Objective To study the inhibition of AP-1 transcription factor activity by Hint1 gene over expression in HepG2 cell lines. Methods The Hintl gene was amplified, and then was inserted into the pcDNA3/HA eukaryotic expression plasmid. The constructed pHA-Hint1 plasmid was confirmed by DNA sequencing. The pHA-Hint1 was transfected into the HepG2 human hepatoma cells. Semi-quantitative RT-PCR and Western-blot were used to detecte the expression of HA-Hint1. The HepG2 cells were co-transfected with pHA-Hint1 and pAP-1/Luc luciferase reporter. At 36 h after transfection, luciferase assay system was used to detect the AP-1 transcription factor activity. Results The constructed pHA-Hint1 was confirmed by DNA sequencing, pHA-Hint1 gene transduction through lipofectine induced over-expression in HA-Hint1 mRNA (t =3.89, P<0.05) and HA-Hintl protein (t=3. 12, P<0.05). Co-transfection of Hint1 gene inhibits AP-1 luciferase activity. Cotransfection with increased concentration of a pHA-Hint1 plasmid (0 μg/ml, 0. 5 μg/ml, 1.0 μg/ml, 1.5 μg/ml, 2. 0 μg/ml) produced a concentration-dependent inhibition of AP-1 transcription factor activity. At the concentration of 1.5 μg/ml, and 2.0 μg/ml, the activity inhibition reaches significant difference ( F = 72. 009, P < 0. 05 ). Conclusion Over-expression of Hintl can, at least in part, inhibit the AP-1 transcription factor activity in HepG2 cells.

Objective To investigate the changes of serum adiponectin level and insulin resistance in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods 80 adult habitual snorers were divided into mild,moderate,severe OSAHS groups and control group,based on their apnea hypopnea index (AHI).Correlative clinical data were measured and analyzed.Results Serum adiponectin level [( 5.44 ± 2.57 ) mg/L] was significantly lower and HOMA-insulin resistance index ( 3.42 ± 0.70) was significantly higher in severe group than other groups ( P ＜ 0.05 ).Serum adiponectin level was negatively correlated with BMI,waist hip ratio,neck circumferences and et al( r =-0.233 ～ -0.499,P ＜0.05),but it was positively correlated with lowest oxygen saturation ( LSaO2 ),Ⅲ + Ⅳ％ and REM％ ( r =0.270～ 0.429,P ＜ 0.05).Conclusions Both hypoadiponectinemia and insulin resistance were observed in severe OSAHS patients.The related risk factors of hypoadiponectinemia in OSAHS might include obesity,disordered sleep architecture and other adipokines.

OBJECTIVE:To explore the feasibility of question-and-answer practice teaching in the pharmacy department of our hospital. METHODS:The practice teaching of pharmacy department was taken as a pilot,and the question-and-answer practice teaching was used in emergency and outpatient pharmacies,inpatient pharmacy,PIVAS,drug warehouse,clinical pharmaceutics room,preparation room and drug testing laboratory. The effects of the practice teaching on internships,teachers,pharmacy depart-ments and patients were excavated. RESULTS & CONCLUSIONS:Satisfaction of teachers,pharmacy,patients and clinics for the question-and-answer practice teaching was 100%,and satisfaction of internships was 94.5%. The question-and-answer practice teaching has improved their professional knowledge and competence,resolved difficulty of patients about drug counseling and helped the improvement of overall business level in department.

Objective To study the characteristics of antimicrobial resistance and molecular epidemiology of Staphylococcus aureus (S .aureus)in the intensive care units(ICUs)of a hospital.Methods Clinical isolates of S .aureus collected from ICUs between January and December 2014 were identified and performed antimicrobial susceptibility testing,then typed by staphylococcal protein A (spa)typing and multilocus sequence typing (MLST) methods.Results Of 160 isolates of S .aureus ,120 (75.00%)were methicillin-resistant S .aureus (MRSA). Resistance rates of MRSA to erythromycin,clindamycin,and levofloxacin were all > 80%;methicillin-sensitive S .aureus (MSSA)were sensitive to cefazolin,resistance rates to erythromycin,clindamycin,and levofloxacin were 62.50%,35.00%,and 10.00% respectively.spa typing and MLST results showed that the main types of 120 isolates of MRSA were ST239-t030,ST239-t037,and ST5-t2460,the major epidemic strains were ST239-t030 (n=105,87.50%),and were isolated from 8 ICUs;MSSA had more types,ST59-t437 were detected only from depart-ment of neurology(n =8)and department of digestive diseases(n =2),ST6-t701 ,ST398-t3625,ST398-t1793,and ST121-t2092 were isolated from departments of neurology(n=7),anesthesiology(n=5),neurosurgery(n=4),and cardiac surgery(n=4)respectively.Conclusion Isolation rate of MRSA in ICUs in this hospital is high,ST239-t030 is the main type,which prevailed in hospital;different types of MSSA have epidemic trends in various departments.

In order to improve the quality standard of Marsdenia tenacissima, a quantitative determination method of tenacissoside H was developed using high performance liquid chromatography. The method was carried out on a YMC ODS-H80 (4.6 mm x 250 mm, 4 microm) column eluted with a mixture of acetonitrile and water (50:50) as the mobile phase. The flow rate was 0.8 mL x min(-1) and the column temperature was 35 degrees C. An evaporative light scattering detector (ELSD) was used with the temperature of drift tube set at 60 degrees C and the gas flow rate of nitrogen set at 1.5 mL x min(-1). The calibration curve was linear in the range from 0.5625 to 36.00 microg (r = 0.9998). The average recovery and RSD were 99.41% and 1.8%, respectively. The contents of tenacissoside H in the 11 samples from different habitats varied from 0.201% to 0.862%. The method established in this paper is specific and reliable to control and evaluate the quality of M. tenacissima.
Chromatography, High Pressure Liquid ; Glycosides ; analysis ; Marsdenia ; chemistry ; Reproducibility of Results

The mortality of sepsis remains high,and it is still a major cause of death in critically ill patients.But its pathophysiological mechanism remains a mystery,not yet fully clear.Endothelium play an important role in the development of sepsis.Maintaining the integrity of its surface glycocalyx to a certain extent reduces sepsis damage;and its destruction mediates a series of pathophysiological responses,including increasing vascular permeability by cell pathway or intracellular pathways,increasing the adhesion of white blood cells to endothelial cejls and a variety of cytokines to promote inflammatory response,activating of thrombin to coagulation dysfunction,promoting synthesis of nitric oxide to change vascular tension.The damage of glycocalyx as a first step in endothelial cell injury can be used as early diagnosis and prognosis of sepsis,which provides new ideas for the diagnosis and treatment of sepsis.

Adenovirus pneumonia is a common type of pneumonia in immunocompetent and immunocompromised patients, and its prognosis is poor.Antiviral therapy includs ganciclovir, valganciclovir, cidofovir, brincidofovir, ribavirin and so on.Among them, cidofovir and brincidofovir have obvious antiviral activity against adenovirus in vitro and in vivo, but further RCT results are still needed.Therefore, antiviral therapy of adenovirus pneumonia still needs further study.

Objective:To compare the characteristics of patients undergoing blood purification treatment in PICU of a children′s tertiary hospital during 8 years, so as to analyze the changes in the development of blood purification technology in children in East China.Methods:Patients who received blood purification treatment in PICU of Children′s Hospital of Fudan University from 2014 to 2021 were included and divided into two study periods: 2014-2017 and 2018-2021.The clinical characteristics and treatment parameters of patients were collected and analyzed.Results:A total of 1 029 patients were included in the study, of which 103 were combined with extracorporeal membrane oxygenation.The 28-day survival rate of 926 patients treated with pure blood purification was 55.7%.Among them, patients with younger age, lower body weight, using mechanical ventilation, using vasoactive drugs before blood purification, and patients with multiple organ dysfunction syndrome had a higher distribution in the death group than those in survival group( P<0.05). During 8 years, a total of 3 688 cases of blood purification were performed.The main mode was continuous veno-venous hemodiafiltration (CVVHDF) (68.6%), followed by therapeutic plasma exchange (TPE) (23.8%) and hemoperfusion (HP) (4.8%); the main indication was acute kidney injury (AKI) (29.3%), followed by severe inflammatory disease (26.2%) and acute liver failure (16.2%). Compared with 2014-2017, the number of blood purification treatments in 2018-2021 increased by 47.4%, and the survival rate of patients increased significantly (48.7% vs. 58.1%, P<0.05). The distribution of blood purification patterns and indications also changed( P<0.05). The proportions of TPE (20.5% vs. 26.0%) and HP (3.1% vs. 6.0%) increased, while the proportion of CVVHDF (71.9% vs. 66.4%) decreased significantly.The proportions of AKI (29.8% vs. 38.9%) and refractory immune diseases (8.4% vs. 15.2%) were significantly higher, while severe inflammatory diseases (29.2% vs. 24.2%) and acute liver failure (19.6% vs. 13.8%) had declined. Conclusion:From 2014 to 2021, the number of blood purifications performed in our center increased significantly.Although the distribution of indications and patterns have also changed significantly, the overall survival rate is significantly improved.However, standardized practice still needs to be strengthened.

Objective:To compare the clinical characteristics, clinical efficacy and adverse drug reactions of rheumatoid factor (RF) positive (+ ) and negative (-) polyarticular juvenile idiopathic arthritis (PJIA).Methods:The clinical data of 67 PJIA patients admitted into Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2013 to December 2018 were analyzed retrospectively.They were divided into RF-positive PJIA group [RF (+ ) group, 23 cases] and RF-negative PJIA group [RF (-) group, 44 cases] according to RF titer.The clinical characteristics, laboratory indexes and clinical efficacy evaluation of the two groups were compared.Results:(1)Distribution of affected joints: the top 3 affected joints in the RF (+ ) group were the knuckles (16 cases, 69.57%), the wrists (15 cases, 65.22%) and the ankles (13 cases, 56.52%), and those in the RF (-) group were the knees (33 cases, 75.00%), ankle joints (29 cases, 65.91%) and hip joints (26 cases, 59.09%). The wrist joint involvement of the RF (+ ) group was significantly higher than that of the RF (-) group, while the knee joint involvement was lower than that of the RF (-) group.The difference was statistically significant (all P<0.01). (2)Magnetic resonance changes of the affected joints: articular cavity effusion (54 cases, 84.38%), synovial thickening (44 cases, 68.75%) and bone edema (26 cases, 40.63%) are common in both groups.The incidence of bone destruction (7 cases, 70.00%) and soft tissue edema (7 cases, 70.00%) in the RF (+ ) group was higher than that in the RF (-) group (2 cases, 18.18% and 2 cases, 18.18%), the difference was statistically significant (all P<0.05). (3) Changes in laboratory indicators: the positive rates of C-reactive protein, erythrocyte sedimentation rate, anti-cyclic citrullinated peptide antibody and anti-nuclear antibody in the RF(+ ) group were significantly higher than those in the RF(-) group, the difference was statistically significant (all P<0.05). (4)Juvenile arthritis disease activity score 27 (JADAS27): the score difference between RF(+ ) group and RF(-) group was not statistically significant [(22.83±5.60) scores vs.(23.07±6.66) scores, t=0.148, P>0.05]. (5) Efficacy analysis: 2 patients were lost to follow-up after discharge, and the remaining 65 patients were treated with traditional therapy, of which 30 were given biologics at the first hospitalization, 9 cases were treated with biologics after the failure of traditional treatments, and 35 patients were treated with biologics to control disease activity.In different dosage regimens, the disease remission rate in the RF(-) group is generally higher than that in the RF(+ ) group. Conclusions:PJIA patients have complicated joint involvement, RF-positive patients are more prone to joint destruction, and traditional treatments are less effective.Biological agents can effectively improve the symptoms of severe PJIA patients, especially those with poor prognosis.

The construction of elderly care needs assessment system is conducive to realize the reasonable matching between care services and needs of the elderly， and to promote the effective allocation of pension resources. It is the basis and premise of the development of long-term care insurance system. Questions such as "Who is responsible for the assessment？ Who can apply for the assessment？ What is the assess tool？ How to pay the assessment fee？" are the core issues that need to be addressed in the construction of the evaluation system. This study compared the current situation of the elderly care needs assessment systems in China， the Netherlands， Germany， Japan and the United States from four aspects： assessment subject， assessment object， assessment cost source， and assessment tools’ dimensions. It has been a trend to entrust a third party for the evaluation work in pilot cities in China. Compared with foreign countries， domestic appraisers’ discipline and professional background are simpler. In foreign countries， the evaluation objects of elderly care needs are more extensive； the legal and financial support system of needs evaluation is more mature； and the evaluation dimensions are more objective and comprehensive. Based on this study， we suggest China to establish a national unified elderly care needs assessment system， cultivate professional assessment teams， expand the coverage of care needs assessment objects， improve the standards of assessment objects and assessment dimensions， and improve the law and financial support regulations related to needs assessment.