Objective To investigate the effects of goal‐directed volume therapy (GDVT )on the intracranial pressure(ICP) and the balance of cerebral oxygen consumption and supply in selective neurosurgery. Methods Twenty‐four patients sched‐uled for intracranial tumor resection were randomly divided into 2 groups:conventional fluid management group (group C ,n=12) and GDVT group(group G ,n=12). Patients in group C received introperative fluid transfusion according to classical fluid management strategies while those in group G received GDT according to stroke volume variation (SVV) ,guided by Flotrac‐Vigileo system.Mean arterial pressure(MAP) ,heart rate(HR) ,cardiac index(CI) ,ICP ,SVV and jugular bulb oxygen saturation (SjvO2 )were recorded before the anesthesia induction(T1 ) ,at the moment of intubation(T2 ) ,at the moment of opening the hard meninges(T3),1hafteropeningthehardmeninges(T4),andattheendofthesurgery(T5).Thecerebraloxygenextractionra‐tio(CERO2 )was calculated. The duration of surgery ,crystalloid volume ,colloid volume ,blood transfusion volume ,urinary output and bleeding volume were recorded as well.Results The colloid transfusion volume ,the total fluid transfusion volume and uri‐nary output were significantly increased in group G when compared with those in group C (P<0.05).MAP ,CI ,and SjvO2 were much higher and CERO2 were much lower at T4 and T5 in group G than in group C(P<0.05). There was no significant differ‐ence in the ICP at each time point between groups G and C (P>0.05).Conclusion Goal‐directed fluid therapy optimizes the cardiac preload without increasing the ICP in selective neurosurgery ,and it also improves the balance of cerebral oxygen con‐sumption and supply.

Objective:To study the curative efficacy of decitabine combine with CAG regimen in the treatment of acute myeloid leukemia and its effects on the serum Interferon-γ (IFN-γ),alpha hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) levels.Methods:70 cases of patients with acute myeloid leukemia who were treated from February 2013 to October 2016 in our hospital were selected as research objects.According to the random number table,the patients were divided into the observation group (n=35) and the control group (n=35).Both groups of patients were treated conventional treatment.The control group was treated with CAG scheme,intravenous injection of aclarubicin,20 mg each time,granulocyte colony stimulating factor,300 μg each time,subcutaneous intravenous cytarabine,10～15 mg/m2 each time,while the observation group was treated with intravenous drip of decitabine on the basis of control group,15 mg/m2 each time.Then the therapeutic effect,serum interferon-γ (IFN-γ),alpha hydroxybutyrate dehydrogenase (HBDH),lactate dehydrogenase (LDH) levels before and after treatment,incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective of observation group was significantly higher than that of the control group [91.42％(32/35)vs68.57％(24/35)] (P ＜0.05);the serum IFN-γ,HBDH,LDH levels were significantly higher than those of the control group [(3.21± 1.01)pg/ml vs.(5.13 ± 1.90)pg/mL,(103.62± 26.39)U/L vs.(118.80± 28.60)U/L,(101.36± 27.32)U/L vs.(123.08 ± 30.59)U/L] (P ＜0.05);the incidence rate of adverse reactions was significantly lower than that of the control group [20.00％(7/35) vs.42.85％(15/35)(P ＜0.05)].Conclusion:Decitabine combined with CAG regimen was more effective for acute myeloid leukemia than CAG regimen alone,which might be related to reduce the serum levels of IFN-γ, HBDH and LDH.

Objective:To evaluate the relationship between red blood cell distribution width (RDW) and metabolic syndrome (MS) in patients with impaired glucose tolerance (IGT).Methods:A total of 415 patients with abnormal glucose tolerance were screened by oral glucose tolerance test in Changsha Traditional Chinese Medicine Hospital (Changsha Eighth Hospital) from October 2015 to September 2019. General data were collected and blood routine and biochemical indexes were detected. There were 193 cases in the observation group and 222 cases in the control group. The RDW and other clinical indicators were compared between the two groups, the correlation between RDW and other indicators was analyzed, and the risk factors of metabolic syndrome were analyzed.Results:⑴ The RDW, systolic blood pressure (SBP), diastolic blood pressure (DBP), height (Ht), weight (Wt), waist circumferenc (Wc), triglyceride (TG), cholesterol (CHOL), low density lipoprotein (LDL), creatinine (Cr), uric acid (UA), alanine aminotransferase (ALT), high sensitive C-reactive protein (hs-CRP), body mass index (BMI) of the observation group were significantly higher than those of the control group, while the high density lipoprotein (HDL) was significantly lower than that of the control group, with statistically significant difference ( P<0.05); ⑵ correlation analysis showed that RDW was positively correlated with SBP, DBP, Ht, Wt, Wc, TG, CHOL, Cr, UA, ALT, hs-CRP, BMI, and negatively correlated with HDL ( P<0.05); ⑶ binary logistic regression analysis showed that RDW, Wt, Wc, CHOL, HDL, LDL and hs-CRP were independent risk factors for MS in patients with impaired glucose tolerance. Conclusions:The increase of RDW is a predictor of metabolic syndrome in people with abnormal glucose tolerance, which may provide some reference value for the prevention and treatment of metabolic syndrome.

Implementing national to community-based "One Health" strategy for human,animal and environmental challenges and migrating-led consequences offer great opportunities,and its value of sustained development and wellbeing is an imperative."One Health" strategy in policy commitment,partnership and financial investment are much needed in advocacy,contextual health human-animal and environmental development.Therefore,appropriate and evidence-based handling and management strategies in moving forward universal health coverage and sustainable development goals (SDGs) are essential components to the China-Africa health development initiatives.It is necessary to understand how to strengthen robust and sustainable "One Health" approach implementation in national and regional public health and disaster risk reduction programs.Understanding the foundation of"One Health" strategy in China-Africa public health cooperation is crucial in fostering health systems preparedness and smart response against emerging and re-emerging threats and epidemics.Building the value of China-Africa "One Health" strategy partnerships,frameworks and capacity development and implementation through leveraging on current and innovative China-Africa health initiatives,but also,mobilizing efforts on climatic changes and disasters mitigation and lifestyle adaptations strategies against emerging and current infectious diseases threats are essential to establish epidemic surveillance-response system under the concept of global collaborative coordination and lasting financing mechanisms.Further strengthen local infrastructure and workforce capacity,participatory accountability and transparency on "One Health" approach will benefit to set up infectious diseases of poverty projects,and effective monitoring and evaluation systems in achieving African Union 2063 Agenda and SDGs targets both in Africa and China.

The important and diverse regulatory roles of Ca(2+) in eukaryotes are conveyed by the EF-hand containing calmodulin superfamily. However, the calcium-regulatory proteins in prokaryotes are still poorly understood. In this study, we report the three-dimensional structure of the calcium-binding protein from Streptomyces coelicolor, named CabD, which shares low sequence homology with other known helix-loop-helix EF-hand proteins. The CabD structure should provide insights into the biological role of the prokaryotic calcium-binding proteins. The unusual structural features of CabD compared with prokaryotic EF-hand proteins and eukaryotic sarcoplasmic calcium-binding proteins, including the bending conformation of the first C-terminal α-helix, unpaired ligand-binding EF-hands and the lack of the extreme C-terminal loop region, suggest it may have a distinct and significant function in calcium-mediated bacterial physiological processes, and provide a structural basis for potential calcium-mediated regulatory roles in prokaryotes.
Amino Acid Sequence ; Binding Sites ; Calcium ; physiology ; Calcium-Binding Proteins ; chemistry ; Crystallography, X-Ray ; EF Hand Motifs ; Molecular Sequence Data ; Protein Binding ; Protein Structure, Tertiary ; Sequence Alignment ; Sequence Homology, Amino Acid ; Streptomyces coelicolor ; Structural Homology, Protein ; Surface Properties

The unprecedented globalization of trade,travel,climate change,protectionism,and geopolitical populism,as well as pandemic health threats are no longer issues for a single nation.In the field of public health,China's Belt and Road Initiative (BRI) offers immense opportunities for partnership and collective actions involving multiple countries to combat globalization-linked infectious and/or chronic diseases,emerging pandemics,and outbreaks of potential threats to both laboratory information management systems and health information management.The national and global health challenges have increasingly proved that economic prosperity cannot be achieved when huge knowledge and capacity gaps exist in health systems.There is thus a need for public health initiatives aimed at strengthening the health systems beyond sovereign borders to influence global geo-economics.We highlight situational insights that offer approaches and strategies for increasing public health investment and capacity development in the countries along the Belt and Road,enhancing public and global health cooperation alongside participation in disease control and elimination,promoting public health governance and data sharing for pandemic threats,and building shared values and benefits in public health through Sino-African cooperation and the BRI.Our approach also examines the values of the China's BRI in relation to public health,projections and initiatives for increasing new investment and development capacity in public health systems,and enhanced public and global health cooperation and participation toward the BRI's framework and scope.

Warfarin resistance is a phenomenon that patients need to take much higher than normally prescribed dosage of warfarin to maintain the target therapeutic international normalized ratio (INR) range, or even fail to reach the target INR. Warfarin resistance can be categorized in etiologic terms as hereditary vs acquired, or in pharmacologic terms as pharmacokinetic vs pharmacodynamic. Once warfarin resistance is diagnosed, the type of resistance should be determined as soon as possible so that treatment could be oriented toward the causes. Poor compliance, genetic mutations, concurrent medications that could decrease the absorption or increase the clearance of warfarin, and consumption of diet rich in vitamin K are the major reasons for warfarin resistance. Educating patients, increasing warfarin dosage and switching to other anticoagulants would be effective for warfarin resistance.
Anticoagulants ; pharmacology ; Drug Monitoring ; methods ; Female ; Humans ; International Normalized Ratio ; Male ; Metabolism, Inborn Errors ; diagnosis ; etiology ; genetics ; Vitamin K ; administration & dosage ; Vitamin K Epoxide Reductases ; genetics

Global health arisen recently, but it developed rapidly and attracted great attention from global researchers and institutions. China, as a member of United Nation, actively participated in many international peacekeeping activities. Health of peacekeepers is global health and it is important to consider and dealt with health of peacekeepers with conception of global health. This article reviewed and analyzed health problems and risk factors faced by peacekeepers,and provided suggestions to strategies to protect health of peacekeepers.
China ; Global Health ; Health ; Humans ; Military Personnel ; Risk Factors

OBJECTIVETo explore the involvement of hepatitis B X protein (HBx) in promoter 3 (P3)-driven mRNA overexpression of the insulin-like growth factor II gene (IGF-II) and investigate the underlying epigenetic mechanism.

METHODSLevels of P3 and HBx mRNA and status of P3 methylation were analyzed in human hepatocellular carcinoma (HCC) samples, with and without hepatitis B virus (HBV) infection, using quantitative reverse transcription-PCR and bisulfite sequencing. In addition, the levels of P3 mRNA and P3 methylation were examined in HepG2 cells stably overexpressing HBx (HepG2-HBx). Finally, P3 promoter-luciferase constructs were cotransfected into HepG2 cells along with an HBx-expressing plasmid, and the effects of HBx on transcriptional activity and methylation of P3 were analyzed. Statistical analyses of the data were conducted by chi square test, Fisher's exact test, Student's t-test, Marn-Whitney U test, and Pearson's correlation coefficient test.

RESULTSThe HBV-positive HCC specimens had significantly higher levels of P3 mRNA than the HBV-negative HCC specimens (-9.59 ± 3.22 vs. -12.97 ± 3.08 delta CT; P=0.006) but significantly lower levels of P3 methylation (mean values for the 17 CpG sites (36.9% ± 15.5% vs. 52.1% ± 19.1%; P=0.025). The P3 transcript abundance was positively correlated with the level of HBx expression and negatively correlated with the level of P3 methylation. The epigenetic results from experiments with the HepG2-HBx cells were similar. Transfection of HBx significantly decreased P3 methylation level and increased its activity.

CONCLUSIONHBx expression may promote IGF-II expression by inducing hypomethylation of its P3 promoter in hepatocellular carcinoma.

Carcinoma, Hepatocellular ; genetics ; metabolism ; DNA Methylation ; Epigenesis, Genetic ; Female ; Gene Expression ; Hep G2 Cells ; Humans ; Insulin-Like Growth Factor II ; genetics ; metabolism ; Liver Neoplasms ; genetics ; metabolism ; Male ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Trans-Activators ; pharmacology

Objective:To evaluate the feasibility and accuracy of a multi-dimensional peripheral quick contrast sensitivity function (pqCSF) measurement established based on Bayesian probability estimation algorithm.Methods:A cross-sectional study was conducted.Nineteen eyes of 12 healthy emmetropic subjects in Zhongshan Ophthalmic Center of Sun Yat-sen University from September 2017 to March 2018 were included, with an average age of (22.92±2.91) years.The average spherical power and cylindrical power were (-0.34±0.52)D and (-0.30±0.42)D, respectively, and the average uncorrected vision acuity was≥1.0.Based on the Bayesian probability algorithm, the peak contrast sensitivity γ max, the peak spatial frequency ? max, the bandwidth β and the low contrast intercept δ were used to quickly describe the contrast sensitivity function (CSF) curve of the full spatial frequency through multi-dimensional pqCSF method.The 16 peripheral visual field positions of all subjects were tested at 6°, 12°, 18° and 24° eccentricity of the superior, inferior, the temporal and nasal visual field by the pqCSF method, but the 18° eccentricity of temporal field, which was near the physiological blind spot, was excluded.The area under Log CSF (AULCSF) of different peripheral visual fields and the Log CSF of 19 spatial frequencies (distributed at equal intervals in logarithmic units) were compared.This study followed the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (No.2018KYPJ017). Written informed consent was obtained from each subject prior to any examination. Results:With the increase of eccentricity in different visual fields, the AULCSF decreased gradually, and there were significant differences in AULCSF between different eccentricities (all at P<0.05). The AULCSF of the nasal and temporal visual field at 6°, 12° and 24° eccentricity was significantly larger than that of the superior and inferior visual field (all at P<0.05). As the distance from the fovea was increased, the pqCSF, the AULCSF, and the high-frequency cutoff were all decreased, and the standard deviation of AULCSF was increased gradually. Conclusions:The pqCSF method can depict a relatively complete peripheral CSF curve of a wide peripheral visual field, and reflect the function quality of the peripheral vision comprehensively and accurately.