AIM　This study was conducted to identify the human CYP isoforms responsible for the biotransformation of clivorine in human liver microsomes and the mechanism of metabolism-induced hepatotoxicity of clivorine. METHODS　Human liver microsomes were used to investigate the metabolism of clivorine in vitro. Selective CYP-450 inhibitors and cDNA expressed human CYPs were used to study their effects on the formation of hepatotoxic metabolites and the metabolism of clivorine and the principal CYP-450 isoform involved in the formation of hepatotoxic metabolite. RESULTS　Four metabolites, namely dehydroretronecine(DHR), 7-glutathionyl-dehydroretronecine(7-GSH-DHR), 7,9-diglutathionyl-dehydroretronecine(7,9-diGSH-DHR) and clivoric acid were found in the microsomal incubations. Chemical inhibition studies indicated that the metabolism of clivorine and the formation of pyrrolic metabolites as well as the bound pyrroles were strongly inhibited by CYP3A inhibitor ketoconazole(Ket). Whereas α-naphthoflavone(Nap), sulfaphenazole(Sulp), quinidine(Qui), diethyldithiocarbamate(DDC) have no significant effects on the metabolism of clivorine and the formation of pyrrolic metabolites in human liver microsomes. The results of metabolism of clivorine by cDNA expressed human CYPs showed that only CYP3A4 was found to be capable of catalyzing the metabolism of clivorine, while CYP1A2, CYP2C9, CYP2D6 and CYP2E1 did not play significant roles in the metabolism of clivorine and the formation of pyrrolic metabolites. CONCLUSION　The resultsdemonstrated that the pyrrolic metabolites were the major in vitro metabolites of clivorine and CYP3A4 was the major CYP isoform involved in clivorine metabolism and the formation of hepatotoxic pyrrolic metabolites in human liver microsomes. CYP3A4 plays a key role in the clivorine induced hepatotoxicity.

This paper was reviewed the research status of health literacy of cancer caregivers, including an overview of health literacy, assessment tools for health literacy of cancer caregivers, factors affecting health literacy of cancer caregivers and measures to improve health literacy of cancer caregivers. To provide theoretical basis for the localized development of health literacy assessment tools for cancer caregivers and further research.

Objective:To evaluate effect of teaching for understanding (TfU) model on the teaching of nursing students in vascular surgery department.Methods:A total of 27 nursing students rotating in vascular surgery department in our hospital from July 2018 to July 2019 were enrolled to receive TfU teaching. This model included setting enlightening topics and understanding goals, designing standardized patients, group scenario simulation and other understanding activities, and sustainability evaluation was carried out for teaching. Compared with 27 interns from July 2017 to July 2018, the teaching effect was evaluated through theoretical achievement assessment and teaching satisfaction survey.Results:The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the and pathogenesis and clinical symptoms ( P>0.05) in the examination. However, the experimental group was higher than the control group in the measurement of the clinical nursing and the total score, with statistical difference ( t=2.934, t=2.641, P=0.005, P=0.011). The results of satisfaction survey showed that the students' satisfaction scores of the experimental group on the mastery of theoretical knowledge, communication ability, teamwork and cooperation, learning interest improvement and the overall teaching were better than those of the control group, with significant differences ( P<0.05). Conclusion:The TfU teaching model can increase the understanding and the mastery of the clinical nursing knowledge of related diseases, improve students' learning enthusiasm, enhance the ability of communication and cooperation, and it's beneficial for the all-round development of students.

Adult ; Arachnoid Cysts ; complications ; Female ; Humans ; Intracranial Aneurysm ; etiology

OBJECTIVETo evaluate clinical result of the micro-decompression procedure for lumbar spinal stenosis.

METHODSFrom September 2001 to May 2006,87 patients (male 60, female 27) with lumbar spinal stenosis underwent micro-decompression. The age of patients were from 43 to 80 years with an average of 51 years. Among them,2 cases with spinal stenosis occured in L(3,4), 47 in L(4,5), 38 in L5S1.

RESULTSAll patients were followed up for 18-48 months with an average of 26 months. The results were excellent in 52 cases, good in 28, poor in 7, according to Macnab of back leg pain standard. The rate of excellent and good was 92%.

CONCLUSIONOperative treatment for lumbar spinal stenosis is focused at the areas causing symptomatic neural root compression rather than prophylactic decompression at areas of nonsymptomatic disease. The micro-decompression procedures are more likely to be well tolerated by older patients.

Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Stenosis ; surgery ; Treatment Outcome

BACKGROUNDEmerging evidence suggests that stem cells can be used to improve cardiac function in patients after acute myocardial infarction. In this randomized trial, we aimed to use Doppler tissue tracking and strain imaging to assess left ventricular segmental function after intracoronary transfer of autologous bone-marrow stem cells (BMCs) for 6 months' follow up.

METHODSTwenty patients with acute myocardial infarction and anterior descending coronary artery occlusion proven by angiography were [corrected] randomized into intracoronary injection of bone-marrow cell (treated, n = 9) or diluted serum (control, n = 11) groups. GE vivid 7 and Q-analyze software were used to perform echocardiogram in both groups 1 week, 3 months and 6 months after treatment. Three apical views of tissue Doppler imaging were acquired to measure peak systolic displacement (Ds) and peak systolic strain (epsilonpeak) from 12 segments of LV walls. Left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were obtained by Simposon's biplane method.

RESULTS(1) 3 months later, Ds and epsilonpeak over the infract-related region clearly increased in the BMCs group [Ds: (4.49 +/- 2.71) mm vs (7.56 +/- 2.95) mm, P < 0.01; epsilonpeak: (-13.40 +/- 6.00)% vs (-17.06 +/- 6.05)%, P < 0.01], but not in the control group [Ds: (4.74 +/- 2.67) mm vs (5.01 +/- 3.23) mm, P > 0.05; epsilonpeak: (-13.84 +/- 6.05)% vs (-15.04 +/- 6.75)%, P > 0.05]. At the same time, Ds over the normal region also increased, but the Ds enhancement was markedly higher in the BMCs group than that in the control group [(3.21 +/- 3.17) mm vs (0.76 +/- 1.94) mm, P < 0.01]. Parameters remained steady from the 3rd to 6th month in either group (P > 0.05). (2) LVEF in treated and control groups were almost the same at baseline (1st week after PCI) [(53.37 +/- 8.92)% vs (53.51 +/- 5.84)%, P > 0.05]. But 6 months later, LVEF in the BMCs group were clearly higher than that in the control group [(59.33 +/- 12.91)% vs (50.30 +/- 8.30)%, P < 0.05]. (3) There were no evident difference in EDV or ESV between two groups at baseline [EDV: (113.74 +/- 23.24) ml vs (129.94 +/- 32.72) ml, P > 0.05; ESV: (57.12 +/- 18.66) ml vs (62.09 +/- 17.68) ml, P > 0.05]. Three months later, EDV and ESV in the control group were markedly greater than those in the BMCs group [EDV: (154.89 +/- 46.34) ml vs (104.85 +/- 33.21) ml, P < 0.05; ESV: (82.91 +/- 35.79) ml vs (49.54 +/- 23.32) ml, P < 0.05]. But EDV and ESV did not change much from 3rd to 6th month in either group (P > 0.05).

CONCLUSIONSEmergency transplantation of autologous BMCs in patients with acute myocardial infarction helps to improve global and regional contractility and attenuate post-infarction left ventricular remodeling. Tissue tracking and strain imaging provide quick, simple and noninvasive methods for quantifying left ventricular segmental function in humans.

Aged ; Double-Blind Method ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; physiopathology ; therapy ; Transplantation, Autologous ; Ventricular Function, Left ; Ventricular Remodeling

Objective To investigate the effect of Porphyromonas gingivalis(Pg) with different fimA genotypes on vascular cell adhesion molecule-1(VCAM-1) and intercellular adhesion molecule-1(ICAM-1) production by human umbilical vein endothelial cells(HUVEC). Methods In the present study, PgATCC33277(type Ⅰ fimA genotype), WCSP 115(type Ⅱ fimA genotype), W83(type Ⅳ fimA genotype), and Escherichia coli-lipopolysaccharide (Ec-LPS) were designed as experimental group 1, 2, 3, and positive control group, respectively, to stimulate HUVEC, and the un-stimulated HUVEC were analyzed as negative control group. The three strains of Pg were cultured anaerobically in standard condition, and then the Pg cells and Ec-LPS were co-cultured with HUVEC for 2, 6, and 24 h, respectively. The amount of ICAM-1 and VCAM-1 produced by HUVEC was detected with flow cytometry(FCM). The expression of ICAM-1 and VCAM-1 by HUVEC were assayed with confocal laser scanning microscope(CLSM). ResultsThe expression of ICAM-1 on the surface of HUVEC were intensified after infected by Pg with Ⅰ, Ⅱ, and Ⅳ fimA genotypes (P<0.05). The amounts of ICAM-1 were 60.27±5.43, 80.81±1.44, and 85.94±2.56 for Pg with type Ⅰ fimA genotype, 86.69±8.81, 90.19±0.00, and 96.18±0.48 for Pg with type Ⅱ fimA genotype, 59.66±0.40, 85.79±4.86, and 96.04±2.07 for Pg with type Ⅳ fimA genotype at 2, 6 and 24 h after infection, respectively. The up-regulation effects caused by Pg with type Ⅱ and Ⅳ fimA genotypes were stronger than those caused by Pg with type Ⅰ fimA genotype at different time points except at 2 h(P<0.05). Under the present experimental condition, infected by Pg with type Ⅰ, Ⅱ and Ⅳ fimA genotypes stimulated low expression of VCAM-1 by HUVEC, it showed no significant differences among all the groups (P>0.05). Expression of ICAM-1 and VCAM-1 in Pg infected HUVEC were confirmed by CLSM. Infection of HUVEC with Pg resulted in more fluorescence staining of ICAM-1 and VCAM-1 compared with that in uninfected HUVEC cultures. Conclusions The virulence and pathogenicity of Pg is associated with its fimA genotypes, Pg with type Ⅱ and Ⅳ fimA genes possess stronger ability to stimulate HUVEC to up-regulate the expression of cell adhesion molecules, which may lead to disorders in vascular endothelial function.

Objective To investigate the changes in psychological state after occupational exposure in the AIDS occupational exposure population and related influencing factors,and to provide baseline data and a basis for related departments to conduct mental health prevention and intervention for personnel with occupational AIDS exposure.Methods AIDS risk assessment was performed for all personnel with occupational AIDS exposure in 2014 in Nanning,China,and the Symptom Checklist-90 (SCL-90) psychological scale was used for psychological state evaluation at 24 hours,1 week,and 3 months after occupational exposure in all persons who met the research criteria.Results Most of the persons with occupational AIDS exposure came from secondary and tertiary hospitals (85％),and nurses accounted for the highest percentage (78.3％).The age ranged from 21 to 50 years,and the mean age was 31.02+7.92 years.The persons with occupational AIDS exposure aged 20～29 years accounted for the highest percentage (51.6％),and most persons (76.7％) graduated from junior colleges.Compared with the adult norm,there was significant increases in the total psychological score and the number of positive items after occupational exposure (P＜0.05).The scores of all items at 24 hours were significantly higher than those at the other time points,and the scores of all items gradually decreased over time (F=227.24,267.57,and 287.46,P＜0.05).Compared with the adult norm,there were significant increases in the factor points at 24 hours and significant reductions in the factor points at 3 months (P＜0.05).Compared with those at 24 hours,the factor scores at 3 months decreased significantly (P＜0.05).Conclusion Occupational AIDS exposure affects the mental status of related personnel,and the mental status at 24 hours after exposure is poor.Related departments should provide corresponding psychological counseling for the occupational exposure population at different exposure times.

Objective To investigate the changes in psychological state after occupational exposure in the AIDS occupational exposure population and related influencing factors,and to provide baseline data and a basis for related departments to conduct mental health prevention and intervention for personnel with occupational AIDS exposure.Methods AIDS risk assessment was performed for all personnel with occupational AIDS exposure in 2014 in Nanning,China,and the Symptom Checklist-90 (SCL-90) psychological scale was used for psychological state evaluation at 24 hours,1 week,and 3 months after occupational exposure in all persons who met the research criteria.Results Most of the persons with occupational AIDS exposure came from secondary and tertiary hospitals (85％),and nurses accounted for the highest percentage (78.3％).The age ranged from 21 to 50 years,and the mean age was 31.02+7.92 years.The persons with occupational AIDS exposure aged 20～29 years accounted for the highest percentage (51.6％),and most persons (76.7％) graduated from junior colleges.Compared with the adult norm,there was significant increases in the total psychological score and the number of positive items after occupational exposure (P＜0.05).The scores of all items at 24 hours were significantly higher than those at the other time points,and the scores of all items gradually decreased over time (F=227.24,267.57,and 287.46,P＜0.05).Compared with the adult norm,there were significant increases in the factor points at 24 hours and significant reductions in the factor points at 3 months (P＜0.05).Compared with those at 24 hours,the factor scores at 3 months decreased significantly (P＜0.05).Conclusion Occupational AIDS exposure affects the mental status of related personnel,and the mental status at 24 hours after exposure is poor.Related departments should provide corresponding psychological counseling for the occupational exposure population at different exposure times.

Objective To analyze the epidemiological characteristics and changing trend as well as the related affecting factors of hepatitis C in China.Methods Data analysis was performed based on the case-reporting data of hepatitis C from 1997 to 2011,using SPSS 19.0.Results The number of reported cases and incidence of hepatitis C had been increasing annually since 1997,especially in 2004.The hepatitis C reported incidence increased from 3.03 per 100 000 in 2004,to 12.97 per 100 000 in 2011.The 15 to 49 age group accounted for more than 50％ of all the reported cases,seen in every year.The number and proportion of hepatitis C reported cases among those over 50 year-olds had an annually increase.From 2005 to 2011,the number of cases in both urban areas and rural areas increased annually,while the urban-rural ratio decreased from 1.47 in 2005 to 0.99 in 2011.There appeared an increasing trend of hepatitis C reported incidence in China,with most of the high reported incidence of hepatitis C fell in the northern parts of China.74.8％ of the HCV/HIV co-infected cases had histories of intravenous drug use,plasma donation,blood transfusion or surgical operation.Conclusion The reported number and incidence of HCV infection had been increasing annually.To develop a more realistic control measures for hepatitisv C,it is necessary to strengthen the monitoring program and carrying out specific epidemiological study among target groups and key areas.