Objective To investigate the derivatives of ginsenoside sapogenins and their activities against HL-60 cells.Methods The total ginsenoside extract was treated by Smith degradation.All products were isolated by silica gel chromatography and purified by preparative HPLC.On the basis of 1D and 2D NMR data,structures were elucidated.The activity against HL-60 cells was measured by MTT method.Results Three compounds were isolated and identified as 20(S)-protopanaxadiol(PD),20(S)-protopanaxatriol(PT),and 24,25-en-3?,6?-dihydroxy-12,20-(1′-hydroxy) ethanedioxy-dammarane(1).Conclusion Compound 1,named 1′-hydroxy ethanedioxy PT,is a novel derivate of sapogenin with higher inhibitory activity against HL-60 cells than PD and PT.

Tissue-engineered skin plays an important role in clinical applications,and even the rapid development of science and technology promotes the research about it.Choosing an appropriate animal model for wound repair is the prerequisite for the objective evaluation of the object of study.In this paper,the research progress of animal models of wound repair was introduced from several aspects,such as selection of experimental animals,making of wound models,skin-related cells and materials,wound healing evaluation indexes,etc.,hoping to provide reference for later research work.

Objective To study the application of cervical vertebral artery CT angiography(CTA) preoperatively in the screw setting of upper cervical spine.Methods The data of 170 patients who underwent upper cervical spine surgery from January 2014 to December 2015 in our hospital were retrospectively analyzed,of whom 80 cases with typeⅡodontoid fractures,90 cases with atlantoaxial dislocation;20 cases were operated with occipitocervical fusion,150 cases treated with atlantoaxial fusion.Seventy-eight cases were examinated by cervical vertebral artery CTA before sugery(observation group) but the other 92 cases(control group).The rate of the vertebral arterial lesion between the two groups were compared.Results Six cases with vertebral artery injury in control group,the incidence of arterial injury was 7％;unilateral vertebral artery was found in 3 cases,small congenital development of left cervical vertebral artery in 5 case,abnormal branch in 5 cases.The rate of dysplasia was 17％,and the rate of vertebral artery injury was 0.The rate of vertebral artery injury in control group was higher than observation group,the difference was significant(P<0.05).Conclusion Vertebral artery CTA examination preoperatively may become a routine examination,in order to make the operator carefully evaluate the relationship between the vertebral artery with atlantoaxial vertebral,choose the accurate screw-setting and avoid the vertebral artery injury in the upper cervical spine surgery.

Objective To investigate the effects of low dose radiation on the level of oxidative damage and antioxidant in population of high background radiation area of Guangdong.Methods A total of 48 male residents who lived in high background radiation area(HBRA) of Guangdong province and 48 male residents who lived in neighboring Enping control area were chosen as the objectives and control respectively.The peripheral venous blood of two groups was collected,and then the levels of 8-OHdG and TrxR were determined by enzyme linked immunosorbent assay (ELISA).Results Compared with the CA group [(315.39 ± 100.59) ng/ml],the level of 8-OHdG [(272.64 ± 96.85) ng/ml] decreased significantly in HBRA (t =2.121,P ＜0.05).Compared with the CA group [(0.467 ±0.056) ng/ml],the level of TrxR [(0.496 ± 0.044) ng/ml] increased significantly in HBRA (t =-2.823,P ＜ 0.05).The results of multiple linear regression analysis demonstrated that the chronic exposure to low dose of radiation had significant effects on the expression level of 8-OHdG and TrxR (t =-2.327,2.367,P ＜ 0.05) after adjustment for confounding factors such as age,drinking,tea drinking,smoking,medical exposure and stressful events.Conclusions Chronic exposure to low dose radiation may decrease the level of oxidative and enhance the level of antioxidant.

Objective To investigate the influence of simvastatin treatment on Toll-like receptor 4 (TLR4) in monocytes of peripheral blood in patients with sepsis and severe sepsis and its significance. Methods A prospective randomized controlled trial was conducted. 106 patients with sepsis and 92 patients with severe sepsis admitted to Department of Critical Care Medicine of Henan Provincial People's Hospital from August 2013 to June 2015 were enrolled. These two groups of patients were randomized into conventional treatment group and simvastatin group. All patients received treatment according to the 2012 International Sepsis Treatment Guidelines, including anti-infection drugs, nutritional support, and palliative treatment, and the patients with severe sepsis were given early goal-directed therapy (EGDT). The patients in simvastatin group received simvastatin 40 mg daily orally for at least 15 days. The peripheral blood was collected and the monocytes were isolated at 1, 5, 10, 15 days after intensive care unit (ICU) admission. TLR4 expression on the surface of TLR4/CD14+ double positive monocytes was determined by flow cytometry, and adverse reaction was observed during treatment. Results TLR4 expression on the surface of monocytes showed a tendency of decreasing with prolongation of simvastatin treatment in the simvastatin group in patients with sepsis (n = 59) or severe sepsis (n = 54). However, in patients with sepsis, TLR4 level was significantly decreased from 10 days in simvastatin group as compared with that of conventional therapy group (n = 47), and it was decreased up to 15 days [mean fluorescence intensity (MFI): 21 (19, 28) vs. 27 (25, 33) at 10 days, Z = 2.198, P = 0.021; 16 (15, 21) vs. 26 (23, 34) at 15 days, Z = 4.611, P = 0.002]. In patients with severe sepsis, there was no significant difference in TLR4 level at different time points between simvastatin group and conventional treatment group (n = 38) [MFI: 55 (52, 63) vs. 56 (48, 65) at 1 day, Z = 0.313, P = 0.692; 47 (42, 56) vs. 49 (41, 58) at 5 days, Z = 0.827, P = 0.533; 40 (35, 42) vs. 42 (37, 45) at 10 days, Z = 1.012, P = 0.301; 33 (30, 38) vs. 38 (35, 41) at 15 days, Z = 0.539, P = 0.571]. No adverse reaction related with simvastatin was found during treatment in patients with sepsis or severe sepsis. Conclusions Statins could significantly down-regulate the TLR4 expression on peripheral blood monocytes in septic patients, while it showed no significant influence on TLR4 expression in patients with severe sepsis. A different effect of statins on TLR4 expression and the downstream inflammation process in sepsis and severe sepsis patients might partially explain the discrepancy in previous reports about the therapeutic effect of statins therapy in sepsis and severe sepsis patients.

Objective To evaluate the effects of serum procalcitonin (PCT)-guided antibiotic therapy in elderly patients with early-onset stroke-associated pneumonia (EOP).Methods Totally 179 eligible elderly patients with EOP were randomly devided into 2 groups:standard therapy group (standard group,n=88) and PCT-guided group (PCT group,n=91).Patients in standard group received antibiotics according to antibiotics guidelines in China by the treating physicians.Patients in PCT group were treated with antibiotics for 5 days,then the antibiotic treatment was based on serum PCT levels as follows:discouraged if PCT＜0.25 μg/L and encouraged if PCT≥0.25 μg/L.Length of hospitalization,duration of antibiotics,costs of hospitalization and antibiotics,clinical efficacy,andmortality,National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI) on the 28th day were observed.Results There were no significant differences in clinical efficacy,mortality,NIHSS score and BI between the two groups on the 28th day [(85.7％ vs.86.3％),(8.8％ vs.7.9％),10.1 (7.8,16.2) vs.9.8 (6.0,15.5),60.1(42.5,82.3) vs.57.9 (39.2,84.8),respectively,all P＞ 0.05].The length of hospitalization,antibiotic duration,costs of hospitalization and antibiotics were lower in PCT group than in standard group [19 (10,38) d vs.26(17,42) d,10 (7,14) dvs.15 (6,21) d,3350 (2052,6163) yuanvs.10355 (6877,15421) yuan,7532 (4810,12116) yuan vs.5358 (3089,8144) yuan,respectively,all P＜0.05].Conclusions PCT guidance of antibiotic therapy is effective and safe for the treatment of early-onset stroke associated pneumonia in elderly patients.It can reduce the antibiotic duration and costs of hospitalization.

Objective:To establish and apply the intervention model of professional attitude for nursing undergraduates in universities of Traditional Chinese Medicine (TCM), and to explore its effect on the professional attitude of the nursing undergraduates.Methods:The study started in August 2018 included two steps. The first step was to develop intervention model of professional attitude for nursing undergraduates in universities of TCM based on the three-stage theory of Kelman ′s attitude formation and with Delphi method. After two rounds of expert consultation, the intervention model of professional attitude for nursing undergraduates in universities of TCM was finally formed, including three intervention stages, a total of 41 intervention measurements. The second step was to use the historical control research method. Grade 2016 nursing undergraduate (the year 2016—2020) in Beijing University of Chinese Medicine was taken as the experimental group ( n=86) and adopted the intervention model. Grade 2012 nursing undergraduate (the year 2012—2016) in the same university was taken as the control group ( n=56) and did not adopted the intervention model during their university study. The two groups were continuously evaluated by "Scale for Nurse ′s Professional Attitude" during their four years in the university. The measurement time was within one week of admission and the 16th week of the second semester of each academic year, with a total of 5 times of measurement. Results:Repeated measurement design showed that the scores of Scale for Nurse′s Professional Attitude of the two groups changed with time. At the end of the first year, the score of the scale in the experimental group was (6.06±0.95) points, higher than (5.41±1.08) points of the control group ( t value was 3.765, P<0.001). There was no difference between the two groups at other time points ( P>0.05). Conclusions:The intervention model of professional attitude for nursing undergraduates in universities of TCM has good operability and can improve the professional attitude of nursing undergraduates in universities of TCM during their freshman year. The intervention model needs to be further adjusted to improve the professional attitude in the subsequent learning stage.

Objective Taking Standardized Patients (SP) technique as basis, combining situational simulative teaching method , SP, as an attempt , is introduced to clinical nursing skill teaching in practice of the course of Emergency Nursing .Effect of this introduction would be explored , and new ideas and new methods in teaching practice of the course Emergency Nursing would also be explored .Methods By teaching the unit of Wound Hemostasis and Bandaging , training of nursing students as SP and compilation of Practice Handbook of Simple SP for Emergency Nursing were completed .50 undergraduate students , majoring in Nursing and admitted in 2011 , were selected and divided randomly into experimental group and control group , each with 25 students . Traditional model patient was used as teaching tool for operation demonstration and practice in the control group , while in the experimental group , operation and practice were done with combination of model patients and situational simulative teaching method basing on SP technique .Before and after the experiment , students in the two groups were asked to fill in the Scale of professional attitude measurement of nurses .Results Practice Handbook of Simple SP for Emergency Nursing was completed .According to the evaluation of simple SP and nursing teachers , this training material was practical in content and operable in reality;5 SSP have received the training and won approval; after the experiment , scores of nurses in the experimental group in the Scale of professional attitude measurement of nurses were higher than those in the control group ( P <0.05 ); in the experimental group , scores of SSP teaching practice after the experiment were higher than that before the experiment (P<0.05).Conclusions Introducing nursing students as SP in teaching practice of the course of Emergency Nursing can improve professional attitude of undergraduate students majoring in Nursing in universities of Chinese Medicine and increase their professional identity .

Objective To analyze the current status of dyslipidemia among employees in a petrochemical enterprise and its influencing factors. Methods A total of 1 636 employees from a petrochemical enterprise were selected as the research subjects by the judgment sampling method. Peripheral venous blood was collected from the research subjects to detect total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C) and low- density lipoprotein cholesterol (LDL-C) in serum. The Effort-Reward Imbalance (ERI) Questionnaire was used to investigate occupational stress in the ERI model. Results The detection rate of dyslipidemia among the research subjects was 52.7%. The detection rates of abnormal total cholesterol, triglyceride, LDL-C, and HDL-C were 35.7%, 31.4%, 24.3%, and 10.0%, respectively. The detection rate of high occupational stress among the research subjects was 26.3%. The result of multivariate logistic regression analysis showed that the risks of dyslipidemia in overweight and obese employees were higher than that of normal body mass [ odds ratio (OR) and 95% confidence interval (CI) were 2.111 (1.692-2.634) and 2.346 (1.591-3.458), both P<0.01]. The risk of dyslipidemia in lean body mass employees was lower than those with normal body mass [OR (95%CI) was 0.130 (0.030-0.564), P<0.05]. The risk of dyslipidemia in smokers was higher than that in non-smokers [OR (95%CI) was 1.462 (1.124-1.902), P<0.01]. Employees with 20-30 years and ≥ 30 years of service had higher risks of dyslipidemia than those with <10 years of service [OR (95%CI) were 1.411 (1.038-1.919) and 1.869 (1.202-2.906), respectively, both P<0.05]. The risk of dyslipidemia among employees with high effort level of occupational stress in ERI model was higher than those with low effort level [OR (95%CI) was 1.351(1.045-1.745), P<0.05]. Conclusion Dyslipidemia prevalence is relatively high among the petrochemical enterprise employees. Overweight, obesity, smoking, long service years, and occupational stress in ERI model are influencing factors of dyslipidemia. To prevent dyslipidemia, it is necessary to strengthen blood lipid monitoring and lifestyle intervention in personnel with overweight, obesity, smoking, long service years, and occupational stress in ERI model.

OBJECTIVE To observe and analyze the characteristics of tinnitus in perimenopausal women. METHODS To do sleep quality assessment, pure-tone test, tinnitus frequency and loudness match, tinnitus questionnaire investigation and FSH testfor 248 subjective tinnitus women with perimenopausal syndrome. RESULTS There was more single tinnitus than double tinnitus, the difference was statistically significant (P＜0. 05); The incidence of tinnitus on left and right ears was basically the same, the difference was not statistically significant;High frequency tinnitus accounted for 62. 73％, medium frequency was 2. 80％, low frequency was 34. 47％; There was no significant correlation between the frequency of tinnitus and hearing loss, There was no significant correlation between loudness and severity of tinnitus; Tinnitus THI loudness rating is mainly grade 2 and 3, accounting for 72. 18％, followed by gradel and grade 4, accounting for 24. 60％, grade 5 is very few, only 3. 22％; There was significant correlation between the FSH and severity of tinnitus, but there was no significant correlation between the FSH and loudness of tinnitus. The incidence of sleep disorders was 58. 06％. With the degree of tinnitus increased, the incidence of sleep disorders increased, and the degree of tinnitus was positively correlated with the quality of sleep. CONCLUSION The characteristics, etiology and pathogenesis of tinnitus in perimenopausal women are different from that of tinnitus happened in auditory system, mainly relate to FSH level. Otologists should pay attention to differential diagnosis, comprehensive analysis and treatment.