Objective To evaluate the influence of international normlized ratio(INR) self-management intervention on the complication of patients after mechanical heart valve replacement (MHVR).Methods The randomized controlled trials (RCT) about comparing the INR self-management with conventional management in patients after MHVR were researched by the database of PubMed, Medline, China Biomedical Literature Database, Wanfang data, Chinese National Knowledge Infrastructure, and the data were analyzed by Stata 12.0 software.Results Nine RCTs were enrolled in this study, 4 265 cases in total.The results of Meta-analysis showed that INR self-management could reduce the incidence of thrombosis, relative risk(RR) was 0.68, 95％ confidence interval (95％CI) was 0.50-0.94, P＜0.05.However, there was no significant difference in hemorrhage between the two groups, yet could not evaluate the effect on INR values within the target range, RR(95％CI) was 1.29(1.20-1.38), P＜0.05.But due to the high heterogeneity in literature, the results were for reference only, it remained to be further argumen.Conclusions INR self-management can reduce the incidence of thrombosis in patients after mechanical heart valve replacement, and does not increase the risk of bleeding complication at the same time.

An effective RT-PCR method was developed to detect exogenous gene xylB transcript levels in Zymomonas mobilis CP4. Total RNAs without genomic DNA contamination were purified from wild-type and gene engineering strains, and were quantified to the same concentration. Then, cDNAs synthesis and PCR analysis of these samples were conducted by reverse transcription PCR. The optimal number of cycles was determined by observing amplification profile of target gene xylB and internal control gene 16s rRNA, and relative expression levels of xylB in various samples were analyzed by RT-PCR. The results indicated that the xylB transcript was not be detected in CP4, however that could be found in recombinant strains, in which xylB transcription abundance was similar. The enzyme assay furthermore confirmed that effective ex-pression of the target gene. The method provided a useful and rapid tool for detecting transcript levels of target genes from various samples of Z. mobilis.

Objective To investigate the correlation of Bax and apoptosis in enterocytes of neonatal rats with necrotizing enterocolitis (NEC).Methods Forty-eight neonatal rats (1 day) were randomly divided into control group (n =24) and NEC model group (n =24) by use of odd and even.The rats in control group were maternal breast-fed.The rats in NEC model group were separated from their mothers.To be given formula feeding,cold exposure after hypoxic-reoxygenation treatment.The intestinal tissue located at the boundary of ileum and caecum of two groups were gained on the 24 h,48 h and 72 h with which that all rats were sacrificed by cutting neck.Section of intestinal tissue were stained with immunohistochemistry to detect the expression of Bax and were stained with TdT mediated dUTP nick end labeling(TUNEL) to evaluate the apoptosis in each group.Results The integrate optical density (IOD) value of expression of Bax in the NEC model group began to increase on the 24 h [(1 005.06-± 11.96) IOD] and reached the summit on the 72 h [(3 340.66 ±68.72)] compared with the control group[(666.55 ± 15.77)IOD].A few of TUNEL positive cells began to increase with time dependence.A lot of TUNEL positive cells could be found in NEC model group on the 24 h [(15.04 ± 0.24) ％],and the apoptotic index reached the peak on the 72 h [(35.65 ±0.61) ％] compared with the control group[(4.73 ±0.04) ％,P ＜0.01]-There was a significantly positive correlation between the cell apoptosis and the ratio change of Bax in NEC model group (r =0.94,P ＜ 0.01).Conclusion There is a significantly positive correlation between the cell apoptosis and the ratio change of Bax in enterocytes of neonatal rats with NEC.The cell apoptosis in enterocytes of neonatal rats with NEC maybe be induced by Bax.

Yunnan Strain Information System has been developed by using the Programming Lan guage and Database Engine It includes information of over 10,000 strains that are stored in Yunnan University Institute of Microbiology Strain Library The S ystem makes a convenience for management of Strain Library and supply i mportant information for study these

Objective To investigate the construction of outpatient quality care services and the needs of patient for outpatient service,and to explore the relevance of the two projects.Methods A total of 152 cases of outpatient department registered nurse of Beijing Union Hospital and 281 cases of hospitalized patients on May,2017 were selected,and then developed the Content Questionnaire on Quality Nursing Work of Outpatient Nurse and the Questionnaire on Outpatient Needs Status to carry out investigation.Results This kind of hospital patients with college or university in 216 cases(76.9%,216/281),personal monthly income of 5.0-10.0 thousand accounted for 44.8%(126/281);outpatient nurses aged ≥46 in 83 cases(54.6%,83/152),the working time≥20 years in 120 cases(78.9%,120/152),college degree or above in 137 cases(90.1%,137/152),97 nurses(63.8%,97/152)in charge.The clinic nursing work relates to the rate of above 85%for disease treatment and consultation,health education,guidance service,self-service system services,on-site inspection,consulting room environment,and the cost of nurses working hours and the most frequent content for the on-site inspection and diagnosis of diseases,counseling,health education,medical order service.The order of patients' needs from high to low was disease and consultation,health education,guidance service,order service,on-site inspection,self-service system,registration service,waiting environment and consulting room environment.There was no correlation between the patient's needs and the rate of nursing,the length of work,and the frequency of work(P＞0.05).There were significant differences in the demand for health education on each department(F =3.047,P ＜0.05),education level,medical order service and on-site inspections have significant difference on demand(F=3.809,3.409,P＜0.05),family income,sources of patients were not statistically significant in the comparison(P＞0.05).The outpatient quality care services had lower improved demand(≤26%),and the first six item that needed to improve are disease and medical consultation,self-service system,treatment order service,waiting environment,health education,guidance services.Conclusions In view of the characteristics of outpatient medical staff and patients in large general hospitals,we will improve the quality of outpatient service and meet the needs of patient outpatient service,which will help to deepen the medical reform and improve the quality of medical service.

OBJECTIVE: To compare the clinical application and health economic values of non-invasive prenatal testing (NIPT) and second trimester serum screening (STSS). METHODS: A retrospective analysis was carried out on 54 026 singleton pregnant women undergoing NIPT and STSS from March 1, 2018 to December 31, 2019 in Changsha Maternal and Child Health Care Hospital. For pregnant women with high-risk results of NIPT, prenatal diagnosis and follow-up of pregnancy outcomes were conducted. The data was grouped to 4 screening models, and their cost-benefit was analyzed. RESULTS: The sensitivity, specificity and positive predictive value of NIPT were all higher than STSS. Screening models 1 to 4 have prevented the birth of 71, 29, 52 and 54 patients with Down syndrome, respectively. The safety index of screening models 1 to 4 were 0.0036, 0.3944, 02215 and 0.1281, respectively. When the price of NIPT was decreased to 600 RMB, the cost-benefit of the screening models 1 to 4 was 0.46, 0.65, 0.44 and 0.40 million RMB, respectively. CONCLUSION NIPT has a better detection performance than STSS. When the price of NIPT is 600 RMB, screening model 1 has the best screening effect and the highest accuracy, safety index and health economical value.
Child ; China ; Cost-Benefit Analysis ; Down Syndrome/diagnosis* ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis/methods* ; Retrospective Studies

ObjectiveTo study the effect of Bazi Bushen capsules on delaying the aging process of naturally aging mice and its mechanism. MethodThe mice were randomly divided into four groups according to their body weight， namely， aging group， low-dose Bazi Bushen capsules group （1 g·kg^-1）， high-dose Bazi Bushen capsules group （2 g·kg^-1）， and rapamycin group （0.002 g·kg^-1）. The debilitating signs were detected by behavioral tests and the weakness index was measured. The percentages of spleen T and B lymphocytes， effector T cells （TE）， memory T cells （TM）， naive T cells （TN）， helper T cells （Th）， cytotoxic T cells （Tc） ，Th1 cells， Th2 cells， and regulatory T cells （Treg） were determined by flow cytometry. Cell proliferation and the cell counting kit-8 （CCK-8） assay was used to detect the proliferation of lymphocytes in mice. The hematoxylin-eosin （HE） staining was used to observe the histopathological changes in the mouse spleen. The expression of cyclin-dependent kinase inhibitor 2A （p16） and cyclin-dependent kinase inhibitor 1A （p21） was detected by immunohistochemistry （IHC）. The mRNA expression of senescence-related proteins p16 and p21 was determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and the inflammatory cytokines， including tumor necrosis factor-α （TNF-α）， interferon-γ （IFN-γ）， interleukin （IL）-1β， IL-2， IL-4， IL-10， and IL-12 p70， in peripheral blood of mice were detected by Luminex. ResultAs compared with the aging group， mice in the Bazi Bushen capsules and rapamycin groups showed significantly improved debilitating signs and reduced weakness index scores （P<0.05， P<0.01）， increased proportions of T cells， TN cells， Tc cells， Th2 cells， and Treg cells in the spleen， decreased proportions of TE cells， TM cells， Th cells， Th1 cells （P<0.05， P<0.01）， and increased proliferation of splenic lymphocytes （P<0.05， P<0.01）. In the Bazi Bushen capsules and rapamycin groups， clear structure of the red and white marrow marginal zone was observed in the spleen of mice， the area of the white marrow was increased， and the area of the red marrow was correspondingly decreased. The protein and mRNA expression of aging-related proteins p16 and p21 in the spleen was decreased （P<0.01）， the levels of serum pro-inflammatory cytokines IL-1β， IL-2， IL-12 p70， IFN-γ， and TNF-α levels were decreased， and the levels of IL-4 and IL-10 were increased （P<0.05， P<0.01） in the Bazi Bushen capsules and rapamycin groups as compared with the aging group. ConclusionBazi Bushen capsules have the effect of regulating the debilitating signs of natural aging mice， regulating the immune homeostasis and inflammation level of the body， and reducing cell aging.

OBJECTIVE： To extablish the method for blood concentration determination of mitoxantrone in rats， and to study the pharamokinetics of mitoxantrone in rats. METHODS： Totally 6 SD rats were collected and given mitoxantrone 5 mg/kg via tail vein. The blood samples 0.3 mL were collected before medication and 5， 10， 20， 40， 60， 120， 240， 480， 720 min after medication. Blood samples were placed in heparinized EP tube， and the plasma was centrifuged and separated. After adding silica gel， the plasma were ground and mixed well， then added into methanol solution containing 0.5 mol/L hydrochloric acid to precipitate protein. After grinding and mixing， the supernatant was centrifuged and dried with nitrogen and then dissolved with mobile phase. HPLC method was adopted to determine the plasma concentration of mitoxantrone. The determination was performed on ZORBAX SB-C18 column with mobile phase consisted of 20 mmol/L ammonium acetate （pH adjusted to 2.0 with hydrochloric acid）-methanol （65 ∶ 35， V/V） at the flow rate of 1.0 mL/min. The detection wavelength was set at 244 nm， and column temperature was 30 ℃. The sample size was 20 μL. Pharmacokinetic parameters were calculated with DAS 3.0 software. RESULTS： The linear range of mitoxantrone were 200-10 000 μg/L （r＝0.999 6， n＝6）. The lower limit of quantitation was 200   μg/L， and the limit of detection was 150 μg/L， respectively. RSDs of intra-day and inter-day precision and stability were all lower than 8.0％ （n＝5， 3， 6， respectively）. The extraction recoveries were （85.64±3.93）％-（92.31±1.68）％ （n＝3）. The recoveries of accuracy test were （93.58±1.42）％-（113.92±2.74）％ （n＝3）. The pharmacokinetic parameters of mitoxantrone were as follows as AUC0-720 min was （5 247.1±474.6.0） μg·h/L； t1 /2z was （24.88±6.94） h； CLZ was （0.46±0.09） L/（h·kg）； Vz was （11.07±2.64） L/kg. CONCLUSIONS： The method has recovery and good repeatability， and is suitable for the determination of blood concentration of mitoxantrone and its pharmacokinetic research.