Objective Interleukin-21(IL-21) is likely to contribute to the development of liver fibrosis, but up to now, no study has been reported on the relationship between IL-21 and intrauterine adhesions ( IUA) .This study aimed to establish a rat model of IUA induced by mechanical injury and lipopolysaccharide (LPS) infection (dual injury), determine the expression level of serum IL-21, and confirm the association of serum IL-21 with the formation of IUA. Methods Forty healthy female SD rats were randomly divided into four groups of equal number,control, mechanical injury, LPSinfection, and dual injury.At 7 days after IUA modeling,uterine tissue-swere collected from all the animals for observation of the endometrial glands,detection of the degree of IUA by Masson staining, measure-ment of the serum IL-21 level by radioimmunoassay, and analysis of the correlation between the number of endometrial glands and the de-gree of fibrosis. Results The number of endometrial glandswas significantly smallerin the dual injury group (3.59±1.20) than in the mechanical injury (11.66±2.34) and LPSinfection group(11.59±1.47)(P<0.05), while the proportion of fibrosis area wassignificantly higher in the former group(0.65±0.03) than in the lattertwo(0.30±0.07 and 0.32±0.08)(P<0.05).The level of serum IL-21 was signifi-cantly increased in the dual injury group ([286.21±27.80]pg/mL) as compared with those in the control ( [ 118.65 ±22.55 ] pg/mL ) , mechanical injury([176.20±19.05]pg/mL), and LPS infection group ([187.98±16.51]pg/mL) (P<0.05), with a positive correlation be-tween the IL-21 level and theproportion of fibrosis area ( r=0.271, P<0.05) . Conclusion A rat model ofIUAwas successfully established by mechanical injury and lipopolysaccharide (LPS) infection.The evi-dent increase of serum IL-21 in the IUA model was positively correlated with the percentage of fibrosis area, suggesting that IL-21 may be involved indirectly in the formation of IUA.

OBJECTIVE:To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia(SAP). METHODS:A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group(42 cases)and observation group (42 cases)according to random number table. Based on routine treatment,control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5% Glucose injection 100 mL,intravenously,twice a day;suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5% Glucose injection 250 mL intravenously,once a day,on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed,and the levels of T-lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)and inflammatory markers(TNF-α,hs-CRP,PCT),length of hospital stay before and after treatment. The ADR was recorded. RESULTS:The total response rate(95.24%)and marked response rate (47.62%)of observation group were significantly higher than those of control group(83.33%,23.81%);length of hospital stay in observation group [(15.24±3.53)d] was significantly shorter than control group [(18.43±4.21)d],with statistical significance (P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of CD8 +,TNF-α,hs-CRP and PCT in 2 groups were significantly lower than before treatment;the observation group was significantly lower than the control group,with statistical significance(P<0.05);there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly,can effectively improve immune function, reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR.

Objective: To evaluate the role of mitochondrion-dependent apoptosis in reduction of bupivacaine-induced cardiotoxicity by lipid emulsion in rats. Methods: Forty-five healthy adult male Sprague-Dawley rats, weighing 300-350 g, were divided into 3 groups by a random number table method: sham operation group (Sham group, n=5), bupivacaine group (B group, n=20), and lipid emulsion group (L group, n=20). Cardiac arrest was induced by intravenously injecting 0.4% bupivacaine 30 mg/kg over 20 s to establish the cardiotoxicity model.Twenty percent lipid emulsion was intravenously injected in a dose of 5 ml/kg during resuscitation in group L, and normal saline was intravenously injected in a loading dose of 5 ml/kg during resuscitation in group B, followed by a 3-min infusion of 1 ml·kg^-1·min^-1in two groups.The successful resuscitation and survival rate at 120 min of return of spontaneous circulation (ROSC) were recorded.Systolic blood pressure, heart rate, mean arterial pressure, rate-pressure product (RPP) and ratio of RPP at each time point after recovery of spontaneous heart beat to baseline value (RPPh) were recorded every 10 min after ROSC.The time from administration to cardiac arrest (T₀), time from beginning of cardiopulmonary resuscitation to appearance of the first spontaneous heart beat (T_s) and time from beginning of cardiopulmonary resuscitation to appearance of ROSC (T_r) were recorded.Rats were sacrificed at 120 min of ROSC, and left ventricular tissues were obtained for determination of the expression of Bax, Bcl-2, cleaved caspase-9, cleaved caspase-3, cytochrome C (Cyt c) in cytoplasm and mitochondria (by Western blot) and expression of Bax and Bcl-2 mRNA (by real-time polymerase chain reaction) and for examination of myocardial ultrastructure. Results: Compared with Sham group, the expression of Bcl-2 protein and mRNA and mitochondrial Cyt c was significantly down-regulated, and the expression of Bax protein and mRNA, cleaved caspase-9, cleaved caspase-3 and cytoplasmic Cyt c was up-regulated in B group (P<0.05). Compared with B group, the rate of successful resuscitation and survival rate were significantly increased, T_r was shortened, systolic blood pressure, heart rate, RPP and RPPh were increased after ROSC, the expression of Bcl-2 protein and mRNA and mitochondrial Cyt c was up-regulated, the expression of Bax protein and mRNA, cleaved caspase-9, cleaved caspase-3 and cytoplasmic Cyt c was down-regulated (P<0.05), no significant change was found in T_o or T_s (P>0.05), and the pathological changes of myocardium were significantly attenuated in L group. Conclusion The mechanism by which lipid emulsion reduces bupivacaine-induced cardiotoxicity may be related to inhibiting mitochondrion-dependent apoptosis in rats.

Objective:To explore the nursing characteristics of patients with atrial fibrillation in "zero ray" transcatheter radiofrequency ablation, and to analyze the postoperative surgical indexes, nursing indexes and anxiety level.Methods:A total of 127 patients who underwent radiofrequency ablation of atrial fibrillation in Xuanwu Hospital, Capital Medical University from October 2018 to September 2020 were divided into the control group ( n=64) and the observation group ( n=63) by random number table method. Patients in the control group received conventional radiofrequency ablation for atrial fibrillation and received conventional nursing care. The observation group made full use of the advantages of the three-dimensional mapping system, using "zero-ray" green electrophysiological technology to complete the intervention of the control group, and parallel personalized nursing intervention measures. The operative indexes, nursing indexes, anxiety and pain levels of 2 groups were compared. Results:The ablation time, total operation time in the control group were (1 917.38±157.74) s, (110.32 ± 35.83) min, respectively, and those in the observation group were (1 915.87±87.19) s, (109.45 ± 28.92) min, and the difference between the two groups was statistically significant ( t value was 1.201, 0.150, P>0.05). The nursing satisfaction score, the time spent with nurses, and the awareness rate of education in the control group were (90.00±3.00) points, (30.36±7.58) min, 68.75%(44/64), respectively, and those in the observation group were (95.00±5.00) points, (40.27±10.68) min, 85.71%(54/63), the difference between the two groups was statistically significant ( t value was -6.845, -6.037, χ2 value was 5.185, all P<0.05). The anxiety score and pain score in the control group were 10.42±2.54 and 7.34±1.55, respectively, and those in the observation group were 6.34±1.21 and 4.64±0.92, respectively. The difference between the two groups was statistically significant ( t value was 11.526, 11.913, both P<0.01). Conclusions:Green electrophysiology transcatheter radiofrequency ablation is a safe, effective and feasible method, and the nursing satisfaction is improved.

OBJECTIVEThe survey will reveal current status of subclinical vitamin A deficiency (SVAD) and explore its affecting factors in children of China.

METHODSTotally 8 669 children aged under 6 years were randomly selected from 14 provinces for clinical examination, health and dietary questionnaire and serum level of vitamin A measurement with fluorescence method. The cut-off value for SVAD was defined as

RESULTSPrevalence of SVAD was 11.7% and that of suspected SVAD 39.2% in all subjects, which decreased with the increase of gross domestic product, average annual family income, mother's schooling and children's age. Prevalence of SVAD and suspected SVAD higher in rural areas (15.0%) than in urban areas (5.2%), and higher in children with a minority mother (22.6%) than in those with a Han nationality mother (8.7%). Prevalence of SVAD and suspected SVAD was higher in children whose blood samples were collected within one week in-taking vitamin A-rich food (12.6%-22.6%) than those in-taking vitamin A daily (4.1%-10.0%), and higher in children suffering from respiratory infection, fever and diarrhea two weeks before their blood collection (15.2%-20.3%) than in those without those diseases (10.1%-11.1%). Logistic regression analysis showed that poor family economic status, living in rural areas, children with a minority mother, younger age, no-dairy milk products intake, and respiratory infection and fever all were risk factors for SVAD.

CONCLUSIONSMore than half of children under six years old in China (50.9%) had vitamin A nutrition problem. Varied factors played roles to different extent in SVAD in children.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Prevalence ; Vitamin A ; blood ; Vitamin A Deficiency ; epidemiology ; etiology

OBJECTIVETo understand the prevalence and spatial distribution of vitamin A deficiency (VAD) in China among children at ages under six years.

METHODSAbout 8,600 children under 6 years of age in 14 cities and 28 counties of 14 provinces were selected with stratified cluster sampling for survey, including interview with questionnaire for their family information and nutritional status. Blood specimens were collected for measuring serum level of VA with fluorescent spectrophotometry in laboratory.

RESULTSTotally, 8,669 children under 6 (2,877 in urban area and 5,792 in rural area) were surveyed in 14 provinces, with 4,629 males and 4,040 females. Eight cases of night blindness and seven cases of xerophthalmia were found among the children at ages of two to five years. Sixty-one mothers of the children in this group were also found suffering from night blindness. All the cases of night blindness and xerophthalmia both in children and mothers were living in rural areas. Based on their serum levels of VA, 11.7% of the all 1 018 children were diagnosed as VAD, with serum VA concentrations below or equal to 0.70 micro mol/L. Prevalence of VAD was 15.0% and 5.8% in rural (23.3% in the poverty-stricken counties) and urban areas, respectively, and 5.8%, 11.5% and 16.8% in the coastal, inland and remote areas, respectively. The average serum level of VA was 1.20 micro mol/L and 0.99 micro mol/L for urban and rural areas, respectively, with a national average of 1.06 micro mol/L. And, babies under six months of age with an average serum levels of VA < or = 0.70 micro mol/L accounted for 33.4%, and those at ages of four to five years with the same level of VA accounted for 8%. There was significant difference in serum levels of VA between ages, but no significant difference between genders.

CONCLUSIONVAD did exist in children of China, especially in the remote and poverty-stricken rural areas and VA supplementation is urgently needed for the children in these regions.

Child ; Child, Preschool ; China ; epidemiology ; Dietary Supplements ; Female ; Health Surveys ; Humans ; Infant ; Male ; Night Blindness ; complications ; Prevalence ; Rural Health ; statistics & numerical data ; Vitamin A ; administration & dosage ; therapeutic use ; Vitamin A Deficiency ; complications ; epidemiology ; prevention & control ; Xerophthalmia ; complications

BACKGROUND:Material biomechanics is the investigation of the mechanical microenvironment of biomaterials through a material science approach,which belongs to the frontier discipline of sustainable development. OBJECTIVE:To explore the current research hotspots and development trends of material biomechanics and provide theoretical references for subsequent research. METHODS:Based on CiteSpace bibliometric software,we generated keyword co-occurrence and clustering,emergent word detection,and other knowledge maps based on 3 182 material biomechanics literature in the Web of Science core database during 2012-2022 for visualization analysis. RESULTS AND CONCLUSION:The number of research articles on the biomechanics of materials has been increasing in the last decade,and the United States,China,and Germany are the top three countries in terms of the number of articles published,and the research is mainly concentrated on major universities and research institutions,with significant aggregation.Material biomechanics research mainly involves the disciplines of material science,biomedical engineering,and kinesiology.Finite element analysis,material properties,mechanical performance of biomaterials,and molecular biomechanics are the focus of scholars'attention and research.At present,the research in the field of material biomechanics focuses on the use of finite element analysis to calculate the mechanical response of different biomedical materials under different conditions of loading and mechanical properties for the prevention of sports diseases,surgical planning,and postoperative rehabilitation.The application of inorganic materials and the mode of transport of molecular signals may be the prospect of future research.