This paper reported the effect of captopril (SQ14225) on rabbits hemorrhagic shock. After late hemorrhagic shock model (MABP 40mmHg, maintained for 90min) was replicated, 26 rabbits were divided randomly into a captopril-treated group (n=13) and a control group (n=13). In the treated group, captopril(1mg/kg) was infused with normal saline (15ml/kg), low molecular dextran (15ml/kg)and shed blood, an hour later, the MABP, CVP and renal blood flow rose markedly, the platelet aggregation was significantly lowered and mesenteric microcireulation was improved remarkably. Three hours later, the various indexes mentioned above returned almost to normal (before the shock). The survival rate in 5 hours was 91.7%. The difference between the control and the treated group was quite significant (P

Objective To investigate the companion care needs of inpatients at four tertiary hospitals in Wuhan,for providing targeted quality of care.Methods A questionnaire was customized according to Maslow＇s theory to survey 526 inpatients at four tertiary hospitals in Wuhan.Resnlts The companion care needs of inpatients were found high.Fore example,the esteem needs were the highest(2.41±0.39)yet with the lowest extent of satisfaction(2.59±0.43),followed by love and belonging needs(2.35±0.40)and safety needs(2.34±0.35)respectively.The physiological needs were the lowest(2.08±0.32)yet with the highest extent of satisfaction(2.63±0.44).Conclusion Nursing staff should change their mindset to respect patients' esteem needs,improve their nursing skills and service for safer care.Multimodel companion care needs should also be provided to meet patients' diversified needs.

Objective To investigate the risk factors of hyperuricemia and type 2 diabetes mellitus(T2DM ) with vascular com‐plication .Methods 97 individuals undergoing the physical examination were included into the control group ,103 patients with pure T2DM and 78 patients with T2DM complicating hyperuricemia were selected .The fasting plasma glucose(FPG) ,glycosylated he‐moglobin(HbA1c) ,total cholesterol(TC) ,triglycerides(TG) ,high density lipoprotein cholesterol (HDL‐C) ,low density lipoprotein cholesterol (LDL‐C) ,apolipoprotein A1(ApoA1) ,apolipoprotein B (ApoB) ,serum creatinine (Cr) and uric acid (UA ) were com‐pared among 3 groups ,meanwhile the first morning urine was collected for detecting urine microalbumin (UMA) ,and the body mass index(BMI) was detected .Then the correlation between hyperuricemia with the diabetes related complications was investigated .Re‐sults The levels of FPG ,TG ,Cr ,UMA and HbA1c in the pure T2DM group were higher than those in the control group(P < 0 . 05) ;BMI ,FPG ,TG ,TC ,LDL‐L ,UMA ,Cr and HbA1c in the T2DM complicating hyperuricemia group were higher than those in the control group (P < 0 .05) ;BMI ,TG ,Cr ,UMA and HbA1c in the T2DM complicating hyperuricemia group were higher than those in the pure T2DM group(P < 0 .05) .The incidence rates of diabetic nephropathy (DN ) ,limb arterial plaques in the T2DM complicating hyperuricemia group were significantly higher than those in the T 2DM group ,the differences were statistically signifi‐cant (P< 0 .05) .Conclusion The patients with T2DM complicating hyperuricemia are easier to develop dyslipidemia ,and their inci‐dence rates of DN and lower limb arterial plaque are also significantly higher than those in patients with pure T 2DM .

Objective To study the relationship between plasma free fatty acids composition and the incidence of nonalcoholic fatty liver disease(NAFLD) .Methods By the design of case‐control study ,105 patients with NAFLD as cases and 110 healthy peo‐ple as controls were enrolled into the study .Plasma free fatty acid levels were determined by gas chromatography .Results High level of plasma palmitic acid(C16 :0)(OR=1 .769) was the risk factors of NAFLD ,while plasma levels of linoleic acid(C18 :2 n‐6) (OR=0 .855) and arachidonic acid(C20 :4 n‐6)(OR=0 .181)were negatively associated with the incidence of NAFLD .Conclusion These findings suggest that a proper ratio of diet fatty acids intake may reduce the risk of NAFLD .

Higher service efficiency and better medical experience are main goals of the healthcare system reform.The article explained the logical framework, main actions, initial results of the " one visit for all" reform, which aims at promoting the efficiency of medical services and management in Hangzhou.Policy suggestions are raised, namely involving more people into the governance mechanism, collaboratively optimizing the working process of medical staff, improving the information security mechanism, and perfecting the effectiveness evaluation system.These measures are designed to accelerate the construction of modern hospital management system, and to build a scientific and orderly hierarchical medical system.

Objective:To study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.Methods:This prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×10 5 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding ( n=257), bottle-feeding ( n=241) and mixed feeding groups ( n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data. Results:The average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log 10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log 10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences ( P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log 10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group ( P=0.553). Conclusions:For pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.

Objective:To explore the prognostic predictive value of deep neural network (DNN) assisted myocardial contrast echocardiography (MCE) quantitative analysis of ST-elevated myocardial infarction (STEMI) patients after successful percutaneous coronary intervention(PCI).Methods:A retrospective analysis was performed in 97 STEMI patients with thrombolysis in myocardial infarction-3 flow in infarct vessel after primary PCI in Renmin Hospital of Wuhan University from June to November 2021. MCE was performed within 48 h after PCI. Patients were followed up to 120 days. The adverse events were defined as cardiac death, hospitalization for congestive heart failure, reinfarction, stroke and recurrent angina. The framework consisted of the U-net and hierarchical convolutional LSTMs. The plateau myocardial contrast intensity (A), micro-bubble rate constant (β), and microvascular blood flow (MBF) for all myocardial segments were obtained by the framework, and then underwent variability analysis. Patients were divided into low MBF group and high MBF group based on MBF values, the baseline characteristics and adverse events were compared between the two groups. Other variables included biomarkers, ventricular wall motion analysis, MCE qualitative analysis, and left ventricular ejection fraction. The relationship between various variables and prognosis was investigated using Cox regression analysis. The ROC curve was plotted to evaluate the diagnostic efficacy of the models, and the diagnostic efficacy of the models was compared using the integrated discrimination improvement index (IDI).Results:The time-cost for processing all 3 810 frames from 97 patients was 377 s. 92.89% and 7.11% of the frames were evaluated by an experienced echocardiographer as "good segmentation" and "correction needed". The correlation coefficients of A, β, and MBF ranged from 0.97 to 0.99 for intra-observer and inter-observer variability. During follow-up, 20 patients met the adverse events. Multivariate Cox regression analysis showed that for each increase of 1 IU/s in MBF of the infarct-related artery territory, the risk of adverse events decreased by 6% ( HR 0.94, 95% CI =0.91-0.98). There was a 4.5-fold increased risk of adverse events in the low MBF group ( HR 5.50, 95% CI=1.55-19.49). After incorporating DNN-assisted MCE quantitative analysis into qualitative analysis, the IDI for prognostic prediction was 15% (AUC 0.86, sensitivity 0.78, specificity 0.73). Conclusions:MBF of the area supplied by infarct-related artery after STEMI-PCI is an independent protective factor for short-term prognosis. The DNN-assisted MCE quantitative analysis is an objective, efficient, and reproducible method to evaluate microvascular perfusion. Assessment of culprit-MBF after PCI in STEMI patients adds independent short-term prognostic information over qualitative analysis.It has the potential to be a valuable tool for risk stratification and clinical follow-up.

Objective: To investigate the effects of tanshinone ⅡA on atherosclerosis plaque formation and adventitial mast cells activation in high-fat-diet induced Apo E^-/- mice model. Methods: Sixteen 8-week-old Apo E^-/-male mice and eight 8-week-old C57BL/6 male mice were randomly allocated into following group: the control group (C57BL/6 + carboxymethyl cellulose per gavage), the atherogenic group (Apo E^-/-+carboxymethyl cellulose per gavage) and the tanshinoneⅡA intervention group (Apo E^-/-+30 mg/kg tanshinone ⅡA per gavage). All three groups were fed with high-fat-diet for 26 weeks. Tanshinone ⅡA/carboxymethyl cellulose was applied by the method of gavage administration 6 weeks before execution. After 26 weeks, tumor necrosis factor-α (TNF-α) andinterleukin (IL)-6 levels in serum were assessed by ELISA. Carotid artery was removed, fixed with paraformaldehyde, embedded with paraffin and sectioned. Percentage of stenosis was evaluated on HE stained sections. Plaque progression was assessed by Movat staining. Toluidine blue staining was used to evaluate mast cells infiltration and activation. Immunochemistry staining was used to assess 5-HT, TNF-α and IL-6 expression. mRNA expression of mast cell marker Fcer1a in adventitial tissue was detected by real time-PCR. Results: After high-fat-diet for 26 weeks, the mice in the atherogenic group showed advanced atherosclerosis, tanshinoneⅡA intervention reduced the percentage of carotid artery stenosis caused by atherosclerotic plaque formation ((58.48±8.07)% vs. (80.31±4.08)%, P<0.05). Compared with the atherogenic group, tanshinone ⅡA intervention group had lower level of TNF-α ((12.39±1.62)pg/ml vs. (17.44±1.42)pg/ml) and IL-6 ((116.24±12.16)pg/ml vs. (166.05±19.09)pg/ml) in serum, lower TNF-α ((20 145±1 556) vs. (25 288±1 671)) and IL-6 ((25 688±1 604) vs. (35 286±4 198)) expression in adventitia (all P<0.05). TanshinoneⅡA intervention also decreased the number of mast cells infiltration and activation, reduced 5-HT expression and mast cell marker Fcer1a mRNA relative expression in adventitia (all P<0.05). Conclusions Tanshinone ⅡA could attenuate induced by high-fat-diet carotid artery atherosclerosis in Apo E^-/- mice. The protective effect of tanshinoneⅡA is probably mediated through reducing the number and activation percentage of mast cells, decreasing the release of inflammatory cytokines and inflammation of carotid artery in adventitia.

A series of new monobactam sulfonates is continuously synthesized and evaluated for their antimicrobial efficacies against Gram-negative bacteria. Compound 33a (IMBZ18G) is highly effective in vitro and in vivo against clinically intractable multi-drug-resistant (MDR) Gram-negative strains, with a highly druglike nature. The checkerboard assay reveals its significant synergistic effect with β-lactamase inhibitor avibactam, and the MIC values against MDR enterobacteria were reduced up to 4-512 folds. X-ray co-crystal and chemoproteomic assays indicate that the anti-MDR bacteria effect of 33a results from the dual inhibition of the common PBP3 and some class A and C β-lactamases. Accordingly, preclinical studies of 33a alone and 33a‒avibactam combination as potential innovative candidates are actively going on, in the treatment of β-lactamase-producing MDR Gram-negative bacterial infections.