This experimental study was aimed to find the effect of different package and storage conditions on the content of effective components of A stragalus pieces. A stragalus pieces were stored under different storage conditions by using different packaging materials and packaging methods. Every three months, the contents of Calycosin-7-glu-coside and astragaloside were determined according to the 2010 version of Chinese Pharmacopoeia. With the extend-edstorage time, the contents of two effective components were significantly decreased. After six-monthstorage, the contents were not consistent with the standard of the pharmacopoeia standards. Room temperature had relatively big influence on the loss of content. The plastic and aluminum paperpackagingwere better than kraft paper packaging. The content ofastragaloside using non vacuum packaging method was relatively higher than the vacuum packaging. Contentunder the conditions of cool storehouse and nonvacuum plastic bags was higher than other packagingmethod. And the changes of both contents were relatively stable. It was concluded that the A stragaluspieces should be packed with non vacuum plastic bags, and stored in a cool and dry place.

Objective To compare the effect of nursing students acting as social volunteers to participate in gerontological nursing practice teaching with traditional practice teaching mode, and promote the reform of teaching mode in nursing practice. Methods Students of two classes from department of nursing, medical college of Wuhan University of Science and Technology were selected as research objects. In class one nursing students acted as social volunteers to participate in gerontological nursing practice teaching (the experimental group), In class two nursing students took practice in geriatric wards according to traditional practice mode(the control group). The practice effect was compared between two groups. Results The average final grade of the experimental group was 86.50, and 78.51 in the control group. Ridit analysis revealed that, setting class one as the experimental group, R=0.796 8,95% confidence interval was 0.715 1-0.878 4, in the control group, R =0.500 0. The investigation showed that the experimental group and the control group were different in moral elevation aspect, teaching level, capability improving aspect and employment promotion aspect, the difference was significant (P<0.01). Conclusions The mode of nursing students acting as social volunteers to participate in gerontological nursing practice teaching has advantage over traditional practice teaching, and it can gain satisfying teaching effect.

Objective　To compare the endocytic routes of exogenous antigen between murine dendritic cells (DCs) and macrophages (Mφs). Methods　Murine bone marrow-derived DCs and peritoneal Mφs were pulsed with horseradish peroxidase (HRP)-5 nm colloidal gold for 10 minutes, then grouped and chased for 0-120 minutes in culture medium. Intracellular distribution of 5 nm colloidal gold was explored by means of the cellular enzymatic-chemistry of acid phosphatase and MHC Ⅱ immuno-cytochemistry under electron microscope. Results　After 10 minutes of pulse with HRP-5 nm colloidal gold and 30 minutes of chase, most HRP-5 nm gold particles internalized by DCs entered into MHC class Ⅱ compartments (MⅡCs), and a small portion entered into acid phosphatase-positive lysosomes. In contrast to DCs, most Mφs lysosomes were accessed by HRP-5 nm gold particles, and a small portion of HRP-5 nm gold particles entered into MⅡCs. After 60 minutes of chase, 5 nm gold particles could hardly be seen within Mφs, whereas most 5 nm gold particles were still retained in DCs. Conclusions　The endocytic route of exogenous antigen in DCs seems to be different from that in Mφs. Antigens taken by Mφs mainly enter into lysosomes within 30 minutes. In the case of DCs, most internalized antigens enter into MⅡCs, which may be related to their unique antigen-presenting function . In addition, Mφs seem to have more powerful capacity to scavenge exogenous antigen than DCs.

Objective To investigate the effect and molecular mechanism of safflower yellow(SY)on wound healing of diabetic foot ulcer(DFU)in mice.Methods Forty-five C57BL/6 mice were injected intraperitoneally with streptozotocin to establish diabetic models.The diabetic mice were randomly divided into the sham operation group,model group,low-dose SY intervention group,high-dose SY intervention group,and high-dose SY combined with insulin-like growth factor-1(IGF-1)group,with 9 mice in each group.Before modelling,mice in the model group were not given any intervention,mice in the low-dose SY intervention group and high-dose SY intervention group were injected intraperitoneally with 5 and 20 mg·kg-1 SY,respectively,and mice in the high-dose SY combined with IGF-1 group were injected intraperitoneally with 20 mg·kg-1 SY and 0.03 mg·kg-1 IGF-1.Except for the sham operation group,the DFU model was established by incising the dorsal skin of the foot in the remaining four groups of mice.No wound on the dorsal skin of the foot was made in the sham operation group,and the remaining surgical steps were the same as those in the model group.The body mass of mice in each group was measured on day 14 after modelling using an electronic scale,tail vein blood was collected for fasting blood glucose measurement,and the wound width was measured using a small vernier caliper.Then,the mice were executed to collect the wound tissues.Hematoxylin-eosin staining was used to detect the histopathological changes in the wound tissues of mice in each group.Reverse transcription-quantitative real-time polymerase chain reaction was used to measure the relative expression levels of platelet-derived growth factor(PDGF),vascular endothelial growth factor(VEGF),alpha-smooth muscle actin(α-SMA),type Ⅰ collagen(collagen Ⅰ),protein tyrosine phosphatase 1B(PTP1B)and advanced glycation end products(AGEs)mRNA in the wound tissues of mice in each group.Western blot was used to detect the relative expression levels of proliferation marker Ki-67,proliferating cell nuclear antigen(PCNA),apoptosis-associated proteins(caspase-3,caspase-6,and caspase-7),p85 phosphatidylinositol-3-kinase(PI3K)and phosphorylated protein kinase B(p-AKT)protein in the wound tissues of mice in each group.Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,and IL-6 in the wound tissues of mice in each group.Results The differences in blood glucose and body mass of mice among the sham operation group,model group,low-dose SY intervention group,high-dose SY intervention group,and high-dose SY combined with IGF-1 group were not statistically significant(P＞0.05).The healing rate of wound tissues in the high-dose SY intervention group was significantly greater than that in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01).There was no statistically significant difference in the healing rate of wound tissues among the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＞0.05).In the high-dose SY intervention group,a large number of collagen fibers were densely and orderly arranged in the wound tissues,accompanied by a large number of neovessels;in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group,the wound tissues were sparsely populated with collagen fibers,accompanied by a small number of neovessels.The relative expression levels of PDGF,VEGF,α-SMA and collagen Ⅰ mRNA in the wound tissues of mice in the high-dose SY intervention group were significantly higher than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01);the relative expression levels of PTP1B and AGEs mRNA in the wound tissues of mice in the high-dose SY intervention group were significantly lower than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01).The relative expression levels of PDGF,VEGF,α-SMA,collagen Ⅰ,PTP1B and AGEs mRNA showed no statistically significant difference among the model,low-dose SY intervention,and high-dose SY combined with IGF-1 groups(P＞0.05).The relative expression levels of Ki-67 and PCNA protein in the wound tissues of mice in the high-dose SY intervention group were significantly higher than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01);the relative expre-ssion levels of caspase-3,caspase-6,caspase-7,p85 PI3K,and p-AKT protein were significantly lower than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01).There was no statistically significant difference in the relative expression levels of Ki-67,PCNA,caspase-3,caspase-6,caspase-7,p85 PI3K and p-AKT protein among the model,low-dose SY intervention,and high-dose SY combined with IGF-1 groups(P＞0.05).The levels of TNF-α,IL-1β and IL-6 in the wound tissues of mice in the high-dose SY intervention group were significantly lower than those in the model,low-dose SY intervention,and high-dose SY combined with IGF-1 groups(P＜0.01).There was no statistically significant difference in the levels of TNF-α,IL-1β and IL-6 in the wound tissues of mice in the model,low-dose SY intervention and high-dose SY combined with IGF-1 groups(P＞0.05).Conclusion High-dose SY intervention promotes DFU wound healing in mice by increasing angiogenesis,collagen formation and cell proliferation and reducing insulin resistance,inflammatory response and cell apoptosis,which may be related to the inhibition of the PI3K/AKT pathway.

Objective:To analyze the characteristics of accidental injury death among Chinese population from 2005 to 2021 and predict its trends from 2022 to 2031.Methods:Based on the China Death Surveillance Database, the accidental injury death data of Chinese population from 2005 to 2021 were collected. The overall accidental injury death of Chinese population during the period was calculated, such as crude mortality rate and standardized mortality rate. A Joinpoint regression model was applied to calculate the standardized mortality rate including the annual percentage change (APC) and average annual percentage change (AAPC) of accidental injury death among Chinese population of different genders, in urban and rural areas, age groups and eastern, central and western regions from 2005 to 2021. The standardized mortality rate of accidental injuries among Chinese population from 2022 to 2031 was predicted by using the exponential smoothing method. Results:From 2005 to 2021, the crude mortality rate of accidental injury among Chinese population decreased from 45.96/100 000 in 2005 to 39.97/100 000 in 2021, with the standardized mortality rate decreasing from 50.20/100 000 in 2005 to 30.74/100 000 in 2021, which showed a monotonous downward trend (APC=AAPC=-2.63, P<0.01). From 2005 to 2021, the standardized mortality rate of accidental injury in males was higher than that in females, showing a downward trend in both males and females (AAPC male=-2.85, AAPC female=-2.17, P<0.01) . From 2005 to 2021, the standardized mortality rate of accidental injury in rural population was higher than that in urban population, showing a downward trend in both urban and rural population (AAPC city=-2.39, P<0.01; AAPC rural=-2.58, P<0.05). From 2005 to 2021, the standardized mortality rate of accidental injury in Chinese population mainly fell in the age group of 15-44 years. From 2005 to 2021, the standardized mortality rate of accidental injury in the western region was higher than that in the eastern and central regions and there was an inflection point from up to down in the standardized mortality rate of accidental injury in the western and central regions in 2011. As the forecasting results showed, the standardized mortality rate of accidental injury among Chinese population would be reduced from 30.26/100, 000 to 20.93/100, 000 from 2022 to 2031. Conclusions:The standardized mortality rate of accidental injury among Chinese population from 2005 to 2021 shows a downward trend. Moreover, the male, rural, young and middle-aged population and population in the western region are still the key groups needing prevention of accidental injuries. There will also be a downward trend in the standardized mortality rate of accidental injuries in Chinese population from 2022 to 2031.

Brain glucose metabolism disorder is one of the pathophysiological features of Alzheimer's disease (AD), in which aerobic glycolysis (Warburg effect) metabolic pathway abnormality is one of the causes of early cognitive impairment in AD, and improving brain energy metabolism has become an important strategy to prevent AD. AMP-activated protein kinase (AMPK) is a central hub regulating glucose metabolism, the most sensitive molecular compound for sensing fluctuations of energy levels in the body. Activation of AMPK can affect the Warburg effect and its key rate-limiting enzyme activity, regulate brain glucose metabolism involved in the pathogenesis of AD, to achieve the purpose of delaying AD progression and improving cognitive function in early clinical stage. In this review, we will discuss the pathogenesis of AD and targeting of AMPK from the perspective of Warburg effect in glucose metabolism.

Objective:To explore the current status of clinical teaching staff for the graduate program of master of nursing specialist (abbreviated to nursing masters) in traditional Chinese medicine (TCM) universities and compare it with the role expectations of students, aiming to provide a reference for the subsequent construction and improvement of clinical teaching staff.Methods:Totally 172 nursing masters from Jiangsu, Zhejiang, Henan provinces and Tianjin and 86 clinical teaching staff from the hospitals where they practiced were selected using convenient samping and investigated with the self-made questionnaire from October to December 2018. The differences between clinical teaching staff's resources, abilities and students' expectations were compared. A total of 258 questionnaires were distributed among 86 clinical teachers and 172 nursing masters, and 258 valid questionnaires were recovered, with an effective rate of 100%. SPSS 22.0 software was used for statistical analysis of data.Results:There was a certain gap between the clinical teaching staff and students' expectations, especially in terms of the graduate school and academic qualifications of the clinical teachers. Totally 34.88% (30/86) of the clinical teachers graduated from TCM universities, while 71.51% (123/172) of the students expected to be taught by teachers graduating from TCM universities. Among the clinical teachers, 60.47% (52/86) were undergraduates, and fewer were masters or graduates with higher education. There was a certain difference between the teaching teachers' abilities and students' expectations. There were statistically significant differences in 17 secondary indicators (χ 2 were 12.027-130.149, P<0.05) , except for the professional attitude in clinical nursing abilities, decision-making abilities in clinical management abilities, communication abilities in interpersonal abilities, and collaboration abilities ( P>0.05) . There were statistically significant differences between students' current status and their learning needs for TCM nursing (χ 2 were 14.722-165.339, P<0.01) . TCM nursing skills and practical application of TCM nursing research were the contents that most students wanted to learn, accounting for 83.72% (144/172) and 70.35% (151/172) , respectively. Conclusions:There were differences between the current status of the teaching staff for nursing masters at TCM universities and the expectations of the students. The universities should fully consider the graduates' own expectations and needs based on the training objectives for graduates, actively explore the admission system for clinical teachers, improve the training system for teachers, and standardize the teaching evaluation mechanism based on the status quo of nursing talents in China.

Lambert-Eaton myasthenic syndrome(LEMS)is an immune-mediated disorder involving neuromuscular junctions,characterized by muscle weakness,autonomic dysfunction,and reduced tendon reflexes.We report a LEMS case presented initially with dizziness and ataxia,followed by eyelid ptosis.Repetitive nerve stimulation revealed low frequency decreasing and high frequency increasing.P/Q type Voltage-gated calcium channels(VGCC)antibody was positive.Chest CT showed pulmonary nodules and enlarged mediastinal lymph nodes which were pathologically confirmed as small cell lung cancer.Given that ataxia is also an important manifestation of LEMS,the case report intends to increase the awareness of LEMS-related ataxia among neurologists to avoid misdiagnosis.

To evaluate the cardiotoxicity of three novel proteasome inhibitors(NNU395, NNU458 and NNU459)in zebrafish, normal developmental zebrafish embryos at 6 hours post fertilization(hpf)were treated with different doses of NNU395 and NNU458 and NNU459 until 72 hpf, the zebrafish mortality was counted. Morphologic changes of the cardiovascular system were observed under a stereomicroscope, and the number of heart beats within 1 min was determined. The expression of cardiac development-related genes in zebrafish was detected by RT-qPCR(Quantitative Real-Time PCR). Results showed that NNU395, NNU458 and NNU459 increased the mortality of zebrafish in a concentration-dependent manner and the values of LC50(50% lethal concentration)were(179. 7±12. 2), (27. 5±1. 3)and(24. 4±2. 6)μmol/L, respectively. Moreover, the toxicity of our three compounds in zebrafish are less when compared with their modified precursors. Upon administration of NNU395 at the concentrations of 120- 200 μmol/L, and NNU458 or NNU459 at the concentration of 30 μmol/L, the zebrafish showed obvious pericardial edema cardiac malformation. 120- 200 μmol/L NNU395 and 0. 1- 30 μmol/L NNU458 or 10- 30 μmol/L NNU459 significantly reduced the heart rate of zebrafish. All of three compounds at the tested concentration had no significant effects on the expression of the heart development-related genes in zebrafish. Our results suggested that low concentrations of NNU395, NNU458 and NNU459 have no obvious toxicity on cardiac development of zebrafish. While, higher concentrations of them showed cardiovascular toxicity on zebrafish.

Objective To study the effect of baseline clinical characteristics of elderly female patients on their long-term ischemic cardiovascular events.Methods Of the 614elderly patients admitted to our center from April 2008to July 2010,144elderly female patients were divided into female cardiovascular events group(n=43)and female control group(n=101),470elderly male patients were divided into male cardiovascular events group(n=127)and male control group(n= 343).Their baseline clinical characteristics were compared.The patients were followed up for 4.5-6.7(5.6±0.9)years,during which the relationship between first ever acute ischemic cardiovascular events and their clinical factors were analyzed.Results The incidence of grade 2hypertension,grade 3hypertension and hypercholesterolemia,the ratios of antiplatelet drug therapy,CCB therapy and hypoglycemic drug therapy were significantly higher while the history of smoking was significantly shorter,the incidence of chronic renal insufficiency and the ratios of statins therapy,nitrates therapy and ACEI/ARB therapy were significantly lower in female patients than in male patients.The incidence of chronic renal insufficiency was significantly higher in female cardiovascular events group than in female control group(9.3％vs 1.0％,P=0.03).The age was significantly older,the incidence of CHD,ischemic cerebral stroke,chronic obstructive pulmonary disease and the ratio of nitrates therapy were significantly higher in male cardiovascular events group than in male control group.Cox multivariate regression analysis showed that the endpoint events were related with CHD,grade 2hypertension,grade 3hypertension,hypercholesterolemia,chronic renal insufficiency in female patients(HR=2.56,95％CI:1.19-5.54,P=0.017;HR=3.29,95％ CI:1.14-9.52,P=0.028;HR=2.77,95％CI:1.08-7.12,P=0.034;HR=2.61,95％CI:1.27-5.36,P=0.009;HR=22.70,95％CI:5.22-98.78,P=0.000)and were related with age,CHD and ischemic cerebral stroke in male patients(P＜0.05,P＜0.01).Conclusion The effect of baseline clinical characteristics of elderly patients on their long-term ischemic cardiovascular events is different in males and females.The incidence of long-term cardiovascular events is closely related with the risk factors for cardiovascular disease in elderly females.