Objective To observe the changes of TNF-α and NF-κB after different doses of nalmefene hydrochloride (NAL) therapy for traumatic brain injury (TBI) in an effort to identify the effect of NAL on TBI-induced inflammatory response and the possible mechanism.Methods A model of TBI in the rat was produced using the improved Feeney' s free-fall impact method.The animals were randomly divided into sham group,TBI group,TBI + large dose of NAL (ip,0.2 mg/kg) group (TBI + NAL1group),TBI + medial dose of NAL (ip,0.14 mg/kg) group (TBI + NAL2 group),TBI + small dose of NAL (ip,0.07 mg/kg) group (TBI + NAL3 group).Form of brain tissues in each group was observed and mRNA levels of TNF-α and NF-κB were measured by real-time quantitative PCR assay.Results HE staining revealed severe injury and inflammatory infiltration of brain parenchyma in TBI group ;on the contrary,the situation ameliorated in TBI + NAL1 group,TBI + NAL2 group and TBI + NAL3group,with especially obvious improvement in TBI + NAL2 group.In PCR assay,significant expression of NF-κB and TNF-α was observed at post-TBI days 1,3,5 and 7 (P ＜ 0.05),followed by great reverse after NAL therapy (P ＜ 0.05),particularly in TBI + NAL2 group.Conclusions NAL can reduce the inflammation response to TBI and promote post-injury recovery.Moreover,there exists a NAL concentration window.

Objective To explore the role of the SerpinB5 and β-catenin in occurrence and development of the primary hepatocellular carcinoma (HCC). Methods The expressions of SerpinB5 and β-catenin protein and mRNA in carcinoma tissues and paracancerous tissues of 60 patients with primary HCC were detected by immumohistochemistry and real-time quantitative reverse transcriptional polymerase chain reaction (RT-PCR) methods. Results The positive expression rate of SerpinB5 protein and SerpinB5 mRNA in carcinoma tissues were significantly lower than those in paracancerous tissues:25.0%(15/60) vs. 63.3%(38/60) and 1.12 ± 0.43 vs. 5.19 ± 0.39, and there were statistical differences (P<0.01). The positive expression rate of β-catenin protein and β-catenin mRNA in carcinoma tissues were significantly higher than those that in paracancerous tissues: 65.0%(39/60) vs. 31.7%(19/60) and 4.23 ± 0.25 vs. 1.19 ± 0.17, and there was statistical difference (P<0.01). Decreased SerpinB5 expression was associated with higher serumα-fetoprotein level, larger tumor size, poor differentiation, advanced TNM stage, capsule invasion and tumor thrombosis (P < 0.01 or 0.05). Increased β-catenin expression was associated with poor differentiation, advanced TNM stage, capsule invasion and tumor thrombosis (P < 0.01 or < 0.05). The correlation analysis result showed that SerpinB5 had negative correlation withβ-catenin (carcinoma issues:r=-0.346, P=0.001;paracancerous tissues:r=-0.258, P = 0.024). Conclusions The abnormal expression of SerpinB5 and β-catenin may contribute to the progression and biologically malignant behavior of primary HCC, and SerpinB5 and β-catenin exists synergistic effect in the occurrence and development of primary HCC.

Objective To learn the awareness,attitude and behavior changes of medical workers to the family doctor service and the influential factors on their utilization of such service since the service is in place.The purpose is to provide theoretical basis to establish the family doctor service model and the incentive mechanism in line with the development of community health service in Beijing.Methods Eight community health centers were sampled randomly from three representative areas of Haidian,Xicheng and Daxing districts,which were grouped randomly as one intervention group and one control group.All the medical workers surveyed were subj ect to the research.The control group was managed as to the existing management mode,and the intervention group was classified and managed according to the new family doctor service model.A questionnaire survey was made to collect data from the baseline and final stages.Comparisons were made among the districts,institutions,and before-after intervention of the institutions themselves to evaluate the effects of the service model and incentive mechanism.Results The survey found a higher awareness by medical workers to such service,higher recognition and satisfaction, and lower rate of services provided by medical workers.The logistic regression analysis found the influential factors for willingness of medical workers to work as family doctors,include group difference, workload changes after signoff as family doctors,residents′acceptance of the community first visit system,recognition or not for whether a family should have a community service team,residents′acceptance,and the general comments on family doctor service (P< 0.05 ).Conclusions Higher incentives of community doctors to embrace family doctor service,calls for the medical workers to change their perception,better incentive mechanism and greater promotion efforts for family doctors′services.

OBJECTIVETo investigate the associations of genetic polymorphisms in GSTs genes of the Hakka population of south China with family histories of certain chronic diseases.

METHODSFive hundred and thirty-nine healthy Hakka natives of Meizhou city of Guangdong province in south China were involved. The genotypes of GSTM1, GSTT1, GSTP1, GSTM3, and GSTA1 were determined using PCR and restriction fragment length polymorphism analysis. The observed polymorphisms were analyzed by Chi-square and Hardy-Weinberg equilibrium tests. Logistic regression analysis was used to determine the associations of the distributions of GST genotypes with family history of certain chronic diseases.

RESULTSThe distributions of polymorphisms in GSTP1, GSTM3, and GSTA1 conformed to the Hardy-Weinberg equilibrium. Compared to the Cantonese, the Hakka had a lower distribution of the GSTM3 deletion genotype (3.15% vs. 11.9%). A weak association was observed between the GSTM1 genetic polymorphism and family history of hypertension. Alcohol drinkers had a higher frequency of the null-GSTM1 genotype, while smokers had a higher frequency of a variant GSTP1 genotype.

CONCLUSIONThe results suggest that the Hakka is a special and distinctive Han Chinese ethnic group with different GSTs genetic polymorphisms. Smoking and drinking might be related to the distribution of GST genotypes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; genetics ; Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Female ; Genetic Predisposition to Disease ; Glutathione Transferase ; genetics ; Humans ; Hypertension ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Smoking ; genetics ; Young Adult

Objective:To explore the tricuspid annular plane systolic excusion(TAPSE) in children with left-to-right shunt after congenital heart disease surgery and to understand the early systolic function of right heart in thesepatient.Methods:From June 2018 to December 2018, a prospective study was conducted in 20 infants after repair of left-to-right shunt congenital heart disease, including 10 males(50%) and 10 females(50%) , aged from 1 to 12 months, with a median of 4.5(2.0, 6.8) months, a body mass of 3.0-9.0 kg with median of 6.0(3.7, 7.7) kg.On the first postoperative day, blood was taken from central venous for N-terminal pro-B-type natriuretic peptide(NT pro-BNP) test, TAPSE and left ventricular ejective fraction(LVEF) was measured by echocardiography.The effects of aortic occlusion time, cardiopulmonary bypass time, preoperative pneumonia and preoperative heart failure on TAPSE were compared. The relationship between TAPSE and heart rate, systolic pressure, central venous pressure, vasoactive drug score, endotracheal intubation time, detention time in intensive care unit, NT pro-BNP and LVEF after operation was analysed.Results:The aortic cross-clamping time was 15-87 minutes, with median 31(28, 50) minutes. The cardiopulmonary bypass time was 35-117 minutes, with an average of(68±22)minutes. The time of tracheal intubation was 4-117 hours, with an average of(50±35) hours. The stay time in CICU was 1-14 days, with a median of 5(2, 7) days.The LVEF was 0.18-0.66, with median 0.53(0.42, 0.57). The TAPSE was 2.0-10.0 mm, with an average of(5.2±2.0) mm. On the first day after operation, NT pro-BNP was 1 548-35 000 pg/ml, with an average of(9 446±8 130) pg/ml.TAPSE was negatively correlated with postoperative intubation time( r=-0.576, P= 0.007) and detention time in ICU( r=-0.765, P=0.000), and positively correlated with postoperative LVEF( r=0.461, P=0.041)( P<0.05). TAPSE was negatively correlated with heart rate( r=-0.303, P=0.193), central venous pressure( r=-0.425, P=0.062), vasoactive drug score( r=-0.418, P=0.067) and NT Pro BNP( r=-0.348, P=0.132), and positively correlated with systolic pressure( r=0.146, P=0.54), but there was no statistical significance in each item.Compared with patients with TAPSE≥5mm, the detention time and tracheal intubation time were longer than those TAPSE<5 mm, the central venous pressure and NT-pro BNP was higher than those TAPSE<5 mm( P<0.05), the difference was statistically significant, other indicators had no significant difference. Conclusion:It is simple and feasible to measure TAPSE by echocardiography in children after operation with left-to-right shunt congenital heart disease.TAPSE decreased postoperatively suggested that the function of right ventricle decreased at the early stage after surgery, and with left ventricle systolic function decreased, which eventually led to the increase of NT pro-BNP, the need for higher doses of vasoactive drug support, longer tracheal intubation time and the stay time in CICU.Attention should be paid to the right heart function of children after congenital heart surgery.

Objective: To examine the integrated model of self-management behavior in middle-aged stroke patients based on health belief model and planned behavior theory. Methods: A self-designed general information questionnaire, self-management behavior cognition and attitude questionnaire and self-management behavior scale, were used to investigate 654 cases of first middle-aged stroke patients in the neurology department of 3 grade a hospitals in Qingdao. Results: The standardization factor load of each theoretical dimension in the theoretical integration model was 0.51-0.91 (0.72±0.11). Behavioral intention had a direct positive predictive effect on self-management behavior, with an effect value of 0.49 (t = 7.41, P < 0.01). Perceived behavior control not only had a direct positive prediction effect on self-management behavior, but also indirectly influenced self-management behavior through behavioral intention. The effect values are 0.12 (t = 2.75, P < 0.05) and 0.04 (t = 2.18, P < 0.05), respectively. Behavioral attitude exerts influence on self-management behavior through behavioral intention, and the effect value is 0.40 (t = 14.71, P < 0.01). Subjective norms not only influenced self-management behavior through behavioral intention, but also indirectly influenced behavioral intention and self-management behavior through behavioral attitude, with the effect value of 0.25. The effects of perceived benefits and perceived severity on self-management behaviors were 0.21 and 0.04, respectively. The theoretical integration model can explain 62% variance variation of self-management behavior. Conclusion The theoretical integration model of self-management behavior of middle-aged stroke patients based on the health belief model and planned behavior theory can better explain the behavior. This model can be applied to stroke patients in an attempt to provide theoretical basis for the formulation of personalized nursing measures for stroke patients.

ObjectiveTo explore the law of women reproductive aging based on theory of "seven-year period" in traditional Chinese medicine（TCM） through analyzing the characteristics of basic sex hormone levels and anti-müllerian hormone levels in women of different ages. MethodsThe data of female who visited Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2018 to December 2022 and accepted basic hormone and anti-müllerian hormone determination were collected retrospectively. According to the age of subjects， they were divided into the "1-2 seven" group （under 21 years old）， "3 seven" group （21-27 years old）， "4 seven" group （28-34 years old）， "5 seven" group （35-41 years old）， "6 seven" group （42-48 years old） and "7 seven" and older group （49 years old and above）. The age， average menstrual cycle in the past 3 months， basic hormone levels including follicle stimulating hormone （FSH）， luteinizing hormone （LH）， estradiol （E₂）， testosterone （T） and FSH/LH value， and anti-müllerian hormone （AMH） levels were collected and compared. ResultsA total of 1221 cases were included. The differences in FSH， LH， FSH/LH values， E₂， T， AMH levels and average menstrual cycle among the groups were statistically significant （P＜0.05 or P＜0.01）. AMH peaked in the "3 seven" group. Compared to those in the "3 seven" group， the FSH/LH value in the "4 seven" group increased， while the LH， AMH and T levels decreased， and the menstrual cycle was shortened （P＜0.01）. The FSH/LH， LH， AMH， T and menstrual cycle in the "5 seven" group were consistent with the changing trend of those in the "4 seven" group， while the FSH and E₂ levels in the "5 seven" group were significantly higher （P＜0.05 or P＜0.01）. Compared to those in the "5 seven" group， the FSH， LH and E₂ levels of the "6 seven" group increased， and the AMH and T levels continued to decrease （P＜0.05 or P＜0.01）. Compared to those in the "6 seven" group， the FSH and LH levels of the "7 seven" and older group continued to increase， and the AMH and E₂ levels decreased （P＜0.01）. ConclusionThe law of women reproductive aging in the "seven-year period" theory is basically consistent with the characteristics of basic sex hormone levels and anti-müllerian hormone levels in women of different ages. The reproductive capacity reaches its peak in the "three-seven-year period" and gradually moves towards reproductive aging in the "four-seven-year period".