Objective To observe the clinical effect of Xiaoke-Yuzu decoction on diabetic peripheral neuropathy (DPN). Methods A total of 100 DPN inpatients were recruited and randomly divided into the treatment and control groups. The two groups were both received basic therapy, while the treatment group additionally received Xiaoke-Yuzu decoction. Toronto clinical scores and Chinese medicine symptom scores of both groups were collected to evaluate the clinical effect before and after the therapy. Results The Toronto scores of treatment group were significantly lower than control group after treatment (symptoms score 1.50 ± 0.94 vs. 2.23 ± 1.01, reflection score 3.60 ± 1.77 vs. 4.27 ± 1.72, feeling test score 1.53 ± 0.63 vs. 2.10 ± 0.84,all P<0.05). Meanwhile, the Chinese medicine symptom scores of treatment group were also significantly lower than the control group (main symptom score 1.77 ± 1.17 vs. 3.17 ± 1.82, posterior symptom score 2.23 ± 1.59 vs. 4.27 ± 1.57, the tongue and pulse score 1.83 ± 0.65 vs. 2.47 ± 0.51, all P<0.05). Conclusion Xiaoke-Yuzu decoction plus basic therpy could improve the clinical symptoms of DPN patients.

Objective To evaluate the effect of indwelling nasointestinal tube for enteral nutrition (EN) support on patients with severe craniocerebral trauma undergoing mechanical ventilation (MV). Methods A total of 100 severe craniocerebral trauma patients undergoing MV admitted to intensive care unit (ICU) of the 117th Hospital of People's Liberation Army from February 2015 to February 2017 were enrolled, and they were divided into nasogastric tube group in which the EN was fed by nasogastric tube and nasal jejunal feeding tube group (nasointestinal tube group) by random digits table, with 50 patients in each group. Blood urea nitrogen (BUN), hemoglobin (Hb), serum albumin (Alb), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, Glasgow coma scale (GCS) score before and 10 days after treatment, duration of MV, hospitalization time, and the incidences of ventilator-associated pneumonia (VAP) and reflux wrong aspiration of the two groups were observed and compared. Results There was no statistically significant difference in BUN, Hb, Alb, APACHEⅡscore or GCS score before treatment between the two groups. Ten days after treatment, BUN and APACHEⅡ score in the nasointestinal tube group were significantly lower than those in the nasogastric tube group [BUN (mmol/L): 6.3±1.6 vs. 8.0±2.2, APACHEⅡscore: 17.9±3.2 vs. 20.8±6.3, both P < 0.05], Hb, Alb, GCS score were significantly higher than those in nasogastric tube group [Hb (g/L): 125.9±19.7 vs. 113.5±19.6, Alb (g/L): 35.9±6.2 vs. 31.9±6.2, GCS score: 9.7±1.9 vs. 8.2±5.7, all P < 0.05], duration of MV and hospitalization time were significantly less than those in the nasogastric tube group [duration of MV (days):14.7±3.4 vs. 17.5±2.9, hospitalization time (days): 15.4±5.6 vs. 19.2±7.3, both P < 0.05], and the complication rate in nasointestinal tube group was obviously lower than that in nasogastric tube group [10% (5/50) vs. 36% (18/50), P < 0.05]. Conclusion For patients with severe craniocerebral trauma treated with MV, the EN treatment by means of indwelling nasointestinal tube is helpful for the recovery of consciousness, improvement of nutritional indexes, reduction of incidences of complications such as reflux aspiration, etc. and shortening the course of disease, thus the method can obviously improve the patients quality of life.

Objective:To explore the value of metagenomic next-generation sequencing (mNGS) in the pathogen diagnosis of liver abscess.Methods:A perspective study was performed in 35 hospitalized patients with liver abscess in Department of Emergency Medicine, Zhongshan Hospital, Fudan University from February 2020 to April 2021. Blood samples and abscess drainage fluid samples were detected by routine microbial culture and mNGS. Patients were divided into two groups according to whether they had septic shock or not. SPSS 25.0 was used for statistical analysis.Results:The overall positive rate of mNGS in blood samples and drainage fluid samples was significantly higher than that of routine microbial culture methods (blood: 67.6% vs. 15.2%, P<0.05; Drainage fluid: 100% vs. 55.2%, P<0.05). In 35 patients with liver abscess, 71.4% of the pathogens were Klebsiella pneumoniae. The sequence number of pathogenic pathogens detected by mNGS in abscess drainage fluid samples of patients in the shock group was significantly higher than that in the non-shock group ( P<0.05). Conclusions:The mNGS can quickly and accurately detect the pathogen of liver abscess, which can provide important etiological diagnostic for clinical treatment.

Objective:To explore the basic biological characteristics of lncRNA B230352I09 and its role in the process of myocardial injury.Methods:We analyzed the biological characteristics of lncRNA B230352I09 on the UCSC website and predicted the possible binding protein of lncRNA B230352I09 by the catRAPID. Real-time fluorescence quantitative (RT) PCR method was applied to detect the expression of lncRNA B230352I09 in heart tissues at different time points (0, 1, 3, 7d) within 7 days after birth, the organs distribution and expression of lncRNA B230352I09 in neonatal mouse and the expression pattern of lncRNA B230352I09 in the heart of mice with myocardial injury. In addition, we constructed hypoxia model by culturing primary cardiomyocytes to detect the effect of lncRNA 230352I09 overexpression on hypoxic cardiomyocyte apoptosis by Hoechst staining kit, the effect of lncRNA B230352I09 overexpression on ROS content of hypoxic cardiomyocyte by DCFDA probe and changes in mitochondrial membrane potential of hypoxic cardiomyocytes by JC-1 Fluorescent probes.Results:Full-length of mouse B230352I09 was 663bp, located in the chr7:123031415-123066439 forward strand. RBBP6 gene was adjacent to B230352I09, which may be the target of lncRNA B230352I09 by catrapid prediction analysis. With the development of the heart, the expression level of lncRNA B230352I09 showed a gradual downward trend. The main expression organs of lncRNA B230352I09 in 1-day-old mice were heart, brain, kidney and liver. In heart tissue, lncRNA B230352I09 expression in non-cardiomyocytes was significantly less than in cardiomyocytes [ (1.0± 0.03) vs. (9.2± 3.29), P=0.013]. After myocardial injury, the expression level of lncRNA B230352I09 showed an increasing trend compared with the normal developing mice, but there was no statistical significance. Hoechst staining showed that lncRNA B230352I09 could inhibit the apoptosis of hypoxic cardiomyocytes. Detecting the content of ROS in cardiomyocytes showed that compared with the hypoxia group, the generation of ROS was significantly reduced in the lncRNA B230352I09 overexpression group ([(3.8±0.71) vs. (1.65±0.56), P=0.015]). JC-1 fluorescent probe was used to detect the mitochondrial membrane potential, and the results showed that the mitochondrial membrane potential of cardiomyocytes in the lncRNA B230352I09 overexpression group was significantly higher than that in the hypoxia group. Conclusions:In heart tissue, lncRNA B230352I09 was mainly expressed in cardiomyocytes. LncRNA B230352I09 has a protective effect in the process of myocardial injury in mice, mainly by inhibiting apoptosis of cardiomyocytes, reducing ROS production, and protecting mitochondrial membrane potential of cardiomyocytes.

Objective To prepare a kind of lipid nanoparticle ultrasound contrast agents with the ability to target to viable myocardium for diagnosis . Methods T he agent was a biotinylated ,fluorescent‐labelled ,lipid‐coated , liquid perfluorocarbon emulsion . Physico‐chemical properties of the agent were measured ,including size distribution ,Zeta Potential ,concentration and so on . Ischemia‐reperfusion models were created in rats ,and then exposed to biotinylated anti‐MCP‐1 monoclonal antibody ,rhodamine avidin and biotinylated ,FITC‐labelled nanoparticles ,respectively . Echocardiography was taken before and after injection . Frozen sections of their hearts were observed under fluorescence microscope . Results T he particle diameter ,zeta potential and concentration of lipid nanoparticles were ( 172 .30 ± 52 .06) nm ,( －33 .10 ± 6 .50) mV and ( 2 .28 ± 0 .46 ) × 1011/ml ,respectively . From the short‐axis view ,the myocardium under endocardium of anterior wall was enhanced obviously . While myocardium of other walls were still . T he lipid nanoparticles located in the myocardium of anterior wall and gave out bright green and red fluorescence under fluorescence microscope ,w hile neither lipid nanoparticles nor fluorescence were found in other sites of ventricular myocardium . Conclusions The viable myocardium can be targeted and acoustically enhanced by the self‐made nano‐scale ultrasound contrast agent . T his new agent has potential to improve sensitivity and specificity for noninvasive identifying viable myocardium .

Objective:To analyze the clinical features of patients with pyogenic liver abscess (PLA) and the application of mNGS in PLA, thus to provide reference for clinical diagnosis and treatment.Methods:The demographic and clinical data of 549 patients with liver abscess admitted to Zhongshan Hospital Affiliated to Fudan University from December 2015 to June 2020 were analyzed retrospectively. According to the detection of Klebsiella pneumoniae in 246 patients with positive etiological test results, the patients were divided into two groups: KPLA group and nKPLA group, and clinical characteristics of the two groups were compared. At the same time, the application value of mNGS in PLA was analyzed.Results:Among the 549 patients, the main clinical symptom of PLA was fever ( n= 503, 91.6%) and other clinical symptoms included chills and abdominal pain. Most patients had a single abscess ( n= 464, 84.5%) located in the right lobe ( n = 368, 67.0%), with a size between 5 and 10 cm ( n= 341, 62.1%). A total of 246 patients had positive etiological test results, including 202 KPLA patients which was the main pathogen of liver abscess. The prevalence of diabetes and fatty liver was higher in KPLA patients ( P < 0.05), but there were more culture of liver positive factors in nKPLA patients ( P < 0.001). Among the 109 patients with traditional microbiological results, 92 patients were suspected to KPLA (Klebsiella pneumoniae), of which 14 patients (15.2%) were multidrug resistant (MDR) infection; 17 patients were suspected to nKPLA, of which 10 patients (58.8%) were MDR infection; the incidence of MDR infection in patients with nKPLA was significantly higher than that in patients with KPLA ( P < 0.05). The positive rate of mNGS in plasma was 85.2%, the positive rate of traditional microbial culture in plasma was 14.8%, the positive rate of mNGS in pus was 96.2% and traditional microbial culture in pus was 65.4%. The positive rate of traditional culture was significantly lower than that of mNGS ( P < 0.05). Conclusions:PLA is usually manifested as fever, single and at the right lobe of the liver. Klebsiella pneumoniae is the most common pathogenic bacteria of PLA, which is more common in patients with diabetes and fatty liver, while non-Klebsiella pneumoniae is relatively more common in patients with culture of liver positive factors. The positive detection rate of mNGS is high, which has a unique advantage in pathogen detection.

Objective:To construct the evaluation index system of the core competence of neonatal specialist nurses, so as to provide reference for clinical training of neonatal specialist nurses.Methods:From January 2020, through literature review, theoretical analysis, interview, Delphi method and superiority chart, the evaluation index and weight of core competence of neonatal specialist nurses were determined.Results:Totally 28 experts in China were invited for 3 rounds of consultation. The effective recovery rate of the questionnaires was 93.33%(28/30) in the first round. The effective recovery rate of the questionnaires was 100.00%(28/28) in the second and third rounds. The authority coefficient of the experts was 0.85 in the third round. The Kendall′s coefficients of concordance of the first-level indexes, second-level indexes and third-level indexes were 0.150, 0.221 and 0.161, respectively. The final evaluation index system of the core competence of neonatal specialist nurses included 5 first-level indicators, 17 second-level indicators and 58 third-level indicators.Conclusions:The evaluation index system of the core competence of neonatal specialist nurses constructed in this study has certain scientific, reliable and clinical application value, which is conducive to the training of newborn specialized nurses in China.

A fitting method of calculating local helix parameters of proteins based on dual quaternions registration fitting (DQRFit) is proposed in this paper. First, the C and N atom coordinates of each residue in the protein structure data are extracted. Then the unregistered data and reference data are constructed using the sliding windows. The square sum of the distance of the data points before and after registration is regarded as an optimization goal. We calculate the optimal rotation matrix and the translation vector using the dual quaternion registration algorithm, and get the helix parameters of the secondary structure which contain the number of residues per turn( ), helix radius( )and helix pitch( ). Furthermore, we can achieve the fitting of three-helix parameters of , , simultaneously with the dual quaternion registration, and can adjust the sliding windows to adapt to different error levels. Compared with the traditional helix fitting method, DQRFit has some advantages such as low computational complexity, strong anti-interference, and high fitting accuracy. It is proven that the precision of proposed DQRFit for α helix detection is comparable to that of the dictionary of secondary structure of proteins (DSSP), and is better than that of other traditional methods. This is of great significance for the protein structure classification and functional prediction, drug design, protein structure visualization and other fields in the future.

Objective:To investigate the efficacy and safety of nasal continuous positive airway pressure (NCPAP) combined with inhalation of pulmonary surfactant (PS) using vibrating mesh nebulizers in the treatment of neonatal respiratory distress syndrome (RDS).Methods:A prospective study was performed on premature infants with RDS admitted to the First Affiliated Hospital of Bengbu Medical College between December 2020 and June 2021. They were randomly assigned into vibrating mesh atomization technology group and intubation-surfactant-extubation (INSURE) technology group. The two groups were treated with NCPAP combined with PS. PS in the vibrating mesh atomization technology group was inhaled into the lungs by the new vibrating mesh atomization technology, while PS in the INSURE group was injected into the lungs by endotracheal tube. The pH value, arterial partial pressure of carbon dioxide (PaCO 2), oxygenation index (PaO 2/FiO 2), mechanical ventilation via endotracheal tube (MVET) demand rate, duration of respiratory support, secondary use of PS, complications, and hospital mortality were compared between the two groups. The occurrences of adverse events in the two groups were recorded. Results:A total of 42 preterm infants were finally enrolled, including 20 cases in the vibrating mesh atomization technology group and 22 cases in the INSURE technology group. There were no significant differences in blood gas analysis and PaO 2/FiO 2 before PS administration between the two groups. One hour after PS administration, blood gas analysis and PaO 2/FiO 2 were significantly improved in both groups. Compared with the INSURE technology group, the improvement of PaO 2/FiO 2 was more obvious in the vibrating mesh atomization technology group [mmHg (1 mmHg≈0.133 kPa): 198±34 vs. 173±39, P < 0.05], but no significant difference in pH value or PaCO 2 was found between the two groups. The duration of respiratory support in the vibrating mesh atomization technology group was significantly shorter than that in the INSURE technology group (hours: 96±13 vs. 120±18, P < 0.01), but there was no statistical difference in MVET demand rate [5.0% (1/20) vs. 13.6% (3/22), P > 0.05]. The incidence of periventricular-intraventricular hemorrhage (PVH-IVH) in the vibrating mesh atomization technology group was less than that in the INSURE technology group [0% (0/20) vs. 18.2% (4/22)], but no statistical difference was found ( P > 0.05). No significant differences in the secondary use rate of PS and incidence of bronchopulmonary dysplasia (BPD) or other complications were found between the vibrating mesh atomization technology group and the INSURE technology group [5.0% (1/20) vs. 9.1% (2/22), 5.0% (1/20) vs. 4.5% (1/22), both P > 0.05]. There were no deaths or serious adverse events such as pneumothorax, pulmonary hemorrhage, periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in both groups. Conclusion:Compared with the INSURE technique, NCPAP combined with vibrating mesh atomization technology was also effective and safe in the treatment of RDS, which could significantly improve PaO 2/FiO 2 and shorten the duration of respiratory support. Thus, it was worthy of clinical popularization and application.

Objective:To observe any effect of low-frequency whole body resonant stimulation on the ba-lance and walking ability of hemiplegic stroke survivors.Methods:Sixty-six stroke survivors with hemiplegia were randomly divided into a low-frequency resonance training group, a high-frequency vibration training group and a control group, each of 22. All received routine exercise training at individualized intensities. All three groups underwent five 1-minute cycles of 7Hz, 15Hz or 1Hz stimulation twice a day, five days a week for eight weeks. Before and after the intervention, balance and walking ability were evaluated using the Berg Balance Scale, the timed up and go test and a 10m walking test. Step length, step frequency and step speed were also measured.Results:There were no significant differences among the three groups before the training. Afterward, significant improvement was observed in all of the groups in terms of all of the measurements. The average results of the low-frequency resonance training group were at that point significantly better than the other two groups′ averages, while the high-frequency vibration training group′s results were superior to those of the control group.Conclusion:Resonance training at 7Hz is the most effective in improving the balance and walking ability of stroke survivors with hemiplegia.