Objective To explore the effect of preeclampsia on the expression of hypothalamic-pituitary-adrenal (HPA) axis related genesin the hippocampus of adolescent offspring rats.Methods The pregnant Sprague-Dawley rats were randomly divided into two groups to be given 125 mg · kg-1 ·d-1 L-NAME or 1 mL pure saline by daily injection from day 14 to delivery.Serum corticosterone (CORT) levels in neonatal offspring rats were detected by ELISA.The mRNA and protein levels of glucocorticoid receptor (GR),corticotropin releasing hormone (CRH),CRH receptor 1 (CRHR1) and IL-6 in the hippocampus of 8-week offspring rats were determined by real-time PCR and Western blot,respectively.Results Compared with normal neonatal rats,the serum CORT concentration of neonatal rats with preeclampsia was increased (P＜0.05).Compared with normal adolescent offspring,the levels of GR,CRH and CRHR1 mRNA and protein were increased in the hippocampus of adolescent rats with preeclampsia (P＜0.05),accompanied by increased IL-6 mRNA and protein (P＜0.05),as a downstream inflammatory gene of the GR.Conclusions We found that adolescent SD rats exposed to preeclampsia showed alteration in the expression of HPA related genes in the hippocampus,which played a role in the impairment of learning and memory in children.

Objective To solve the difficulty of intubation of nasojejunal feeding tube under digital subtraction angiography (DSA) system when conventional methods were failed.Methods Seventy-one patients who failed to place the nasojejunal feeding tube by single guide wire under DSA conventional methods.With the methods of decreasing the stomach volume,changing the body posi-tion,and using a catheter or gastrointestinal motility,the nasojejunal feeding tube was placed into the proper position (more than 30cm far away from Treitz or gastrointestinal anastomosis).Results All the procedures were successfully accomplished.No compli-cations,such as throat damage,abdominal pain,perforation and hemorrhage of digestive tract were found.The mean duration under DSA was four minutes (2-7min).Conclusion With the help of various methods above,we can improve the success rate of intuba-tion and reduce the duration of the nasojejunal feeding tube placement,when conventional methods were failed.

Objective To study the effect of cardiac contractility modulation (CCM) on TGFβ1/Smad/CTGF signaling pathway.Methods A rabbit heart failure (HF) model was established by ligating the ascending aortic root.Thirty rabbits were divided into sham operation group (n=10),HF group (n=10) and CCM group (n=10).Myocardial tissue collagen Ⅰ and collagen Ⅲ were analyzed with Sirius red staining,myocardial tissue hydroxyproline level was measured by chromometry,and expressions of TGFβ1,Smad3,Smad7,CTGF were detected by Western blot in 3 groups.Results Collagen Ⅰ,collagen Ⅲ and hydroxyproline content were highcr in HF group than in sham operation group,while collagen Ⅰ,collagen Ⅲ and hydroxyproline conten were lower in CCM group than in sham operation group (0.69±0.05 μg/mg vs 0.98±0.04 μg/mg,P＜0.05).The expression levels of TGFβ1,Smad3,CTGF were higher while those of Smad7 were lower in HF group than in sham operation group (P＜0.05).The expression levels of TGFβ1,Smad3,CTGF were lower while those of Smad7 were higher in CCM group than in HF group (0.49±0.03 vs 0.67±0.04,0.43±0.06 vs 0.59±0.06,0.45±0.08 vs 0.75±0.09,P＜0.05;0.43±0.08vs 0.26±0.04,P＜0.05).Conclusion CCM can improve the myocardial fibrosis in HF rabbits by downregulating the expression of TGFβ1,Smad3,CTGF and upregulating the expression of Smad7.

Objective To observe the effect of self-practice-oriented teaching method on injection skills, psychological status and blood glucose control of type 2 diabetes mellitus patients receiving pen insulin injection for the first time. Methods A total of 105 patients with type 2 diabetes mellitus who received insulin injection for the first time were divided into the control group and the observation group according to admission sequence. The control group adopted the method of one-to-one bedside health education of primary nurses. Insulin injection demonstration and disease-related knowledge education were conducted on the day of the medical order to start insulin treatment. Health education was conducted once a day for 3-5 minutes each time for a total of 5 days. The observation group adopted centralized health education, which insulin injection teaching desk, video and other teaching aids, combined with the guidance and correction of primary nurses were used, focusing on the use of teaching aids and self-injection as early as possible during hospitalization. The levels of fasting and postprandial blood glucose, insulin injection skills and anxiety and depression scale (HADS) were compared between the two groups. Results There was no statistically significant difference in blood glucose level, anxiety scores and depression scores between the two groups before the intervention (P>0.05). Two weeks after the hospital discharge, the anxiety and depression scores of the observation group was 7.31 ± 1.78, 7.00 ± 1.73, significantly lower than the anxiety and depression points of the control group 9.33 ± 2.21, 8.61 ± 1.79 (t=2.492, 3.097, P<0.05);The insulin injection skills assessment score of patients in the observation group was (90.90 ± 4.15) points, significantly higher than the points of the control group (83.74 ± 6.22) (t=-6.593,P<0.01);In the observation group, fasting blood glucose and postprandial 2-hour blood glucose were (7.56 ± 1.86) mmol/L and (10.61 ± 2.25) mmol/L, respectively Compared with the control group (8.55 ± 1.96) mmol/L ,(12.91 ± 2.95) mmol/L, there was statistically significant difference between the two groups(t=2.542, 4.301, P<0.05). Conclusion The self-practice-oriented teaching method can effectively alleviate the negative emotions of the patients with the first insulin injection, improve their insulin injection skills to better control blood glucose.

Spinal cord injury (SCI) is a serious nervous system disease that usually leads to the impairment of the motor, sensory, and autonomic nervous functions of the spinal cord, and it places a heavy burden on families and healthcare systems every year. Due to the complex pathophysiological mechanism of SCI and the poor ability of neurons to regenerate, the current treatment scheme has very limited effects on the recovery of spinal cord function. In addition, due to their unique advantages, exosomes can be used as carriers for cargo transport. In recent years, some studies have confirmed that treatment with mesenchymal stem cells (MSCs) can promote the recovery of SCI nerve function. The therapeutic effect of MSCs is mainly related to exosomes secreted by MSCs, and exosomes may have great potential in SCI therapy. In this review, we summarized the repair mechanism of mesenchymal stem cells-derived exosomes (MSCs-Exos) in SCI treatment and discussed the microRNAs related to SCI treatment based on MSCs-Exos and their mechanism of action, which is helpful to further understand the role of exosomes in SCI.

Objective To observe the feasibility and safety of CT-guided fine-needle assisted localization for puncturing difficult lung or liver lesions.Methods Data of 30 patients with single difficult lung or liver lesion,i.e.lesion located at difficult part for puncturing or deep lesion with diameter of 0.5-2.0 cm who underwent CT-guided 22G needle assisted localization before puncturing were retrospectively analyzed.The success rate of fine-needle assisted localization,the success rate of the first-time puncturing and the occurrence of complications were recorded.Results Among 30 difficult lesions,there were 27 lung lesions and 3 hepatic lesions,with a mean diameter of(1.0±0.4)cm.Assisted localization of difficult lesions were successfully performed with 22G needle under CT guidance at the edge of lesion,1 cm adjacent to lesion or at the puncture path,with success rate of fine-needle assisted localization of 100%,and no obvious complication happened.The followed operations included preoperative localization of 14 lung nodules,biopsy of 10 lung nodules and 3 liver nodules,as well as microwave ablation of 3 liver nodules,with the success rate of the first-time puncturing of 100%.Mild pneumothorax was observed in 3 cases(3/27,11.11%)of difficult lung lesions after biopy.No other obvious complication occurred.Conclusion CT-guided fine-needle assisted localization for percutaneous puncturing difficult lung or liver lesions was feasible and safe.

OBJECTIVETo investigate the status of exclusive breastfeeding(EBF) and possible influencing factors during 0-7 days postpartum in China.

METHODSDuring 2011 to 2013, healthy mothers and neonates who were in the period of 0- 7 days postpartum from 8 provinces across different regions of China were recruited to take the questionnaire investigations and physical examinations. Information about socio-economic, pregnant, and delivery status, infant healthy situation and feeding indicators was collected to calculate the rate of exclusive breastfeeding during 0- 7 days postpartum and analyze the influencing factors.

RESULTSA total of 1 882 pairs of mothers and neonates were covered by this study. The rate of EBF was 13.3% (250 cases) during 0- 7 days postpartum. Bottle feeding (OR=0.08, 95% CI: 0.05- 0.12), the mothers themselves mixed fed at their 0-4 months old (OR=0.22, 95%CI: 0.08-0.58), the mothers who had used methods to stimulate milk secretion (OR=0.58, 95% CI: 0.35- 0.94) might decrease the EBF rate. Compared with the mothers who believed that their breast milk was not enough for their infants, the mothers who believed breastmilk was enough may increase the EBF rate (OR=6.04, 95%CI: 3.34-10.94). Comparing to the EBF rate of Beijing, Yunnan (OR=0.10, 95%CI: 0.04-0.24), and Gansu(OR=0.03,95%CI: 0.01-0.08) had lower EBF rate during 0-7 days postpartum. What's more, the EBF rate increased with the increasing neonates' age (OR=1.33, 95% CI: 1.16- 1.53).

CONCLUSIONThe EBF rate during 0- 7 days postpartum is still low in China and had significant differences in different regions. Suboptimal feeding knowledge and practices affected the EBF rate significantly.

Bottle Feeding ; Breast Feeding ; statistics & numerical data ; China ; Female ; Humans ; Infant, Newborn ; Milk, Human ; Mothers ; Postpartum Period ; Pregnancy ; Surveys and Questionnaires

In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.

The gut microbiota plays an important role in the development and progression of colorectal cancer (CRC). To learn more about the dysbiosis of carcinogenesis, we assessed alterations in gut microbiota in patients with CRC. A total of 23 subjects were enrolled in this study: 9 had CRC (CRC group) and 14 had normal colons (normal group). The microbiome of the mucosal-luminal interface of each subject was sampled and analyzed using 16S rRNA gene amplicon sequencing. We also used Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) to predict microbial functional profiles. The microbial composition of the mucosal lumen differed between the groups, and the presence of specific bacteria may serve as a potential biomarker for colorectal carcinogenesis. We identified a significant reduction in Eubacterium, which is a butyrate-producing genera of bacteria, and a significant increase in Devosia in the gut microbiota of CRC patients. Different levels of gut microflora in healthy and CRC samples were identified. The observed abundance of bacterial species belonging to Eubacterium and Devosia may serve as a promising biomarker for the early detection of CRC.