Aim To evaluate the effects of salvianolic acid B ( Sal B ) on bone metabolism and its potential mechanism in high fat diet ( HFD) mice.Methods Thirty C57BL/6J male mice were divided into three groups with 10 mice each, namely normal , HFD and HFD+Sal B.HFD and HFD+Sal B mice were treated with HFD, and HFD+Sal B group mice were also with Sal B (125 mg· kg -1· d-1).After 12 weeks' treat-ment, femurs were harvested .The effects of Sal B on biomechanical strength were evaluated by biomechani-cal tests, and the effects of Sal B on bone microstruc-ture were evaluated by Safranin O/fast green staining and hematoxylin and eosin staining .The expression of nuclear factor-kappa B ( NF-κB)-p65 and NADPH ox-idase 4 ( Nox4 ) and cathepsin K in femurs was deter-mined by immunohistochemical staining . Results Maximum load and elastic load significantly decreased ,and the trabeculae became thinner and irregular in the femurs of HFD mice , while Sal B treatment could re-verse the descending biomechanical strength and the disorganized femurs bone micro-structures in HFD mice.In addition, the expressions of Nox4, NF-κB-p65 and cathepsin Kmarkedly increased in HFD mice , and Sal B possessed the ability to down-regulate the ex-pression of Nox4, NF-κB-p65, and cathepsin K in the femurs triggered by HFD .Conclusions Sal B treat-ment improves bone metabolism via regulating Nox 4/NF-κB/cathepsin K signaling pathway in HFD mice . The findings contribute to the understanding and exten-sion of the applications of Salvia miltiorrhiza and its constituents on osteoporosis .

OBJECTIVETo evaluate the use of clinical nutritional support in critical SARS patients, and the relationship between blood glucose levels/insulin administration amount and outcome.

METHODSTwenty-one SARS patients who reached the standard of Ministry of Health's "critical level" were transferred into our ICU in an average of 11 days after onset and enrolled in this clinical trial. All patients underwent respiratory support and clinical nutrition support as scheduled. For about 60 kg patient per day 3347.2 kJ(800 kcal), 36 g protein, and 125 g carbohydrate was given intravenously; 4184 kJ(1000 kcal), 38 g protein, and 125 g carbohydrate was provided by enteral route. MCT/LCT as fat resource shared 50% calories intake. All patients received similar doses of intravenous Methylprednisolone(about 200 mg/d). Blood glucose, serum albumin, blood lymphocyte counts, and serum alanine transminase (ALT) were checked on the first admission day in ICU and on the 12th day after nutrition therapy was started. Insulin was started to pump in to maintain the blood glucose levels between 4.44-7.78 mmol/L (80-140 mg/dl) when the levels exceeded normal range.

RESULTSUpon admission into ICU, all patients had poor nutrients intake for an average of 11 days and 16 patients (76.2%) were diagnosed as malnutrition. Parenteral and enteral nutrition therapy were then offered for an average of 12 days. On the 12th day, the serum albumin increased [(28.5 +/- 2.2)] g/L vs (37.0 +/- 4.1) g/L] (P = 0.0001) and so did the lymphocytes count [(0.74 +/- 0.47)] x 10(9)/L vs (1.22 +/- 0.73) x 10(9)/L] (P = 0.02). The blood glucose maintained at lower level in the surviving patients when compared with those who died [(9.5 +/- 2.3) mmol/L vs (6.3 +/- 1.8) mmol/L] [(196 +/- 70) mg/dl vs (110 +/- 21) mg/dl] (P = 0.0002), and the abnormally high ALT levels presented in some of the patients decreased but not significantly (81.0% vs 57.1%) (P = 0.18). In order to keep blood glucose within the range 4.44-7.78 mmol/L (80-140 mg/dl), only 18.8% of the surviving patients needed insulin intervention as opposed to 80.0% of those who died (P = 0.03). The amount of insulin used in the surviving group was significant lower than that in the group who died [(24 +/- 2) IU/d vs (72 +/- 9) IU/d] (P = 0.01).

CONCLUSIONSEleven days after SARS onset, most of the critical patients presented with malnutrition. Some improved nutrition related parameters may be associated with clinical nutritional support. The surviving patients required less insulin when compared to those who died. 80.0% of the patients who died need insulin versus only 18.8% of the surviving patients. Due to the difficulty of SARS management, this study was not a randomized controlled clinical trial. More clinical trials will be needed for checking the results of this investigation.

Adult ; Blood Glucose ; metabolism ; Enteral Nutrition ; Female ; Humans ; Insulin ; administration & dosage ; Male ; Malnutrition ; blood ; etiology ; therapy ; Middle Aged ; Nutritional Support ; Parenteral Nutrition ; Severe Acute Respiratory Syndrome ; blood ; complications ; therapy ; Treatment Outcome

The present study aimed to investigate the effect of proto-oncogene c-src on the viability of rat spermatogonial stem cells from 9 day-old rat in vitro. MTT method was used to observe the viability of the spermatogonial stem cells treated with antisense c-src oligodeoxynucleotides (ODNs) in vitro; RT-PCR was utilized to observe the expression of c-src mRNA and Western blot was used to observe the protein expressions of pp60c-src and phosphorylated signal transducer and activator of transcription-3 (p-STAT3). Compared with that in control group, the viability of spermatogonial stem cells decreased by 8.1% (P<0.05) and the expression of c-src mRNA decreased significantly after treatment with 10 μmol/L antisense c-src ODNs for 12 h. Compared with that in the control group, the protein expressions of pp60c-src and p-STAT3 decreased by 33.8% and 45.3% (both P<0.01), respectively, in the spermatogonial stem cells after being transfected with antisense c-src ODNs. The results suggest that proto-oncogene c-src regulates the viability of rat spermatogonial stem cells through p-STAT3.
Animals ; Cells, Cultured ; Genes, src ; Male ; Phosphorylation ; Proto-Oncogene Proteins pp60(c-src) ; metabolism ; RNA, Messenger ; Rats ; STAT3 Transcription Factor ; metabolism ; Spermatogonia ; cytology ; metabolism ; Stem Cells ; cytology ; metabolism ; Transfection

Objective To observe the current status of secondary prevention medication usage and their relation with on-treatment platelet reactivity in patients with Acute Coronary Syndrome(ACS) treated with aspirin and clopidogrel. Methods A total of 176 patients hospitalized from 2014 to 2015 due to ACS in the Department of Cardiology, Peking University People's Hospital were enrolled and on-treatment platelet reactivity was tested by thromboelastography(TEG)and CYP2C19*2,*3 and*17 alleles were analysed. Details of secondary prevention medication and patients' clinical characteristics were recorded. The relation of secondary prevention medication and on-treatment platelet reactivity was analyzed by multi-logistic regression after adjusting for CYP2C19 alleles and clinical characteristics covariates.Results A 94.89% of patients was treated with statins while 80.68% with beta blocker. The platelet inhibition rate were (45.33±28.78)% and the high on-treatment platelet reactivity (HTPR) rate tested by TEG was 37.50%. In the multivariate logistic regression analysis, usage of β-blockers during hospitalization as well as phenotypes of CYP2C19*2,*3 and *17,clinical presentation with ST-segment elevation myocardial infarction and the length of stents were associated with HTPR defi ned by TEG. The percentage of HTPR rate was signifi cantly lower in patients treated with than those without β-blockers (72.73% vs. 85.45%,OR 0.18,95%CI 0.06-0.53,P=0.002)after adjusting genetic factors and other covariates.Conclusions There was a signifi cant correlation between beta blockers usage and high clopidogrel on-treatment platelet reactivity.

Objective To explore the application of fuzzy mathematics theory in the evaluation of medical students' comprehensive mental quality. Methods A total of 80 medical undergraduates studying in the Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University from October to December 2017 were randomly selected to conduct a questionnaire survey on medical students' mental quality. The questionnaires were designed by the study group, containing 3 first-level items (learning pressure, life stress and interpersonal stress), and 19 secondary items, with the recovery rate as 95%. Fuzzy comprehensive evaluation method was used for data processing and analysis. Results By comparing the data obtained from the comprehensive evaluation of the secondary factors with those of the pre-set evaluation set, the study concluded that 25.00% of the medical students need to adjust the future pressure, 41.70% the family health status pressure and 26.79% the appearance pressure according to the principle of maximum mem-bership degree. The comprehensive evaluation of the first four factors (0.249 7, 0.268 9, 0.270 2, and 0.211 2) showed that the comprehensive mental quality of medical students was "good". The quantitative analysis results showed that 27.02% of the medical students had good comprehensive mental quality, 24.97% need the mental quality adjustments, 26.89% had the average mental quality, and 21.12% had outstanding mental quality. Fuzzy comprehensive evaluation indicated that it is necessary to adjust the learning pressure and life stress of medical students, while the interpersonal stress had little effect on the mental quality of medical students. Conclusion The fuzzy comprehensive evaluation adopts the quantitative method to deal with the qualitative indicators uniformly, being scientific and reasonable. The corresponding data of each indicator can be easily identified with the help of the indicator system built up in the evaluation, which provides evidence for distinguishing and improving the corresponding decision-making for improving the medical students' mental quality. This evaluation method has strong applicability and provides new methods and ideas for objectively evaluating the comprehensive mental quality of medical students.

OBJECTIVE: To study the association between superior mesenteric artery hemodynamic indexes and scores of lower gastrointestinal symptoms rating scales(LGSRS) in patients with type 2 diabetic mellitus. METHODS: Totally 142 inpatients with type 2 diabetes with average age of 58.76±12.32 yrs were enrolled, who were treated from August 2016 to March 2018. The history, gender, age,course and BMI were recorded, and fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), 2-hour postprandial blood glucose(PBG), total cholesterol(TC), triglyceride(TG), urine ACR and LGSRS were determined. Ultrasonic scanning of mesenteric artery was performed for hemodynamic indexes, including artery inner diameter(ID), peak systolic velocity(PSV), end-diastolic velocity(EDV), and resistance index(RI)at starting part,first level branch, and second level branch from root of the superior mesenteric artery(SMA).Patients were divided into 2 groups according to their LGSRS, 74 patients with LGSRS≥6 were in positive group, and 68 patients with LGSRS<6 were in control group. RESULTS: 1. There were no significant differences between the 2 groups in gender, BMI, HbA1C, FBG, PBG,TC or TG(P>0.05), but the age and DD were significantly higher in positive group than in control group(P<0.05). 2. There were three patients(4.41%) who had atheroma or plaques in SMA in control group, while five patients in positive group(6.76%)(P>0.05). 3. There were no significant difference between positive group and control group in ID at starting part and first level branch of SMA, while ID at second level branch was significantly increased in positive group compared with control group [(3.83±0.85)mm vs.(3.53±0.90)mm, P<0.05)].4. RI at first(0.816±0.059 vs 0.842±0.063,P<0.05) and second level branch(0.813±0.076 vs 0.845±0.073, P<0.05) and PSV at first level branch[(110.89±46.89)cm/s vs(95.72±36.59)cm/s,P<0.05] were significantly high in positive group; there were no difference in other hemodynamic indexes between the groups. 5.Adjusted by age,DD,glycemic and lipidemic profile,Logistic regression showed that ID at first(RR=2.092,95%CI 1.080-4.050,P=0.029) and second level branch(RR=0.491,95%CI 0.252-0.955,P=0.36) and EDV at second level branch(RR=0.897,95%CI 0.824-0.976,P=0.012) were independent factors influencing LGSRS(P<0.05). CONCLUSION: Ultrosonic hemodynamic abnormalities in the superior mesenteric artery might be important factor in development of lower gastrointestinal tract symptoms in patients with type 2 diabetes.

OBJECTIVETo construct a satisfaction evaluation indicator system based on patients' experiences of medical services.

METHODSA questionnaire was designed by expert interview and literature review and 400 copies were randomly handed out to inpatients and outpatients from five 3A-public hospitals in Shanghai. The patient's evaluation of importance of various factors in medical services was analyzed and the mean and weight of indicators in terms of recognition, importance and evaluation were determined to establish a satisfaction evaluation indicator system.

RESULTSA total of 396 valid questionnaires were retrieved, with an effective response rate of 99%. By analyzing survey data, the patient satisfaction evaluation indicator system was constructed with 5 primary indicators (hospital environment, medical procedures, attitude, and quality of care and patient rights) and 25 secondary indicators (convenient hospital environment, auxiliary facilities, reasonable arrangement, clearly mark, convenient appointment, simple procedures, short time, the attitude of medical staff, solutions of medical dispute, medical technology, treatment, medical equipment, medical expenses, respect, patient privacy, etc.).

CONCLUSIONA patient satisfaction evaluation indicator system has been established based on patients' experience of medical services in the study, which may be applicable to measure patients' satisfaction and to improve medical services in hospitals.

China ; Humans ; Patient Satisfaction ; Surveys and Questionnaires

OBJECTIVE: To analyze the sociodemographic and clinical factors related to anxiety in patients with major depressive disorder (MDD). METHODS: This study involved a secondary analysis of data obtained from the Diagnostic Assessment Service for People with Bipolar Disorders in China (DASP), which was initiated by the Chinese Society of Psychiatry (CSP) and conducted from September 1, 2010 to February 28, 2011. Based on the presence or absence of anxiety-related characteristics, 1,178 MDD patients were classified as suffering from anxious depression (n=915) or non-anxious depression (n=263), respectively. RESULTS: Compared with the non-anxious group, the anxious-depression group had an older age at onset (t=-4.39, p<0.001), were older (t=-4.69, p<0.001), reported more lifetime depressive episodes (z=-3.24, p=0.001), were more likely to experience seasonal depressive episodes (chi2=6.896, p=0.009) and depressive episodes following stressful life events (chi2=59.350, p<0.001), and were more likely to have a family history of psychiatric disorders (chi2=6.091, p=0.014). Their positive and total scores on the Mood Disorder Questionnaire (MDQ) and the 32-item Hypomania Checklist (HCL-32) (p<0.05) were also lower. The logistic regression analysis indicated that age (odds ratio [OR]=1.03, p<0.001), a lower total MDQ score (OR=0.94, p=0.011), depressive episodes following stressful life events (OR=3.04, p<0.001), and seasonal depressive episodes (OR=1.75, p=0.039) were significantly associated with anxious depression. CONCLUSION: These findings indicate that older age, fewer subclinical bipolar features, an increased number of depressive episodes following stressful life events, and seasonal depressive episodes may be risk factors for anxiety-related characteristics in patients with MDD.
Anxiety* ; Asian Continental Ancestry Group ; Bipolar Disorder ; Checklist ; China ; Depression ; Depressive Disorder ; Depressive Disorder, Major* ; Humans ; Logistic Models ; Mood Disorders ; Risk Factors* ; Seasons

OBJECTIVE: To compare the therapeutic effect of plum-blossom needle tapping at three meridians of wrist combined with rehabilitation training and simple rehabilitation training on wrist joint contracture after stroke. METHODS: A total of 72 patients with wrist joint contracture after stroke were randomized into an observation group and a control group, 36 cases in each one. In the control group, simple rehabilitation training was applied, 5 times a week, 3 weeks as one course and totally 3 courses were required. On the basis of the treatment in the control group, plum-blossom needle tapping at three meridians of wrist was adopted in the observation group. The tapping regions were wrist traveling parts of three meridians of hand, ranging from up 3 to below 1 of wrist crease, 3 times a week, 3 weeks as one course and totally 3 courses were required. The active range of motion (AROM) of active wrist extension, Fugl-Meyer score (FMA) and Barthel index (BI) score were observed before and after treatment in the two groups. RESULTS: The AROM, FMA scores and BI scores after treatment in the two groups were superior to before treatment (<0.05), and the improvements of 3 indexes in the observation group were superior to the control group (<0.05). CONCLUSION The therapeutic effect of plum-blossom needle tapping at three meridians of wrist combined with rehabilitation training is superior to simple rehabilitation training on wrist joint contracture after stroke.
Acupuncture Therapy ; Contracture ; etiology ; therapy ; Humans ; Meridians ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome ; Wrist ; Wrist Joint

Objective : To investigate the effectiveness of fluoride varnish in preventing first permanent molars caries inschool-age children and provide necessary information for oral health instruction. Methods: 378 children aged 6-7 years old in the first grade of primary school in dahua country, hechi city, Guangxi province (1 053 first permanent molars) were randomly recruited into 2 groups. The test group (542 first permanent molars in 191 children) was treated with fluoride varnish one time in a half year and given oral hygiene instruction 3 times; The control group (511 first permanent molars in 187 children) was only given oral hygiene instruction 3 times. All first permanent molars were checked after 18 months later for caries. Results: After intervention, the caries prevalence rate in the test group raised from 21.99% to 27.75% compared with the control group from 24.60% to 37.43%. The caries incidence rate in test and control group was 5.76% and 12.83% respectively. There was a significant difference between 2 groups regardless of caries prevalence, caries incidence, the DMFT reduction, the DMFs reduction, the occlusal caries prevalence, the pit and fissure caries prevalence, the proximal caries prevalence. Conclusion Semi-annual application of fluoride varnish is effective in the prevention of dental caries in first permanent molars , which was worth of being popularized in clinic.