Objective To translate the English version of Heart Continuity of Care Questionnaire (HCCQ) into Chinese and to test the reliability and validity of the Chinese version of HCCQ in congestive heart failure (CHF) patients and atrial fibrillation (AF).Methods Totally 339 patients with CHF (n=170) and AF (n=169) were recruited and were investigated by the Chinese version of HCCQ.Results The internal consistency coefficient of the Chinese version of HCCQ ranged from 0.821 to 0.913,both above 0.7.The split half coefficient was 0.649,and test-retest reliability was 0.812,which demonstrated better internal consistency.The content validity index was 0.940.Factor analysis got three factors,which explain 47.059％ of the total variance.Conclusions The Chinese version of HCCQ has been proved to be reliable and valid.It can be used as a valid tool for the measurement of heart continuity in cardiac patients.

Designing of natural product-like compounds using natural products as template structures is an important strategy for the discovery of new drugs. Gambogic acid (GA), which is a Garcinia natural product with a unique caged xanthone scaffold, inhibits potent antitumor activity both in vitro and in vivo. This review summarized the researches on the identification of the antitumor pharmacophore of GA, and the design, structural optimization and structure-activity relationship (SAR) of natural product-like caged xanthones based on it.

To investigate the role of Egr-1 in the carcinogcnestic process of hepatocellular carcinoma (H-CC). Methods Expression of Egr-1 gene in HCC tissues were detected by in situ hybridization and immunohistochemistry. Human breast andmouse liver and brain tissues were used for control. ResultsLittle or no Egr-1 transcription was detected both in HCC tissues and in their normal counterparts. High transcription of Egr-1 was detected in the LCD and atrophic-like liver plate of HCC tissues. Protein expression of Egr-1 gene was consistent with mRNA transcription. High expression of Egr-1 protein was also detected in normal breast and mouse brain tissues. ConclusionsLittle or no expression of Egr-1 may play a role in the deregulation of normal growth in the carcinogenestic process of HCC. The differences of Egr-1 expression among liver cells, breast epithelia and mouse brain tissues might be associated with their different ways of proliferation and differentiation in different cell types.

Objective:To investigate the knowledge, attitude and practice status of ophthalmic nurses on prevention and control of intraocular infection in grade Ⅲ class A hospitals.Methods:A self-made questionnaire was used to investigate the knowledge, attitude and practice of 236 nurses on prevention and control of intraocular infection in the ophthalmology department of 8 grade Ⅲ class A hospitals in Zhengzhou from January to June 2020. The correlation between the knowledge, attitude and practice were analyzed by Pearson correlation analysis and the influencing factors of each term were analyzed by multivariate Logistic regression.Results:The scores of knowledge, attitude, practice of all nurses were (26.08 ± 2.46), (67.45 ± 8.48), (50.31 ± 6.67) points, and the scoring rate were (87.0 ± 8.2)%, (84.3 ± 10.1)%, (83.9 ± 9.8)%, respectively. The scores of each dimension of knowledge, attitude and practice were significantly positively correlated ( r values were 0.26-0.42, all P<0.05), respectively. Multivariate Logistic regression analysis showed that education background, professional title and training experience of infection were the influencing factors of knowledge score ( P<0.05), education background, professional title, training experience of infection and demand were the influencing factors of attitude score ( P<0.05), and nursing age and work post were the influencing factors of practice score ( P<0.05). Conclusions:The level of knowledge, attitude and practice of ophthalmic nurses in grade Ⅲ class A hospitals on prevention and control of intraocular infection is overall good. Hospital management department still needs to make reasonable management countermeasures according to personnel characteristics to improve the knowledge, attitude and practice level of ophthalmic nurses and to reduce post-operative intraocular infection.

Objective:To study the efficiency and difference of the artificial intelligence (AI) system based on fundus-reading in community and hospital scenarios in screening/diagnosing diabetic retinopathy (DR) among aged population, and further evaluate its application value.Methods:A combination of retrospective and prospective study. The clinical data of 1 608 elderly patients with diabetes were continuously treated in Henan Eye Hospital & Henan Eye Institute from July 2018 to March 2021, were collected. Among them, there were 659 males and 949 females; median age was 64 years old. From December 2018 to April 2019, 496 elderly diabetes patients were prospectively recruited in the community. Among them, there were 202 males and 294 female; median age was 62 years old. An ophthalmologist or a trained endocrinologist performed a non-mydriatic fundus color photographic examination in both eyes, and a 45° frontal radiograph was taken with the central fovea as the central posterior pole. The AI system was developed based on the deep learning YOLO source code, AI system based on the deep learning algorithm was applied in final diagnosis reporting by the"AI+manual-check" method. The diagnosis of DR were classified into 0-4 stage. The 2-4 stage patients were classified into referral DR group.Results:A total of 1 989 cases (94.5%, 1 989/2 104) were read by AI, of which 437 (88.1%, 437/496) and 1 552 (96.5%, 1 552/1 608) from the community and hospital, respectively. The reading rate of AI films from community sources was lower than that from hospital sources, and the difference was statistically significant ( χ2=51.612, P<0.001). The main reasons for poor image quality in the community were small pupil (47.1%, 24/51), cataract (19.6%, 10/51), and cataract combined with small pupil (21.6%, 11/51). The total negative rate of DR was 62.4% (1 241/1 989); among them, the community and hospital sources were 84.2% and 56.3%, respectively, and the AI diagnosis negative rate of community source was higher than that of hospital, and the difference was statistically significant ( χ2=113.108, P<0.001). AI diagnosis required referral to DR 20.2% (401/1 989). Among them, community and hospital sources were 6.4% and 24.0%, respectively. The rate of referral for DR for AI diagnosis from community sources was lower than that of hospitals, and the difference was statistically significant ( χ2=65.655, P<0.001). There was a statistically significant difference in the composition ratio of patients with different stages of DR diagnosed by AI from different sources ( χ2=13.435, P=0.001). Among them, community-derived patients were mainly DR without referral (52.2%, 36/69); hospital-derived patients were mainly DR requiring referral (54.9%, 373/679), and the detection rate of treated DR was higher (14.3%). The first rank of the order of the fundus lesions number automatically identified by AI was drusen (68.4%) and intraretinal hemorrhage (48.5%) in the communities and hospitals respectively. Conclusions:It is more suitable for early and negative DR screening for its high non-referral DR detection rate in the community. Whilst referral DR were mainly found in hospital scenario.

Objective:To observe the presence or absence of necroptosis in PC12 cells after radiation injury, and to detect the expression of receptor-interacting protein 3(RIP3) and evaluate its regulatory effect on necroptosis.Methods:PC12 cells were treated with different doses of irradiation and their necroptosis was detected by lactate dehydrogenase (LDH) release at different time points. After pretreatment with necroptosis inhibitor Necrostatin-1(Nec-1), the changes of cell necroptosis were detected by LDH. The expression level of RIP3 after irradiation intervention was detected by Western blot (WB). After pretreatment with the RIP3-specific inhibitor GSK′872, the changes of cell necroptosis were detected by LDH. The best transfection sequence of RIP3 knockout was screened by WB. The cells were divided into the control group, irradiation group, solvent control group, no-load control group and pretreatment group. WB, immunofluorescence staining, MTT, LDH and Annex V-fluorescein Isothiocyanate/Propidium Iodide (AnnexV-FITC/PI) flow cytometry were used for detection and analysis.Results:After 4 Gy irradiation, the degree of cell necrosis was the highest after 3 hours of culture, and the expression level of RIP3 protein was up-regulated. The cell necrosis was decreased after Nec-1, GSK′872 and RIP3 gene knockdown pretreatment.Conclusions:The radiation injury of 4 Gy can induce the necroptosis of PC12 cells, and the most significant effect can be observed when cultured for 3 hours after irradiation. RIP3 is involved in the process of necroptosis of PC12 cells induced by radiation injury, and plays a pivotal positive regulatory role.

OBJECTIVETo discuss the clinical features of perianal Crohn disease (PCD).

METHODSClinical data of 52 PCD patients who were treated at the Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to October 2014 were analyzed retrospectively. Montreal classification, clinical symptoms, the subtype of perianal lesions, history of perianal surgery and medical treatment, disease active indexes, serum inflammation markers and nutritional indexes were included.

RESULTSAmong 52 patients, there were 40 males and 12 females with a mean age of (27.9±9.1) years. According to Montreal classification, 51.9%(27/52) of patients had ileocolic involvement and 75.0%(39/52) had inflammatory disease behavior. Thirteen (25.0%) and 15(28.8%) patients had abdominal pain and diarrhea respectively at admission. With respect to the subtype of perianal lesions, there were 32(61.5%) cases of anal fistula and 16(30.8%) cases of perianal abscess. Thirty-nine(75.0%) and 33(63.5%) patients had a history of perianal surgery and medical treatment before admission resepectively. Laboratory findings revealed high C-reaction protein level in 63.5%(33/52), high erythrocyte sedimentation rate in 61.5%(32/52), elevated platelet in 32.7%(17/52), low body weight in 44.2%(23/52), low albumin in 26.9%(14/52) and anemia in 42.3%(22/52) of patients.

CONCLUSIONSThe clinical features of PCD patients include male predominant, early onset disease, high prevalence of ileocolic involvement and inflammation disease behavior. Features prompting underlying PCD diagnosis include characteristic gastrointestinal symptoms, requiring multiple perianal surgery, and abnormality of inflammation markers and nutritional indexes.