Objective To study the effect of FK506 pretreatment on endotoxin shock induced by LPS. Methods 155 mice of the Kunming strain were randomly divided into LPS group (n=80) and LPS|FK group (n=75). An endotoxin shock model of mice was reproduced by an intraperitoneal injection of LPS (25ml/kg for each mouse). Beginning from 2 days before the reproduction of the model, each mouse of the LPS+FK group were given 20ml/kg of FK506 q 12 h, by gastric gavage while animals of the LPS group were given an equal amount of 0.9% sodium chloride solution in the same way. The survival time of 20 mice of the LPS group and 15 mice of LPS+FK group was observed. 10 mice of each group were sacrificed at 0,0.5,2,4,6 and 8 hours after the injection of LPS, respectively. Blood samples were collected and serum TNF-? and IL-1?, contents, and activiry of ALT and AST were determined. The ratio of the wet weight and dry weight (W/D) of the lung was calculated, and the histopathology of the lung and the liver was studied. Results The mean survival time was longer and the 72h survival rate in mice of LPS+FK group was higher, but the serum ALT and AST activity and serum TNF-? and IL-1? contents were lower than those of LPS group at each time point. The W/D ratio of the lung in animals of both groups at 4,6 and 8 hours after the injection of LPS was greater than that at 0 hour (P

BACKGROUND: Nestin is a specific antigen of neural stem cells which widely expressed in lesion of nervous system and brain regeneration.Thus,nestin expression is commonly used to assess whether lesion or damage of the nervous system can promote neural regeneration.OBJECTIVE: To investigate the effects of erythropoietin(EPO)on nestin expression in neural stem cells after hypoxia-ischemia brain damage(HIBD)in neonatal rats from the angles of neural regeneration and activation of neural stem cells.METHODS: HIBD model was established by ligation of the right common carotid artery along with 2-hour 8% hypoxia exposure in neonatal rats.The control group was not subjected to hypoxia-ischemia,and the right common carotid artery was dissociated.The treatment group received an intraperitoneal injection of recombinant human erythropoietin(rh-Epo,5 000 IU/kg)once a day for three days after hypoxia/ischemia,while the two other groups intraperitoneally received normal saline at the same time.In each group,rats were randomly executed immediately,at 4,7,14 days after operation(n = 8).The nestin expression in hippocampal dentate gyrus region was examined by immunohistochemical staining and image quantitative analysis respectively.RESULTS AND CONCLUSION: The number of nestin-positive cells was significantly increased in HIBD group compared to control group at all time points(P < 0.05),and it was also significantly increased in treatment group than the other two groups at all time points(P < 0.05).The numbers of nestin-positive cells in hippocampal dentate gyrus region were significantly increased,and peaked on day 7 after operation in the three groups.The results showed that exogenous rh-Epo could enhance the expression of nestin in hippocampal dentate gyrus region of neonatal rats with HIBD,and promote the proliferation of neural stem cells,rh-Epo plays an important role in the regeneration and repair of neurocytes damaged by hypoxia-ischemia.

ObjectiveTo investigate the effects of platelet derived growth factor (PDGF) on brain cell apoptosis rate and serum neuron-specific enolase (NSE) concentration after hypoxic-ischemic brain damage (HIBD) in neonatal rats. MethodsForty-eight HIBD models of 7-day old neonatal Wistar rats were established and then divided into two groups randomly:PDGF group and normal saline control group (n =24 in each).Another 24 neonatal Wistar rats were taken into the sham operation group.The treatment group received intraperitoneal injection of PDGF-BB (50 ng/kg) once,while the other two groups received normal saline at the same time.In each group,rats were randomly sacrificed immediately at 12,24 and 72 hours after injection (n=8).The serum of rats were reserved for NSE concentration determination by enzyme linked immunosorbent assay,and the right brains of the sacrificed rats were used to prepare brain cell suspension for neurocyte apoptosis rate examination by flow cytometry.Mono-variate analysis and q-test were performed for statistical analysis. Results(1) The brain cell apoptotic rates of treatment group [ (6.09 ± 0.70)％,(9.67 ± 1.52) ％ and (14.15±1.52)％] and control group [(8.00± 1.10)％,(11.45±2.42)％ and (22.90±2.03) ％] were significantly increased compared to that of sham group [(2.11 ± 0.54)％,(2.34 ±0.46)％ and (2.21±0.49)％] at all time points (all P＜0.01 or ＜0.05),the apoptotic rate of treatment group was lower than that of control group (P＜0.01 or ＜0.05).Statistical differences were found among the three groups at 12,24 and 72 hours (F =39.01,66.60 and 194.20respectively; P＜0.01).(2) Serum NSE concentration was significantly increased in the treatment group [(8.43 ± 0.17) μg/L,(6.73 ± 0.16) μg/L and (6.12 ± 0.13) μg/L] and control group [(10.04±0.19) μg/L,(9.330.15) μg/L and (8.36 ± 0.16) μg/L] than in the sham group [(4.22±0.53) μg/L,(3.96±0.60) μg/L and (3.59±0.55) μg/L] at all time points,and it was significantly lower in treatment group than in control group (P＜ 0.01).Statistical difference was found among three groups at 12,24 and 72 hours (F=371.25,245.61 and 236.22 respectively,P＜0.01). ConclusionsPDGF might have neuroprotective effect,which could inhibit apoptosis of neural cells and decrease the serum NSE concentration.

Objective To investigate the efficacy and safety as well as the effects of rituximab on B-lymphocytes and anti-platelet glycoprotein-specific antibodies,in patients with steroid-resistant idiopathic thrombocytopenic purpura(ITP).Methods Twelve steroid-resistant ITP patients,16 to 54 years old,received intravenous rituximab at the dose of 375 mg/m2 once-weekly for 4 weeks.Lab studies included CBC,serum concentrations of IgG,IgM and IgA.CD+3,CD+4,CD+8,CD+19,CD+20 cell numbers were assayed by flow cytometry and anti-platelet glycoprotein-specific antibodies(GP Ⅱ b/Ⅲ a,GP Ⅰ b/Ⅸ)were assayed by monoclonal antibody-specific immobilisation of platelet antigens prior to and following rituximab therapy.Results A complete response(platelet counts ≥100×109/L)was observed in 4 cases,a partial response (platelet counts between 50 and 100×109/L)in 3 cases,a minor response(platelet counts between 30 and 50×109/L)in 2 cases,and non response(platelet counts＜30×109/L)in 3 cases.Responses were sustained 0.5 to 12 months(median 5 months).After 4 weeks of rituximab therapy,anti-platelet glycoprotein-specific antibodies(GP Ⅱ b/Ⅲ a,GP Ⅰ b/Ⅸ)disappeared except one NR patient and CD+19/CD+20 cells were almost depleted in all patients(295.0±86.4)×106/L vs(4.1±2.2)×106/L(P＜0.01).As expected,the T cell counts,and the serum concentrations of IgG,IgM and IgA were not changed after therapy.No severe side effects were observed.Conclusion Rituximab may be an effective and safe treatment for adults with steroid-resistant ITP.

Objective To develop training program of evidence implementation(EI) based on PARIHS model and to evaluate the effectiveness on clinical nurses for evidence-based nursing knowledge,attitudes and ability,and to understand the evaluation of participants about the methodological training.Methods A quasi-experiment design was conducted.A 6-month comprehensive evidence implementation training program was developed including methodological lecture,group discussion,EI case analysis,EI project development and implementation,and was carried out among 44 clinical nurses from 11 tertiary hospitals in Shanghai.The participants' EBN knowledge,attitudes and ability were measured by EBN knowledge,attitudes and ability questionnaire at 3 months and 6 months after training.Results Participants' EBN knowledge and ability were significantly improved at 3 months and 6 months after training(P＜0.05),and participants' EBN attitude had no significant difference before and after training (P＞0.05).The level of training satisfaction among participants was higher than 80.0％,and participants had finished 22 evidence implementation programs.Conclusion Evidence implementation training based on PARIHS can enhance clinical nurses' EBN knowledge and ability.Participants' EBN attitude hasn't been significantly improved.Participants have high satisfaction towards methodological training.

Objective To establish WeChat official account-based platform for evidence dissemination,and to evaluate the effects of the platform.Methods The WeChat official account-based platform for evidence dissemination was established,and big data analysis and sampling survey were adopted to analyze information and its communication effects published from December,2014 to September,2016.Results Totally 22 369 followers used the platform and conducted 404 232 hits on its pages in total.The most frequent searches were Evidence and Knowledge of evidence-based nursing.The WeChat Communication Index was 433.07.The overall evaluation score was 4.34± 0.67.Conclusion WeChat official account-based platform for evidence dissemination can promote the accessibility of evidence and receives high evaluation score from followers.

Objective To investigate the polymorphism of human cytomegalovius UL143 gene of low passage clinical isolates in Guangzhou,China.Method PCR was performed to amplify the entire HCMV ULl43 gene region of 3 clinical isolates,which had been proven by multiplex PCR.The amplification products were cloned into pMD18-T-Vector and subjected to sequencing.The result of DNA sequences were analyzed together with the one of published homologous sequences in GenBank from 14 clinical isolates.Result There were several stop codons in UL143 gene due to a base deletion in open reading frame (ORF) of D3 isolate,which could lead to produce non-functional protein.UL143 ORF of Toledo isolate consisted of 279 nueleotides,encoding a protein with 92 amino acids.UL143 ORFs of other isolates consisted of 252 nueleotides,encoding a protein with 83 amino acids.The DNA sequences were quite conserved and all the variations were base substitution.The amino acid sequences of different isolates were highly conserved.with variation of 1.2%-2.4%.There were no additional or deleted sites of post translational modification of UL143 protein in all clinical isolates except Toledo isolate.There were some differences in the secondary structure among different isolates.The isoelectric point of UL143 protein of all clinical isolates except Toledo isolate was 8.75.Conclusion All DNA and deduced amino acid sequences of UL143 gene shared great similarity among HCMV clinical strains regardless of their polymorphism.

Objective:To investigate the risk factors for progression to castration-resistant prostate cancer (CRPC) in metastatic prostate cancer (mPCa) patients who underwent androgen deprivation therapy (ADT).Methods:One hunred mPCa patients underwent ADT were followed up from January 2014 to December 2020 in the Affiliated Central Hospital of Shenyang Medical University. Retrospective analyze the patient′s Gleason score, initial PSA value, minimum prostate specific antigen (nPSA) and time when PSA drops to the lowest point (TTN), and record the state of lymph node metastasis and bone metastasis. Single factor Kaplan-Meier analysis and multivariate Cox regression analysis were used to explore the related risk factors affecting the progress of CRPC.Results:A total of 82 cases (82%) of ADT patients progressed to CRPC. Univariate Kaplan-Meier analysis showed that Gleason score, PSA initial value, lowest nPSA and time to TTN, lymph node metastasis and bone metastasis are risk factors for CRPC ( P<0.01 or<0.05); Multivariate Cox regression analysis showed that Gleason score, initial PSA value, nPSA and TTN are independent risk factors for PCa patients to progress to CRPC ( P<0.01 or<0.05). Conclusions:This study demonstrated that Gleason score, lymph node metastasis, bone metastasis, initial PSA value, nPSA and TTN are risk factors for the progression of CRPC. Patients with higher Gleason grade, higher nPSA, shorter TTN, lymph node and bone metastasis have shorter PFS and higher risk of progression to CRPC.

Objective:To investigate the effect of three-dimensional printing technique assisted knee arthroplasty in the treatment of knee osteoarthritis with extraarticular deformities.Methods:Twelve patients with knee osteoarthritis and extraarticular deformities in the Sixth People's Hospital of Fuyang were selected as the study subjects from January 2016 to June 2018, and all patients were treated with total knee arthroplasty assisted by 3D printing.The operation time, intraoperative blood loss, preoperative simulated osteotomy value, intraoperative osteotomy value, postoperative drainage volume, joint activity score and Hospital for Special Surgery (HSS) score before treatment, 6 months after replacement and at the last follow-up were observed.Results:The intraoperative blood loss of patients was an average of (389.9±32.6)mL, and the drainage volume of patients was an average of (405.2±85.4)mL.There were no statistically significant difference between preoperative analogue value and intraoperative osteotomy value (all P>0.05). The HSS score ( P<0.001) and knee joint mobility ( P<0.001) were significantly higher at 6 months after operation and the last follow-up, and the mechanical axis deviation of lower limbs was significantly lower than that before operation ( P<0.001). Conclusion:Treatment of knee osteoarthritis with extra-articular deformity by using 3D printing assisted technique can restore the lower limbs and promote the recovery of knee joint function, which has satisfactory short-term effect and deserves further study and discussion.

OBJECTIVE: Discuss the working ideas of the dynamic adjustment mechanism of medical device classification in the United States, and provide reference for the construction of medical device related mechanisms in China. METHODS: Collect and interpret the documents of regulatory background, procedures and orders of the dynamic adjustment mechanism of the medical device classification in the United States, and summarize the overall situation and specific cases of the medical device classification adjustment under this mechanism in recent years. RESULTS: The US work idea of the medical device classification dynamic adjustment mechanism is based on the latest valid scientific evidence, conducting risk analysis and identification, and determining the corresponding measures. CONCLUSIONS During the adjustment process, industry stakeholders have repeatedly discussed and achieved final agreement. Its procedures and working ideas can be used as a reference for China's work.
China ; United States ; United States Food and Drug Administration