ObjectiveTo investigate the effect of cholinesterase inhibitor on endotoxin-induced brain injury in rabbits.Methods Twenty-one healthy male rabbits were randomly assigned into three groups ( n ＝ 7each):group sham operation (group S),lipopolysaccharide (LPS) group and cholinesterase inhibitor (tacrine hydrochloride,THA) group.LPS 200 μg/kg was intracerebroventricularly injected in LPS group,LPS 200μg/kgand tacrine hydrochloride 150 μg/kg were injected in THA group,while same volume of normal saline was injected in S group.Then blood and tissue samples were collected in different groups after 4 hours.Nuclear factor-kappa B (NF-κB) p65 activity of brain tissues was determined by using Western blot analysis.Tumor necrosis factor-alpha (TNF-α) levels in plasma,cerebrospinal fluid and brain tissues were measured using enzyme linked immunosorbent assay.The brain tissue's myeloperoxidase (MPO) activity and the ratio of wet to dry weight (W/D) were also analyzed.ResultsAs compared with S group,TNF-α level in plasma,cerebrospinal fluid and brain tissues,NF-κB p65 level,MPO activity and W/D ratio increased in LPS and THA groups (P < 0.05).When compared with LPS group,TNF-α level in plasma,cerebrospinal fluid and brain tissues,NF-κB p65 level,MPO activity and W/D ratio decreased in THA group ( P < 0.05 ).ConclusionCholinesterase inhibitor can attenuate the endotoxin-induced brain injury through inhibiting local inflammatory responses.

OBJECTIVE:To explore the present situation of scientific research of clinical pharmacists in domestic third-grade class A hospitals,and discuss its feasible research ideas. METHODS:Questionnaire was conducted for the scientific research situa-tion of clinical pharmacists who obtained the certification in domestic 63 third-grade class A hospitals,the questionnaire data was collected,and data was statistically analyzed by using IBM SPSS Statistics 22.0 software. RESULTS:Totally 315 questionnaires were sent out,282 were effectively received,with effective recovery of 89.52%. In terms of attitude to scientific research,propor-tion of the surveyed clinical pharmacists who thought it was quite necessary and necessary was more than 70%;except for academ-ic degree(P<0.05),the different gender,age and job title did not cause the differences in scientific research attitude(P>0.05). In terms of the present situation of scientific research,achievements of them were relatively simple,thinking the biggest difficulty was insufficient of experiment condition;there was significant difference in the numbers of authorized patents in recent 5 years by different gender (P<0.05),the numbers of applications for approved funds,authorized patents and paper published in recent 5 years by different academic degrees(P<0.05),as well as the numbers of applications for approved off-campus funds(title also re-lated to the number of hospital funds)and the numbers of paper published in domestic magazine in recent 5 years by different ages and job titles (P<0.05). In terms of direction of scientific research,most of surveyed clinical pharmacists thought they should strengthen communicate with physicians and look for the breakthrough point,they also thought the optimal one was clinical re-search;the direction selection was basically similar no matter the gender,academic degree,age and job title(P>0.05). In terms of ability enhancement,the surveyed pharmacists thought liter-ature review,evidence-based literature/experimental interpreta-tion and foreign language reading were the abilities most need to be enhanced;except for gender,academic degree,age andjob title showed similarity in enhancing the literature review,evidence-based literature/experimental interpretation ability (P>0.05),while there were significant differences in enhancing foreign language reading ability by different gender,academic degree, age and job title (P<0.05). CONCLUSIONS:Clinical pharmacists show certain differences in the attitude to scientific research, present situation and direction of scientific research,and ability enhancement because of different gender,academic degree,age and job title,but there are also common. In order to improve the competence of scientific research and promote the discipline devel-opment of clinical pharmacy,pharmacy administrator in hospital should improve the academic degree and job title on clinical phar-macists and provide necessary advanced scientific platform and pertinent training at the same time. Additionally,except for the ratio-nal drug use,evidence-based pharmacy and pharmacoeconomics,clinical pharmacists can find new breakthrough point from phar-maceutical care,drug treatment decisions,translational medicine and medicine large data.

Objective:To construct an intelligent performance measurement system of gastrointestinal endoscopy and to analyze its value for endoscopic quality improvement.Methods:The intelligent gastrointestinal endoscopy performance measurement system was developed by using the deep convolutional neural network (DCNN) and deep reinforcement learning, based on the Digital Imaging and Communications in Medicine. Images were acquired of patients undergoing gastrointestinal endoscopy at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from December 2016 to October 2018. The system applied cecum recognition model (DCNN1), images in vitro and in vivo recognition model (DCNN2), and identification model at 26 gastric sites (DCNN3) to monitor indices such as cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage. Images of 83 gastroscopies and 205 colonoscopies acquired at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from March to November 2019 were randomly selected to examine the effectiveness of the system. Results:The intelligent gastrointestinal endoscopy performance measurement system consisted of quality analysis of both gastroscopy and colonoscopy, including all indices, and could be generated automatically at any time. The accuracy for cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage were 92.5% (172/186), 91.7% (188/205), 100.0% (83/83), 89.3% (1 928/2 158), respectively.Conclusion:The intelligent performance measurement system for gastrointestinal endoscopy can be recommended for the quality control of gastrointestinal endoscopy, from which endoscopists can get feedback and improve the quality of gastrointestinal endoscopy.

Objective To discuss the effects of pressure control (PC) and positive end-expiratory pressure (PEEP) incremental method lung recruitment maneuver (RM) on haemodynamics in piglets with acute lung injury (ALI) induced by paraquat (PQ) poisoning. Methods The ALI/acute respiratory distress syndrome (ARDS) model was reproduced by intraperitoneal injection of 20% PQ (20 mL) in 10 healthy female piglets, and they were randomly divided into PC lung RM group (RM1 group) and PEEP incremental method lung RM group (RM2 group), with 5 piglets in each group. Heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) were monitored by pulse-indicated continuous cardiac output (PiCCO) monitoring before model reproduction (baseline), on the time of successfully set up of model and at 5, 15 and 30 minutes after RM. At the same time the arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) were recorded, and oxygenation index was calculated. Lung tissues were collected before model reproduction, on the time of successfully set up of model, and at 30 minutes after RM respectively, and pulmonary pathology changes were observed after hematoxylin and eosin (HE) staining under light microscopy. Results The HR, MAP, and PaCO2 on the time of successfully set up of model in both groups were increased obviously while CI, PaO2, and oxygenation index were decreased obviously as compared with those at baseline, all of which conformed to the expression of ALI/ARDS. With RM time extended, the HR in both groups was declined while MAP and CI were increased gradually. The HR and MAP at 5 minutes after RM of RM1 group were significantly lower than those of the RM2 group [HR (bpm): 126.8±5.2 vs. 134.0±3.8, MAP (mmHg, 1 mmHg = 0.133 kPa): 98.4±3.3 vs. 102.8±2.6, both P < 0.05]. The CI at 5 minutes and 15 minutes after RM of RM1 group was significantly higher than that of the RM2 group (mL·s-1·m-2: 56.7±5.0 vs. 46.7±6.7, 65.0±5.0 vs. 56.7±5.0, both P < 0.05). PaO2 and oxygenation index at 5 minutes after RM in both groups were significantly higher than those on the time of sucessfully set up of model. The PaO2 and oxygenation index were gradually decreased, and PaCO2 was increased with RM time extended, but no statistically significant differences at all time points were found between the two groups (all P > 0.05). The lung tissue in both groups showed a variety of pathological changes at 30 minutes after RM. The main performances were the loss of alveolar epithelial cells, the further wideness of alveolar interval and the distension of alveolar, and the part breakage of alveolar interval. The wideness of alveolar interval was more significant in RM2 group than that of RM1 group, and alveolar cleft was more common too. Conclusion Both PC and PEEP incremental method lung RM can improve the oxygenation of the piglets with ALI/ARDS induced by PQ, and the PC lung RM has less impact on haemodynamics.

Objective To observe the clinical efficacy of fire-needle acupuncture in treating chronic cough after a cold. Method Totally 120 eligible subjects with chronic cough after a cold were randomized into two groups: 60 cases in the treatment group were intervened by acupuncture with fire-needles, while the other 60 cases in the control group were by acupuncture with ordinary filiform needles plus cupping. Result The recovery rate was 85.0% in the treatment group versus 65.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Fire-needle acupuncture can produce a significant efficacy in treating chronic cough after a cold, and it has a rapid onset of action, lower cost, and it’s easy-to-operate.

Objective To analyze the epidemiological characteristic of New Delhi metallo-β-lactamase (NDM)-1-positive bacteria in China and explore its mechanism of drug-resistance.Methods The published papers from 2010 to 2015 about domestic blaNDM-1 were collected and analyzed according to the bacteria species,regional distribution,NDM-1-positive bacteria,infectious source,drug-resistance spectra and transfer mechanism.Results NDM-1-positive bacteria were isola-ted from 25 provinces (municipalities)in China,Guangdong Province was predominant and accounted for 39.49%(P <0.05).The number of Klebsiella pneumoniae and Enterobacter cloacae were predominant in the NDM-1-positive bacteria (P <0.05).Number of patients under the age of ten and among 60 -80 years which infected by NDM-1-positive bacteria were predominant of all the reported patients(P <0.05).The most kinds of samples and diseases were sputum sample (P <0.05)and pulmonary diseases(P <0.05).NDM-1-positive bacteria which found in China had the lowest resistance to amikacin and tigecycline accounted for 7.69% and 2.33%(P <0.05).Conclusion Antibiotic resistant bacteria with NDM-1 resistant gene have become a global public health problem,and significant difference among age,districts and sources,which need active surveillance and more studies to find how it happens and epidemic in the future.

Objective To analyze the expression of serum carbohydrate antigen 153(CA153) and human epididymis protein 4 (HE4) in the cervical cancer patients. Methods 72 cases of cervix neoplasms patients received from Jun 2010 to July 2013,were divided into the cervical cancer group(36 cases)and cervical benign lesions group(36 cases)according to different pathological results, 36 cases of healthy women undergoing physical examination at the same time were chosen as control group. The level of serum CA153 and HE4 of above research subjects were detected and analyzed. Results The level of serum CA153 of cervical cancer group(79.6±14.8)U/mL was higher than that of cervical benign lesions group (t=5.17, P<0.05) and control group (t=7.31, P<0.05), there was statistically significant differ-ence; the level of serum HE4 of cervical cancer grou (216.3±8.1) pmol/L was higher that of cervical benign lesions group(t=9.71,P<0.05) and control group (t=11.84, P<0.05), there was statistically significant difference; the posi-tive rate of combined detection was higher than that of single detection, there was statistically significant difference(χ2=4.527,P<0.05); The level of serum CA153 and HE4 in III/IV stage were higher than that in I/II stage, and the difference was statistically significant (P<0.05). Conclusion The level of serum CA153 and HE4 of cervical cancer patients increase significantly. The combined detection of CA153 and HE4 can improve the diagnostic sensitivity,specificity and accordance rate of cervical cancer prominently,so it has great reference value in the early diagnosis and treatment of cervical cancer.

Objectives:To explore the association between the r'wave amplitude in lead V1 and impedance changes with left bundle branch pacing electrode implantation depth. Methods:A total of 78 patients with normal heart structure and underwent left bundle branch area pacing(LBBAP)in the Second Affiliated Hospital of Nanchang University from January 1,2019 to December 31,2021 were included in this retrospective analysis.Baseline data,intraoperative and imaging data,and 3,6,9 and 12 months of follow-up results were collected.Correlation and regression analysis were performed to define the feasibility using the r'wave in lead V1 during pacing and impedance changes to estimate the electrode depth. Results:r'waves at the end of the QRS complex in lead V1 during pacing were found in 70 cases(89.7%),and 8 cases(10.3%)showed rS,RS type QRS waves,or no r'wave at the end.Correlation analysis showed that r'wave amplitude was positively correlated with electrode depth(r=0.424,P<0.01),negatively correlated with impedance(r=-0.256,P=0.03).There was no significant statistical correlation between electrode implantation depth and impedance(r=-0.132,P=0.27).Regression analysis found that electrode depth was an important factor affecting r'wave amplitude(regression coefficient=0.056,P=0.000).Combined with the established regression model and impedance,it was found that the amplitude of the r'wave in lead V1 is at the range of 0.24-0.69 mV,and the impedance ranges from 648.30 to 828.90 Ω,and the electrode implantation depth is 6-11 mm,which is most suitable.The risk of perforation is low,and the left bundle branch can be successfully captured with a high probability.The pacing parameters are satisfactory,and the pacing QRS wave duration is narrow.During the intraoperative,postoperative 48 hours,and 12-month follow-up period,the patient did not experience complications such as electrode perforation,thromboembolism,cardiac tamponade,infection,or wire dislocation. Conclusions:Left bundle branch region pacing is a safe and feasible pacing method.During LBBAP,the amplitude of the r'wave in lead V1 at the range of 0.24-0.69 mV,and the impedance ranges from 648.30 to 828.90 Ω can be used to guide the pacing in the left bundle branch region and reduce the risk of electrode perforation.

Objective To analyze effects of mindfulness intervention on mindfulness, psychological health and quality of life for uremia patients. Methods A total of 82 uremia patients in Wuxi No.2 People′s Hospital from January 2013 to July 2015 were randomly assigned to the intervention group ( n=41) and the control group ( n=41). Patients in the control group were given routine nursing, while patients in the intervention group were given additional mindfulness intervention. The classification of mindfulness, the status of psychological health and quality of life scores after 8 weeks intervention and before the intervention were compared between two groups. Results After 8 weeks′ intervention, the grading state of mindfulness in the intervention group was obviously superior to the control group. The scores of interpersonal relationship, somatization, compulsion, depression, anxiety, crankiness, fear, nervousness and the total score were significantly lower than those of the control group ( P<0.05) . Quality of life scores in the intervention group (74.22±11.17) was higher than the control group (65.78±10.45)(P<0.05).Conclusions Mindfulness-based intervention is conducive to improve mindfulness of uremia patients and reduce patients′ negative mental states and it is of great significance to improve the quality of life.

Objective: To explore the clinical and molecular genetic features of a Chinese patient with catecholaminergic polymorphic ventricular tachycardia (CPVT). Methods: Clinical data including resting electrocardiography, echocardiography and treadmill exercise testing of a patient with CPVT admitted to our department in March 2013 were analyzed, and the peripheral venous blood samples of the patient and his family members and 400 ethnicity-matched healthy controls were obtained. All exons and exon-intron boundaries of the six CPVT-related genes including RYR2, CASQ2, TRDN, CALM1, KCNJ2 and ANKB were sequenced to detect the variants related to CPVT. The relationship between the genotypes and phenotypes was analyzed to direct the target therapy. Results: Recurrent syncope induced either by exercise or extreme frightened fear was observed in this patient. There was no positive family history of syncope or sudden death. The resting electrocardiography and echocardiography of the patient were normal, while the exercise testing revealed bidirectional and polymorphic ventricular tachycardia. A cardiac ryanodine receptor gene mutation (R2401H) was identified in this patient, while this mutation was absent in his parents and sister and 400 controls. No variant was detected in the remaining five candidate genes. Treatment with high dose of metoprolol succinate (118.75 mg/d) was effective and patient was free of syncopal attack during the 2 years follow-up. Conclusion This is the first report on RyR2-R2401H mutation in Chinese patient with CPVT, and high dose of metoptolol is the effective therapy option for CPVT related to RyR2 mutation.