and self-filled questionnaire are used to investigate 980 nurses from 7 hospitals in Quzhou, including two third-level hospitals and five second-level ones. T-test, F-test, Pearson and linear regression are used in data with the method of statistical analysis. Results: The total score of turnover intention of nurses was (14.95±3.17) points, and the index value was 62.27%, of which the turnover intention was above 78%. The analysis of Single factor showed that age (F=4.895) , Department (F=2.971) , title, nursing age (F=5.863) , self-assessment of physical conditions (F=4.092) were closely related to nurses’ turnover intention(P<0.05). According to Person’s correlation analysis, there are positive correlations between turnover intention and source of stressor, and moral distress (P<0.05) . Multiple linear regression showed that the nurses’ turnover intention was age, Department, health selfevaluation, stressor and moral distress. Conclusion The turnover intention of nurses is high, which is related to age, Department, self-evaluation of health, stressor and moral distress.

Objective To investigate the pathogen characteristics of perforated appendicitis in children and the perioperative use of antimicrobials in order to provide evidence for the rational use of perioperative antibiotics. Methods The perioperative usage of antibiotics was analyzed to determine the reasonableness of antimicrobial use in children with perforated appendicitis who were discharged from July 2011 to August 2014,based on“guidelines of clinical use of antibiotics”and results of bacterial culture. Results Inflammatory secretions obtained from 126 children(126/ 149)were sent for examination and the examination rate was 84.56%.A total of 117 cases were found positive for cultured pathogens,and the detection positive rate was 92.86%.Three types of bacteria ranking the first three places were Escherichia coli,Pseudomonas aeruginosa and CitroBacter freundii.The utilization rate of antibacterial agents was 100.00%,with a dominant use of cephalosporins and nitrate imidazoles. Rational use of antimicrobial agents was found in 144 cases(accounting for 96.64%). Conclusion The major pathogen in perforated appendicitis is still Escherichia coli,which is highly sensitive to commonly used antibiotics,and drug-sensitivity testing results can help guide the treatment programs and antibiotics selection.

AIM:To discover the effect of MCPH1 on the DNA damage induced by ionizing radiation in esoph-ageal cancer cells.METHODS:ECA109 cancer cells were radiated at dose of 8 Gy.The nuclear foci of relevant factors were detected 1 h after irradiation in the ECA109 cells after silence of MDC1 gene.A cell line was established that was sta-ble low expression of MCPH1.The nuclear foci induced by ionizing radiation after silence of MCPH1 were determined.RE-SULTS:The MCPH1 gene silenced ECA109 cell line was successfully constructed.A strong relationship between MDC1, MCPH1 andγ-H2AX was observed 1 h after 8 Gy irradiation.Silence of MDC1 did not affect the nuclear foci formation ofγ-H2AX and MCPH1.The nuclear foci of MDC1 but notγ-H2AX significantly reduced after silencing of MCPH1.CON-CLUSION:MCPH1 is located in the downstream of H2AX and upstream formation of MDC1, and regulates the nuclear fo-ci formation of MDC1 during DNA damage response.

[ ABSTRACT] AIM:To investigate the inhibitory effect of Am80 on neointima hyperplasia in carotid arteries after balloon injury and to observe the interaction between Krüppel-like factor 4 (KLF4) and retinoic acid receptorα(RARα). METHODS:Neointima hyperplasia in carotid arteries was observed by hemotoxylin and eosin staining.The expression of KLF4 and cyclin D1 was examined by immunostaining and Western blotting analysis.To detect the interaction between KLF4 and RARαin the vascular tissue, the injured arteries were harvested, and the protein extracts were prepared and subjected to co-immunoprecipitation assay.RESULTS:Compared with injured group, Am80 significantly reduced neointi-mal hyperplasia and the thickness ratio of intima to media.Am80 not only up-regulated KLF4 or RARαexpression in caro-tid arteries, but also increased the interaction between KLF4 and RARαat tissue levels.CONCLUSION:Am80 inhibits neointima hyperplasia in carotid arteries after balloon injury by promoting the interaction between KLF4 and RARα.

Objective:To investigate the off-label drug use in the outpatients of Zhengzhou children's hospital in 2013 to provide the evidence for improving the rational drug use in pediatrics. Methods:The prescriptions of outpatients were randomly selected from January to December in 2013. According to the drug instruction, the off-label drug uses were analyzed in the following aspects: sam-pling conditions, the kinds of off-label drug use, the incidence of off-label drug use in different age groups and drug categories. Re-sults:A total of 8 684 prescriptions with 16 344 medical records involving 410 kinds of drugs were analyzed, and the rate of off-label drug use was 70. 87% for prescription, 51. 21% for medical orders and 71. 95% for category, respectively. The primary types of off-label drug use were over applicable people (50. 83%), dosage(21. 00%) and frequency (19. 04%). The top 3 age groups with high-est off-label drug use rate were neonates (63. 27%), infants (56. 20%) and school-age (44. 98%). The top 5 drugs with highest off-label drug use rate were cardiovascular system medicines (99. 02%), anti-infective agents (64. 14%), vitamin and mineral drugs (62. 89%), hematological system medicines (59. 48%) and Chinese patent drugs (53. 43%). Conclusion: Off-label drug use in outpatients is prevalent. Physicians should master indications, usage and dosage described in instructions, select suitable dosage form, reduce off-label drug use and improve drug safety in pediatrics.

OBJECTIVE:To explore the effects of enteral nutrition powder in children with phenylketonuria(PKU)under one year. METHODS:120 PKU children under one year were selected and given enteral nutrition powder(20 g/kg,qd)for consecutive 32 weeks. The level of benzene,height,weight,head circumference,IQ level,nutrition indicators and ADR were compared be-fore treatment,8 weeks after treatment,32 weeks after treatment. RESULTS:8 and 32 weeks after treatment,the level of benzene decreased gradually,and height,weight and head circumference increased gradually,with statistical significance(P<0.05). IQ lev-el of children after 8 weeks treatment were better than before,and those of children after 32 weeks treatment were better than after 8 weeks treatment,with statistical significance(P<0.05). 8 and 32 weeks after treatment,nutrition indicators were improved sig-nificantly,compared with before treatment;ALT,Alb and TP levels 32 weeks after treatment were significantly better than 8 weeks after treatment,with statistical significance(P<0.05).There was no statistically significant difference in BUN,TBil and Pa levels between 32 weeks after treatment and 8 weeks after treatment(P>0.05). 66 cases suffered from 181 times of ADR,mainly including 10 times diarrhea and 126 times upper respiratory tract infection,among which one children developed moderate gastroen-teritis. They were all recovered after symptomatic treatment. CONCLUSIONS:For PKU children under one year,enteral nutrition powder can effectively control the phenylalanine levels,prevent the decrease of IQ and improve the nutritional status so as to meet the normal growth and development of children nutritional requirements,with better safety and tolerance.

Objective To translate the English version of Incontinence-Associated Dermatitis Severity Instrument ( IADS ) into Chinese and to test its reliability and validity. Methods The IADS was introduced and localized with the permission by the author. A total of 60 patients who had IAD in the Affiliated Hospital of Nantong University from June to August 2012 were investigated. The internal consistency reliability, inter-rater reliability and content validity were used to evaluate the scale. Results The reliability and validity of IAD severity scale showed that Cronbach′α coefficient was 0.72;inter- rater correlation coefficient was 0.82, P<0.01;content validity ratio was 0.91. Conclusions The Chinese version of IADS was proved to be reliable and valid. It can be used to identify IAD and its severity and provide the basis for clinical intervention and dynamic assessment.