Objective To explore prevention and cure effects of the freeze-dried human fibrin glue as the way of the lacrimal duct embolization on xerophthalmia in perimenopausal female rabbit.Methods A total of 72 female rabbits,after anti infection treatment and were cut off third eyelid,were made into perimenopausal xerophthalmia rabbit models.After surgery,all of these rabbits were randomly divided into 6 groups (12 rabbits per group):No treatment group after surgery (group A),PBS prevention group (group B),freeze-dried human fibrin prevention group (group C);no treatment group after modeling (modeling time:Two weeks after surgery,group D),PBS treatment group (group E),freeze-dried human fibrin treatmentgroup (group F).The Schirmer test (SIT),corneal fluorescein (FL) and corneal confocal microscope were performed before and 2 weeks,4 weeks,6 weeks after injection.Results There were statistical differences in FL score and SIT in group A,group B and group C among different time points (F =27.346,10.608;P =0.000,0.001);There were statistical differences between FL scores and SIT among three groups (F =7.579,6.786;P =0.002,0.007);There was significant difference in FL scores and SIT trends among three groups(F =44.897,3.424;P =0.000,0.045).The FL score and SIT of group D,group E and group F were significantly improved after treatment for 2 weeks,4 weeks and 6 weeks,the differences were statistically significant (t =2.906,3.654,4.504;P =0.022,0.017,0.013.t =4.573,5.759,7.231;P =0.032,0.019,0.008);The difference between FL score and SIT in group E and group F was statistically significant after treatment (t =2.776,4.124,5.324;P =0.032,0.026,0.017.t =1.969,3.122,4.324;P =0.038,0.023,0.009).After injection of 6 weeks,the epithelial basal cells (F =17.306,P =0.002) and inflammatory cells (F =34.024,P =0.000) of group A,B and C were significant changed,the differences were statistically significant.After injection of 6 weeks,the epithelial basal cells (F =3.749,P =0.042)and inflarnmatory cells(F=8.806,P =0.005) of group D,E and F were significant changed,the differences were also statistically significant.Conclusion Lacrimal duct embolization with freeze-dried human fibrin glue is effective for the xerophthalmia.

Objective To analyze the thickness of cornea and corneal epithelium in healthy subjects by optical coherence tomography angiography (OCTA).Methods Totally 100 healthy subjects aged between 20 and 30 years were analyzed by OCTA technique.Using AngioVue OCTA system of retinal imaging mode,and using SSADA algorithm for imaging,the cornea and the corneal epithelium in the central corneal diameter range of 9 mm were measured.The differences of corneal and corneal epithelial thickness in different gender regions were compared.Results In the male and female group,the corneal central total thickness were (559.92 ±33.26) μm and(540.06 ±31.63)μm,and the corneal epithelial thickness were(57.78 ±4.88) μm and(56.88 ±4.57) μm,The total central corneal thickness and central corneal epithelial thickness of the male were greater than those of the female,the difference was statistically significant (t =3.06,2.10;all P ＜ 0.05).The cornea of male was the thickest at S5,S7 and SN9,there were significant differences at S5 and S7 compared with female (t =2.93,2.83;all P ＜ 0.05);The female cornea was the thickest at S5,SN7 and SN9,and the difference was significant at S5 compared with male.The cornea of male subjects was the thinnest at IT,which was statistically significant only at IT5 compared with female subjects in the same area (t =2.02,P ＜ 0.05);The cornea of female subjects was the thinnest at T5,IT7 and T9,which was statistically significant only at T5 and T9 compared with male subjects in the same region (t =2.63,2.20;all P ＜ 0.05);There was significant difference in corneal thickness between male and female at ST (t =3.1 1,2.79,2.33;all P ＜ 0.05).The corneal epithelium was the thickest at IT5,I7,and I9,and the lowest at S5,S7 and S9,and there was no significant difference compared with female in the same region (all P ＞ 0.05).The corneal epithelium of female at the IT5,T7,N9 were the thickest,SN5,S7,S9 were the thinnest;Except for M2 and SN5,there was no significant differences in corneal epithelium between male and female groups (all P ＞ 0.05).Corneal central epithelium accounted for the largest percentage of total corneal thickness,and gradually decreased from inside to outside.Conclusion OCTA can be used to measure the thickness of corneal and corneal epithelial regions.

Objective:To compare the efficacy and safety of red light and daylight photodynamic therapy in the treatment of facial common acne.Methods:From March 2019 to November 2019, 52 patients with facial common acne who received 5-aminolevulinic acid photodynamic therapy in the Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine were enrolled, including 34 males and 18 females, aged 18-35 years, with an average age of 23.2 years. A 5% concentration of 5-aminolevulinic acid was applied to the entire face, with the right side of the face being exposed to red light for 20 minutes and the left side to daylight for 2 hours. The treatment was administered once a week for a total of 4 sessions. After the treatment, the acne remission, adverse reactions, and patient satisfaction on both sides of the face were compared.Results:Compared with before treatment, the number of inflammatory and non-inflammatory lesions on both sides of the face in the enrolled patients decreased, and there was no significant difference in the clearance rate of skin lesions between the two sides [53.7% (28/52) vs 59.1% (31/52), χ 2=0.89, P>0.05]. The overall effective rate on the red light side was 88.5% (46/52), and 82.7% (43/52) on the daylight side, with no significant difference between the two (χ 2=0.38, P>0.05). In terms of adverse reactions, mild erythema was common, and it was less on the daylight side than on the red light side [34.6% (18/52) vs 19.2% (10/52), χ 2=5.98, P<0.05]. During the treatment period, the pain score on the daylight side decreased compared to the red light side [(7.6±2.3) vs (4.1±1.3), t=13.10, P<0.001]. Overall satisfaction with the daylight side was reported in 49 cases (94.2%), and with the red light side in 37 cases (71.2%), with the daylight side being higher than the red light side, and the difference was statistically significant (χ 2=9.60, P<0.05). Conclusion:Daylight photodynamic therapy is as effective as red light photodynamic therapy for common acne, but it produces fewer adverse reactions and higher patient satisfaction.

In proteins of thermophilic bacteria, Gly is tend to be replaced by Ala and Lys is tend to be replaced by Arg to adapt the high temperature. In order to improve the thermal stability of phenylalanine hydroxylase (PAH) from Chromobacterium violaceum, all the Gly on PAH were mutated to Ala and Lys to Arg. Positive mutant enzymes with improved thermal stability were selected, followed by combined mutation and characterization. The results revealed that half-lives of K94R and G221A mutants at 50 °C were 26.2 min and 16.8 min, which were increased by 1.9-times and 0.9-times than the parent enzyme (9.0 min). The residual activity of K94R/G221A mutant was improved to 65.6% after keeping at 50 °C for 1 h, which was 6.6 time higher than the parent enzyme (8.6%). Circular dichroism (CD) spectroscopy revealed that Tm values of the parent enzyme, K94R, G221A and K94R/G221A were 51.5 ℃, 53.8 ℃, 53.1 ℃ and 54.8 ℃, respectively. According to the protein structure simulation, the two mutations were located on flexible loop. In the K94R mutant, the mutated Arg94 on the surface of the enzyme formed an extra hydrogen bond with Ile95, which stabilized the located loop. In the G221A mutant, the mutated Ala221 formed hydrophobic interaction with Leu281, which could stabilize both the loop and flexible area of the C-terminus of G221A. The results not only provided a reference for protein modification on thermal stability, but also laid the foundation for application of phenylalanine hydroxylase in the field of functional foods.
Bacterial Proteins ; biosynthesis ; genetics ; Chromobacterium ; enzymology ; Enzyme Stability ; Hot Temperature ; Kinetics ; Mutagenesis, Site-Directed ; Mutation ; Phenylalanine Hydroxylase ; biosynthesis ; genetics ; Protein Engineering

Objective: To investigate the predictive value of neutrophil-to-lymphocyte Ratio (NLR) in 30-day mortality of patients with acute paraquat poisoning. Methods: We respectively reviewed the clinical parameters of 115 patients with acute paraquat poisoning. They were divided into survival (n=64) and non-survival (n=51) groups based on their 30-day outcome. Multivariate logistic regression was performed to identify risk factors of 30-day mortality. Receiver operating curve (ROC) test was applied to analysis to the predictive value of NLR in 30-day mortality ofacute paraquat poisoning patients. The correlations between NLR and severity index of paraquat poisoning (SIPP) were analyzed using Spearman’s rank correlation coefficient. Results: Of the 115patients included in the study, 54 (46.96%) patients were males and 61 (53.04%) were females with a mean age of 38.96±13.58 years. The total mortality in 30-day was 44.35% (51/115) . The NLR at admission was an independently risk factor of 30-day mortality of patients with acute paraquat poisoning (OR 1.477, 95%CI 1.035-2.107, P<0.05) . The NLR to predict the death of the area under the ROC curve was 0.894 (95%CI: 0.8212-0.9663, P<0.01) ; the optimal cutoff threshold was 11.71; the sensitivity was 71.79% and the specificity was 94.29%; the positive predictive value was 93.33%and negative predictive value of 75.00%. Meanwhile, the positive likelihood ratio was 12.57 and the negative likelihood ratio was 0.30. The NLR was significantly associated with SIPP (Spearman rho 0.525; P<0.01) and it was significantly higher in patients with SIPP of ten or higher than in those with an SIPP less than 10 (15.02±12.40 vs. 6.19±2.54, P<0.05) . Conclusion The increased NLR at admission was an independently risk factor of 30-day mortality of patients with acute paraquat poisoning and it was significantly correlated with SIPP score. Therefore, NLR was useful for predicting prognosis of patients with acute paraquat poisoning.

Based on the resutls of literature review and interviews of experts, two rounds of Delphi surveys were conducted. The mean, importance ratio, coefficient of variation and coordination coefficient were used for assessment of survey from multiple perspectives, and finally form a framework model of factors affecting the efficacy of Tuina therapy. A total of 37 experts were selected for questionnaire surveys, the positive coefficients of experts' participatation in the first round and second round were 92.5% and 80.0%, respectively. The overall coordination coefficient in the second round is 0.68. The items were included into the consensus meeting if the importance ratio of items were equal to and more than 80%. After the expert consensus meeting, 22 items were included to form a framework model of factors affecting the efficacy of Tuina therapy, and summarized as 5 major influencing factors, including diagnostic factors, treatment factors, prognostic factors, patient factors, and doctor-patient communication. This framework can guide and help young Tuina practitioners to improve clinical efficacy. It is also clearly pointed out that the effect of Tuina for pain is not only related to disease diagnosis or manipulation, but also related to home exercise, health care, and doctor-patient communication.

AIM:To analyze the mechanism of tumor-associated macrophage (TAMs) in the development of cervical cancer and to investigate its correlation with Th1/Th2 and Th17/CD4+ CD25+ Foxp3 + Treg.METHODS:Twenty seven cases of cervical cancer and 53 cases of cervical intraepithelial neoplasias (including 22 cases of CIN Ⅱ and 31 cases of CIN Ⅲ) were selected as subjects.The venous blood of patients before treatment was extracted to detect Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg with flow cytometry,and detect serum IFN-γ,IL-4,IL-17A,IL-17F,TGF-β1 and IL-10 levels with ELISA Kits.Furthermore,pathological tissues were extracted during operation,and its TAMsCD68 expression was detected by immunohistochemistry technique.RESULTS:The Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg of cervical cancer were both lower than those of CIN Ⅲ,and those of CIN Ⅲ were both lower than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The serum IFN-γ,IL-4,IL-17A,IL-17F,TGF-β1 and IL-10 levels of cervical cancer were all higher than those of CIN Ⅲ,and those of CIN Ⅲ were all higher than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The TAMsCD68 expression level of cervical cancer was higher than that of CIN Ⅲ,and that of CIN Ⅲ was lower than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The correlation analysis results showed TAMsCD68 expression level had negative correlations with Th1/Th2,Th17/CD4+CD25+ Foxp3+ Treg,and serum IL-17A level,whereas presented positive correlations with serum IL-10 and IL-4 level (P ＜ 0.05).CONCLUSION:TAMs is closely related with Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg in cervical cancer,and possibly is mediating the occurrence and development of cervical cancer through influencing the balance of these two systems.

Objective:To survey on the status quo of the role cognition and job burnout among family doctor team members in Shenzhen Futian district.Methods:A survey on the role cognition and job burnout of family doctor members was conducted in October 2022. One family doctor team was randomly selected from each of the 92 community health service centers in Futian district of Shenzhen city, and all members of the selected family doctor teams were included in the survey. The Chinese version of the Maslach Burnout Inventory-Human Services Survey was used in the study, and the influencing factors of role cognition and job burnout, as well as the impact of role cognition on job burnout were analyzed.Results:A total of 361 family doctor team members were included in the survey, The scores of the Role Ambiguity and Role Conflict Scale were (35.25±5.21) and (27.03±13.73), respectively. In the Occupational Burnout Scale, the scores of Emotional Exhaustion, Dehumanization, and Personal Achievement Scale were (17.89±6.82), (6.51±2.54), and (30.95±5.70), respectively. There were significant differences in role ambiguity and job burnout among family doctor team members with different ages, professions, and years of work ( P<0.05). Team members aged≤30, general practitioners, and working time ≤5 years had higher scores for role ambiguity, emotional exhaustion, dehumanization, and lower personal achievement ( P<0.05). The score of role ambiguity was negatively correlated with the degree of emotional exhaustion and dehumanization ( r=-0.544, -0.352), and positively correlated with personal achievement ( r=0.473). The score of role conflict was positively correlated with the degree of emotional exhaustion and dehumanization ( r=0.352, 0.376), and negatively correlated with personal achievement ( r=-0.440). Regression analysis showed that the role cognition was significantly associated with the emotional exhaustion, dehumanization, and personal achievement ( F=10.28-85.12, P<0.01). Conclusion:Active and effective measures should be taken to improve the role cognition and reduce job burnout of family doctor team members in primary health care institutions.

Objective To analyze the effect of edaravone combined with statins on levels of serum homocysteine (Hcy),C-reactive protein (CRP) and total cholesterol (TC),triglyceride (TG),high-density lipoprotein HDL),low-density lipoprotein cholesterol (LDL-C) in patients with ischemic stroke.Methods A total of 63 patients with ischemic stroke in our hospital were divided into two groups,27 cases in control group were given atorvastatin,and 36 patients in the observation group were given edaravone treatment in addition.The levels of Hcy,TG,TC,HDL and low LDL-C were detected.At the same time,stroke scale of NIHSS,Barthel index of daily living ability,Self Anxiety Scale (SAS) and Self Depression Scale (SDS) were recorded at 14 days before and after treatment.Results The observation group had lower Hcy,CRP and LDL-C levels,while higher HDL level.Total effective rate in the observation group was significantly higher than the control group (88.89％ vs.77.78％,P ＜0.05).The observation group had higher Barthel index and lower SAS,SDS scores than the control group (P ＜ 0.05).Conclusion Edaravone combined with atorvastatin can significantly improve patients' treatment outcomes,and improve prognosis and life ability.

Objective To observe the effect of oxiracetam combined with edaravone on clinical efficacy and serum inflammatory factors in patients with acute cerebral infarction and their influence on serum inflammatory factors.Methods A total of 68 patients with acute cerebral infarction were equally divided into observation group and control group by random number table method.All patients were given anti-stroke therapy.Patents in control group were given edaravone,while,patients in observation group were given oxiracetam on the base of control group.Then the clinical efficacy and adverse reactions of two groups were observed.The changes of NIHSS,C-reactive protein (hs-CRP),interleukin-6 (IL-6),tumor necrosis factor (TNF-α) levels were also measured.Results The total effective rate of observation group was 94.12％ and 76.47％ in the control group.The total effective rate of observation group was higher than control group (P ＜ 0.05).Both the basic cure rate and significant progress rate of observation group were also less than control group (P ＜0.05).The NIHSS,CRP,IL-6 and TNF-α levels of patients in two group decreased after treatment (P ＜ 0.05),and those indexes of observation group were much lower than that in the control group after treatment (P ＜ 0.05).Conclusion Treatment of oxiracetam combined with edaravone in patients with acute cerebral infarction can reduce the NIHSS and serum CRP,IL-6,TNF-α levels,and improve neurologic impairment.