Objective To investigate the effect of Yantiao Fang on apoptosis of intestinal epithelial cells in mice with acute gastrointestinal injury caused by sepsis by regulating the Rho/ROCK signaling pathway.Methods Seventy BALB/c mice were randomly divided into normal,sham,and model groups.Except for normal and sham groups,mice were subjected to cecal ligation and perforation to establish a mouse model of acute gastrointestinal injury caused by sepsis.The mouse models were randomly divided into model,Low,Medium,and High dose of Yantiao Fang,and ROCK inhibitor groups.Histopathological changes of the ileum were observed by HE staining.Serum levels of IL-1β,IL-6,TNF-α,and IL-10 were measured by ELISA.PCNA and Ki-67 expression was detected by immunohistochemistry.Cleaved caspase3 and Bax expression was detected by Western blot.ROCK and MLC mRNA expression in the ileum was measured by RT-qPCR.Results Compared with normal and sham groups,Chiu's pathological score,proinflammatory factor(IL-1β,IL-6,and TNF-α)levels,cleaved caspase3 and Bax protein expression,and ROCK and MLC mRNA levels were increased in the model group(P＜0.05).Moreover,anti-inflammatory mediator IL-10 and expression of PCNA and Ki-67 in the ileum were decreased in the model group(P＜0.05).Compared with the model group,histopathological changes of the ileum in all Yantiao Fang groups were improved by various degrees with the increase in dose.Chiu's pathological score,IL-1β,IL-6,and TNF-α serum levels,cleaved caspase3 and Bax protein expression,and ROCK and MLC mRNA levels were decreased in Yantian Fang groups(P＜0.05).The IL-10 level and expression of PCNA and Ki-67 in the ileum were increased in Yantian Fang groups(P＜0.05).Conclusions Yantiao Fang may inhibit apoptosis of intestinal epithelial cells in mice with acute gastrointestinal injury due to sepsis by regulating the Rho/ROCK signaling pathway,thereby alleviating intestinal tissue inflammation and ultimately preventing intestinal mucosal tissue injury.

ObjectiveTo validate the alleviating effect of Gegen Qinliantang （GGQLT） on insulin resistance in db/db diabetic mice by regulating the silent information regulator 1 （SIRT1）/forkhead transcription factor O1 （FoxO1） autophagy pathway. MethodSeventy-five SPF-grade spontaneous type 2 diabetic db/db mice and 15 control db/m mice were selected and maintained on regular feed for one week before measuring blood glucose. They were randomly divided into six groups， with 15 mice in each group. The groups included a normal group （physiological saline， 0.2 g·kg^-1）， a metformin group （0.2 g·kg^-1）， high-， medium-， and low-dose GGQLT groups （31.9， 19.1， 6.9 g·kg^-1）， and a model group （physiological saline， 0.2 g·kg^-1）. They were orally treated with corresponding drugs for eight weeks， once daily. Fasting blood glucose （FBG） was measured using a Roche glucometer. Serum levels of high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， triglyceride （TG）， and total cholesterol （TC） were measured using an automated biochemical analyzer. Fasting serum insulin （INS） levels were determined using enzyme-linked immunosorbent assay （ELISA）， and the homeostasis model assessment of insulin resistance （HOMA-IR） was calculated. Western blot was used to detect the expression of Beclin-1， microtubule-associated protein 1 light chain 3 （LC3）， and SIRT1/FoxO1 autophagy pathway-related proteins in liver tissues. Immunohistochemistry was performed to assess the expression of SIRT1， FoxO1， Beclin-1， and LC3B proteins in liver tissues. Transmission electron microscopy was used to observe the formation of autophagosomes in the liver. ResultCompared with the normal group， the model group showed significant increases in FBG， FINS， HOMA-IR， TC， TG， LDL-C， and HDL-C levels （P<0.01）， and significant increases in the expression of SIRT1， Beclin-1， LC3， and FoxO1 proteins in liver tissues （P<0.01）. Transmission electron microscopy revealed the highest number of autophagosomes in the model group. Compared with the model group， the metformin group and the low-， medium-， and high-dose GGQLT groups showed significant decreases in serum FBG， FINS， HOMA-IR， TC， TG， LDL-C， and HDL-C levels （P<0.05， P<0.01）， significant decreases in the expression of SIRT1， Beclin-1， LC3 （P<0.05， P<0.01）， and up-regulated FoxO1 protein （P<0.01）. Transmission electron microscopy showed a reduction in the degree of autophagy in the treatment groups. Compared with the metformin group， the medium- and high-dose GGQLT groups showed significant decreases in FBG， FINS， and TG levels （P<0.01）， significant decreases in the expression of SIRT1， Beclin-1， and LC3 in liver tissues （P<0.05， P<0.01）， and reduced FoxO1 protein （P<0.01）. The high-dose GGQLT group showed reduced HOMA-IR， TC， LDL-C， and HDL-C levels （P<0.05， P<0.01）. Transmission electron microscopy revealed a significant reduction in autophagosomes in the medium- and high-dose GGQLT groups. ConclusionGGQLT can significantly improve glucose and lipid metabolism disorders， alleviate insulin resistance in db/db mice， and prevent and treat type 2 diabetes by activating the SIRT1/FoxO1 autophagy pathway.

Dysglycemia is independently associated with the mortality of critically ill patients. Therefore, the management of blood glucose plays an important role in comprehensive therapy. It is suggested that the same target value of blood glucose (7.8-10.0 mmol/L) should not be set for all critically ill patients. Instead, it should be individually set based on the causes of the patient's admission and the status of blood glucose before admission. For this reason, there is an urgent need for a convenient protocol and method to regulate the dosage of insulin. The first hospital of Jiaxing, collaborating with information engineers, developed a modified eProtocol-insulin for domestic population with mathematical modeling and developed an Application Software (APP), which is convenient for clinical use. This is the first eProtocol-insulin and smart device APP for critically ill patients in China.

Objective:To translate the health literate healthcare organization 10 item questionnaire(HLHO-10) into Chinese and examine its reliability and validity.Methods:The Chinese version of HLHO-10 questionnaire(HLHO-10-C) was developed by following the Brislin translation model of translation, back translation, cultural adaptation and questionnaire epistemological survey.Five experts and 1 071 medical staff from 24 healthcare organizations in Zhejiang province were selected to conduct the validity and reliability test of the HLHO-10-C.Results:The content validity indices at the item level and total questionnaire level of HLHO-10-C were from 0.8 to 1.0 and 0.96 respectively, and the results of the exploratory factor analysis showed good structural validity.Conclusions:HLHO-10-C proves adequate reliability and validity to serve as a tool for healthcare organizations in evaluating and becoming HLHO. It can also help the implementation of the Healthy China Initiative(2019—2030), which is a performance assessment mechanism for health education and promotion of healthcare providers and health care organizations.

Betacoronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; Single-Cell Analysis

Objective ThispaperpresentedaninvestigationonthesimilaritiesanddifferencesintheclinicalfeaturesandCTfindings betweenallogeneichematopoieticstem celltransplantation (allo-HSCT)inducedandnon-transplantinducedair-leaksyndromes (ALS)inpatientssufferingfromhematopathy,toimprovetheunderstandingofALSinpatientswithhematopathy.Methods Retrospective analysesandcomparisonsofclinicaldataandCTimageswereconductedbetweenGroupA (12patientswithALSafterallo-HSCT) andGroupB (26patientswithnon-transplant-relatedALS).A M annG W hitney U testwasperformedtoevaluatethemeasurementdata, andthe χ 2testor Fisher exacttestwasconductedtoexaminetheenumerationdata.Differencethresholdsof P＜0.05from bothsides weretakentobethedeterminantforstatisticalsignificance.Results TheincidenceratesofALSinpatientswithhematopathyafter anallo-HSCTwerefoundtobesignificantlyhigherthanthoseinpatientsonwhomsuchtransplantshadnotbeenperformed(1.84%. vs.0.06%),P＜0.001.SymptomsofdyspneaweremuchmorefrequentlyobservedingroupAcomparedtogroupB (7/12vs1/26), P＜0.01;whereasthedifferencesforthesymptomsofchesttightness,chestpain,andpharyngalgia werenotadequateintermsofstatistical significance,P＞0.05.IngroupA,theoccurrencesofALSsecondarytolongonsetnon-infectionpulmonarycomplications(LONIPC) associatedwithchronicgraft-versus-hostdisease(cGVHD)werefoundin8/12patients,whereastheoccurrencesin15/26patients weresecondarytopulmonaryinfectioningroupB,P＜0.01.Therewerenostatisticallysignificantdifferencesinage,gender,BMI, backgroundblooddisease,basictreatmentcounts,CTtype,treatmentmethodsandCTdisappearancetimelengthbetweenthetwo groups,P＞0.05.Conclusion Thereweredifferencesintheincidencerates,basiclungdiseasesandclinicalsymptomsbetweenallo-HSCT inducedandnon-transplantinducedALSinpatientssufferingfromhematopathy.Hematopathy-associatedALSwascommoninyoung adultswithlankypostures,patientswithleukemiaasback-grounddisease,patientswithahistoryofchemotherapyandpatientswith pulmonarydiseases.Thecommonsymptomsofpatients with hematopathy-associated ALS were chesttightness and chest pain,andpatients’overallprognosisweregood,meanwhileCT manifestationsweremainlycharacterizedbymixedpulmonary interstitialemphysema(PIE)+pneumomediastinum (PM)andsimplepneumothorax (PT).

To explore the clinical efficacy and toxicity of the NAPD regimen(vinorelbine, cytarabine, cisplatin, and dexamethasone) in the treatment of recurrent refractory non-Hodgkin' s lymphoma.
 Methods: A total of 67 patients identified with recurrent refractory non-Hodgkin's lymphoma were enrolled for this retrospective study. The curative efficacy of NAPD regimen was evaluated after 2 consecutive cycles. The toxicities and side effects were evaluated after 1 cycle. The objective response rate (ORR), overall survival (OS), progress free survival (PFS), 1, 2 or 4 years of OS and PFS rates were analyzed. The prognosis was evaluated with univariate and multivariate analysis.
 Results: The ORR was 53.8% after two cycles, including 5(7.5%) complete responses and 31(46.3%) partial responses. The clinical benefit rate (CBR) was 88.7% (59/67). The median OS was 22 (1.5-140.0) months. 1, 2 or 4 years of OS rates were 70.9%, 49.0%, and 35.0%, respectively. The median PFS was 14 (1.5-140.0) months; and 1, 2 or 4 years of PFS rates were 57.5%, 38.3%, and 29.8%, respectively. The main side effect was myelosuppression. The rates of Grade III/IV leukopenia and thrombocytopenia were 13.4% (9 cases) and 3.0% (2 cases), respectively. Gastrointestinal toxicity was at Grade I or II and 6% patients displayed gastrointestinal toxicity at Grade III/IV. No severe cardiac and hepatorenal functional toxicity was observed.
 Conclusion: The NAPD regimen for recurrent refractory non-Hodgkin's lymphoma is effective, and its toxicity is well tolerated. It is a salvage chemotherapy regimen and be of worth to be verified.
Antineoplastic Combined Chemotherapy Protocols ; Cisplatin ; Dexamethasone ; Etoposide ; Humans ; Lymphoma, Non-Hodgkin ; drug therapy ; Neoplasm Recurrence, Local ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome

To investigate the clinical efficacy and toxicities for the NAPD regimen (vinorelbine, cytarabine, cisplatin, and dexamethasone) in the treatment of recurrent refractory diffuse large B-cell lymphoma.
 Methods: A total of 30 patients identified with recurrent refractory diffuse large B-cell lymphoma were enrolled in this retrospective study. The curative efficacy of NAPD regimen was evaluated after 2 consecutive cycles. The toxicities and adverse reaction were evaluated after 1 cycle. The objective response rate (ORR), overall survival (OS), progress free survival (PFS), and the rates of 1, 2, and 4-year OS and PFS were analyzed. The prognosis was evaluated with univariate analysis.
 Results: The ORR was 56.7% and clinical benefit rate (CBR) was 83.3% after 2 cycles. Five patients achieved complete remission, 12 achieved partial remission, and 8 achieved stable disease. The median OS was 22 (1.5-140) months. The 1, 2, and 4-year OS rates were 59.1%, 48.2%, and 40.2%, respectively. The median PFS was 14 (1.5-140) months. The 1, 2 and 4-year PFS rates were 56.3%, 42.2%, and 31.7%, respectively. The main adverse reaction was myelosuppression. Three patients suffered from grade III-IV leukopenia and 1 thrombocytopenia. Grade I-II gastrointestinal toxicity was 20%. No heart, liver, and kidney damages at grade III-IV were observed.
 Conclusion: The NAPD regimen is effective and its toxicity is well tolerated for the treatment of recurrent refractory diffuse large B-cell lymphoma. It is a salvage chemotherapy regimen worth to be verified.
Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; administration & dosage ; Cytarabine ; administration & dosage ; Dexamethasone ; administration & dosage ; Humans ; Induction Chemotherapy ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; mortality ; Neoplasm Recurrence, Local ; drug therapy ; mortality ; Retrospective Studies ; Salvage Therapy ; methods ; Treatment Outcome ; Vinblastine ; administration & dosage ; analogs & derivatives ; Vinorelbine

Adolescent ; Angiofibroma ; pathology ; Humans ; Male ; Nasopharyngeal Neoplasms ; pathology ; Pharynx ; pathology

Objective To explore the changes of corticotropin releasing factor (CRF) levels secreted by hypothalamus neuron in children with acute brain injury. Methods Fifty-one intracranial-infection children with brain injury and 11 intracranial-noninfection children with brain injury were chosen from pediatric intensive care unit of our hospital. Severities of their brain damage were evaluated by Glasgow score,and CRF level in cerebrospinal fluid (CSF) and serum TNF-α and IL-6 levels were measured by radioimmunoassay. Results There was no significant difference of Glasgow scores between the intracranial infection group and intracranial-noninfection group ( P = 0. 302 6 ), CSF CRF level of intracranial infection group was significantly lower than that of intracranial-noninfection group ( P ＜ 0. 01 ), serum TNF-α and IL-6 levels of intracranial infection group were significantly higher than those of intracranial-noninfection group ( P ＜ 0. 01,P ＜0. 001 ). As comparing to the children with Glasgow score of 6 ～ 7, the levels of CSF CRF and serum TNF-α and IL-6 in children with Glasgow score of 4 ～ 5 were significantly increased ( P ＜ 0. 05, P ＜ 0. 001 ).Conclusion CSF CRF level of the children with acute brain injury is changing, which may be concerned with the secretion of hypothalamus CRF neuron stimulated by TNF-α, IL-6 and hypoxia stress in children with brain injury.