ObjectiveTo evaluate the efficacy and safety of domestic taerolimus in the manage-ment of acute rejection in renal transplantation reeipienta.MethodsA multieeneter, open and com-parative study for domestic Taerolimua and Prograf was performed. Eighty reeipienta of first allogenie renal transplantation were randomized into 2 groups: ①Experimental group (accepting Fumeixin ad-ministration, n=58) included 23 males and 35 females with the mean age of(39.1±9.6)years. ②Control group(accepting Prograf administration, n=22) included 12 males and 10 females with the mean age of(41.34±8.5)years. There was no significant difference in the volume, warm and cold is-chemia time of donor renal, age and sex of donor. All of the 80 cases accepted tacrolimus (domestic or foreign made, at the dose of 0. 10～0. 15 mg·kg-1·d-1 , q 12 h) treatment that combined with MMF and prednisone posttransplantation. Tacrolimus CO was aimed to 8-12 ng/ml in the first 60 days and 5-10 ng/ml later. The dose of MMF was according to the rule of each transplantation center based on the following recommendation: 1.5-2.0 g/d for the weight above 70 kg, 1.5 g/d for the weight 50-69 kg, and 1.0 g/d for the weight below 49 kg, in two divided doses. Prednisone was ad- ministrated as per ruler of each center. ResultsObservation termination was 3 months. Morbility of actue rejection was 3.40% (2/58)and 13.6% (3/22) in experimental and control group(P>0.05). Ad-verse events including hypertension, hyperlipemia, hyperglycemia and slight abnormality of liver func-tion occurred in 36. 2%(21/58) and 36. 4% (8/22) cases of experimental and control group(P> 0. 05). The survival rate in the 2 groups was 100%. The dose of tacrolimus in experimental group was significantly lower than that in the control group at 8 and 12 weeks posttransplant, while drug valley concentration in serum was proximal in 2 groups during the whole observation period.Conclusion Domestic tacrolimus capsules can be used effectively and safely in the management of acute rejection in renal transplantation.

The papers published by 17 municipal mental health institutions in Shandong Province from 2008 to 2012 , author cooperation and publication journals were analyzed, which indicated that although the number of papers published by mental health institutions in Shandong Province creased with their academic levels improved, the number of papers published by mental health institutions was significantly different , the number of researches with innova-tion was rather small, and the core author groups have not formed.

Abstract: Objective　To evaluate the influence of coronavirus disease 2019 (COVID-19) prevention and control measures on the transmission and epidemic of influenza in Chongqing, so as to provide references for formulating targeted influenza prevention and control strategies. Methods　The influenza surveillance data, during the year 2018 to 2020, were collected through the "China Influenza Surveillance Information System", and the seasonal characteristics of influenza epidemic were analyzed. The percentage of influenza like cases (ILI%) and influenza virus positive rate between 2020 and 2018-2019 were compared, so as to evaluate the impact of COVID-19 prevention and control measures on influenza epidemic characteristics. Results　The annual proportions of ILI cases in Chongqing were respectively 3.53%, 2.23% and 1.2% from 2018 to 2020, while the positive rates of influenza virus were respectively 13.97%, 23.81% and 2.65%. The distribution trend of ILI% from 2018 to 2019 fluctuated were similar, but it continued to drop and remain at a low level since February 2020. The positive rate of influenza virus showed an epidemic peak from December to March in 2018-2019, also peaked from November 2019 to January 2020, but decreased to 0 in March. ILI% was positively correlated with the positive rate of influenza virus (r=0.404 8, P<0.05). In 2020, compared with the same period of 2018-2019, the growth rate of ILI% was -66.09% and -46.32%, respectively. The positive rate of influenza virus in 2020 decreased by 81.03% and 88.87% compared with the same period of 2018-2019, respectively. The growth rates of influenza virus positive rate in January 2020 were decreased with a small rate of about 39.87%, and with a significantly decline of more than 93.65% from February. No influenza epidemic was found after March. Conclusions　Since COVID-19 prevention and control measures were implemented in January 2020 in Chongqing, the ILI% and the positive rate of influenza virus in sentinel hospitals decreased significantly. In the season of high incidence of respiratory infectious diseases, personal protection and other measures can effectively reduce influenza virus infection.

OBJECTIVE: To study the clinical effect of maternal voice stimulation in alleviating procedural pain in neonates during heel blood collection. METHODS: A total of 72 neonates who were admitted to the neonate intensive care unit were randomly divided into an intervention group (n=35) and a control group (n=37). Heel blood collection was performed by the routine method in the control group. The intervention group listened to their mothers' voice from 1 minute before heel blood collection to the end of the procedure. Pain score, incidence of crying, and vital signs were recorded before and after heel blood collection. RESULTS: Compared with the control group, the heart rate was significantly reduced, the blood oxygen saturation significantly increased, the incidence of crying and the pain score were significantly reduced in the intervention group during the procedure of heel blood collection (P<0.05). CONCLUSIONS Maternal voice stimulation helps to reduce procedural pain and maintain stable vital signs in neonates.
Crying ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Mothers ; Pain Management ; Pain, Procedural ; Speech

OBJECTIVETo explore the molecular mechanism of Qiangxin Fumai granule (QFG, an effective Chinese composite drug) in preventing and treating sick sinus syndrome (SSS).

METHODRabbit model of sinoatrial ischemia/reperfusion was established by occluding and loosening the root of right coronary artery. Effect of QFG on cell apoptosis was observed by TUNEL method, and its effect on apoptotic related gene Bax, Bcl-2 and Fas-L gene protein expression was observed by immunohistochemical method. Average light density values of the expression of Bax, Bcl-2 and Fas-L of SAN cells was determined by Imagepro Plus image analysis system.

RESULTSinoatrial injury induced by ischemia/reperfusion could cause evident sinoatrial cell apoptosis, enhance Fas-L gene protein expression and obviously enhance Bax gene protein expression, reduce Bcl-2/Bax ratio. QFG could significantly down-regulate Fas-L and Bax gene protein expression, up-regulate Bcl-2/Bax ratio, significantly inhibit and block the sinoatrial cell apoptosis.

CONCLUSIONTo inhibit and block the event of cell apoptosis through regulating Bax, Bcl-2 and Fas-L gene protein expression in sinoatrial node after ischemia/reperfusion might be one of the mechanisms of QFG in preventing and treating sinoatrial ischemia/reperfusion injury of SSS.

Animals ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fas Ligand Protein ; metabolism ; Immunohistochemistry ; In Situ Nick-End Labeling ; In Vitro Techniques ; Microscopy, Fluorescence ; Muscle Cells ; cytology ; drug effects ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rabbits ; Random Allocation ; bcl-2-Associated X Protein ; metabolism

DNA, Viral ; chemistry ; Humans ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Torque teno virus ; classification ; genetics

OBJECTIVESTo evaluate the diagnostic value of arterial spin labeling (ASL) technology in newborns with hypoxic ischemic encephalopathy (HIE).

METHODSeven full-term newborn infants without any history of asphyxia and other nervous system diseases were selected as the control and 33 full-term newborn infants were assigned into HIE group. The patients in HIE group were further divided into three subgroups (19 cases of mild, 6 cases of moderate and 8 cases of severe HIE) based on their clinical diagnosis. The control group and HIE group were examined with GE Signa EXCITE HD 3.0T superconducting MRI scanner with a head phase array coil. Both groups were scanned with conventional axial MRI (T1FLAIR, T2WI and T2FLAIR), 1HMRS (PRESS sequence) and ASL (FAIR). Original images of 1HMRS and ASL were processed by Functool software of ADW 4.3 workstation. ASL perfusion images were observed and the signal intensity values of the region of interest (bilateral gray, white matter and basal ganglia) of the two groups were quantitatively measured, and mean value were calculated and compared between groups. Statistical analysis was performed with SPSS 13.0 software, and statistically significant difference was set at P < 0.05.

RESULTThe perfusion images of two groups were obtained perfectly. The signal intensity values of bilateral gray, white matter and basal ganglia of control group were 125.34 ± 11.76, 73.42 ± 11.67 and 173.65 ± 15.49, respectively and there was a statistically significant difference between the different areas. The signal intensity values of bilateral gray, white matter and basal ganglia of HIE group were 153.47 ± 11.72, 71.35 ± 10.37 and 217.13 ± 12.51, respectively. There was a statistically significant difference (P < 0.05) in the average signal intensity value of gray matter and basal ganglia, but there were no statistically significant difference (P > 0.05) in white matter between the two groups.

CONCLUSIONASL Perfusion technique can assess HIE comprehensively and accurately. Furthermore, it can evaluate the brain damage of hypoxic ischemia. The results provide a strong basis for clinical treatment.

Case-Control Studies ; Electron Spin Resonance Spectroscopy ; Female ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant, Newborn ; Male ; Spin Labels

The revolution involving the current pattern of cultivating medical talents by combining clinical practice and education is a key step to train the high-level practical talents with clinical medicine. In this paper, we analyze the current graduate training management and quality evaluation in clinical medicine. As a result,we find some deficient exist in the present pattern of education management that is recognized as valuing scientific re-search and ignoring the clinical practice,such as a lack of effective feedback and backward in the present assess-ment system.That will inevitably influence the clinical training quality of graduate students with professional degree and lead to an awkward result that the graduate have poor knowledge in both the clinical practice and scientific re-search,resulting in a serious shortage of clinical practical talents.To solve the dilemma,our hospital constructed the intelligent digital information management platform,which has synthesized intelligent schedule,clinical rota-tion management and assessment system.With the perfect platform,the problems including clinical rotation,exam-ination,assessment in cultivating management and monitoring were primely solved. It is realizable to upgrade the graduate management from the traditional extensive management to the refined management mode and to further strengthen management,restraint and feedback system with the intelligent platform. Gradually,the fundamental purpose to cultivate the high-level talents for clinical practice could be achieved.

OBJECTIVE: To investigate the effect of placement of peripherally inserted central catheter (PICC) via the upper versus lower extremity veins in neonates through a Meta analysis. METHODS: CNKI, Wanfang Data, VIP Data, CBMdisc, PubMed, Web of Knowledge, Embase, Medline, Cochrane Library and Google Scholar were searched for control studies on the effect of PICC placement via the upper versus lower extremity veins in neonates. RevMan 5.3 was used to perform a Meta analysis of the studies which met the inclusion criteria. RESULTS: A total of 18 studies were included, among which there were 8 randomized controlled trials and 10 cohort studies, with 4 890 subjects in total. Compared with those undergoing PICC placement via the upper extremity veins, the neonates undergoing PICC placement via the lower extremity veins had significantly lower incidence rates of complications (RR=0.83, 95%CI: 0.75-0.92, P<0.05), catheter-related infections (RR=0.77, 95%CI: 0.60-0.99, P<0.05), catheter malposition (RR=0.28, 95%CI: 0.18-0.42, P<0.05), extravasation of the infusate (RR=0.52, 95%CI: 0.40-0.70, P<0.05), and unplanned extubation (RR=0.82, 95%CI: 0.69-0.98, P<0.05). They also had a significantly higher first-attempt success rate of puncture (RR=1.17, 95%CI: 1.05-1.30, P<0.05) and a significantly shorter PICC indwelling time (MD=-0.93, 95%CI: -1.26-0.60, P<0.05). CONCLUSIONS The above evidence shows that PICC placement via the lower extremity veins has a better effect than PICC placement via the upper extremity veins in neonates.
Catheterization, Central Venous ; Catheterization, Peripheral ; Cohort Studies ; Humans ; Infant, Newborn ; Lower Extremity ; Retrospective Studies

Objective To investigate the correlative factors of constipation in patients with Parkinson′s disease(PD).Methods Two hundred and twelve patients with PD were enrolled in our study.Constipation scale was used to evaluate the degree of constipation.The data of patient′s age,course of disease and medication were collected; UPDRS Ⅲ scale,Hoehn-Yahr scale,Hamilton Depression Rating Scale(HAMD),Chinese version of mini mental state examination(MMSE)were performed; risk factors of constipation in patients with PD were analyzed by partial correlation and binary-logistic regression.Results The age,Hoehn-Yahr stage,HAMD scores in 212 patients with PD were significantly associated with constipation(P＜0.05)and were the risk factors for constipation.However,gender,course of disease,paralest daily dose,piribedil sustained daily dose,levodopa daily dose,UPDRS Ⅲ scores and MMSE scores were not significantly correlated to constipation(P＞0.05).Conclusion Age,Hoehn-Yahr stage and HAMD scores have correlation with constipation in patients with PD.