AIM: To study the potential effects of lipoteichoic acid (LTA)-induced delayed preconditioning (PC) on cardioplegic arrest/reperfusion injury in donor rat heart. METHODS: The rats were pretreated with LTA (1 mg/kg, ip) 24 h before the experiment, and the isolated hearts were subjected to arrested by cardioplegic solution and stored in Eurocollin's solution for 4 h by the Langendorff method, and to evaluate the changes of cardiac function at the reperfusion for 30 min and 60 min, to measure the amounts of MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH) and total nitric oxide (NO) oxidation products in the coronary effluent, and to detect myocardial apoptosis on tissue samples of left ventricle at the end of reperfusion by TUNEL staining. RESULTS: Pretreated with LTA significantly improved the recovery of cardiac function with a significant increase in coronary flow (CF), left ventricular developed pressure (LVDP), maximal rate of left ventricular developed pressure (+dp/dt_ max), and minimal rate of left ventricular decline pressure (-dp/dt_ max) at 30 min and 60 min of reperfusion (all P

Aim To explore the effects of lipoteichoic acid (LTA) induced delayed preconditioning (PC) on hypoxia-reoxygenation (H/R) injury of cultured human coronary artery endothelial cells (HCAECs), and to investigate the potential role of endogenous nitric oxide (NO) participated in the protective mechanism. Methods HCAECs were incubated for 2 h in a hypoxic atmosphere and reoxygenated for 4 h in a normoxic atmosphere. The delayed PC was induced by pretreatment with LTA assessed by the percentage of cellular injury with Trypan blue exclusion and by the amount of lactate dehydrogenase (LDH) in culture media. The NO level of the culture media was measured detect the expression of eNOS mRNA by RT-PCR method after cells were recovered from different points.Results LTA pretreatment significantly decreased the percentage of the killed cell and the concentration of LDH in media. Also, LTA pretreatment obviously raised the concentrations of NO in culture media. The protective effects of LTA were abrogated by pretreatment with N-monomethyl-L-arginine (L-NMMA).Moreover, the expression of eNOS mRNA was significantly upregulated after HCAECs exposure to LTA for 4 h following 2 h or 4 h recovery. Conclusion LTA could induce the delayed protection against H/R induced endothelial injury and dysfunction of cultured HCAECs. NO produced by eNOS acts initially as a trigger and subsequently as a mediator of delayed PC.

OBJECTIVE:To systematically review the effect of organic cation transporter 2 [(OCT2)808G>T] gene polymor-phism on the metformin hydrochloride pharmacokinetics in vivo,and to provide evidence-based reference for clinical medication. METHODS:Retrieved from PubMed,EMBase,Foreign Medical Journey Service,CJFD,VIP database and Wanfang database,re-lated studies about the effect of (OCT2)808G>T gene polymorphism on the metformin hydrochloride pharmacokinetics in vivo were collected,and Meta-analysis was performed by using Rev Man 5.1 statistics software. RESULTS:A total of 5 retrospective studies were included,involving 172 patients. The result of gene type was type GT,type TT and type GG. Results of Meta-analysis showed,compared with type GT volunteers,type TT could prolong the half-time period of metformin hydrochloride;compared with type TT,type GG could increase the peak concentration. However,(OCT2)808G>T gene polymorphism had no effects on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. CONCLUSIONS:(OCT2)808G>T gene poly-morphism has certain effect on the half-time period and peak concentration of metformin hydrochloride in vivo of health volunteer, and has no effect on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. Due to the limit of re-search methodological quality,large-scale and high quality studies are required for further validation of the conclusions.

Objective To investigate the effect of noninvasive positive pressure ventilation treatment on patients with acute left heart failure and hyoxemia.Methods Sixty-two patients with acute left heart failure and hyoxemia were divided into control group (31 cases) and treatment group (31 cases).All patients were treated with a conventional therapy plan and patients in treatment were received noninvasive positive pressure ventilation beside conventional therapy.Blood gas analysis,plasma B-type natriuretic peptide (BNP) and clinical manifestation before and after treatment were monitored.Results The time of clinical manifestation al0leviation in treatment group was (33.7 ±7.9) min,shorter than that of control group ((55.9 ± 12.1) min,t =8.554,P ＜0.01).Compared with pre-treatment,heart rate (HR),respiratory rate(RR),mean arterial pressure(MAP),pH,oxygen saturation of blood (SaO2),arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide(PaCO2) and BNP in treatment group were improved significantly(HR:(133.89 ± 5.45) beat/ min vs.(87.27 ± 5.74) beat/min,t =32.794,P ＜ 0.01 ; RR:(34.25 ± 5.67) beat/min vs.(20.15 ± 2.54) beat/min,t =12.636,P ＜ 0.01 ; MAP:(104.52 ± 7.25) mmHg vs.(76.57 ± 3.76) mmHg,t =19.055,P ＜0.01; pH:(7.29±0.06) vs.(7.40 ±0.06),t=7.218,P＜0.01;SaO2:(81.52 ±5.01)％ vs.(97.16±1.27) ％,t =16.848,P ＜ 0.01 ; PaO2:(55.30 ± 7.14) mmHg vs.(92.80 ± 6.24) mmHg,t =22.019,P ＜0.01;PaCO2:(46.23 ±10.30) mmHg vs.(40.56 ±5.19) mmHg,t =2.737,P＜0.05;BNP:(831.59 ±292.65) ng/L vs.(265.52 ±65.39) ng/L,t =10.511,P ＜0.01).And after treatment,HR,RR,MAP,SaO2,PaO2,BNP in control group were improved compared with that before treatment (HR:(132.13 ± 5.31) beat/min vs.(92.15 ± 4.28) beat/min,t =32.638,P ＜ 0.01 ;RR:(34.96 ± 4.78) beat/min vs.(23.91 ± 3.27) beat/min,t=l0.634,P＜0.01;MAP:(102.56 ±7.14) mmHg vs.(82.83±3.52) mmHg,t =13.800,P＜0.01;SaO2:(82.15 ± 5.24) ％ vs.(93.16 ± 2.59) ％,t =10.488,P ＜ 0.01 ; PaO2:(54.56 ± 6.27) mmHg vs.(75.19 ±3.52) mmHg,t =15.974,P ＜0.01 ;BNP:(823.15 ±277.26) ng/L vs.(371.15 ±87.55) ng/L,t =8.656,P ＜0.01).Statistical differences of pH and PaCO2 were not found in the control group before and after treatment(pH:7.32 ± 0.05,t =1.426,P =0.159 ;PaCO2:(43.78 ± 6.74) mmHg,t =0.253,P =0.801).HR,RR,MAP,pH,SaO2,PaO2,PaCO2 and BNP in treatment group were more significantly improved than that of control group(t =3.795,5.056,6.767,5.703,7.721,13.686,2.107 respectively,P ＜ 0.01or P ＜ 0.05).Conclusion The therapy plan of noninvasive positive pressure ventilation on patients with acute left heart failure and hyoxemia can improve cardiac function and oxygenation quickly,and decrease the plasma BNP level.

Objective:To investigate the residual narcotics for injection after used in wards in order to provide evidence for the use standardization of narcotics for injection. Methods:A retrospective research method was adopted. Totally 5 288 prescriptions including narcotic drugs for injection in wards were collected and analyzed from June to August in 2014. Results:Only four kinds of narcotics for injection were used in wards, the residual proportion of morphine hydrochloride injection and pethidine hydrochloride injection was 2%, and that of fentanyl citrate injection was 0. 2%. Conclusion:The residue of narcotics for injection in wards is very little, and the specifi-cations of the medication in our hospital meet the demands of clinics. The research is beneficial to improving the management efficiency.

Objective:To statistically analyze the prescription writing norms of narcotic drugs for injection in the operation room and inpatient area of our hospital to improve the prescription writing quality and the efficiency of management. Methods:A retrospec-tive research method was adopted, and 17 103 prescriptions for narcotic drugs for injection in the operation room and inpatient area were collected and analyzed from June to August in 2014. Results:The irregular proportion of prescriptions of narcotic drugs for injec-tion was 9. 05%, and the abnormal item was lack of the text. The proportion of prescriptions using residual amount and needing to be marked was 4. 01%. Conclusion: Improving the management and unifying the prescriptions of narcotics, or applying the electronic prescription if allowed will improve the quality of prescriptions of narcotics and achieve the purpose of fine management.

Objective To identify a clinical isolate of Mycobacterium abscessus.Methods A pus sample was collected from a patient with suspected nontuberculous mycobacterial infection who visited the Affiliated Hospital of Weifang Medical University on December 18,2017,and was subjected to bacterial culture,Gram staining and acid-fast staining.Drug sensitivity test was conducted by the proportion method.The genome DNA of the strain was extracted and amplified by PCR with the universal primer of 16S rRNA.The PCR products were sequenced after collection and purification,and were compared with the known sequence of Mycobacterium abscessus in GenBank database.The isolate was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).Results The clinical isolate was identified as Mycobacterium abscessus both by MALDI-TOF MS and 16S rRNA gene sequencing.The drug sensitivity test showed that the strain was sensitive to amikacin,moxifloxacin,levofloxacin,but was resistant to streptomycin,isoniazid,rifampicin,ethambutol,ofloxacin,kanamycin,capreomycin,aminosalicylic acid,protionamide and rifabutin.The patient was diagnosed with subcutaneous soft tissue infection in the left knee joint.According to the results of drug sensitivity test,the patient was treated with amikacin and levofloxacin,and her condition was improved after treatment.Conclusion The 16S rRNA gene detection and MALDI-TOF MS both can be applied in the identification of Mycobacterium abscessus.

ObjectiveTo construct an evaluation index system for the development of district-level disease prevention and control centers according to the requirements of the modernization of Shanghai’s disease control system and public health work practices， and to comprehensively assess the construction and development of district-level disease prevention and control institutions. MethodsAccording to the national and municipal requirements for the development of disease prevention and control institutions， an index framework was proposed through literature search and expert interviews. 39 representative experts in the field of public health at the national， provincial， and municipal （district） levels were selected to participate in the consultation and construction of the index system. The authority coefficient， the coefficient of variation， etc. were used to carry out quality control and determination of each index on the Delphi method. ResultsThe questionnaire response rate was 100%， the expert authority coefficient was 0.86，the degree of familiarity was 0.79， and the judgment basis was 0.92. The coefficients of variation of the necessary indicators in the index system were all <0.25 in the dimension of importance， and there were statistical differences in the statistical test of Kendall’s W coordination coefficients at all levels and dimensions （all P<0.001）. After multiple rounds of consultation， experts reached a consensus， forming a development evaluation index system of district-level CDCs with 6 first-level indicators， 24 second-level indicators， and 105 third-level indicators （including 63 necessary indicators and 42 recommended indicators）. ConclusionThe evaluation index system of Shanghai district-level CDCs based on the Delphi method has good authority， reliability， sensitivity and operability. This indicator system can effectively support the development of Shanghai district-level CDCs， and can be used for evaluation at multiple levels and in an all-round way in the future. The evaluation results can provide an evidence-based basis for the modernization of the disease prevention and control system and the continuous and dynamic updating of the development goals in the future.

Objective:To investigate the effectiveness of a hierarchical teaching model guided by "residency-specialty integration" in residency training and specialty training of oral and maxillofacial surgery with the training base of oral and maxillofacial surgery in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, as the research subject.Methods:A total of 144 trainees receiving residency training and 32 receiving specialist training were enrolled from June 2022 to April 2023 and were divided into experimental group and control group, with 72 trainees receiving residency training and 16 receiving specialist training in each group. Clinical and learning tasks were designed using the traditional model for the control group and the hierarchical teaching model guided by "residency-specialty integration" for the experimental group, and the performance of trainees in theoretical assessments and self-evaluations was recorded. SPSS 23.0 was used to perform the t-test. Results:The hierarchical teaching model guided by "residency-specialty integration" achieved a significant effect in both theoretical assessments and self-evaluations of the trainees. As for the trainees receiving specialty training, there was a significant difference in the score of theoretical assessment between the experimental group and the control group (84.56±4.05 vs. 81.13±2.78, P<0.05), and as for the trainees receiving residency training, there was also a significant difference in this score between the experimental group and the control group (84.74±4.85 vs. 82.10±4.34, P<0.01). The results of self-assessment questionnaire showed that compared with the control group, the experimental group had a higher proportion of trainees giving positive evaluations of various indicators. Conclusions:This study suggests that the hierarchical teaching model guided by "residency-specialty integration" provides an effective teaching model for residency training and specialty training of oral and maxillofacial surgery, and this model may help to enhance disciplinary interests and promote clinical practice abilities, thereby providing valuable insights for future medical education in China.

Nonalcoholic steatohepatitis (NASH) is a spectrum of chronic liver disease characterized by hepatic lipid metabolism disorder. Recent reports emphasized the contribution of triglyceride and diglyceride accumulation to NASH, while the other lipids associated with the NASH pathogenesis remained unexplored. The specific purpose of our study was to explore a novel pathogenesis and treatment strategy of NASH via profiling the metabolic characteristics of lipids. Herein, multi-omics techniques based on LC-Q-TOF/MS, LC-MS/MS and MS imaging were developed and used to screen the action targets related to NASH progress and treatment. A methionine and choline deficient (MCD) diet-induced mouse model of NASH was then constructed, and Schisandra lignans extract (SLE) was applied to alleviate hepatic damage by regulating the lipid metabolism-related enzymes CES2A and CYP4A14. Hepatic lipidomics indicated that MCD-diet led to aberrant accumulation of phosphatidylethanolamines (PEs), and SLE could significantly reduce the accumulation of intrahepatic PEs. Notably, exogenous PE (18:0/18:1) was proved to significantly aggravate the mitochondrial damage and hepatocyte apoptosis. Supplementing PE (18:0/18:1) also deteriorated the NASH progress by up regulating intrahepatic proinflammatory and fibrotic factors, while PE synthase inhibitor exerted a prominent hepatoprotective role. The current work provides new insights into the relationship between PE metabolism and the pathogenesis of NASH.