OBJECTIVE:To investigate the clinical efficacy and safety of recombinant human epidermal growth factor(rhEGF) combined with lipoic acid in the treatment of diabetic foot. METHODS:A total of 68 patients with diabetic foot were randomly divid-ed into observation group and control group with 34 cases in each group. Both groups were given conventional therapy and Lipolic acid injection 0.6 ml added into Sodium chloride injection 250 ml. ivgtt(protecting form light),qd;observation group was additionally giv-en rhEGF for external use 1 ml and vaseline on the wounds,gauze dressing,qd. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,ulcer area,the expression of Bcl-2 and Bax were compared between 2 groups as well as the occurrence of ADR. RESULTS:The total effective rate of observation group(94.1%)was significantly higher than that of control group(67.6%),with statistical sig-nificance (P<0.05). Before treatment,there was no statistical significance in ulcer area,the levels of Bcl-2 and Bax between 2 groups(P>0.05). After treatment,ulcer area decreased significantly, the level of Bcl-2 increased significantly in 2 groups,while the level of Bax decreased significantly;the improvement of observation group was more significant than that of control group,with statis-tical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLU-SIONS:rhEGF combined with lipoic acid is effective for diabetic foot with good safety.

Sustained hypoxic pulmonary vasoconstriction (HPV ) as experienced at high altitude can lead to hypoxic pulmonary hypertension(HPH).HPV,a special physiological phenomenon of lung,is the physiological reflex of organism in hypoxic envi-ronment.However,in high altitude hypoxic environment,the sustained HPV can lead to pulmonary vascular remodeling and right ventricular hypertrophy,at the same time,the degree of hypoxia in alveoli can be aggravated.Vicious circle of hypoxia is formed,further causing the severe high altitude sickness such as pulmonary edema and pulmonary heart disease.HPV appears in preliminary of HPH,but in the chronic phase,irreversible hy-poxic pulmonary vascular remodeling forms.Therefore,studying the mechanism of HPV and the effect of HPV in HPH can pro-vide targets and ideas for the prevention and treatment of high al-titude sickness. Additionally, in preliminary stage of HPV, prompt treatment is critical for the prevention of high altitude sickness.However,the mechanism of HPV and its roles in HPH are still not fully elucidated in current studies.This paper sum-marizes the studies about HPV in HPH of recent years,aiming to provide references for researchers and clinical treatment in this research field.

The morphology and position of the AV node and AV bundle were observed in 13 human hearts with serial sections. 1.the AV node is a long sagittal flatt ened structure, its transverse section is triangular in shape with a right convex surface, sometimes the cross section is fusiform or half oval in shape. Its size is 3.5x3.3x1.1 mm in adult. In 5 cases the endocardium lying on the right surface of the AV node is elevated.2.The AV node is situated in the upper border of the atrioventricular septum (between the levels of the attachment lines of the mitral and tricuspid valves). The adult AV node is 1.8-5.8 mm anterior to the coronary sinus orifice, 0.3-0.7 mm from the endocardium of the right atrium, 3.3-7.5 mm above the upper border of the septal leaflet of the tricuspid valve. The left surface of the AV node contacts with the central fibrous body.3.The AV node can be divided in 2 parts: superficial and deep, the fibers of the super ficial part are longitudinal in sections and end in the lower border of the AV node. In one case, the deep part is subdivided in an upper part and a lower part. In the specimens in which the right atrial endocardium lying on the right surface of the AV node is elevated, the overlaying fibers end in the endocardium. At the upper border, right surface, and posterior margin of the AV node, there are atrial fibers ending to the AV node. 4. The adult AV bundle is 5.7-7.9 mm long, 1.1-1.5 mm in diameter. Its anterior part is on top of the muscular interventricular septum in 7 specimens, on its left surface in 3 specimens, and in the substance of the muscular interventricular septum in 2 specimens. In one case its course is very special, at first on the top of muscular interventricular septum, then at its left surface, finally in the substance of the right part of the muscular interventricular septum.

Aim To investigate the effect of orientin on proliferation and differentiation of 3T3-L1 pre-adipocytes and on insulin resistance(IR) in 3T3-L1 adipocytes and the possible mechanisms.Methods MTT assay and oil red O staining were applied to investigate the proliferation and the differentiation of 3T3-L1 pre-adipocytes, respectively.The intracellular triglyceride(TG) contents were detected by enzymatic analysis.IR model was induced with dexamethasone.A fluorescent glucose analogue, 2-NBDG, was used to measure the rate of glucose uptake.Western blot was used to detect the protein level of GLUT4 and phosphorylation of AMPK and ACC.The GLUT4 translocation was measured by fluorescent-immunohistochemistry.Results Orientin decreased the formation of lipid droplets and intracellular TG contents(P<0.01) in a concentration-dependent manner(P<0.05), but it had no obvious effects on the cell vitality.Under the IR state, orientin significantly increased 3T3-L1 adipocytes glucose uptake(P<0.05).Meanwhile, orientin up-regulated the protein expression of p-AMPK, p-ACC, and enhanced GLUT4 translocation and its expression.Conclusion Orientin can effectively inhibit the differentiation of 3T3-L1 pre-adipocytes and increase insulin sensitivity due to the activation of AMPK/GLUT4 signal pathway.

Objective To analyze the influence of the cesarean section and vaginal delivery at term pregnancy when fetal distress in labor conditions on maternal and neonatal outcomes .Methods 238 cases of fetal distress in labor when full-term pregnant were selected ,and they were randomly divided into the observation group and control group,119 cases in each group .The control group was given midwifery vaginal delivery ,while the observation group was given cesarean section .The maternal and neonatal outcomes were compared between the two groups . Results 78 cases(65.55%) of neonatal score above 7 or more points and 7 or more points of the control group were 58 cases(48.74%),the difference was significant (P<0.05).The incidence rate of neonatal complications in the observation group was 5.88%, which was significantly lower than 20.16% of the control group ( P <0.05 ). Conclusion Fetal distress in full-term pregnancy in labor , the use of cesarean section has higher neonatal score compared with vaginal delivery ,and it has low incidence rate of neonatal complications ,it is worth to be applied in clinical.

Objective To analyze and explore the correlation between the onset time of lactogenesisⅡ and lactation yield of the early stage after delivery in preterm's mothers by continuously determining the lactation yield of the early stage after delivery in hospitalized preterm's mothers and the onset time of lactogenesisⅡin neonatal intensive care unit (NICU). Methods We measured lactation yield and recorded the onset time of lactogenesis Ⅱ from 100 premature labour puerpera with hospital delivery of Obstetrics Department at a class Ⅲgrade A general hospital in Shandong Province. The relative factors of delayed onset of lactogenesis Ⅱ (DOL Ⅱ) were investigated with the preterm's mothers lactation-related factors comprehensive questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). Results The mean onset time of lactogenesis Ⅱ of hospitalized preterm's mothers in NICU were (68.23±26.42) hours. The incidence of DOL Ⅱ was 36% (36/100). The onset time of lactogenesis Ⅱwas negatively related to the lactation yield 14 days after delivery (r=-0.525--0.354, P<0.01). The lactation yield 14 days after delivery of onset delay group of lactogenesis Ⅱ was less than that of non-delayed group (Z=-4.89--3.10, P<0.01). The influencing factors of DOL Ⅱ included whether they were combined with pregnancy-induced hypertension syndrome (OR=4.589, P< 0.01), hours of sleep (OR=0.649, P<0.01) and the first breast-feeding (OR=1.120, P<0.01). Conclusions The incidence of DOL Ⅱ is high in hospitalized preterm's mothers of NICU.The DOL Ⅱ affects the lactation yield of the early stage after delivery in preterm's mothers. Medical workers should pay attention to the onset time of lactogenesis Ⅱ, correct pregnancy-induced hypertension syndrome in time, increase hours of sleep of puerpera and promote the first breast-feeding early enough so as to reduce or prevent the DOL Ⅱand to improve the lactation condition of premature labour puerpera.

PURPOSE: This study aimed to evaluate the effect of delayed lactogenesis II on early milk volume in mothers expressing milk for their preterm infants. METHODS: 142 mothers with preterm infants participated in a longitudinal cohort study, the milk volumes over 14 days postpartum between mothers with delayed lactogenesis II (≥ 72 hours) and mothers with non-delayed lactogenesis II(< 72 hours) were compared using Wilcoxon's rank sum tests. RESULTS: The prevalence of delayed lactogenesis II among mothers of preterm infants was 36.0% (36/100). There existed negative correlations between the onset of lactogenesis II and the daily milk volumes(r(s) = −0.525~−0.354, p = .002 ~ p < .001). The milk volumes in every 24-hour of the 14 days postpartum in delayed group were significantly less than that in non-delayed group (p = .002 ~ p < .001). After controlling for the covariates, pregnancy-induced hypertension syndrome, delayed expression initiation, shorter daily sleeping time were found to be the risk factors for delayed lactogenesis II. CONCLUSION: Delayed lactogenesis II was associated with lower milk volume in early postpartum period. Women who were at risk for delayed lactogenesis II need targeted interventions and additional support during pregnancy and postpartum.
Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Infant, Premature ; Lactation ; Milk ; Milk, Human ; Mothers ; Postpartum Period ; Pregnancy ; Premature Birth ; Prevalence ; Risk Factors

Background and Purpose:Prostate cancer is one of the most common cancers and the second leading cause of cancer-related death in Europan and North American males.The incidence of prostate cancer has also been increasing during the past few decades in China.It is widely accepted that this heterogeneity,which results from the tumor progression driven largely by genomic instability(genetic and/or epigenetic alterations)of tumor cells in primary tumor,endows specific populations of tumor cells with the unique character needed for invasion,migration,and metastasis colony formation in other organs and only these subpopulations possessing thost character can survive the potentially destructive journey from the primary tumor to the sites of metastases.The purpose of the present study was to explore the genes associated with invasion and metastasis of human prostate cancer cell line PC-3M in nude mice.Methods:After PC-3M cells were inoculated into orthotopic site(prostate) in a male nude mouse for two months,tumor cells were isolated from the primary tumor and lymph node metastasis,separately.Cell invasion and adhesion ability in vitro were first compared between two cells.Then metastasis-related genes differentially expressed between them were analyzed by utilizing cDNA microarray technique.Results:The in vitro cell invasion and adhesion potential of tumor cells from lymph node metastasis was significantly higher than those from primary tumor by 2.5 fold and 1.5 fold,respectively.Metastasis-related genes differentially expressed between those two sublines were identified,all of them were up-regulated in the tumor cells from lymph node metastasis and could be categorilized: 1.genes encoding cellular matrix-degrading proteolytic enzyme including cathepsin and MMP.2.genes encoding transcription factors.3.genes related to heterotypic adhesion of tumor cells.4.genes encoding cell surface receptors.Conclusions:There are significant differences in invasion and adhesion potential between cells from primary tumor and those from lymph node metastasis.Some differentially expressed molecules might be playing pivotal roles in promoting tumor cells to migrate from primary tumors to distant metastases,which may be helpful to elucidate the possible mechanism of metastasis in prostate cancer.

Objective To elucidate the clinical significance in facilitating timely diagnosis and treatment of RMPP in children by investigating the association between infection caused by macrolide-resistant Mycoplasma pneu-moniae(MRMP)and refractory Mycoplasma pneumoniae pneumonia(RMPP)in pediatric patients.Methods The clinical data of 714 hospitalized children with refractory Mycoplasma pneumoniae pneumonia(RMPP)were retro-spectively analyzed.Bronchoscopy and bronchoalveolar lavage fluid(BALF)were performed on each subject,and the BALFs were collected to detect mutation sites in the V region of 23S rRNA for Mycoplasma pneumoniae DNA.Based on the gene detection results,children with RMPP were categorized into a macrolide-resistant group and a control group(non-macrolide-resistant group).Results A total of 714 children diagnosed with refractory Mycoplasma pneumoniae pneumonia(RMPP)were enrolled in this study,including 509 cases in the macrolide-resistant group and 205 cases in the control group.Among them,there were 369 males(54.7%)and 345 females(45.3%).The macrolide-resistant group exhibited higher average age,fever duration,and hospitalization days compared to the control group.Furthermore,elevated levels of white blood cell count(WBC),neutrophil percentage(NE%),high-sensitivity C-reactive protein(hs-CRP),lactate dehydrogenase(LDH),and interleukin-6(IL-6)were observed in the macrolide-resistant group when compared to the control group(P<0.05 or P<0.000 1).Compared to the control group,children with macrolide-resistant Mycoplasma pneumoniae pneumonia(RMPP)exhibited higher incidences of lung consolidation,pleural effusion,necrotic pneumonic lesions,severe MPP(SMPP)/fulminant MPP(FMPP),flocculent and viscous tracheal secretions,severe mucosal lesions(erosion,ulceration or necrosis),bronchial inflammatory stenosis,endo-bronchial plastic phlegm plugs and extra-pulmonary complications(P<0.05 or P<0.0001).Conclusions MRMP infection can contribute to the development of RMPP,potentially exacerbating respi-ratory conditions in affected children.Timely bronchoscopy and collection of BALF samples for accurate evaluation of respiratory tract lesions and detection of MRMP infection have significant implications for guiding precise clinical diagnosis and treatment.

Objective To understand the changing trend of dementia disease burden attributed to high BMI in China from 1990-2019, and to provide a basis for the development of dementia prevention and control strategies. Methods Using data from the Global Burden of Disease Study 2019(GBD2019)，the changes in disease burden were analyzed using indicators such as deaths, disability adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs) and their standardized rates. The differences between sexes and age groups were compared. Joinpoint regression model was used to analyze the trend of changes in the disease burden of dementia attributable to high BMI in China. Results From 1990 to 2019, the burden of dementia disease attributed to high BMI continued to increase, with 20,300 more deaths, 404,200 more DALYs, and more than a four-fold increase in both mortality and DALYs rates. The overall burden of disease was greater for women than for men, but the rate of increase in the burden of disease was higher for men than for women. The disease burden in the age group of 80 and over was significantly higher than in other age groups. Conclusion Attention should be paid to people with high BMI, especially for the prevention and control of dementia risk in older age groups with high BMI. Active countermeasures should be taken to control the occurrence of dementia.