Objective To explore the expression of Akt in peripheral blood mononuclear cells (PBMCs) and its regulatory role on its downstream molecules forkhead box transcription factor O1 (FOXO1) and Bim in patients with systemic lupus erythematosus (SLE).The role of Akt/FOXO1/Bim signaling pathway on PBMCs apoptosis was clarified.Methods Sixty-three SLE patients and 23 healthy controls were enrolled.PBMC were separated from the peripheral blood specimen.Western blot technique was applied to analyze the expression of Akt,FOXO1 and Bim.Flow cytometry was applied to analyze PBMCs apoptosis.The t-test was used for statistical analysis.Results The apoptosis of PBMCs in patients with active SLE [(16.3±4.0)％] was significantly higher than that of patients with inactive SLE [(5.6 ±2.9)％] and normal controls [(5.2 ±4.2)％,t=4.83,5.05;P＜0.05].The levels of phosphorylation of Akt,FOXO1 and Bim expression was significantly decreased in patients with active SLE as compared with controls and patients with inactive SLE (P＜0.05).However,these indicators had no significant difference between the controls and patients with inactive SLE (P＞0.05).Conclusion ① The results of this study suggest that the expression level of Akt may be a good indicator for disease activity of SLE.Decrease of Akt may promote the occurrence and development of SLE.② Akt activity decline may lead to increased apoptosis of PBMCs.In this process,Akt may regulate its downstream FOXO1 and Bim phosphorylation levels which can enhance their ability to pro-apoptotic.

Objective:To study the effects of group counseling which based on interpersonal activities and aimed at the college students with computer gaming addiction in China.Methods:Seventeen college students with computer game addiction were chosen as the experimental group,and 10 college students from another college were chosen as the control group.The two groups had no difference in the scores of Computer Gaming Addiction Invention(CGAI)and several other scales before group counseling.There were a pre-test and a post-test separately set when the group counseling was started and finished,focused on CGAI and negative emotions and cognitions.Results:In post-test,the score of CGAI in experimental group was significantly lower than that in control group[(92.6±16.7)vs.(105.9±13.0)] and lower than that in pre-test(98.9±16.4)by analysis of covariance(Ps<0.01).The scores of Beck Depression Inventory(BDI),Self-Rating Anxiety Scale(SAS),and the negative cognition of oneself in socical settings in experimental group were also lower than those in control group [(6.4±7.9)vs.(13.5±5.6),(39.7±6.4)vs.(49.9±10.3),(15.1±4.3)vs.(19.9±3.0),Ps<0.01],while the score of Rosenberg Self-Esteem Scale(SES)was higher than that of the control group [(29.3±2.9)vs.(24.6±4.8),P<0.01].Conclusion:Group counseling based on interpersonal activities has obvious effects on the college students with computer gaming addiction.

ObjectiveTo investigate the risk factors of preterm birth, as well as the clinical characteristics in dichorionic diamniotic (DCDA) twins and monochorionic diamniotic (MCDA) twins. MethodsA retrospective study was conducted on 290 premature cases out of 363 twin pregnancies who delivered alive babies in the First Affiliated Hospital, Sun Yat-sen University from September 2012 to March 2015. The selected cases, including 219 cases of DCDA and 71 cases of MCDA,were divided into three groups according to their gestational age at delivery: 28-31+6, 32-33+6 and 34-36+6 weeks. The clinical features, causes and risk factors were described between these three groups. Analysis of variance,Chi-square test and multi-variant Logistic regression were used for statistical analysis.ResultsThe incidence of premature delivery in twin pregnancies was 79.9% (290/363), while this figure was lower in DCDA twins than in MCDA [76.3%(219/287) vs 93.4%(71/76),χ2=10.955,P=0.001]. The three leading causes of preterm birth in DCDA twins were gestational age≥36 weeks (33.8%, 74/219), preterm labor (30.6%, 67/219) and preterm premature rupture of membrane (PPROM) (8.7%, 19/219), while in MCDA twins were preterm labor (31.0%, 22/71), selective intrauterine growth restriction (21.1%, 15/71) and gestational age≥36 weeks (19.7%, 14/71). Logistic regression analysis showed that the independent risk factors of preterm birth in twins at 28-31+6 weeks was PPROM (OR=2.390, 95%CI: 1.006-5.872,P=0.043), and for those twins at 32-33+6 weeks, the independent risk factors were MCDA (OR=2.758, 95%CI: 1.243-6.118,P=0.013), preeclampsia (OR=12.176, 95%CI:4.685-31.642,P=0.000), PPROM (OR=5.348, 95%CI: 2.151-13.294,P=0.000) and preterm labor (OR=3.274, 95%CI:1.453-7.375,P=0.004). MCDA (OR=3.666, 95%CI: 1.364-9.585,P=0.010) and preeclampsia (OR=8.086, 95%CI:1.044-62.617,P=0.045) were the risk factors in the group of 34-36+6 weeks.ConclusionsAlthough preterm birth in MCDA and DCDA twins is due to different reasons, the former has a higher incidence than the latter. The risk factors of premature delivery at different gestations are also different.

Objecitve:To investigate effects of urotensin Ⅱ( UⅡ)/UT system on innate immune inflammatory signal pathway TLR4-IRF3 in the lipopolysaccharide (LPS)-stimulated Kupffer cells (KCs).Methods: Rat KCs were isolated and cultured.Pro-in-flammatory cytokines including IL-6,IFN-βand IFN-γwere assayed by ELISA in culture supernatant of KCs.Cell surface TLR4 were tested with flow cytometry technique.Expression of IRF3 were tested with real-time PCR and Western blot.Results: Significant increases were showed in IL-6, IFN-βand IFN-γsecretion, TLR4-expressed positive rates and IRF3 mRNA levels in KCs after stimulated by LPS,but were inhibited via urantide pretreatment.In addition,LPS induced upregulation of nuclear IRF3 protein and downregulation of cytoplasm IRF3 protein in KCs,which were blocked by urantide pretreatment.Conclusion:UⅡ/UT system mediates immune inflammatory response in part through activating TLR 4-IRF3 pathway in LPS-stimulated KCs.

Objective:To observe the efficacy of gentle moxibustion combined with Western medicine in treating rheumatoid arthritis(RA)due to damp heat affecting bones/joints to further certificate the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy". Methods:A total of 78 patients with RA due to damp heat affecting bones/joints were divided into an observation group and a control group using the random number table method,with 39 cases in each group.The control group was treated with regular Western medicine,on the basic of which the observation group was treated with additional gentle moxibustion.Patients in the observation group received gentle moxibustion therapy once a day for 8 weeks with a one-day rest every 2 weeks.The wrist circumference,wrist pain degree,skin color and temperature of the wrist,and range of dorsiflexion motion of the wrist in the two groups of patients were compared before and after treatment under the condition of safety observed. Results:The total effective rate in the observation group was 94.9%,which was higher than the result of 79.5%in the control group(P<0.05).Among the quantitative indicators of syndrome differentiation,the wrist circumference,pain degree,skin temperature,and range of dorsiflexion motion in both groups were significantly improved(P<0.01),and the improvements were more significant in the observation group than in the control group(P<0.05).The skin color of the wrist joint was improved in both groups after treatment(P<0.05),and there was no statistical significance in comparing the improvement of skin color and the occurrence of adverse reactions between the two groups(P>0.05). Conclusion:Compared with Western medicine treatment alone,the combination of gentle moxibustion and Western medicine treatment has significantly better treatment efficacy and shares high safety,which helps to prove the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy".

Objective:To explore the effectiveness of the Exowalk gait training robot in improving the walking ability of stroke survivors.Methods:Forty stroke survivors were randomly divided into a control group and an experimental group, each of 20. In their rehabilitation, the control group was given routine walking training, while the experimental group′s training was assisted with the Exowalk robot. Both groups trained for 60 minutes a day, five days a week for four weeks. Before as well as after 2 and 4 weeks of training functional ambulatory categories (FACs), the Berg balance scale (BBS), the 6-minute walking test (6MWT), the 10-minute walking test (10MWT), the Rivermead mobility index and an exercise index were used to evaluate those in both groups.Results:After 2 weeks significant improvement was observed in the average FAC, BBS, 6MWT and 10MWT results of both groups, without significant differences between them. After 4 weeks there was still no significant difference in the groups′ average BBS scores. However, the average FAC rating in the experimental group had improved significantly while there was no significant increase in the control group′s average score.Conclusions:The Exowalk robot can help to improve the balance and walking ability of hemiplegic stroke survivors.

Objective To explore the effect of transcutaneous electrical acupoint stimulation bracelet at Neiguan acupoint on the postoperative nausea and vomiting after thyroidectomy under general an-esthesia.Methods Seventy-two female patients underwent thyroidectomy,aged 18-50 years,ASA physical status Ⅰ or Ⅱ,were enrolled.The patients were assigned 1 ∶ 1 to two groups by permuted block randomization:the electrical stimulation group and the control group,36 patients in each group.Before an-esthesia induction,patients in both groups wore domestic transcutaneous electrical acupoint stimulation bracelets,and the electrodes were aimed at Neiguan acupoint.The electrical stimulation group started to stimulate Neiguan acupoint,and adjusted the proper intensity to make the patient feel tingling in the related area of the hand.When the bracelet was fixed firmly,turned it off.At the end of the operation,the bracelet was turned on with the stimulation intensity set before induction for 24 hours.Patients in the control group also wore the bracelet for 24 hours,but it was never turned on.The number of cases of postoperative nausea and vomiting(PONV)and the number of remedial cases of antiemetic drugs were recorded.Results Compared with the control group,the incidence of PONV and postoperative vomiting in the electrical stimula-tion group were significantly reduced within 24 hours after surgery(P＜0.05),and the differences were mainly in 1-6 hours after surgery(P＜0.05).There was no significant difference in the rate of remedial ca-ses of antiemetic drugs between the two groups at different time periods.Conclusion Transcutaneous electri-cal stimulation bracelet at Neiguan acupoint can effectively reduce the incidence of PONV within 24 hours after thyroidectomy.

Objective: To construct evaluation index system of nursing quality in day operation center and to provide the basis for scientific and objective evaluation of nursing quality in day operation center. Methods: Based on Donabedian quality model as the theoretical framework, the evaluation index system of nursing quality in day operation center was constructed by applying literature research, process tracking, hierarchical analysis and Delphi expert letter. Results: The recovery rate of RR for two rounds of questionnaire was 94.12% and 100.00%. The expert authority coefficient Cr values were 0.816/0.857 respectively. The W value of the coordination coefficient was 0.335/0.381, both of which were statistically significant (P < 0.01). Finally, an evaluation index system of quality of assisted fertility treatment care with 3 dimensions, 12 secondary indicators and 48 items was formed. Yaaph software was used to determine the weight coefficients of primary and secondary indicators, and the consistency test (CR<0.1) was performed, and the variation coefficients of all tertiary items were <0.17. Conclusion The weight distribution of the nursing quality index system in day operation center is reasonable, the index entry is clear, and it is scientific and practical.

ObjectiveTo investigate the efficacy and safety of Shengxiantang in the treatment of early Parkinson's disease with autonomic dysfunction of Qi deficiency pattern. MethodA total of 82 eligible patients were randomized into control group （41 cases） and traditional Chinese medicine （TCM） group （41 cases）. On the basis of standardized treatment of western medicine， TCM group was prescribed Shengxiantang while control group were treated with placebo for 12 consecutive weeks additionally. Scale for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT） questionnaire， Unified Parkinson's Disease Rating Scale （UPDRS）， Traditional Chinese Medicine Qi Deficiency Symptom Score of Parkinson's Disease （TCMQDSSPD）， serum levels of glutathione peroxidase （GPx） and superoxide dismutase （SOD）， daily dosage of pramipexole and levodopa and benserazide hydrochloride， and safety index were evaluated both before and after treatment. ResultAfter treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the control group were higher than those before treatment （P<0.01）， while the above sores in the TCM group were lower than those before treatment （P<0.05， P<0.01）. In addition， the cardiovascular score， pupillomotor score， and sexual score in two groups showed no significant difference from those before treatment. After treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the TCM group were lower than those in the control group （P<0.05， P<0.01）， and cardiovascular score， pupillomotor score， and sexual score showed no significant difference between two groups. After treatment， the total score of TCMQDSSPD， main symptom scores， and minor symptom scores in the control group had no significant difference from those before treatment. The total score of TCMQDSSPD and minor symptom scores of TCM group were lower than those before treatment （P<0.01）， while the main symptom scores of the TCM group showed no significant difference from those before treatment. After treatment， the UPDRS score， serum GPx and SOD levels， and daily dosage of pramipexole and levodopa and benserazide hydrochloride demonstrated no significant difference from those before treatment in the two groups and between the two groups. No abnormality was found in the safety indexes. ConclusionBased on the standardized treatment of western medicine， Shengxiantang can effectively and safely improve the autonomic symptoms of gastrointestinal system， urinary system， and thermoregulation， as well as the symptoms of Qi deficiency syndrome in early Parkinson's disease with autonomic dysfunction.

Objective: To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen, and to accumulate experience in the diagnosis and treatment of HFRS in this area. Methods: A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018. The demographic characteristics, epidemiological, clinical manifestations, examinations, treatments and prognosis, and other characteristics were analyzed. Results: All the 46 patients with HFRS were residens in Shenzhen, with a male-to-female ratio of 6.67∶1.00(40∶6), aged (40.18 ± 15.63) years old, and 38 patients (82.61%) aged 23-45 years old. There were 41 patients (89.13%) with a history of HFRS epidemiology, and there were mice in their houses or workplaces. The houses of 39 patients (84.78%) were rented, and 34 patients(87.18%) rented their houses in urban villages. There were morbidity throughout the year, and 33 patients (71.74%) were ill from January to June. In clinical classification, 44 cases (95.65%) were mild, 2 cases (4.35%) were medium, and there were no severe or critical cases. The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia. Thirty-nine patients (84.78%) were presented with systemic aches, headaches, low back pain and eyelid pain, and 28 patients (60.87%) had skin and mucous membrane hyperemia flushing. Clinical stages showed that all patients had pyretogenesis stage and polyuria stage, including pyretogenesis stage [(7.34 ± 6.82) d], polyuria stage [(9.94 ± 5.77) d], only 4.35% (2/46) patients with hypotension shock stage, all patients did not have oliguric stage. On the next day of admission, the number of white blood cells in 46 patients was (8.17 ± 3.19) × 10⁹/L, and 38 cases (82.61%) in the normal range; platelet was (61.92 ± 32.53) × 10⁹/L, and 42 cases (91.30%) were decreased; the procalcitonin was (1.62 ± 0.38) ng/ml, and 41 cases (89.13%) were increased; C-reactive protein was (74.33 ± 30.48) mg/L, and 46 patients (100.00%) were elevated; creatinine was (176.25 ± 55.15) μmol/L, and 19 cases (41.30%) were increased. Abnormal liver function was manifested by increased enzymology, alanine aminotransferase was (137.58 ± 46.76) U/L, and aspartate aminotransferase was (129.82 ± 40.29) U/L. All patients were positive for Hantavirus IgM. B-ultrasound results showed that in 58.70% (27/46) patients, both kidneys were plump and the parenchymal echo was enhanced. Liver injury occurred in 39 patients (84.78%) and sinus bradycardia in 2 patients (4.35%). All the 46 patients were clinically cured. Conclusion The epidemiological characteristics of patients with HFRS in Shenzhen are typical, the clinical manifestations are mild, and the curative effect and prognosis are good.