Objective To study the effective anticoagulant components of the fermented products of mycelium from Tremella aurantialba 9800. Method To adopt system menstruum deal with fermented products of mycelium from Tremella aurantialba,then mycelium from tremella aurantialba was studied with the clotting time of the thrombogen,the whole blood clotting time in mice and thrombosis experiment in mice. Result Butanol extract of fermented products of mycelium from Tremella aurantialba behave anticoagulant function. Ethyl acetate extract and water extract also behave feeble activity. Conclusion The effective anticoagulant components of the fermented products of mycelium from Tremella aurantialb is butanol extract.

Objective To investigate whether poly arginine as the carrier can carry foreign proteins to penetrate the cell membrane and even penetrate the eyeball barrier.Methods Poly-Args (R9) was used as a CPP in this study.R9-green fluorescent protein (GFP) and GFP were constructed.In vitro,human lens epithelial cells were treated with these two proteins.Then,MTT assay were used to detect whether the protein could affect the proliferation of the cells.Flow cytometry and laser confocal microscopy were used to detect the penetrability of CPPs on the cells.In vivo,eyes of mice were treated with protein in eye drops way for 7 days.Then total protein were extracted,ELISA were used to detect the penetrability of CPPs.Results The results of MTT,flow cytometry and laser confocal microscopy showed that CPPs could carry protein into cells in a dose dependent manner without affecting cell proliferation.In vivo,slit lamp showed that the mice eyeballs had no any abnormal after treated by GFP,R9-GFP,and ELISA results also showed that R9 could effectively get foreign protein into the eyeball.Conelusion R9 can carry foreign protein into the cell membrane and eyeball barrier.This study provides the basis for the eye medication and dosing mode improvement.

Objective To observe the clinical effect of xerophthalmia of meibomian glands dysfunction treated with meibomian glands massage and tobramycin dexamethasone in the northeast area.Methods The clinical data of 403 patients (767 eyes) with xerophthalmia of meibomian glands dysfunction in the northeast area in January to November 2013 were analyzed retrospectively.The patients were divided into 3 groups.Patients of treatment goup 1 were combined modality therapy by meibomian glands massage and tobramycin dexamethasone and artificial tears (carbomer eye ophthalmic gel).Patients of treatment goup 2 were treated with tobramycin dexamethasone and artificial tears.Patients of control group were only used by artificial tears.Tear film break-uptime (BUT),tear secretion test (Schirmer Ⅱ),corneal staining score and symptom score were measured before treatment and after treatment for 1,3 months.Results There was no significant difference in the subjective symptoms,BUT,Schirmer Ⅱ,corneal staining score before treatment among three groups (P ＞ 0.05).Compared with that before treatment,the subjective symptoms,BUT,Schirmer Ⅱ,corneal staining score after treatment for 1 month was improved in treatment group 1 and treatment group 2 (P ＜ 0.01),but there was no significant difference in control group (P ＞ 0.05).After treatment for 3 months,the effective power in treatment group 1 [87.1％(122/140)] and treatment group 2 [60.8％(79/130)] was higher than that in control group [48.9％(65/133)],and there was significant difference (P ＜ 0.05).And there was significant difference between treatment group 1 and treatment group 2 (P ＜ 0.05).Conclusions Xerophthalmia of meibomian glands dysfunction in the northeast area due to speciality in the geographical environment and food habits.Combined modality therapy (applied heating,meibomian glands massage and tobradex) can provide a new direction of xerophthalmia of meibomian glands dysfunction,retrieve in the lipids component of the tear film and eliminate the inflammation.But,dependence of the out-patients are very important in the therapeutic process.

Objective To explore the application of extended care on hepatitis C anti-virus therapy, so as to improve patient′s quality of life and treatment compliance. Methods A total of 120 hepatitis C patients, who hospitalized our department for anti-viral therapy from April to September 2014, were divided into experimental group ( extended care based on routine care) and control group ( routine care) on average. After 6 months interventions, SF-36 and daily behavior self management comprehensive evaluation questionnaire were used to compare quality of life and treatment compliance between two groups. Results After 6 months interventions, each dimensions of quality of care in the experimental group were higher than that of the control group (t=3. 647,2. 658,9. 512,2. 392,4. 246,4. 587,2. 332,4. 437;P <0. 05); the treatment compliance presented the same trend as above (t =8. 940,8. 710,10. 803,11. 529,9. 415,9. 780,7. 619;P <0. 01). Conclusions The extended care for patients with hepatitis C anti-viral therapy can improve their quality of life and treatment compliance, so as to reach a preferable treatment effects.

Objective To investigate the effects of physical and mental rehabilitation exercise on coping style and self-management efficacy of patients with cervical cancer. Methods A total of 60 cervical cancer chemotherapy patients were randomly divided into rehabilitation exercise group and control group, with 30 cases in each group. The patients of control group used conventional methods of nursing care, while patients in rehabilitation training group received the physical and mental rehabilitation exercise positive. The two groups had three months of intervention. Coping style of two groups before and after intervention in cervical cancer patients was contrasted, as well as self-efficacy, complications and nursing satisfaction. Results After the intervention, two groups of patients with cervical cancer, their response were significantly improved, and in the physical and mental rehabilitation exercise group of cervical cancer patients, the coping styles significantly was better than that the control group (P<0.05); after intervention, self-management efficacy of three dimensions and total score in rehabilitation exercise group of cervical cancer patients were significantly improved, and in the physical and mental rehabilitation exercise group of cervical cancer patients, the self-management efficacy of three dimensions and total score were significantly better than those of the control group (P < 0.05); the incidence rate of complications in rehabilitation exercise group after the intervention (6.7%) was significantly lower than it in the control group (33.3%) (P < 0.05); in rehabilitation exercise group, the cervical cancer patients' satisfaction was significantly better than that of the control group (100.0% vs 86.7%)(P < 0.05). Conclusions Nursing care of physical and mental rehabilitation exercise, which is used in cervical cancer patients with radiotherapy and chemotherapy, can significantly improve the coping style and self-efficacy of patients, reduce the incidence of complications, and improve nursing satisfaction.

OBJECTIVETo analyze the clinical features and genetic cause for a family affected with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

METHODSClinical manifestations, neuroimaging, and genetic analysis were performed.

RESULTSThe main clinical features have included stroke, emotional disturbance and history of migraine without progressive memory impairment. A positive family history was confirmed. Cranial MRI has revealed multi-infarct lesions and white matter hyperintensity involving bilateral basal ganglia, subcortex and brain stem. All such features were in keeping with the diagnosis of CADASIL. A rare 2182C>T mutation in exon 14 of the NOTCH3 gene was identified in all available cases.

CONCLUSIONBoth clinical and molecular features suggested that the family has been affected with CADASIL.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Migraine Disorders ; genetics ; Receptor, Notch3 ; Receptors, Notch ; genetics

Objective:To explore the risk factors, clinical features, endoscopic characteristics and the efficacy of antiviral therapy in ulcerative colitis (UC) patients complicated with cytomegaloviremia (CMV) and Epstein-Barr (EB) viremia.Methods:From April 1, 2014 to January 31, 2019, at The Second Hospital of Hebei Medical University, a total of 320 UC patients hospitalized at the Department of Gastroenterology were enrolled. According to the pathogens, the patients were divided into four groups: complicated with CMV and EB viremia group ( n=35), only complicated with CMV viremia group ( n=33), only complicated with EB viremia group ( n=52) and without CMV and EB viremia group ( n=200). Clinical features and the efficacy of antiviral therapy of the patients were retrospectively analyzed. Multivariate logistic regression was used to analyze the risk factors of UC complicated with CMV and EB viremia. Kruskal-Wallis H test, Chi-square test and Fisher exact test were used for statistical analysis. Results:The proportion of patients of age>60 years old (42.86%, 15/35), the rate of glucocorticoid use (51.43%, 18/35) within three months before onset and the inefficacy rate of glucocorticoid treatment (22.86%, 8/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (14.00%, 28/200; 24.50%, 49/200; 1.00%, 2/200), and the differences were statistically significant ( χ2=17.062, 10.598 and 29.769; all P<0.01). However, there were no statistically significant differences between UC complicated with CMV and EB viremia group and UC without CMV and EB viremia group in gender, and treatment of 5-aminosalicylic acid (5-ASA), azathioprine and infliximab within three months before onset (all P>0.05). The proportion of patients with fever (54.29%, 19/35), abdominal pain (91.43%, 32/35), hematochezia (94.29%, 33/35), weight loss (28.57%, 10/35), severe disease activity (94.29%, 33/35), total colon involvement (91.43%, 32/35), serum albumin less than 30 g/L (71.43%, 25/35) and hemoglobin less than 100 g/L (48.57%, 17/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (13.50%, 27/200; 43.00%, 86/200; 44.00%, 88/200; 13.50%, 27/200; 38.00%, 76/200; 65.00%, 130/200; 18.00%, 36/200 and 18.50%, 37/200), and the differences were statistically significant ( χ2=31.475, 27.945, 32.930, 5.100 and 40.194, Fisher exact test, χ2=44.242 and 15.220, all P<0.01). However, there were no statistically significantl differences in clinical classification and disease course (all P>0.05). The incidence rates of deep ulcer (45.71%, 16/35), irregular ulcer (42.86%, 15/35) and longitudinal ulcer (8.53%, 3/35) under endoscopy of UC complicated with CMV and EB viremia group were significantly higher than those of UC without CMV and EB viremia group (1.50%, 3/200; 3.50%, 7/200 and 1.00%, 2/200), and the differences were statistically significant ( χ2=72.521 and 49.837, Fisher exact test, all P<0.01). The incidence rates of deep ulcer and irregular ulcer under endoscopy of UC complicated with CMV and EB viremia group were higher than those of UC only complicated with EB viremia group (15.38%, 8/52 and 11.54%, 6/52), and the differences were statistically significant ( χ2=9.663 and 11.206, P=0.002 and 0.001). The results of Multivariate Logistic regression analysis showed that severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy were risk factors of UC patients complicated with CMV and EB viremia (odds ratio=48.519, 44.352, 53.432 and 39.989, 95% confidence interval 9.057 to 587.669, 4.499 to 437.245, 3.302 to 864.670 and 3.418 to 467.910, all P<0.05). The improvement rate of antiviral therapy in UC complicated with CMV and EB viremia group (73.53%, 25/34) was significantly lower than those of UC only complicated with CMV group (96.88%, 31/32) and UC only complicated EB viremia group (95.65%, 44/46), and the differences were statistically significant ( χ2=6.989 and 6.310, P=0.008 and 0.012). Conclusions:UC patients with severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy are more likely to develop CMV and EB viremia. The more severe the disease, the worse the treatment response, so it is necessary to strengthen the screening to CMV and EB virus infection in UC patients.

PEP06 is a novel endostatin-Arg-Gly-Asp-Arg-Gly-Asp(RGDRGD)30-amino-acid polypeptide featuring a terminally fused RGDRGD hexapeptide at the N terminus.The active endostatin fragment of PEPO6 directly targets tumor cells and exerts an antitumoral effect.However,little is known about the kinetics and degradation products of PEP06 in vitro or in vivo.In this study,we investigated the in vitro metabolic stability of PEP06 after it was incubated with living cells obtained from animals of different species;we further identified the degradation characteristics of its cleavage products.PEP06 underwent rapid enzymatic degradation in multiple types of living cells,and the liver,kidney,and blood play important roles in the metabolism and clearance of the peptides resulting from the molecular degradation of PEP06.We identified metabolites of PEP06 using full-scan mass spectrometry(MS)and tandem MS(MS2),wherein 43 metabolites were characterized and identified as the degradation metabolites from the parent peptide,formed by successive losses of amino acids.The metabolites were C and N terminal truncated products of PEP06.The structures of 11 metabolites(M6,M7,M16,M17,M21,M25,M33,M34,M39,M40,and M42)were further confirmed by comparing the retention times of similar full MS spectrum and MS2 spectrum information with reference standards for the synthesized metabolites.We have demonstrated the metabolic stability of PEP06 in vitro and identified a series of potentially bioactive downstream metabolites of PEP06,which can support further drug research.

Objective To understand the experiences of repeated hospitalization in liver cirrhosis patients with upper gastrointestinal hemorrhage, and analyze its influencing factors. Methods By using the qualitative phenomenological research methodology,10 patients who had liver cirrhosis with upper gastrointestinal hemorrhage and had experiences of repeated hospitalization were selected and the in-depth interview were conducted. The results were analyzed, concluded and refined with Colaizzz′s seven steps of phenomenological analysis. Results By means of analysis, induction and distilling, 5 themes were addressed including recurrent disease causing as the main reasons for repeated hospitalization, cognitive shortcomings of disease, high pressure of the management of the disease, needing a strong social support system, and repeated hospitalization causing psychological pressure increase. Conclusions Medical staff should improve the cultivation of professional quality, strengthen the intervention on health education and outside the hospital way of life in liver cirrhosis patients with upper gastrointestinal hemorrhage, give targeted psychological care, improve the patients cognition of disease and self-management ability, and reduce the pressure of the patient′s disease management, so as to reduce readmission rate of patients.

Background::Gestational weight gain (GWG) is associated with the risk of gestational diabetes mellitus (GDM). However, the effect of weight gain in different trimesters on the risk of GDM is unclear. This study aimed to evaluate the effect of GWG on GDM during different trimesters.Methods::A birth cohort study was conducted from 2017 to 2020 in Shenzhen, China. In total, 51,205 participants were included comprising two models (early pregnancy model and middle pregnancy model). Gestational weight (kg) was measured at each prenatal clinical visit using a standardized weight scale. Logistic regression analysis was used to assess the risk of GDM. Interaction analysis and mediation effect analysis were performed in the middle pregnancy model.Results::In the early pregnancy model, the risk of GDM was 0.858 times lower (95% confidence interval [CI]: 0.786, 0.937) with insufficient GWG (iGWG) and 1.201 times higher (95% CI: 1.097, 1.316) with excessive GWG after adjustment. In the middle pregnancy model, the risk of GDM associated with iGWG increased 1.595 times (95% CI: 1.418, 1.794) after adjustment; for excessive GWG, no significant difference was found ( P = 0.223). Interaction analysis showed no interaction between GWG in early pregnancy (GWG-E) and GWG in middle pregnancy (GWG-M) ( F = 1.268; P = 0.280). The mediation effect analysis indicated that GWG-M plays a partial mediating role, with an effect proportion of 14.9%. Conclusions::eGWG-E and iGWG-M are associated with an increased risk of GDM. Strict control of weight gain in early pregnancy is needed, and sufficient nutrition should be provided in middle pregnancy.