Objective To find the microorganisms which hydrolyze sugar residues of steroidal saponins at C-3 position and to obtain their glucosyl-derivatives.Methods The enzymes secreted by fermentation of Curvularia lunata((3.438 1)) in the culture medium were employed to transform polyphyllin Ⅴ(compound Ⅰ) and polyphyllin Ⅵ(compound Ⅱ).The products were separated by means of chromatography on C_(18) column and their structures were elucidated on the basis of spectral analyses.Results Compounds Ⅰ and Ⅱ could be transformed by C.lunata((3.438 1)) and the main products were identified as diosgenin-3-O-?-D-glucopyranoside,named trillin(compound Ⅲ) and pennogenin-3-O-?-D-glucopyranoside(compound Ⅳ),respectively.Conclusion The terminal rhamnosyls of polyphyllin Ⅴ and polyphyllin Ⅵ at C-3 position could be hydrolyzed selectively by C.lunata((3.438 1)) for the first time.

Kidney transplantation is a high-cost and high-risk surgery,thus genuine informed consent from the patients and their family members is indispensable both for protecting rights of patients and ensuring medical safety.Guided by related regulations and ethical guidelines,this paper proposes necessary information which should be provided for patients,one example of Informed Consent Form(ICF) composing of information sheet,and consent signature form offered for reference.The proposed ICF applies three accepted requirements for informed consent,i.e.,completely being informed,fully understood and free to make choice.

Objective To observe the effect of different concentrations of realgar on the apoptosis of gastric adenocarcinoma cell Line SGC-7901. Methods MTT assay was conducted to detect the growth inhibition ratio of SGC-7901 cells treated by different concentrations of realgar (0,10,20,50 and 80 μg·mL-1 ). AnnexinⅤ/ Propidium iodide double staining method together with flow cytometry were used to detect the effect of realgar at 0,20,50 and 80 μg·mL-1 on the apoptosis of SGC-7901 cells. Results The growth inhibition ratio of SGC-7901 cells by various concentrations of high-purity realgar (10,20,50 and 80 μg·mL-1 ) was 6. 15% ,7. 54% ,42. 31% and 63. 54% ,respectively,24 h after realgar treatment. At 48 h after the treatment,the growth inhibition ratio rose to 32. 56% ,46. 14% ,64. 51% and 87. 52% ,respectively (P<0. 05). Half inhibitory concentration was 45. 23 μg·mL-1 after 24 h and 15. 34 μg·mL-1 after 48 h. After treated by various concentrations of pure realgar (0,20,50 and 80 μg·mL-1 ) for 24 h,early cell apoptosis rate was (11. 10±2. 10)% ,(15. 31±1. 30)% ,(25. 81 ±2. 68)% and (43. 62 ±8. 51)% ,respectively,significantly different among the four groups (P<0. 05). The late cell apoptosis rate in each group was (1. 84±0. 25)% ,(4. 41±0. 09)% ,(4. 37±0. 14)% and (5. 00±0. 10)% ,respectively (P>0. 05). Conclusion High purity realgar can inhibit the proliferation and induce early apoptosis of gastric adenocarcinoma SGC-7901 cells.

Objective To investigate the requirements of hospitalized patients on humanized nursing in the ward of whole-process humanistic care mode and provide scientific references for continuous improvement of nursing quality.Methods A total of 408 patients from 2 wards of whole-process humanistic care mode.Patients were applied the self-designed questionnaire in combination with interview to understand the patients’ requirements of humanized nursing.Survey was carried out before the inpatients were discharged from the hospital adopting the “Evaluation Table of Patients’ Satisfaction Degree about the Nursing Service” produced and researched by our hospital independently.Results After carrying out the whole-process humanistic care service mode,the inpatients’ overall satisfaction degree and satisfaction rate with humanistic care were respectively 98.2％,97.5％.Conclusions Carrying out the quality care demonstration project and enhancing the concept of humanistic care can promote each other.Carrying out the inpatients’ care needs survey in the ward of whole-process humanistic care mode,integrating humanistic into every aspect of clinical nursing,are the crux of deepening high-quality nursing care as well as a new subject that clinical nurses should confront conscientiously.

Objective To estimate the clinical features of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection among acquired immune deficiency syndrome (AIDS) patients and the interaction of lamivudine (3TC) contained antiretroviral therapy (ART) with hepatitis virus replication.Methods From 2004 to 2010,199 human immunodeficiency virus (HIV)/HBV coinfected patients admitted to Zhongnan Hospital of Wuhan University were enrolled,including 76 cases of HIV/HBV/HCV triple infection and 123 cases of HIV/HBV dual infection.Hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) were detected routinely.HBV DNA,HCV RNA before and after ART with 3TC and incidence of end-stage-liver-diseases in two groups were compared.Categorical data were analyzed by chi-square test,and measurement data were compared by t test.Results Positive rates of HBV DNA in HIV/HBV and HIV/HBV/HCV coinfection group before treatment were 45.5 ％ (56/123) and 25.0 ％ (19/76),respectively (x2 =8.429,P=0.004).The levels of HBV DNA in the two groups before treatment were (5.61±1.88) lg copy/mL and (4.70±1.84) lg copy/mL,respectively (t=2.589,P=0.003).After ART with 3TC,detectable rate of HBV DNA in HIV/HBV/HCV group decreased to 9.2％ (7/76),which was significantly lower than pretreatment (x2 =6.681,P=0.010),but serum HCV RNA increased significantly from 56.6％ (43/76) pretreatment to 72.4％ (55/76) post-treatment (x2 =4.136,P=0.042).The incidence of end-stage-liver-diseases in HIV/HBV/HCV co-infected group was significantly lower than that of HIV/HBV dual infection group (18.8 per 1000 person years vs 42.1 per 1000 person years; x2 =4.459,P =0.035) during an average of 5.6 years of follow up.Conclusion It is possible that there are interactions between HBV and HCV when the two viruses are co infected.The timing of patient enrollment might be an impact factor on study results.

Objective:To investigate the epidemic trend and risk change of acquired immunodeficiency syndrome (AIDS) complicated with malignant tumors after combination antiretroviral therapy (cART).Methods:The types of malignant tumors in patients with AIDS at different stages of cART were analyzed among anti-human immunodeficiency virus (HIV)-positive population in Hubei Province screened in National AIDS/HIV prevention and control information system from 1st January, 2004 to 31st December, 2018. The standardized incidence ratios(SIR) of malignant tumors in AIDS patients was analyzed based on the incidence of malignant tumors in the general population in Hubei Province or China in 2013. The changes in risks for development of malignant tumors in AIDS patients at different cART stages from 2004 to 2013 and 2014 to 2018 were compared.Chi-square test was used for statistical analysis.Results:Three hundred and twenty-three out of 22 994 AIDS patients were diagnosed with malignant tumors. Non-Hodgkin lymphoma(NHL) and cervical cancer were most common types in acquired immunodeficiency syndrome-defining cancers (ADC), while liver cancers and lung cancers were the most common types in non-acquired immunodeficiency syndrome-defining cancers (NADC). The overall risk of malignancy in AIDS patients was similar to that in the general population (SIR=1.06, χ2=0.62, P=0.426). However, the risks of Kaposi sarcoma, NHL, Hodgkin lymphoma, cervical cancer, and head and face cancers (excepting nasopharyngeal cancer) in AIDS patients were significantly higher than those in the general population (SIR=834.09, 9.65, 13.33, 5.22 and 2.94, respectively, χ2=11 747.27, 625.54, 56.65, 184.21 and 13.66, respectively, all P<0.01). The risks of lung cancer, colorectal anal cancer, stomach cancer and breast cancer in AIDS patients were significantly lower than those in the general population (SIR=0.33, 0.36, 0.43 and 0.45, respectively, χ2=33.43, 12.84, 9.01 and 7.21, respectively, all P<0.05). The SIR of cervical cancer, liver cancer and colorectal anal cancer from 2014 to 2018 were 4.06, 0.43 and 0.10, respectively, which were significantly lower than those from 2004 to 2013 (7.42, 1.96 and 0.84, respectively). The differences were all statistically significant ( χ2=5.39, 19.52 and 10.86, respectively, all P<0.05). Conclusions:At present, there are no significant differences of the incidences of malignant tumors between AIDS patients and general population, but the tumor types are different. The most common malignant tumors in this region are NHL and cervical cancer, which should be noted that HIV screening among patients with such tumors is conducive to comprehensive treatment to improve the efficacy.

Objective To analyze the equity of health human resource allocation in public hospitals of Zhaotong city during 2008-2012,and to provide theoretical basis for the reasonable allocation of health resources.Methods The statistical description was used to analyze the number of the medical health resource,and Gini coefficient and Theli index were used to analyze the equity of health resource allocation in public hospitals of Zhaotong city.Results The amount of medical health resource showed an increasing tendency with low speed,and gaps among different areas were still existed.From 2008 to 2012,Gini coefficients of three medical health resources including the doctors,nurses and health technicians were all under 0.3.And the fluctuant tendency of the Theli Indexes and Gini coefficients were accordant with no significant increase or decrease as a whole.The combination of differences within region and difference between regions leaded to the inequity of health human resource allocation in Zhao tong city,and within region in the contribution rate of the total Theil index was greater than the difference between regions.Conclusions The quantity of health human resource is not enough in Zhaotong.The equity fluctuation of three health resources has no significatnt change.The differences within region mainly cause the inequity of health resource allocation in public hospitals of Zhao tong city.

Objective To explore the clinical characteristics, pathological features and prognostic factors of patients with acquired immune deficiency syndrome (AIDS) related lymphoma (ARL).Methods The clinical characteristics, treatment regimen and survival status were retrospectively analyzed.At a ratio of 1∶2, 106 general non-Hodgkin lymphoma (NHL) cases were included after matching for demography and clinical characteristics with 53 ARL patients.Chi-square test was used for statistical analysis.Overall survival was analyzed using Kaplan-Meier curves.Cox regression was used for multivariant analysis.Results The predominant pathologic type of ARL was diffuse large B cell lymphoma (60.4%, 32/53).B cell lymphoma accounted for 88.7% (47/53) and T cell lymphoma accounted for 11.3% (6/53).Patients in ARL group (62.3%, 33/53) had lower proportion of receiving radiotherapy or chemotherapy compared with patients in general NHL group (94.3%, 100/106) (χ2=26.58, P<0.05).ARL group had lower hepatitis B surface antigen (HBsAg) positivity rate compared with general NHL group (1.9% vs 26.4%, χ2=14.26, P<0.05).No other characteristic was found significantly different between these two groups.The survival time of ARL and general NHL patients was (6.0±1.3) months and (48.0±10.0) months, respectively (t=8.13, P<0.01).The 1-year, 2-year, 3-year and 5-year survival rates of ARL patients were 39.6%, 32.7%, 27.7% and 20.1%, respectively, while those of general NHL patients were 79.2%, 56.8%, 42.4% and 25.0%, respectively.Of the 33 ARL patients and 100 general NHL patients who received anti-NHL treatment, the 1-year survival rates were 60.6% and 83.0%, respectively (χ2=4.040, P=0.043), the 2-year survival rates were 53.5% and 60.5%, respectively (χ2=0.003, P=0.096), the 3-year survival rates were 48.1% and 45.9%, respectively (χ2=0.288, P=0.59), the 5-year survival rates were 39.1% and 27.5%, respectively (χ2=0.798, P=0.372).Multivariate analysis revealed that anti-NHL therapy and international prognostic index score were independent predictors for prognosis (both P<0.05).Conclusions Diffuse large B cell lymphoma is the predominant pathologic type of ARL.ARL patients has significantly lower survival rate compared with general NHL patients.Combination of anti-HIV therapy and anti-lymphoma therapy in individuals with ARL can prolong their survival time.

Objective To investigate the incidence and risk factors of end-stage liver disease (ESLD) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients after antiretroviral therapy (ART).Methods The demographic and clinical data of HIV-HCV coinfected patients in Zhongnan Hospital,Wuhan University and local Centers for Disease Control and Prevention (CDC) from Jan 2003 to Dec 2010 were analyzed retrospectively. Single factor and multiple factor Logistic regression were used to analyze the correlation between the variables and incidence of ESLD,such as baseline age ≥40,male,previous blood transfusion history,duration of HCV persistent infection,hepatitis B virus (HBV) co-infection (HBsAg positive),HIV RNA≥-1 ×104 copy/mL at last visit,HCV RNA≥ 1.× 105 copy/mL at last visit,CD4 count ＞ 200 / μL at last visit,alanine aminotranferase (ALT) ≥ 2 × upper limit normal (ULN) at last visit,ART containing nevirapine (NVP),follow-up duration,ART duration＞5 years and HCV genotype 1b.The effect of ESLD on the survival of HIV-HCV co-infected patients was analyzed by Kaplan-Meier method.Results Totally 427 HIV-HCV co-infected patients were followed up with average of 3.7 years. Fifty-five patients (12.9％) developed ESLD,and 52 patients (12.2％) died.Factors independently associated with ESLD included baseline age≥40 (OR=2.385,P=0.039),ALT ≥2× ULN (OR=16.374,P=0.000),HBV-coinfection (OR=2.507,P=0.042),duration of ART ＞ 5 years (OR=3.232,P=0.010),and CD4 count ≥200/μL (OR=0.364,P=0.011).The cumulative mortality of HIV-HCV co-infected patients with ESLD was 50.9％,whereas that of HIV-HCV co-infected patients without ESLD was 6.5％ (P=0.000).Conclusion In the ART era,ESLD is common among HIV-HCV co-infected patients in China,which is responsible for reducing the survival time of the patients.

Objective To investigate the effects of peptide-binding domain (PBD) of heat shock protein (HSP) 72 on epithelial to mesenchymal transition (EMT) in rat renal tubular epithelial cells.Methods The expressions of wild-type HSP72,mutant of HSP72 lacking peptide binding domain (HSP72-△PBD) and HSP72-PBD were induced by plasmid transfection.NRK-52E ceils were stimulated by TGF-β1 for 48 h.The expressions of α-smooth muscle actin (α-SMA),E-cadherin,HSP72 and Smad3/p-Smad3 were detected by Western blot and immunofluorescence.Results After NRK-52E cells were stimulated by TGF-β 1 (10 μg/L) for 48 h,the expression of α-SMA was increased and the protein level of E-cadherin was decreased.Western blotting and immunofluorescence showed that over-expression of both HSP72 and PBD inhibited TGF-β1-induced up-regulation of protein α-SMA expression,down-regulation of protein E-cadherin.However,overexpression of HSP72-△PBD did not change the protein level of E-cadherin and α-SMA.In addition,over-expression of HSP72 and PBD significantly inhibited the phosphorylation of Smad3.Conclusion Inhibition of Smad3 activation and EMT by HSP72 is associated with the function of PBD.