Objective To study the effects of anthocyanins on hepatic lipid accumulation and to explore the possible mechanisms. Method HepG2 cells were treated with 1,10 and 100 ?mol/L cyanidin-3-0-?-glucoside (Cy-3-g) for 1h,carnitine palmitoyl transferase-I (CPT-I) protein level and acetyl CoA carboxylase (ACC) phosphorylation,triglyceride,fatty acid oxidation,the activity of AMPK,AMPK and p-AMPK protein levels were evaluated. Results Compared with the control,the treatment of HepG2 with 1,10,100 ?mol/L Cy-3-g resulted in significant decrease of intracellular triglyceride,and significant increase of CPT-I protein,and AMPK activity and phosphorylation. However,there were no differences in AMPK protein level among all groups. The treatment of 100?mol/L Cy-3-g promoted the fatty acid oxidation in HepG2. The treatment of 10,100 ?mol/L Cy-3-g significantly increased ACC phosphorylation. Conclusion Anthocyanin Cy-3-g could attenuate hepatic lipid accumulation in HepG2. The mechanism may result from the regulation of the AMPK-ACC-CPT-I signal pathway and promotion of fatty acid oxidation.

Objective To investigate the features of gait in patients with lumbar disc herniation suffering low back pain radiating to the unilateral lower limbs during walking, and estimate the test-retest reliability of the plantar pressure distribution. Methods 32 patients of lumbar disc herniation with low back pain radiating to the unilateral lower limb were tested with the Footscan plantar system during normal walking for 5 times. The gait phases, contacting time of every plantar region and maximum force were recorded in both the uneffected and the affected lower limbs in patients. The reliability was estimated with the intraclass correlation coefficient (ICC). Results There were significant differences between the uneffected and the affected lower limbs in the gait phase except for the Initial Contact Phase. The Forefoot Contact Phase and Foot Flat Phase of the affected lower limbs were obvious shorter than the uneffected ones (P<0.01), while the Forefoot Push Off Phase was longer (P<0.01). Except for the region of Metatarsal 5, the contacting time of every plantar region of the affected lower limbs were lower than the uneffected ones (P<0.05). The maximum force of regions of Metatarsal 4, Metatarsal 5 and Heel Lateral were lower in the affected limbs than the uneffected ones (P<0.05). ICCs of gait phase, the contacting time of every plantar region and maximum force were generally over 0.76. Conclusion Differences were found in gait phase, the contacting time of every plantar region and maximum force between the uneffected and the affected lower limbs in patients with lumbar disc herniation. All the variables are reliable for test-retest.

Objective To compare two different gastric tube insertion methods on neonatal pain responae.Methods From April to July 2010,47 neonatal patients underwent gastric tube insertion in the neonatal department of our hospital were randomly classified into two groups:the nasal gastric tube insertion group(28 cases) and the oral gastric tube insertion group( 19 cases).Neonatal pain score and incidence of complications during gastric tube insertion between both groups were compared.Results The mean rank of pain scores were significantly higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.The incidence of pain and complications were higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.Conclusions The impact of oral gastric tube insertion on neonatal pain response is not significant,and few complications occur during oral gastric tube insertion,so it is worthy of clinical application.

Objective To explore the outpatients′experience of caring and provide references for improving their experience of medical care.Methods The phenomenology research method was adopted in this study,and twenty-one outpatients were subject to an in-depth interview to learn their outpatient experiences.Results Ten themes of experience with caring were extracted as follows:passionate and patient,careful and considerate,respect for others,offers to help,encouraging and comforting,apologies and courteously,humor,truthful considerations,conscientious and responsible,and a caring environment setup.Five themes of experience without caring were extracted as follows:impatient communication, careless seeing of outpatients,delayed service,passive reminders,and facilities without enough details. Conclusions The outpatients may have abundant experiences of caring at the outpatient clinic,also lack of caring sometimes as well.Outpatient managers should keep an eye on outpatients′needs and satisfaction of caring from time to time,to improve the quality of outpatient service.

Objective Investigating the relationship between the incidence of Primary Acute Cerebral Infarction (PACI) and seasonal variation to employ measures to prevent PACI with climate change. Methods A retrospective analysis of patients diagnosed with PACI between 2009 and 2013 in the department of Neurology of Second hospital of Tian Jin Medi-cal University (n=1 198 patients) was carried out. Combined with the general clinical data, we analyzed seasonal, monthly and weekly variation among PACI incidents. Results The incidence of PACI increases over years between 2009 to 2013 (P ＜ 0.01). Significant difference of incidents of PACI was observed between each season (P=0.047). Incidence of PACI peaked in winter(30.33 ± 9.63/month), while bottomed in spring(21.83 ± 5.36/month). Significant difference of incidents of PACI was also observed between each months(P=0.010). The monthly incidence was highest in January and February (33.25 ± 9.62/month)and lowest in March and April(20.75 ± 4.89/month). The seasonal variation was only found in the pa-tients who are complicated with pulmonary infection (P＜0.01) regardless of the presence or absence of other risk factors, such as smoking, drinking ,hypertension, coronary heart disease, and diabetes mellitus. The weekly variation of PACI was on-ly significant in patients younger than 65 years old(P=0.043). The peak incidence among a week was Monday(17.86%),and incidence bottomed on Friday (13.36%). Conclusion Our study revealed that the incidence of PACI increase over year be-tween 2009 to 2013 and it shew a characteristic variation with respect to season, month and week. Based on these results, we can formulate prevention measures accordingly.

Objective To investigate the association of risks related to maternal factors with the subsequent development of necrotizing enterocolitis (NEC) in very preterm infants and to determine whether the placental inflammatory lesions were also related to the NEC.Methods This retrospective cohort study examined newborns born at ＜ 32 weeks (n =180) between July 2006 and July 2015 and their mothers at our hospital,recorded the maternal age,body mass index (BMI),multiparity situation,and the usage of prenatal steroids or antibiotics.Medical records of eligible newborns and their mothers were reviewed.Maternal blood white blood cell and differential counts were measured at admission and the placentas were examined histologically after delivery.The primary outcome measure was NEC Bell Stage Ⅱ a.Bivariate analyses and multivariate logistic regression were used for the statistical analyses.Results NEC was diagnosed in 14 of 180 very preterm infants (7.8％),including 11 Stage Ⅱ and 3 Stage Ⅲ infants,and the overall mortality rate of these infants was 7.1％ (n =1).Multivariate regression analysis identified maternal neutrophil-to-lymphocyte ratio (OR =1.07,P =0.002),muhiparity (OR =3.39,P =0.013),and birth weight (OR =0.06,P =0.01) were significantly associated with an increased risk of NEC development.Neonatal neutrophil-to-lymphocyte ratio (NLR) as measured within 24 hours of birth (P =0.65) was not associated with NEC development.Clinical chorioamnionitis (P≥0.99) and histological chorioamnionitis (P =0.46) and funisitis (P =0.21) could not be used as significant predictors of NEC.Conslusions The development of NEC in very preterm infants is associated with the maternal NLR,parity,and birth weight,not with clinical and histological chorioamnionitis and funisitis.

Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.

Objective: To investigate the prevalence of scoliosis among primary and middle school students in Jiaxing City, Zhejiang Province, so as to provide insights into scoliosis control among children and adolescents. Methods: Grade 4 to 6 primary school students and grade 1 to 3 junior high school students were recruited using a stratified cluster sampling method in Jiaxing City in 2019. Participants' demographic characteristics, dietary habits and nutritional status, physical activity, learning environments, reading and writing habits were collected using questionnaires. Scoliosis was screened through general examinations, forward bend test and scoliometer, and scoliosis was diagnosed with whole-spine X-ray scans in an erect position. The prevalence of scoliosis was descriptively analyzed among primary and middle school students. Results: A total of 8 026 primary and middle school students were included, 7 304 valid questionnaires were recovered, with an effective recovery rate of 91.00%. The respondents included 3 667 primary school students (50.21%) and 3 637 junior high school students (49.79%), and included 3 776 boys (51.70%) and 3 528 girls (48.30%). There were 659 participants with initial screening positive for scoliosis (9.02%), and the percentages of positive initial screening of thoracic, thoracolumbar and lumbar scoliosis were 2.93%, 4.56% and 4.56%, respectively. A higher percentage of positive initial screening of scoliosis was diagnosed among participants living in Pinghu City (10.45%), junior high school students (11.74%), girls (11.96%), students with a medical history of anemia (22.44%), students with less than 3 days of moderate-intensity physical activity in the past week (9.46%), students with less than 3 days of walking duration of over 10 minutes in the past week (10.18%), students with daily sitting duration of 5 hours and more in the past week (10.74%), students with their class seats exchanged every semester or month (10.28%), students with daily reading and writing duration of 3 hours and more after school (10.93%) and students with less than 10 cm distance from the chest at reading or writing to the edge of the table (9.67%) (all P<0.05). A total of 218 students received whole-spine X-ray scans in an erect position, 132 participants were definitively diagnosed as scoliosis (60.55%), and the estimated prevalence of scoliosis was 5.46%. Conclusion The percentage of positive initial screening of scoliosis was 9.02% among primary and middle school students in Jiaxing City. Gender, stage of learning, nutritional status, exercise frequency and habits of reading and writing may be factors affecting the development of scoliosis.

OBJECTIVE To understand the synaptic remodel in inner ear after hearing injury by investigating growth associated protein 43(GAP-43) expression in the inner ear hair cells after exposed Kangmin mice to neural injury noise stimulation to induce permanent threshold shift(PTS) or temporary threshold shift(TTS).METHODS To compare the expressions of GAP-43 of NMDAR signal pathway during neural injury stimulation by immunocytochemistry.RESULTS The sustained GAP-43 increase occurs after 7d and 14d of PTS group,and there is not remarkable difference between them.Compared with normal control,the change is not significant in TTS group.CONCLUSION The increase of GAP-43 in spiral ganglion after 7d trauma reveals the synaptic remodel in inner ear.

Objective To investigate the predictive value of red blood cell distribution width (RDW) for no early improvement after intravenous thrombolysis in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke received intravenous thrombolysis in the Department of Neurology,the Second Hospital of Tianjin Medical University between January 2017 and December 2018 were enrolled retrospectively.The National Institutes of Health Stroke Scale (NIHSS) score declined ≥4 or the NIHSS score 0-1 in 24 h after thrombolytic therapy was defined as early improvement,and the NIHSS score declined＜4 was defined as no early improvement.Multivariate logistic regression analysis was used to determine the independent risk factors for no early improvement.Receiver operator characteristic (ROC)curve was used to analyze the predictive value of RDW for no early improvement after intravenous thrombolysis in patients with acute ischemic stroke.Results A total of 119 patients were enrolled in the study,46 (38.7％) had early improvement and 73 (61.3％) had no early improvement.Hypersensitive C-reactive protein,RDW,the time from onset to thrombolysis,and the proportion of complicated hypertension and fasting blood glucose in the no early improvement group were higher or longer than those in the early improvement group,and the differences were statistically significant (all P ＜0.05).Multivariate logistic regression analysis showed that the elevated RDW was an independent risk factor for no early improvement (odds ratio 3.119,95％ confidence interval 1.584-6.141;P =0.001).ROC curve analysis showed that the best cut-off value of RDW for predicting no early improvement after intravenous thrombolysis in acute ischemic stroke was 13.35％.The area under the curve was 0.737 (95％ confidence interval 0.645-0.828).The sensitivity and specificity were 64.4％ and 87.0％,respectively.Conclusion Elevated RDW has certain predictive value for no early improvement after intravenous thrombolysis in patients with acute ischemic stroke.