OBJECTIVE: To investigate the effects of Shenshuning Recipe (SSNR) on gene expression of hepatocyte growth factor (HGF) in renal tissues in rats with glomerulosclerosis. METHODS: Glomerulosclerosis was induced in 42 rats by unilateral nephrectomy and intravenous injection of doxorubicin. Then these 42 rats were randomly divided into three groups: untreated group, SSNR-treated group and benazepril-treated group. Another eight rats were included into sham-operation group. The rats in the SSNR-treated group and the benazepril-treated group were fed SSNR or benazepril respectively for 8 weeks. The levels of 24 h urine protein (Upr), serum creatinine (Cr) and blood urea nitrogen (BUN) of rats in each group were examined. The renal morphological changes were observed under microscope, and the diameter of glomerular capillary, mesangial matrix and glomerulosclerosis index were analyzed by image analysis software. Reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the gene expression of HGF in the renal tissues. RESULTS: The levels of 24 h Upr, serum Cr and BUN in the untreated group were remarkably increased than those in the sham-operation group (P<0.01). The pathological morphological changes in the untreated group showed that the glomerulosclerosis was diffused around the renal tissue and the capillaries were shrunk. The expression level of mesangial matrix was up-regulated and the glomerulosclerosis index was 3.32+/-0.35. The expression level of HGF mRNA in the untreated group was obviously lower than that in the sham-operation group (P<0.05). The levels of 24 h Upr, serum Cr and BUN in the SSNR-treated group and the benazepril-treated group were remarkably decreased as compared with those in the untreated group, while the expression levels of HGF mRNA were both obviously higher than that in the untreated group (P<0.01). The pathological morphological changes in the SSNR-treated group and the benazepril-treated group were both alleviated. There was no significant difference in therapeutic effect between the SSNR-treated group and the benazepril-treated group. CONCLUSION: Shenshuning Recipe can up-regulate the expression of HGF mRNA, decrease the mesangial matrix, and improve the renal function, so that it may retard the development of glomerulosclerosis.

Objective:To explore the competency for the assistant general practitioners in China to provide theoretical support for the construction of the post competence model of assistant general practitioners and training and evaluation of assistant general practitioners.Methods:During January 22 to June 18, 2019, Using snowball sampling method and behavioral event interviews, 23 general practitioners and assistant general practitioners were interviewed in China, including 14 general practitioners in the superior performance group and 9 assistant general practitioners in the average performance group. The interview contents were coded and analyzed, and the statistical methods of t test and rank sum test of two independent samples were used to screen competency characteristics and construct the competence model of assistant general practitioners.Results:The total classification consistency and the total coding reliability coefficient was respectively 0.79, 0.87. 59 competency characteristics of assistant general practitioners were obtained including 3 differentiated competency characteristics "Understanding the medical and health system and related policies", "Critical thinking skills" and "General practitioner clinical thinking" and 10 baseline competency characteristics. There was no statistically significant difference between the average performance group and the superior performance group in the total frequency of competency [(29.4±12.7) times to (23.4±7.0) times, t=1.27, P=0.22]. Conclusion:The preliminary competency characteristics of assistant general practitioners have good reliability and can provide references for further exploration of the competency model.

The right ventricle was considered had not played a major role in the achievement of the whole cardiac function.With the progress of researches on right ventricular structure and function,people are gradually aware of the important role of right ventricular morphology and function in clinical and prognostic evaluation.As a result,a variety of imaging technologies for overall evaluating the right ventricular functions have been developed.With the development of echocardiography,speckle tracking imaging (STI) technology has been widely used in right ventricular function evaluation.The STI technology provides a new simple and practical method for right ventricular function evaluation and research,as well as the diagnosis and prognosis evaluation of the right ventricular function associated heart and lung diseases.In this paper,the principle,method and importance of STI technology in right ventricular function evaluation and the problems in clinical application were summarized.

OBJECTIVETo explain a method for lower face and anterior neck reconstruction.

METHODSTissue expanders were implanted subcutaneously beside the defect. When the skin was properly expanded, the bipedicled expanded skin flap was created and transferred to the lower face and the anterior neck. If the defect can not be repaired by one stage, the expanded skin was re-expanded for the rest.

RESULTS11 patients have been treated with this method since 1990. All flaps survived and all the defects have been successfully repaired with satisfactory results.

CONCLUSIONThe bipedicled expanded flap, which provided good blood supply, improved the survival rate of the flap and reduced the incision scar on the face, is an effective surgical procedure.

Adolescent ; Adult ; Child ; Face ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Time Factors ; Treatment Outcome

Objective To observe the effect of aralia saponins on the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in the kidney of diabetic nephropathy mice.Methods After 10 days of adaptive feeding,90 clean Kunming mice were randomly divided into the normal group (n =10) and 5 model groups (model group,positive drug benazepril intervention group,aralia saponins low,middle and high doses treatment groups).Excepted the normal group,the kidney damage model of type 2 diabetes mellitus in mice was induced by high-fat and high-sugar diet for one month plus disposable streptozotocin (STZ).The model was successfully constructed and killed after 6 weeks of treatment.A total of 25 mice failed to establish the model.And totally 55 mice were randomly divided into 5 groups with 11 mice in each group.The serum changes of blood urea nitrogen (BUN),serum creatinine (SCr),insulin,inflammatory factors interleukin-1α (IL-1α),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in each group were detected.The expression of vascular endothelial growth factor and MMP-9 protein in renal tissue were detected by immunohistochemistry and Western blot.Results Compared with the normal group,the levels of blood glucose,insulin,BUN,SCr,IL-1α,IL-6 and TNF-α in the model group were significantly increased (P ＜ 0.05).The above indexes were decreased in positive drug group and aralia saponins treatment groups.The contents of insulin,BUN and SCr in the high dose of aralia saponins group were significantly lower than those parameters in benazepril group (P ＜ 0.05).In addition,the contents of blood glucose,IL-1α,IL-6 and TNF-α in the three dose aralia saponins groups were significantly lower than those parameters in the benazepril group (P ＜ 0.05).Compared with the normal group,the expression level of VEGF protein in the model group was significantly higher (P ＜ 0.05),and the expression level of MMP-9 protein was significantly lower (P ＜ 0.05).Compared with the model group,both benazepril and aralia saponins can reduce VEGF (P ＜ 0.05),increase MMP-9 (P ＜ 0.05).In addition for VEGF and MMP-9,the high dose of aralia saponins group and benazepril group was basically same.Conclusions Aralia saponins can significantly reduce blood glucose,insulin and serum inflammatory factors,while downregnlate VEGF and increase MMP-9 protein levels,thereby protecting the kidneys of diabetic nephropathy mice.

Objective To evaluate the effect of isosceles right angle triangulation on deep vein puncture under ultrasound localization. Methods In this prospective randomized case-controlled clinical study, the enrolled patients who required deep veins puncture to establish transient hemodialysis pathway were randomly divided into treatment group treated with ultrasound localization puncture based on isosceles right triangle theory, and control group treated with traditional localization puncture following exploration of blood vessels using color doppler ultrasound, with 46 cases in each group. The differences in gender, age, causes for hemodialysis, puncture sites, successful rate of initial puncture, rates of complications and cathetering-consuming time were compared between two groups. Results The differences in gender, age, causes for hemodialysis and puncture sites between two groups were not statistically significant. In control group, 30 patients received puncture through internal jugular veins, among whom 16 received successful initial puncture, with the successful rate of initial puncture of 53.33%, and the cathetering-consuming time of (545.5 ± 120.3) s; and 16 patients received puncture through femoral veins, among whom 8 received successful initial puncture, with the successful rate of initial puncture of 50.00%, and the cathetering-consuming time of (500.6 ± 120.6) s. Meanwhile, in control group, 3 patients had hematoma in puncture sites, and another 3 had arterial mis-puncture, with the total rate of complications of 13.04%(6/46). In treatment group, 32 patients received puncture through internal jugular veins, among whom 31 received successful initial puncture, with the successful rate of initial puncture of 96.88%, and the cathetering-consuming time of( 99.5 ± 34.8) s;and 14 patients received puncture through femoral veins, among whom 14 succeed in initial puncture, with the successful rate of initial puncture of 14/14, and the cathetering-consuming time of (99.8 ± 44.8) s. None in treatment group had hematoma in puncture sites or arterial mis-puncture. Both groups finished deep veins puncture intubation successfully. Treatment group was markedly higher in the successful rate of initial puncture (P<0.05), notably shorter in cathetering-consuming time (P<0.05), and prominently lower in the total rate of complications than control group (P<0.05), and all differences were statistically significant. Conclusions Ultrasound localization based on isosceles right triangle theory has superiority to traditional B-ultrasound localization in deep veins puncture in that it can promote the successful rate of initial puncture and shorten cathetering-consuming time without increasing the occurrence rates of complications, and can be completely operated by single clinical physician independently, thus deserving to be popularized in clinical practice.

Objective: To understand the demand of rural parents for children’s sexual education knowledge and associated factors, to provide reference and advise for the development of the children’s sexual education in the rural areas. Methods: In this study,1 015 parents from 16 rural kindergartens in Luzhou City and Mianyang City were selected as the research objects by multiple-stage stratified sampling from March to May, 2019. The self-interview or face-to-face questionnaire survey was used to investigate the demand for children’s sexual education among parents. Results: Totally 81.7%(829) of parents expressed their demand for children’s sexual education knowledge. Multivariate logistic regression analysis showed that age was negatively associated with demand for sexual education of children(OR=0.73,95%CI=0.61-0.88). Junior middle school education background of mothers(OR=2.45,95%CI=1.36-4.41), received sexual education for children(OR=2.85，95%CI=1.84-4.42), reckon sexual education for children as necessary(OR=4.97，95%CI=3.16-7.83)and regarded it as parents’ own responsibility(OR=2.11，95%CI=1.30-3.43) had a high demand for children’s sexual education knowledge(P<0.05). Conclusion Parents in Sichuan rural areas generally have a high demand for children’s sexual education. We should intensify publicity and training about sexual education knowledge among parents in rural areas and attach importance to the cooperation between family and kindergarten in order to jointly promote the development of children’s sexual education.

Objective: To analyze the level of sex-related knowledge and behavior and related factors among children in senior grade of kindergarten in rural areas, and to provide the evidence for early childhood sexuality education. Methods: Multi-state stratified sampling method was adopted. From March to May 2019,a total of 324 students and their parents from 16 kindergartens of rural areas in Sichuan Province were enrolled, self-developed questionnaire was used to collect the basic demographic characteristics, information of sexuality education knowledge and sex-related behavior. Results: The average score of sexuality education knowledge was 5(4,6) point, and the awareness rate was 33.6%(109). The qualified sex-related behavior was observed in 75.0%(243 of all the children), while 25.0%(81) needed to be improved. Multivariate analysis showed that,compared with children were aware of the sexuality education knowledge, children who were unaware of the sexuality education knowledge were more likely to have good sex-related behavior, with the OR(95%CI) value was 2.06(1.14-3.72). The possibility of having good sex-related behavior among those children with more than 2 members in the family parents carring out sexuality education was higher than children without sexuality education in the family, with the OR(95%CI) value being 2.40(1.17-4.89). Conclusion The level of sexuality education knowledge among children in senior grade of kindergarten of rural areas in Sichuan is low, and most children s behavior needs to be improved. Children s awareness of sexuality education knowledge and the number of family members who have carried out sexuality education are related to the occurrence of children s sex-related behavior.

OBJECTIVE: To investigate the relationship between the promoter polymorphism of IL6 (-174G > C, -572G > C and -597G > A) and chronic rhinosinusitis (CRS). METHOD: The case-control study consisted of 123 patients with CRS and 239 controls from a Chinese Han population from Shanghai. The genotypes of the subjects were determined by polymerase chain reaction-restriction fragment length polymorphism and gene sequencing. Besides, the concentrations of the totle immunoglobulin E (TIgE) and eosinophilic cationic protein (ECP) in the blood were also determined. RESULT: The -174G > C and -597G > A polymorphisms were not detected in this study population. Significant differences in genotype and allele frequencies of -572C/G were observed between CRS patients and control groups. In CRS patients, the CC, CG, GG genotype frequencies were 69.1%, 29.3%, 1.6%, C, G allele frequencies were 83.7%, 16.3%. In control group, the genotype frequencies were 55.2%, 42.3%, 2.5%, the allele frequencies were 76.4%, 23.6%, respectively. The -572CC genotype was associated with an increased risk of developing CRS (P < 0.05, OR = 1.932, 95% CI, 1.205-3.097). There was no significant differences in the concentrations of the TIgE and ECP among each genotype. CONCLUSION IL-6 gene -572G > C polymorphism is associated with the susceptibility to CRS. CC genotype could be an independent risk factor.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; China ; Chronic Disease ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Interleukin-6 ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Risk Factors ; Sinusitis ; genetics ; Young Adult