Objective To explore the mechanism of IL-6 in EAE. Methods 25 female Wistar rats were randomly divided into 2 groups, EAE group( n=15 ) and normal control group( n=10). The expression of IL-6, TNF-αtand TGF-β of the two groups rots were ob-served by immunohistochemistry staining, and then correlation analysis of the expression of IL-6, TNF-αtandTGF-β was made. Results There was negative correlation between gray scale of IL-6 and symptom scores( r=-0.953, P＞0.05). IL-6 and TGF-β had no statistical-ly significant correlation ( r=-0.492, P＞0.05). There was negative correlation between gray scale of TNF-α and symptom scores( r=-0.978, P＜0.05), and both of the correlation between TNF-α and TGF-β ( r=-0.502, P＞0.05), TGF-β and scores( r=0.470,P＞0.05 ) were not statistically significant. Conclusions IL-6 may participate in EAE as a inflammatory factor.

BACKGROUND:Intestinal fibrosis is a common complication in inflammatory bowel disease and leads to functional damage and intestinal obstruction. Intestinal fibrosis is mainly related to the imbalance of deposition and degradation of extracellular matrix components, such as collagens and fibronectins. Studies have found that mesenchymal stem cells secreted soluble bioactive substance such as extracellular vesicles via paracrine action, which exerted marked anti-fibrosis effect. OBJECTIVE: To investigate the effect of human placenta mesenchymal stem cells-derived extracellular vesicles on collagen deposition in mice with colitis. METHODS: Totally 24 BALB/c mice were randomly divided into sham operation group, model group and extracellular vesicles group, with 8 mice in each group. Except the sham operation group, the remaining mice of model group and extracellular vesicles group were treated with trinitro-benzene-sulfonic acid to induce intestinal fibrosis, once a day for 6 weeks. The mice in the extracellular vesicles group and model group were administered with extracellular vesicles and phosphate-buffered saline, respectively, at 3 weeks, once a day for 6 weeks. The therapeutic effect of extracellular vesicles was evaluated by disease active index score and the colon weight/length ratio at 1-7 weeks. Diseased intestinal segment was subjected to histological staining. Western blot assay and RT-PCR were used to measure fibrosis related indicators so as to evaluate the degree of intestinal fibrosis. RESULTS AND CONCLUSION: (1) Compared with the model group, disease active index score and the colon weight/length ratio were significantly reduced, and colonic pathology was significantly improved in the extracellular vesicles group. (2) Compared with the model group, collagen deposition in colon mucosa of mice was significantly reduced, and the expression of collagen I, collagen III and transforming growth factor-β1 decreased significantly in the extracellular vesicles group. (3) Compared with the model group, expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 in mouse colon tissue were significantly increased, while the expression level of tissue inhibitor of metalloproteinase 1 was decreased in the extracellular vesicles group. (4) Results suggest that human placenta mesenchymal stem cells-derived extracellular vesicles can obviously improve the severity of colon injury and reduce the collagen deposition of intestinal mucosa in mice with enteritis.

Objective To assess the value of echo tracking(ET) technique on atherosclerosis in the rabbit models, and to probe the pathological foundation of its indexes changes and the usefulness in evaluating arterial elasticity. Methods Thirty New Zealand rabbits were divided into 3 groups randomly: group A was the control group;group B,C were fed with high lipid feedstuffs for 8 weeks and 12 weeks, respectively. The ET examination of abdominal aorta was performed in group A and group B at the end of 8 weeks,it was performed in group A and group C at the end of 12 weeks. The parameters of elasticity were measured including pressure-strain elastic modulus (Ep), stiffness parameters(β), pulse wave velocity (PWVβ), augmentation index (AI), arterial compliance (AC), etc. Two dimensional ultrasound and pathological examination of abdominal aorta were performed at the same time. Results No obvious plaque and arterial wall thickness were seen in the abdominal aorta. Ep,β,PWVβ of group C were higher than that of group A and B, while AC of group C was lower than that of group A and B, and the difference had statistical significance (P<0.05). AI had no significant difference in all groups (P>0.05). Pathological examinations indicated that foam cell formation was seen in the abdominal aorta intima, the elastic fiber layer and smooth muscle layer were kept well in B group. Lots of cholesterol crystal formation was seen in the abdominal aorta intima and the two layer were obvious destroyed in group C. Conclusions ET can detect the atherosclerosis earlier than two-dimensional ultrasound. ET can detect the elasticity changes only when the elastic fiber layer and smooth muscle layer were destroyed . So it can be concluded that the destroy of elastic fiber layer and smooth muscle layer may be the pathological foundation of ET elasticity parameters changes.

Good self-management behaviors can control symptoms of the patients with osteoarthritis, improve the patients' joint function and quality of life. Patients' self-management behaviors have been impacted by disease knowledge, self-effcacy, emotional state, and social support. All the above factors should been taken into full consideration when intervening. Self-management program is an intervention mode which can improve patient self-management behaviors and promote patient health.

ObjectiveTo explore and evaluate the application effect of scenario simulation teaching method in the standardized training of neurosurgery junior nurses. MethodsTotally 38 junior nurses in Neurosurgery Department of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 2016 to December 2018 were selected as the subjects in the study and randomly divided into control group (n=19) and observation group (n=19)by simple random sampling method. The control group was given the standardized training process of our hospital for stage training, while the observation group was added scenario simulation teaching method on that basis. The differences of theoretical and operational assessment scores, operational assessment time, emergency response ability, team cooperation ability and patient satisfaction between the two groups were compared. ResultsThe results of operation assessment, emergency response ability, patient satisfaction and team cooperation ability of junior nurses in the observation group were better than those in the control group (P＜ 0.05). There was no significantly statistical difference between the two groups in theoretical and operational assessment results (P＞0.05). ConclusionsOn the basis of standardized training and neurosurgery scenario simulation training, the operation ability, emergency response ability,medical cooperation ability and patient satisfaction of junior neurosurgery nurses can be improved.

Objective To assess the dietary intake status of Chinese lactating women during the first month postpartum. Methods Data were extracted from Chinese National Nutrition and Health Surveillance, children aged 0-5 years and lactating women (2013). A total of 55 counties from 30 provinces in China (excluding the Tibet Autonomous Region) were selected using a multi-stage stratified cluster randomization sampling method. A group of 3 623 lactating women, at 1-6 months after delivery, were investigated in the study. The semi-quantitative food frequency questionnaire (FFQ) was used to collect information on frequencies and amounts of food consumed. Differences in food consumption rates and dietary intake in lactating women having different characteristics were analyzed and compared. Results To eliminate abnormal values, 3 300 lactating women were included in the study. During the first month postpartum, food types with higher consumption rates were animal products (98.2%,3 239) and vegetables (90.7%,2 987), in addition to cereals (100%) and liquids (100%). The consumption rate of fruits was 67.4%(2 222) and the lowest consumption rate was for dairy products (38.3%, 1 262). The median intake of cereals, vegetables, fruits and animal products were 247.8, 150.0, 40.0 and 178.6 g/d, respectively. The daily median intake of dairy products and soybean/nut products was 0.0 g/d. Overall, the lactating women consumed 895.7 ml/d liquids. About 49.3% (1 627) of the subjects consumed less than the recommended intake for animal products in Chinese Dietary Guideline (2016). More than 50% of the lactating women consumed less than the recommended intakes for the other types of food, especially dairy, soybean/nut and liquids. The consumption rates for dairy products were 26.9%, 29.4%, 31.8% and 33.8% and those for soybean/nut products were 33.9% , 35.8% , 37.5% and 41.7% for the lactating women living in rural areas, with educations at junior high school level and below, with average family incomes under 15 000 yuan per capita in 2012 and who work as household mothers, respectively. These consumption rates for dairy and soybean/ nuts were significantly lower than those in women living in cities (48.4%, 55.0%), with an education level of senior high school or above (48.8%, 55.7%), with average family income over 15 000 yuan per capita in 2012 (45.5% , 52.8% ) and who work outside the home (43.7% , 49.4% ). P values were <0.05 for all comparisons. Conclusion The daily intake of all foods by lactating women during the first month postpartum was lower than the levels recommended in Chinese Dietary Guideline (2016). The consumption rate of dairy and soybean/nut products during this time period was low, especially for those living in rural areas, with education levels of junior high school and below, with average family incomes less than 15 000 yuan per capita in 2012 and who are housemothers.

Objective To analyze serum vitamin D levels in Chinese lactating women, in 2013, and to evaluate their vitamin D nutritional status and influencing factors. Methods Data were from the Chinese National Nutrition and Health Surveillance in 2013. Using the multistage stratified cluster sampling method, serum samples from lactating women, at 0-24 months postpartum, were obtained from 55 sites in 30 provinces of China, excluding the Tibet Autonomous Region. The concentration of serum vitamin D was determined by mass spectroscopy. A standard questionnaire was used to obtain basic information and the season of blood collection. Dietary information for one recent month was collected using a food frequency questionnaire. A total of 1 981 lactating women were included in the study. A multiple logistic regression model was used to analyze the factors related to vitamin D levels among lactating women. Results The mean vitamin D level was (16.6±6.5) ng/ml, the prevalence of vitamin D deficiency (VDD) (vitamin D<12 ng/ml) was 25.2% (499 cases) and the prevalence of vitamin D inadequacy (12 ng/ml≤vitamin D<20 ng/ml) was 45.4% (900 cases). Compared with in the Han ethnic group, the OR value of VDD was 13.37 for Muslim ethnic women. Compared with women having a junior high school education or below, the OR value of VDD was 1.40 for those women with an educational level of senior high, middle school or above. Compared with housewives or nonworking women, the OR value of VDD was 1.62 for professional women. Compared with women living in general rural settings, the OR values of VDD for women living in large cities, medium and small cities or poor rural settings were 1.99, 1.46 and 2.66 respectively. Compared with the women surveyed in the fall, the OR value of VDD was 2.19 for the women surveyed in winter or spring. The VDD prevalence increased with higher latitude (OR=1.12) and decreased with increased meat consumption per day (OR= 0.73). (P<0.05 for all comparisons). Conclusion Vitamin D deficiency and vitamin D inadequacy were common in lactating women in China. Those with increased risk of VDD included lactating women who were ethnic Muslims, with higher education levels, engaged in a professional occupation, living in higher latitude region and were surveyed in winter and spring.

Objective To study the prevalence of delayed onset of lactation (later than 3 days) in lactating women in China and to analyze its influencing factors. Methods Data were extracted from Chinese National Nutrition and Health Surveillance-Mothers, from mothers with children under 2 years of age (in 2013). A total of 11 178 women who were lactating or had lactated were selected from 55 counties of 30 provinces (excluding the Tibet Autonomous Region) in China, using the multi-stage stratified cluster randomization sampling method. Basic information, including onset of lactation, initiation of breastfeeding, breastfeeding difficulties and breastfeeding knowledge were collected using a questionnaire investigation. The prevalence of delayed onset of lactation were analyzed by the weighted processing of complex sampling from the 6th national population census data. A multiple logistic regression was used to analyze the factors associated with delaged onset of lactation. Results Among 11 178 lactating women, 3 388 had an onset of lactation later than 3 d. The prevalence of delayed onset of lactation was 30.3%. After complex weighting, the prevalence of delayed onset of lactation was 31.2% (95%CI: 25.7%-36.8%) for lactating women in China. Delivery by Caesarean section (OR=1.28, 95%CI:1.06-1.53) and initiating breastfeeding≥4 h (OR=
2.34, 95%CI:1.76-3.11) were the negative factors for delayed onset of lactation. Compared with those living in large cities, lactating women living in medium or small cities (OR=1.39, 95%CI:1.05-1.84) had a higher risk of delayed onset of lactation. Compared with the lactating women doing housework, the risk of delayed onset of lactation was lower (P<0.05) among those whose occupations were as leaders of Enterprises/Institutions (OR=0.68, 95%CI:0.47-0.99), in catering and service trades (OR=0.61, 95%CI:0.43-0.86), in agriculture/forestry/fishery/herdsmen fields (OR=0.65, 95%CI:0.44-0.96) and who were unemployed (OR=0.64, 95%CI:0.46-0.90). Breastfeeding education during pregnancy might lower the risk of delayed onset of lactation (OR=0.78, 95%CI: 0.62-0.98). Conclusion The prevalence of delayed onset of lactation was relatively high for Chinese lactating mothers. Caesarean section and late initiation of breastfeeding were the primary risk factors. Lactating mothers living in medium or small cities and those doing housework appear to be high-priority groups for intervention. Based on our findings, breastfeeding education during pregnancy is recommended to lower the risk of delayed onset of lactation.

Objective To analyze the status of postpartum weight retention and its associated factors among Chinese lactating women in 2013. Methods This study was based on the databank of Chinese National Nutrition and Health Surveillance in 2013. Using the multi-stage stratified cluster sampling method, we enrolled 12 514 women, at 0-24 months postpartum, from 55 sites in 30 provinces of China (excluding the Tibet Autonomous Region). Questionnaires were used to collect data on basic characteristics, physical activity, lifestyle, food intake, pre-pregnancy weight, weight before delivery, disease history during pregnancy, delivery date, delivery mode, parity and breastfeeding information. Current body weight and height of each subject were measured. Postpartum weight retention in each subject was calculated as the difference between pre-pregnancy and current weights. High postpartum weight retention was defined as≥5 kg.

ObjectiveTo determine the optimal dose of Dachengqi Decoction （大承气汤， DCQD） for the treatment of acute intestinal obstruction （AIO） through a randomized， double-blind， dosage parallel controlled， multi-center clinical trial， and to providee evidence support for the reasonable dosage of DCQD in clinical practice. MethodsBased on the commonly used clinical dose of DCQD， three different groups were set up， including low-dose group which used Dahuang （Radix et Rhizoma Rhei） 12 g， Houpo （Cortex Magnoliae Officinalis） 9 g， Zhishi （Fructus Aurantii Immaturus） 9 g， and Mangxiao （Natrii Sulfas） 4.5 g， medium-dose group using Dahuang 36 g， Houpo 27 g， Zhishi 27 g， Mangxiao 13.5 g， and high-dose group using Dahuang 60 g， Houp0 45 g， Zhishi 45 g and Mangxiao 22.5 g. Initially， 149 AIO patients with Yangming （阳明） bowel excess syndrome were randomly assigned to three groups using a stratified randomization method， and both the patients and the doctors were blinded. In addition to conventional western medicine treatment， each group was given 12 bags of granules made from the raw herbs of DCQD at different doses， taken orally or injected through a gastric catheter once every 6 hours， 3 bags each time， for 3 consecutive days. After treatment， the indicators of the three groups of patients with primary AIO and non-primary AIO were evaluated respectively， and the full analysis set （FAS） and per-protocol set （PPS） were used for analysis. The primary outcomes were the time to recover voluntary bowel movements and voluntary flatulence. The secondary outcomes were the ideal rate of spontaneous defecation and the ideal rate of spontaneous flatus. The occurrence of adverse events during the study was recorded and analyzed using the safety analysis set （SS）. ResultsA total of 91 patients with primary AIO and 58 patients with non-primary AIO were included in the FAS and SS analysis， while 80 primary AIO patients and 56 non-primary AIO patients were included in the PPS analysis. Both FAS and PPS analysis showed significant differences in the time to recover voluntary bowel movements and voluntary flatulence among primary AIO patients in different dose groups of DCQD （P＜0.01）， and the high- and medium-dose groups assumed less time than the low-dose group （P＜0.05）. There was no statistically significant difference in the ideal rate of spontaneous defecation and spontaneous flatus among the three groups （P＞0.05）. And consistent results were seen in the non-primary AIO patients among the three groups. Five adverse events occurred in primary AIO patients （3 in the low-dose group， 1 in the medium-dose group， and 1 in the high-dose group）， mainly manifested as abdominal distension and abdominal pain， and there was no statistically significant difference in the incidence of adverse events （P＞0.05）. No adverse events occurred in patients with non-primary AIO. ConclusionDCQD， as an effective treatment for patients with AIO， is commonly used at a medium dose for patients with primary AIO and at a high dose for patients with non-primary AIO. The therapeutic advantage is mainly reflected in the shorter time to recover spontaneous defecation and spontaneous flatulence and the improvement of intestinal function.