Objective To investigate self-management behaviors of kidney transplantation recipients after discharge.Methods A total of 97 kidney transplantation recipients were recruited from a teaching hospital of Peking University From September 2009 to June 2012,and all eligible subjects were then assigned to 3 groups:post-transplantation less than 6 months group (group A),post-transplantation 6-12 months group (group B),and post-transplantation more than 12 months group (group C).The subjects were required to complete self-management scale for renal transplant recipients.ANOVA was used for data analysis.Results There were 32 patients in group A,31 in group B,and 34 in group C.Self-management behavior score of the participants of the three groups was 100.1 ± 7.0,99.0 ± 7.3 and 91.3 ± 5.8,respectively (F =3.53,P =0.03).In terms of diet,group B got the highest score (F =16.41,P =0.00).However,group A showed excellence in physical activities (F =11.50,P =0.00).For three groups,score of drug effect and side effect was 2.00 ±0.00,2.03 ±0.18,and 2.41 ±0.50; score of routine laboratory values was 2.00 ±0.00,2.05 ± 0.16 and 2.82 ±0.39; and score of skin protection was 3.09 ±0.30,3.03 ± 0.91,and 2.85 ±0.36,respectively.Conclusions Post-transplantive self-management behavior of patients who completed the surgery for more than 12 months may not be better than others.Healthcare professionals need to improve patients' self-management through health education.

ObjectiveTo evaluate the effects of cardiac resynchronization therapy (CRT) on improving left ventricle (LV) function and LV asynchrony in patients with dilated cardiomyopathy(DCM)using three-dimensional ultrasound speckle tracking imaging(3D-STI).MethodsTwenty one patients with DCM and 25 normal subjects were enrolled in this study.Parameters including LV mean longitudinal peak strain (MLS),LV mean circumferential peak strain (MCS),LV mean radial peak strain (MRS),LV ejection fraction(3D-LVEF),maximal temporal difference in area strain of LV 16 segments (A-MaxTs) and its standard deviation (A-Ts-SD) were investigated by 3D-STI.LV ejection fraction (ECT-LVEF) and LV phase angle width (LVW) were obtained by radionuclide ventriculography and phase image analysis.Results The indexes of MLS,MCS,MRS and 3D-LVEF were decreased and A-MaxTs,A-Ts-SD were prolonged in DCM group compared with those of control group.There was a slightly improvement in MRS and ECTLVEF 1 week after CRT,but other Parameters including MLS,MCS,A-MaxTs,A-Ts-SD and 3D-LVEF had no significant change.Compared with corresponding values before and 1 week after CRT,all parameters (MCS,MRS,A-MaxTs,A-Ts-SD,3D-LVEF and ECT-LVEF) were further improved 6 months after CRT.MLS,MCS,MRS and 3D-LVEF had good relationship with ECT-LVEF,and A-MaxTs,A-Ts-SD had good relationship with LVW in DCM group.Conclusions3D-STI is a simple and accurate method for evaluating effects of CRT on improving LV function and LV asynchrony in patients with DCM.

Objective:To evaluate the clinical effect and safety of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP) and malocclusion.Methods:A retrospective analysis was conducted in 25 AgP patients,who had received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology.Clinical indexes,including probing depth (PD),bleeding index (BI) and percentage of sites with bleeding on probing (BOP％) were evaluated at three time points:Baseline (T0);active periodontal treatment finished and before orthodontic treatment (T1);and after orthodontic treatment (T2).Also changes of ratio of the residual alveolar bone height (RBH) and the occurrence of root resorption were evaluated by periapical radiographs.Results:(1) Compared with T0,all the clinical parameters including PD,BI,BOP％ and percentage of sites with PD ＞ 3 mm were significantly improved (P ＜0.001).(2) Significant difference was observed in the average RBH between T0 (68.37％ ± 15.60％ and T2 (70.27％ ± 14.23％).RBH in upper incisors [(58.79％ ± 16.71％ at T0,65.54％ (55.74％,78.13％) at T2],upper canines [77.62％ (66.06％,87.17％) at T0,79.57％ (69.75％,86.52％) at T2] and upper molars [74.30％ (61.69％,84.45％) at T0,76.76％ (68.12％,85.09％) at T2] showed significant increase (P ＜ 0.05).(3) After orthodontic treatment,varying degrees of root resorption occurred in (23.94％ ± 13.45％) of teeth per capita,among which the lower and upper incisors showed the highest incidence (68.48％ and 65.31％ in homogeneous teeth,respectively).Conclusion:After active periodontal treatment,orthodontic treatment in AgP patients had not aggravated inflammation and alveolar bone resorption;root resorption occurred in two-thirds of incisors approximately.

Isatidis Radix,the root of Isatis indigotica Fort.(Cruciferae),is a representitive herb widely used for clearing away heat-toxin in traditional Chinese medicine (TCM).Lariciresinol is a representitive component of lignans and an important efficacious substance with the antiviral effect.This review elucidated the progress on its biosynthetic pathways,the screening of key regulatory genes and metabolic engineering of lignans components in Isatidis Radix,providing a favorable reference for the full understanding of biosynthesis of antiviral active components,the quality improvement of Isatidis Radix and the sustainable utilization of TCM resources.

Objective:To analyze clinical data related to mineral and bone disorder(MBD)in elderly maintenance hemodialysis patients and provide a basis for the development of precise clinical treatment strategies.Methods:A total of 267 patients receiving regular hemodialysis at Beijing Huairou Hospital and Huairou District Hospital of Traditional Chinese Medicine between April 2022 and June 2022 were selected and divided into an elderly group(age≥60 years)with 129 patients and a younger group(age<60 years)with 138 patients.Patients' general information, medication use, and laboratory data including routine blood work, blood calcium, blood phosphorus, and intact parathyroid hormone were collected, and a survey questionnaire was conducted to collect data on hyperphosphatemia patients' knowledge about diet and medication use.Differences in the rate of meeting calcium and phosphorus target ranges, medication use, and questionnaire scores were compared between patients in the two groups.Results:(1)The rates of controlled Ca(2.3±0.2)mmol/L, P(1.9±0.6)mmol/L and iPTH[213.5(93.5, 359.9)ng/L]levels in the elderly group were 65.1%(84/129), 43.4%(56/129)and 51.2%(66/129), respectively.There were no statistically significant differences compared with the younger group(all P>0.05). The prevalence of hyperphosphatemia in the elderly group(66/129, 51.2%)was lower than that in the younger group(90/138, 65.2%)( χ2=5.422, P=0.020). (2)Compared with the younger group, the elderly group had lower levels of serum creatinine[(796.6±225.2)μmol/L vs.(1025.6±281.4)μmol/L], uric acid[(416.9±97.0)μmol/L vs.(445.0±106.6)μmol/L], albumin[(37.9±2.9)g/L vs.(39.0±3.0)g/L]and serum phosphorus[(1.9±0.6)mmol/L vs.(2.1±0.6)mmol/l]( t=7.289, 2.238, 2.941, 2.820, P<0.05), and a higher blood glucose level[6.9(5.2, 9.8)mmol/L vs.6.1(4.9, 8.2)mmol/l, Z=2.314, P=0.015]. (3)Compared with the younger group, the elderly group had significantly lower utilization rates of calcium-free phosphate binders[12.4%(16/129) vs.23.9%(33/138)]and calcimimetics[2.3%(3/129) vs.10.9%(15/138)]( χ2=5.895, 7.742, P<0.05, respectively). (4)Compared with the younger group, the elderly group had a lower total questionnaire score(36.8±6.6 vs.39.5±6.0), a lower hyperphosphatemia knowledge score(4.7±3.1 vs.6.0±2.8), a lower diet knowledge score(2.8±2.2 vs.4.0±1.9)and a lower medication knowledge score(2.1±1.9 vs.3.1±1.8, t=3.442, 3.694, 4.677, 4.398, respectively, P<0.05 for all), but had a higher compliance score(17.3±1.9 vs.16.4±2.4, t=3.390, P=0.001). (5)Multivariate Logistic regression analysis indicated that pre-dialysis blood urea nitrogen( OR=1.082, 95% CI: 1.011-1.159, P=0.024)and serum creatinine( OR=1.002, 95% CI: 1.001-1.005, P=0.036)were independent predictors of hyperphosphatemia in elderly hemodialysis patients. Conclusions:Compared with the younger group, the serum albumin and phosphorus levels were lower, the utilization rates of calcium-free phosphate binders and calcimimetics were lower, and the total score of the hyperphosphatemia questionnaire was also lower in the elderly group.However, the compliance score was significantly higher in the elderly group.We should focus on the relevant weak links to bolster diet education and medication management for elderly hemodialysis patients.

OBJECTIVEUsing the carbon tetrachloride liver cirrhosis rat model, the protective effect of the green tea extractive (GTE) on the liver cirrhosis was studied.

METHODSMale SD rats were randomly divided into three groups: normal group, GTE group and cirrhosis group. The GTE group and the cirrhosis group were injected subcutanuously 2 times/wk over 9 weeks with 40% CCl(4). In the second and the ninth week, the rats were sacrificed to measure MDA and hydroxyproline concentrations and TGF-beta(1) mRNA expression in liver tissue, as well as to conduct histological examination on various organs.

RESULTSCompared with the cirrhosis group, the MDA and the hydroxyproline concentrations in the GTE group were significantly reduced (P < 0.05). The liver necrosis and cirrhosis were extenuated in the GTE group by means of histologic examination. The expression of the TGF-beta(1) mRNA was reduced significantly in the GTE group.

CONCLUSIONDietary supplementation of GTE can protect against CCl(4)-induced liver damage and cirrhosis in rats.

Animals ; Carbon Tetrachloride ; toxicity ; Chronic Disease ; Liver ; drug effects ; metabolism ; pathology ; Liver Cirrhosis ; chemically induced ; prevention & control ; Male ; Malondialdehyde ; metabolism ; Plant Extracts ; chemistry ; pharmacology ; RNA, Messenger ; drug effects ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tea ; chemistry ; Transforming Growth Factor beta ; genetics ; Transforming Growth Factor beta1

Summary: CD4+CD25+ regulatory T cells (Tregs) and the expression of their molecular markers (GITR, Foxp3) in peripheral blood of the patients with systemic lupus erythematosus (SLE) were investigated in order to reveal the pathogenesis of SLE on the cellular and molecular levels. The level of Tregs in peripheral blood was detected by flow cytometry. The expression levels of GITR and Foxp3 mRNA in peripheral blood mononuclear cells (PBMCs) were assayed by reverse transcriptasepolymerase chain reaction (RT-PCR). The level of IL-6 in the plasma was measured by ELISA.Comparisons were made among 3 groups: the active SLE group, the inactive SLE group, and normal control group. The level of Tregs in the active SLE group and the inactive SLE group was significantly lower than in the normal control group (P<0.01). The level of Tregs in the active group was lower than in the inactive group with the difference being not significant (P>0.05). The level of Tregs in SLE patients was significantly negatively correlated with the disease active index in SLE (SLEDAI) (r=--0.81, P<0.01). The expression levels of GITR mRNA in PBMCs of the active SLE group and the inactive SLE group were significantly higher than in the normal control group (P<0.05), and those of Foxp3 mRNA in SLE patients of both active and inactive SLE groups were significantly lower than in the normal control group (P<0.05). There was no significant difference in the expression of GITR and Foxp3 mRNA between the active SLE group and inactive SLE group (P>0.05). The plasma levels of IL-6 in both the inactive SLE group and active SLE group were significantly higher than in the normal control group (P<0.01). The plasma level of IL-6 in the active S LE group was significantly increased as compared with that in the inactive SLE group (P<0.05), and the plasma level of IL-6 in SLE was significantly positively correlated with SLEDAI scores (r=0.58, P<0.01) and significantly negatively correlated with the ratio of CD4+CD25+ cells/CD4+ cells (r=-0.389, P<0.05). It was concluded that the levels of Tregs and Foxp3 mRNA in peripheral blood of SLE patients were decreased and the levels of GITR mRNA and plasma IL-6 were increased. The Tregs and their molecular markers GITR, Foxp3 as well as the plasma IL-6 might play an important role in the pathogenesis of SLE.

Objective To investigate the value of lung ultrasound scores ( LUS ) combined with echocardiography for evaluation of the state of preterm neonatal respiratory distress syndrome ( RDS ). Methods Lung ultrasound and echocardiography were conducted on 43 preterm newborns with RDS. The echocardiographic parameter included the area and velocity of tricuspid regurgitation, patent ductus arteriosus ( PDA ) and pulmonary artery systolic pressure ( PASP ). Correlational analyses of LUS and PASP,or X-ray grading were conducted. LUS difference was compared between the groups with PDA and without PDA. Results ① There was positive correlations between LUS and PASP ( r ＝ 0.647, P ＜0.05),LUS and X-ray grade ( r ＝0.770, P ＜0.05). ②LUS was significant different in different X-ray grade( F ＝ 31.460, P ＜ 0.05). ③ Significant difference was found between the groups with PDA and without PDA( t ＝3.08, P ＜0.05). Conclusions LUS combined with echocardiography can be used as an effective method for early diagnosis,condition assessment and prognosis of RDS,and it is more direct,fast and without radiation.

Objective:To evaluate the value of p16 INK4a detected by p16 INK4a immunostaining as a new generation of cervical cytology for primary screening and secondary screening in population-based cervical cancer screening, and in improving cytological diagnosis. Methods:Between 2016 and 2018, 5 747 non-pregnant women aged 25-65 years with sexual history were recruited and underwent cervical cancer screening via high-risk (HR)-HPV/liquid-based cytological test (LCT) test in Shenzhen and surrounding areas. All slides were immuno-stained using p16 INK4a technology, among them, 902 cases were offered p16 INK4a detection during primary screening, and the remaining 4 845 cases were called-back by the virtue of abnormal HR-HPV and LCT results for p16 INK4a staining. Participants with complete LCT examination, HR-HPV test, p16 INK4a staining and histopathological examination results were included in this study. The performance of p16 INK4a in primary and secondary screening, and in assisting cytology to detect high grade squamous intraepithelial lesion [HSIL, including cervical intraepithelial neoplasia (CIN) Ⅱ or Ⅲ] or worse [HSIL (CIN Ⅱ) + or HSIL (CIN Ⅲ) +] were analyzed. Results:(1) One-thousand and ninety-seven cases with complete data of p16 INK4a and histology were included. Pathological diagnosis: 995 cases of normal cervix, 37 cases of low grade squamous intraepithelial lesion (LSIL), 64 cases of HSIL and one case of cervical cancer were found. Among them, 65 cases of HSIL (CIN Ⅱ) + and 34 cases of HSIL (CIN Ⅲ) + were detected. The positive rate of p16 INK4a in HSIL (CIN Ⅱ) + was higher than that in CINⅠ or normal pathology (89.2% vs 10.2%; P<0.01). (2) p16 INK4a as primary screening for HSIL (CIN Ⅱ) + or HSIL (CIN Ⅲ) + was equally sensitive to primary HR-HPV screening (89.2% vs 95.4%, 94.1% vs 94.1%; P>0.05), but more specific than HR-HPV screening (89.8% vs 82.5%, 87.7% vs 80.2%; P<0.05). p16 INK4a was equally sensitive and similarly specific to cytology (≥LSIL; P>0.05). (3) The specificity of LCT adjunctive p16 INK4a for detecting HSIL (CIN Ⅱ) + or HSIL (CIN Ⅲ) + were higher than that of LCT alone or adjunctive HR-HPV ( P<0.01), while the sensitivity were similar ( P>0.05). (4) p16 INK4a staining as secondary screening: p16 INK4a was significantly more specific (94.1% vs 89.7%, 91.9% vs 87.4%; P<0.01) and comparably sensitive (84.6% vs 90.8%, 88.2% vs 91.2%; P>0.05) to cytology for triaging primary HR-HPV screening. HPV 16/18 to colposcopy and triage other HR-HPV with p16 INK4a was equally sensitive (88.2% vs 94.1%; P=0.500) and more specific (88.3% vs 83.0%; P<0.01) than HPV 16/18 to colposcopy and triage other HR-HPV with LCT≥ atypical squamous cells of undetermined significance (ASCUS), and the referral rate decreased (14.0% vs 19.4%; P=0.005). Conclusions:For primary screening, p16 INK4a is equally specific to cytology and equally sensitive to HR-HPV screening. p16 INK4a alone could be an efficient triage after primary HR-HPV screening. In addition, p16 INK4a immunostaining could be used as an ancillary tool to cervical cytological diagnosis, and improves its accuracy in cervical cancer screening.

Objective To explore the relationship between cervical lesions and high risk HPV (HR-HPV) viral load reflected by the cycle threshold (Ct) values of Cobas 4800 HPV (Cobas 4800) system. Methods From August 2016 to September 2017, 7 000 women from Shenzhen, were recruited for cervical cancer screening with Cobas 4800 system and cytology co-test. Colposcope biopsies were performed on women who were positive of HPV 16, 18, and positive of HPV types other than 16, 18 with cytology [≥atypical squamous cell of undetermined signification (ASCUS)], or HPV negative but abnormal of cytology [≥low grade squamous intraepithelial lesion (LSIL)]. The Ct values of HPV 16, 18 and all combined other types coming from Cobas 4800 system were used as an indicator of viral load to analyze the relationship between type-specific HPV load and the cervical lesions. Results (1) Among the 7 000 screening women, 370 cases were positive for cervical cancer screening, 325 of them underwent colposcope biopsies, and coloposcopy referred rate was 87.8% (325/370). Among 325 women undergoing cervical biopsy, pathological diagnosis was 119 cases of normal cervical cervix, 151 cases of LSIL, and 55 cases of high-grade squamous intraepithelial lesion (HSIL) and above (HSIL+; including 53 cases of HSIL, 1 case of cervical adenocarcinoma, and 1 case of cervical squamous cell carcinoma). (2) The Ct value of HPV 16 was inversely correlated with the upgrading of the lesions (r=-0.617, P=0.000), and significant different among normal cervix,LSIL and HSIL+(35.4±4.5 vs 31.0±6.0 vs 26.5±4.0; F=25.537, P=0.000). There was no correlation between Ct value of HPV 18 and cervical lesions (r=-0.021, P=0.902). The Ct value of other 12 HPV types was statistically difference among normal normal cervix , HSIL+and cervicitis (33.0±5.3 vs 29.9±7.2 vs 29.8±5.8; F=5.087, P=0.007). Among them, LSIL and HSIL+ were significantly lower than normal cervix (P<0.05), but there was no significant difference between LSIL and HSIL+(P>0.05). Conclusion The Ct value of HPV 16 detecting in Cobas 4800 system as an indicator of virus load obviously correlates with different grades of cervical lesions, therefore could be a reference of cervical lesion existence and an indicator of lesion prognosis.