Objective To learn the effects of crude herb moxibustion combined with rehabilitation training on the recovery of pulmonary functions and quality of life of patients with stable-stage chronic obstructive pulmonary diseases (COPD) in Nanning communities. Methods Two hundred patients with stable-stage COPD, sampled from Nanning communities and used as the subjects of this study, were divided into the experiment group and the control group by the random number table method. Patients in the control group were given conventional medication and community health care education and guides;Patients in the experiment group were not only offered the same treatment as mentioned above, but treated during dog days and the coldest days of winter with moxibustion medicine cakes which were applied accurately on selected acupuncture points, together with moxibustion with moxa cone done on the cakes. Treatment was done 6 times in each course of treatment, and 2 courses were given, combined with rehabilitation training. Examination of pulmonary functions was conducted for all patients before and after the treatment and St. George′s Respiratory Questionnaires (SGRQ) were distributed to them. Results Forced vital capacity patients, forced expiratory volume in first second, the percentage of forced expiratory volume in first second and forced vital capacity of experimental group before the intervention were (2.27 ± 0.36) L, (1.56 ± 0.30) L, (44.81 ± 5.35) %, while six months after the intervention were (3.36 ± 0.42) L, (2.25 ± 0.27) L, (65.38 ±8.08)%. The difference was statistically significant (t=18.90, 16.40, 20.36, P<0.01);The above indexes of control group respectively before intervention were (2.28±0.43) L, (1.58±0.33) L, (45.17 ± 4.97) %, while six months after the intervention were (2.57 ± 0.57) L, (1.71 ± 0.35) L, (46.94 ± 8.42)%. Difference was not statistically significant (t = 1.81, 2.04, 1.70, P > 0.05). Differences between two groups before intervention had no statistical significance (t = 0.17, 0.43, 0.47, P > 0.05), and differences between two groups after the intervention were statistically significant (t=10.62, 11.62, 14.99, P < 0.01). In the experimental group,before intervention the total score of SGRQ and the part scores of symptom, the activity ability and the influence of the disease were (16.56 ± 1.76) points, (10.44 ± 1.57) points, (18.55±2.17) points, (45.73 ± 2.53) points, 6 months after the intervention the scores were (10.77 ± 1.56) points, (7.28±1.23) points, (14.33 ±1.66) points, (32.98 ± 2.35) points. The difference was significant (t=14.82-35.50, P<0.01);In the control group before intervention the total scores of SGRQ and the part score of symptom, the activity ability and the influence of the disease were (16.47 ±1.81) points, (10.39 ± 1.66) points, (18.52 ± 2.16) points, (45.79 ± 2.49) points, 6 months after the intervention the scores were (16.12 ±1.36) points, (9.89 ±1.38) points, (16.96 ±1.58) points, (42.15±2.34) points. The lower score was not obvious, there was no statistically significant difference (t=1.45-2.17, P > 0.05). Intervention before comparing differences between two groups had no statistical significance (t=0.09-0.34, P > 0.05). Intervention after comparing differences between two groups was statistically significant (t=10.88-26.22, P<0.01). Conclusions Clinically, crude herb moxibustion combined with rehabilitation training is to some extent conducive to delaying the decrease in pulmonary functions, reducing complications, and improving the quality of life of patients with stable-stage COPD.

From the ethical point of view,this paper explores to carry out AIDS-related training for nursing staff,to enhance their awareness of self protection and occupational protection for better nursing work,and provides reference for training in AIDS prevention and control and reduce occupational risk among nursing staff.

Objective To report a case of Hutchinson-Gilford progeria syndrome,and to make a molecular genetic diagnosis.Methods Peripheral blood samples were collected from a 12-month-old child with HutchinsonGilford progeria syndrome,his parents,and 150 unrelated healthy controls.DNA was extracted from these samples,and PCR was performed to amplify exon 11 of the LMNA gene and its flanking sequence followed by sequencing.Results The patient presented with scleroderma-like tight skin on the trunk,hair loss and prominent scalp veins for 9 months,whose body height and weight were two standard deviations below the mean.Physical examination showed thin skin and prominent superficial veins over the scalp.The skin over the trunk was tight,hard,shiny and dry with a small number of tiny scales,mottled pigmentation and hypopigmentation,induration and hypertrophy giving a cobblestone-like appearance.The subcutaneous fat was diminished on the lower limbs.Skeletal X-ray examination of the left hand revealed phalangeal acroosteolysis.A known heterozygous mutation c.1824C ＞ T (dbSNP:rs58596362) was detected in the exon 11 of the LMNA gene in the proband,but not in his parents or the 150 unrelated healthy controls.Conclusion The mutation c.1824C ＞T in the LMNA gene may be responsible for Hutchinson-Gilford progeria syndrome in this patient.

OBJECTIVETo explore and analyze the feasibility of Community Health Service Center(CHSC)-based HIV prevention and intervention in China.

METHODSData on case finding and case management indexes were collected from 42 CHSCs in 8 cities from November, 2011 to December, 2012, and complemented by questionnaires to investigate the willingness to accept community-based HIV services among health care providers and the service targets.

RESULTSDuring November, 2011 and December, 2012, 6 729 person-times HIV tests were carried out among MSM in the cooperation between CHSCs and CBOs, and 235 HIV positives were found. A total of 40 CHSCs among 42 have conducted HIV rapid tests. The sample sources were broad and the HIV screening positive detection rate from high-risk populations in key divisions of CHSCs 0.66% (38/5 769) was higher than that in outreach high-risk populations 0.41% (15/3 623) and people receiving physical check 0.31% (20/6 532). HIV positive detection rate in CHSCs was higher 0.4% (96/23 609) than that in conventional medical institutions 0.1% (11 870/9 644 944) and newly found positives among the confirmed positives was a little lower 73.7% (56/76) than conventional programs 80.1% (8 038/10 039). The case follow-up and CD4(+) T cell testing rates in CHSCs were 100.0% (1 046/1 046) and 99.1% (1 037/1 046), respectively. The testing cost was 6.1 RMB per person on average, and the cost of 1 case found positive was 2 727.3 RMB on average. Among 361 service providers, 68.1% (246)and 91.4% (330) service providers were willing to be involved in AIDS response and support HIV service in local CHSCs. Among 755 service targets including people who seek health care in key divisions of CHSCs, MSM, and high-risk populations in local communities, 77.3% (348), 73.9% (173) and 78.1% (57) were willing to accept free HIV tests in local CHSCs.

CONCLUSIONThe effect of case finding and case management in CHSCs was good and the cost of conducting HIV tests and finding new cases were relatively low, meanwhile, most of the service provides in CHSCs and service targets support HIV service in local CHSCs. The future CHSC-based HIV prevention and intervention was feasible.

China ; Community Health Centers ; Community Health Services ; HIV Infections ; prevention & control ; HIV Seropositivity ; Health Care Costs ; Humans ; Mass Screening ; Surveys and Questionnaires

Enteral nutrition is an indispensable part of the treatment for critically ill patients. Various authoritative guidelines point out that early enteral nutrition is the key to improve the prognosis of disease. The key to improve and promote standardized enteral nutrition for criti-cally ill patients is the application of guidelines in the clinical practice. Based on clinical practice and theoretical basis, the authors propose a new insight into enteral nutrition and a new nutritional strategy of "individual treatment, circular evaluation, channel basis, quality-quatity balance, step-up achievement" for critically ill patients on basis of a 5W1H mindset.

Objective To report a case of Costello syndrome complicated by curis laxa,and to make a molecular genetic diagnosis.Methods Clinical data were collected from a case of Costello syndrome complicated by cutis laxa.Skin tissues were resected from the patient,and peripheral blood samples were obtained from the patient's parents and 150 unrelated healthy controls.Genomic DNA was extracted from these samples,and all the exons and their flanking sequences of the HRAS gene were analyzed by DNA sequencing.Results The 13-month-old female patient presented with growth retardation,severe malnutrition,coarse facial appearance,severely loose skin over the limbs,and decrease or disappearance of subcutaneous fat.A heterozygous mutation c.34G ＞ T (p.Gly12Cys) was detected in exon 2 of the HRAS gene in the patient,but not in her parents or 150 unrelated healthy controls.Conclusion The c.34G ＞ T (p.Gly12Cys) mutation in exon 2 of the HRAS gene may be responsible for Costello syndrome in the patient.

Objective To investigate the role and related mechanisms of exosomes derived from mesenchymal stem cells (MSCs) in radiation-induced lung injury (RILI). Methods Human umbilical cord-derived MSCs were isolated and cultured for the extraction and identification of exosomes. Eighteen male SD rats were randomly divided into Control group, RILI group and RILI + exosomes group (EXO group), with 6 rats in each group. Except for Control group, the other groups received a single X-ray dose of 30 Gy to the right lung. Immediately after irradiation, the EXO group was administered 2 × 10⁹ exosomes/kg via tail vein injection. Control group and RILI group were given the same volume of normal saline. Eight weeks post-irradiation, the rats were sacrificed, lung tissue and peripheral venous blood were collected. HE and Masson staining were employed to observe the pathological and fibrotic changes of lung tissue. The levels of serum inflammatory factors IL-6, IFN-γ, TNF-α, and IL-10 were detected by ELISA. RT-qPCR was used to assess the mRNA levels of IL-1β, IL-6, Cdh1, and Col1a1 in lung tissue. The expression levels of Vimentin and TGF-β1 in lung tissue were measured by immunohistochemical staining. The expression levels of AMPK, p-AMPK, and TGF-β1 in lung tissue were detected by Western blot. Results MSC-derived exosomes were successfully extracted and identified. Compared with RILI group, EXO group showed significantly reduced pathological changes of lung inflammation and collagen deposition. The levels of serum inflammatory factors IL-6, INF-γ, and TNF-α were significantly decreased (P < 0.05), and the level of anti-inflammatory factor IL-10 was significantly increased (P < 0.05). The mRNA levels of IL-1β, IL-6, and Col1a1 in lung tissue were significantly decreased (P < 0.05 or P < 0.01), and the mRNA level of Cdh1 was significantly increased (P < 0.05 or P < 0.01). The levels of Vimentin and TGF-β1 in lung tissue were significantly reduced, while p-AMPK level was significantly up-regulated (P < 0.05). Conclusion Exosomes derived from MSCs may alleviate RILI by inhibiting inflammatory responses and regulating epithelial-mesenchymal transition mediated by AMPK/TGF-β1 signaling pathway.

AIM: To establish a ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to determination the plasma concentration of clozapine and compare the bioequivalence of a generic clozapine tablet with Clozaril

To investigate the incidence of postoperative neuropsychic dysfunction (PND) in Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) and to analyze its influencing factors.

A prospective study was conducted between January 2020 and December 2022, recruiting PD patients from the Functional Neurosurgery Outpatient Clinic of Beijing Tiantan Hospital, Capital Medical University. All patients were scheduled to undergo bilateral subthalamic nucleus (STN)-DBS surgery. Perioperative clinical data were collected, and PND (outcome measure) within 3 days postoperatively was assessed using the Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), Hamilton depression and anxiety scales, and 3-minute diagnostic interview for confusion assessment method (3D-CAM). Multivariate Logistic regression was used to analyze the influencing factors of PND.

A total of 216 PD patients were enrolled. Within 3 days after DBS surgery, 77 patients (35.6%) developed PND, including 24 cases (31.2%) of depression or worsening depression, 16 cases (20.8%) of anxiety or worsening anxiety, 13 cases (16.9%) of cognitive decline, and 24 cases (31.2%) of delirium. Univariate analysis revealed that dural opening method, dural opening time, intraoperative improvement rate of the unified Parkinson's disease rating scale -Ⅲ (UPDRS-Ⅲ) score, and postoperative intracranial air volume were significantly different between PND and non-PND patients (all P < 0.05). Multivariate Logistic regression analysis showed that female sex (OR=2.468, 95% CI: 1.077-5.657, P=0.033) and postoperative intracranial air volume (OR=1.217, 95% CI: 1.096-1.351, P < 0.001) were independent risk factors for PND, while a higher intraoperative UPDRS-Ⅲ improvement rate was a protective factor (OR=0.894, 95% CI: 0.863-0.925, P < 0.001).

PD patients have a high incidence of PND after DBS surgery. Sex, postoperative intracranial air volume, and the degree of improvement in PD motor symptoms can influence the risk of PND. These findings highlight the importance of individualized management based on sex, improving surgical techniques, and enhancing monitoring of neuropsychiatric status to optimize the efficacy of DBS surgery.