Objective To study the life quality and influencing factors for empty nester elderly in rural area in Hunan,and to provide the scientific basis for the effective interventions.Methods The two villages of Yiyang and Huaihua were randomly selected by cluster sampling from June 2011 to December 2011 in Hunan.Data of the world health organizations quality of life instrument-short version (WHOQOL-BREF) was collected by face to face interview with the empty nesters.The risk factors for the quality of life in empty nester elderly in rural area were analyzed by the multiple linear regression analysis.Results A total of 785 valid questionnaires were acquired,among which 472 cases were from empty nester elderly (60.1％,472/785),the average age of them was (69.3±7.3) years,and the male:female ratio was 1.1:1 (250:222).The literacy of 81.8％ of empty nester elderly were under junior middle school,69.7％ of them married with consorts who were still living,74.4％ of them were farmer,75.2％ of them had monthly income under 500 Yuan,56.4％ of them got the income from their own labor,69.9％ of them considered that their relationship with children were harmony.64.2 ％ of empty nester elderly in village suffered from chronic diseases and 16.7 ％ of them suffered from accidental injury within the last one year.The scores in physiological health,psychological health and quality of life were lower in empty nester elderly than in the non-empty nester elderly [(60.8±15.7) vs.(63.1±13.5),(59.0±12.1) w (64.6±17.4),(59.5±9.8) vs.(63.0 ± 10.1),t=3.18,4.43,4.91,all P＜0.05].The multiple linear regression analysis showed that the influencing factors for quality of life in empty nester elderly were education background,marital status,source of finance,relationship with children,chronic disease and accidental injury within the last one year (β=1.693,2.426,0.779,1.060,-7.007,-3.784,all P＜0.05).Conclusions The empty-nest elderly accounts for more than half of the elderly in rural area,who have the lower levels in physio-psychological health and quality of life.We should improve their awareness and knowledge of health,build their harmonious relationship with spouse and children,improve the social security and medical insurance system,actively promote the knowledge of chronic disease and accidental injury,in order to improve the quality of life in empty nester elderly and achieve the healthy aging.

Objective To detect the level of CD64 and serum procalcitonin (PCT ) and investigate the diagnosis value of CD64 and serum PCT in cirrhosis patients with spontaneous bacterial peritonitis (SBP) .Methods Participants were categorized in‐to three groups including liver cirrhosis with SBP(45 patients) ,liver cirrhosis without SBP(93 patients) and health personnel(50 persons) .CD64 was detected by flow cytometry and serum PCT was measured by electroc hemiluminescence immunoassay .The li‐mosis vein blood samples were obtained from the patients with SBP at the time of 24 h after admission ,before antibacterial drugs use and 7 days after the effective treatment of antibacterial drugs .The CD64 and serum PCT were detected with the limosis vein blood samples .At the same time ,the complete blood count ,liver ,kidney and blood coagulate functions were tested .The participants in other two groups were detected the CD64 ,serum PCT ,complete blood count ,liver ,kidney and blood coagulate functions at the same time .Results The level of CD64 and serum PCT in cirrhosis patients with SBP were significantly higher than those in liver cirrhosis without SBP and normal controls (P< 0 .01) .ROC curve analysis showed that the sensitivity and specificity of CD64 and serum PCT were 95 .5% ,93 .8% and 96 .1% ,85 .2% respectively .Conclusion CD64 and serum PCT can be determined as the im‐portant indicator in early diagnosis and efficacy criterion .

Objective To report the prenatal molecular diagnosis for two gravida in a family with spondylepiphyseal dysplasia congenita(SEDC)caused by G504S mutation of COL2A1 gene.Methods DNA of the two fetuses was extracted from amniotic fluid at the 19+3 and 18+6 weeks of gestation respectively.Direct sequencing of two samples were performed after amplifying exon 23 of COL2A1 containing the potential mutation.The femur length and biparietal diameter of the first fetus were measured by sonographic scans every two weeks from 17+3 weeks to 27+3 weeks of gestation,and for the second fetus these parameters were measured from 16+1 to 19+1 weeks of gestation.Results Sequncing analysis revealed the first fetus and his mother presented the same mutation which is specifically associated with SEDC,but the second fetus did not show the mutation of COL2A1 gene.Biparietal diameters of the both fetuses were appropriate for gestational age.Femur length of the second fetus was normal for gestational age but that of the first fetus was shortened evidently after the 23 week of gestation.The parents of the first fetus determined to terminate the pregnancy.A medical termination was carried out at 27+5 weeks of gestation and a male fetus with a relatively large head and short limbs was delivered.The radiological findings of the fetus were consistent with SEDC including generalized platy spondesand shortened long bones.Conclusions Prenatal molecular diagnosis is important for the fetus with risk of SEDC and useful for genetic counseling.Genotype of fetus with risk of SEDC can be identified before sonographic scan.Molecular genetic analysis in conjunction with sonographic monitoring was helpful in prenatal diagnosis of SEDC.

Objective:To investigate a large Chinese family in which 9 patients over 4 generations were diagnosed with a form of autosomal dominant spondyloepimphyseal dysplasia(SEMD).Mothods:X-Ray radiograph of proand at 18-month showed absence of secondary ossification centra of femoral heads.His father at 24-year presented severe spondyloepiphyseal changes that principally involved the vertebral bodies,the femoral necks and femoral heads and characterized by generalized platyspondyly with thoracolumbar scoliosis,irregular femoral necks,absent ossification of femoral heads,flat acetabular roofs and coxa vara.The other patients had similar clinical and radiological features.Haplotyping was performed with leukocyte DNA for 5 micosatellite repeat markers from chromosome 12 and the result showed COL2A1 gene as a candidate gene.A total of 54 exons and promoter of COL2A1 gene were amplified and sequenced from all patients and available normal relatives.In addition,exon 23 of COL2A1 gene was amplified and sequenced from 10 controls simultaneously.Results:All patients were identified a 1510(G→A) transition in exon 23 of COL2A1 gene that caused a change from a COL2A1 coding region in available glycine to serine at amino acid position 504.No mutation was found in the normal relatives and 10 controls. Conclusion:The mutation of COL2A1 gene is responsible for this form of SEDC of the family.This is the first familial report of SEDC relating to 1510G→A mutation of COL2A1 gene.The detailed clinical radiogram data will be useful for extending the phenotypic spectrum of type Ⅱcollagenopathies.

Objective:To develop a learning scale of scientific methods for medical students and to evaluate the reliability and validity of the scale.Methods:Based on the principles of planned behavior theory, the original scale was developed through literature analysis, pre-interview and experts’ consultation. A preliminary survey was conducted among 105 medical undergraduates with random cluster sampling, and the primary scale was formed by exploratory factor analysis. Then, 851 undergraduates were selected as the objects of formal survey, and the formal scale was finally determined by the reliability and validity evaluation and confirmatory factor analysis.Results:The formal scale was composed of 5 latent variables, 9 observed variables and 51 items. The overall Cronbach’s α coefficient and the overall retest reliability were 0.970 and 0.887, respectively. Composite reliability and KMO values of each latent variable were more than 0.8, and the values of average variance extraction were over 0.5. The fitness test ( P=0.155) showed acceptable fitting quality with the main fit indices of χ2/ df=1.405, RMR=0.039, RMSEA=0.022, etc. Conclusion:The learning scale of scientific methods shows satisfactory reliability, validity and fitness, which can be applied as a measuring tool to evaluate the learning behavior of scientific methods for medical students.

Objective:To develop a learning scale of scientific methods for medical students and to evaluate the reliability and validity of the scale.Methods:Based on the principles of planned behavior theory, the original scale was developed through literature analysis, pre-interview and experts' consultation. A preliminary survey was conducted among 105 medical undergraduates with random cluster sampling, and the primary scale was formed by exploratory factor analysis. Then, 851 undergraduates were selected as the objects of formal survey, and the formal scale was finally determined by the reliability and validity evaluation and confirmatory factor analysis. SPSS 22.0 and AMOS 22.0 softwares were used for statistical analysis of the measurement data.Results:The formal scale was composed of 5 latent variables, 9 observed variables and 51 items. The overall Cronbach’s α coefficient and the overall retest reliability were 0.97 and 0.89, respectively. Composite reliability and KMO values of each latent variable were more than 0.80, and the values of average variance extraction were over 0.50. The fitness test ( P=0.155) showed acceptable fitting quality with the main fit indices of χ2/ df=1.41, RMR=0.04, RMSEA=0.02, etc. Conclusion:The learning scale of scientific methods shows satisfactory reliability, validity and fitness, which can be applied as a measuring tool to evaluate the learning behavior of scientific methods for medical students.

Objective To evaluate the relationship between inflammatory responses and autophagy in lung tissues after scald and nucleotide-binding oligomerization domain-containing protein 2 (NOD2) signaling pathway in septic rats.Methods Twenty SPF healthy male Sprague-Dawley rats,weighing 200-250 g,were divided into control group (group C,n=10) and sepsis after scald group (group SS,n=10) using a random number table.The rats were subjected to a third-degree scald burn covering 20％ of total body surface area (body surface was shaved and then exposed to 99-100 ℃ water for 12 s),and 24 h later muramyldipeptide 5 mg/kg was intravenously injected to induce sepsis.The rats were only exposed to 20 ℃ water,and 24 h later normal saline 1 ml was given instead in group C.At 6 h after muramyldipeptide injection in group SS and at 6 h after normal saline injection in group C,arterial blood samples were collected for determination of serum tumor necrosis factor-r and interleukin-6 concentrations by enzyme-linked immunosorbent assay.Then rats were sacrificed and lungs were removed tor measurement of activity of myeloperoxidase,NOD2 mRNA expression (using real-time polymerase chain reaction) and expression of receptor interacting protein 2,nuclear factor kappa Bp65 and microtubule-associated protein 1 light chain 3 Ⅰ (LC3 Ⅰ) and LC3 Ⅱ in lung tissues (by Western blot).The LC3 Ⅱ / Ⅰ ratio was calculated.Results Compared with group C,the expression of NOD2 mRNA,receptor interacting protein 2 and nuclear factor kappa Bp65 was significantly up-regulated,and the LC3 Ⅱ / Ⅰ ratio and serum tumor necrosis factor-α and interleukin-6 concentrations were increased in group SS (P＜0.05).Conclusion The mechanism underlying enhanced inflammatory responses and autophagy in lung tissues during sepsis after scald may be related to activation of NOD2 signaling pathway in rats.

Objective·To study the differences in the structure and load of hair follicle microbiota in non-lesional areas among patients with moderate-to-severe acne vulgaris and healthy individuals,and to explore the relationship between microorganisms and the severity of acne vulgaris.Method·A cross-sectional study was used.Patients with moderate or severe acne vulgaris(referred to as acne)and healthy volunteers who visited the Department of Dermatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,from August 2022 to August 2023.16S rRNA high-throughput sequencing and quantitative real-time polymerase chain reaction(qPCR)were performed on the follicular contents from the non-lesional areas of the faces of patients with moderate or severe acne and healthy volunteers to analyze the diversity,species composition,and microbial load differences in hair follicle bacteria in patients with different severity of acne.Results·Ten patients with moderate acne,eleven patients with severe acne,and eleven healthy volunteers were included.There were no statistically differences in general data such as age and gender ratio among the three groups.Bacterial α-diversity was significantly lower in both the moderate and severe acne groups compared to the healthy group(P=0.020,P=0.013).The principal coordinates analysis(PCoA)plot showed that the sample distribution of the healthy group was relatively concentrated,with small differences within the group,and the distribution of samples in the moderate and severe acne groups exhibited a certain trend but was relatively scattered,with differences between the groups.There were differences in the trend distribution of the three sample groups,and there were differences in the microbial community structure between the groups.The results of similarity analysis showed significant differences in β-diversity and low similarity in species composition between the healthy and moderate acne groups(P=0.027)and between the healthy and severe acne groups(P=0.017),and high species similarity between the moderate acne and severe acne groups(P=0.160).The dominant bacterial groups at the phylum level were Actinobacteria,Firmicutes,Proteobacteria,and Bacteroidetes.At the genus level,the dominant bacteria in the healthy group were Propionibacterium and unclassified Actinomycetales,and the dominant bacteria in both acne groups were Staphylococcus and Propionibacterium.Compared to the healthy group,the relative abundance of Staphylococcus species in the hair follicles in non-lesional areas of the moderate and severe acne groups was significantly increased(P=0.010,P=0.019).Compared with the healthy control group,the hair follicle microbiota load in non-lesional areas of both the moderate and severe acne groups was significantly increased(both P=0.001).Compared with the moderate acne group,the bacterial load in the hair follicle samples of the severe acne group was significantly increased(P=0.017).Conclusion·The microbial community structure of hair follicles in non-lesional areas of patients with moderate or severe acne is different from that of healthy individuals,and the microbial diversity in the acne group is significantly reduced.The relative abundance of Staphylococcus species in the hair follicles in non-lesional areas of the moderate or severe acne groups is significantly increased compared to the healthy group.As the severity of acne increases,the bacterial load in hair follicles in non-lesional areas significantly increases.This research suggests that the occurrence and severity of acne may be related to the community structure and load of hair follicle microbiota.

Objective To explore the effect and mechanism of berberine combined with curcumin on ath-erosclerosis(AS)by mediating M1 macrophages polarization.Methods M1-type macrophages were obtained from mouse mononuclear macrophages(RAW264.7)induced by lipopolysaccharide(LPS,100 ng/mL)and interferon(IFN)-γ(20 ng/mL).A cell model was established.The cells were divided into a control group,model group,berberine group,curcumin group and berberine plus curcumin group.Concentrations of berberine and curcumin were detected by CCK-8 assay.The expression levels of M1-type macrophage markers iNOS,TNF-α,CXCL9 and p-STAT6/STAT6 in macrophage supernatant were detected by ELISA.Levels of iNOS,TNF-α and CXCL9 mRNA were detected by RT-PCR.Levels of iNOS,STAT6 and p-STAT6 proteins in each group were detected by Western blot.After down-regulation of STAT6 level by siRNA technology,expression of p-STAT6 protein was detected by Western blot.Expression levels of iNOS,TNF-α,CXCL9 and p-STAT6 were detected by ELISA.Results In the polarization of M1 macrophages induced by LPS and IFN-γ,berberine(25 μmol/L)and curcumin(20 μmol/L)were the best concentrations as compared with other drug concentration groups,and neither alone nor combined use could significantly inhibit the viability of RAW264.7 cells(P<0.05).As compared with the normal group,iNOS,TNF-α and CXCL9 mRNA and protein levels were increased in the model group,while P-STAT6/STAT6 levels were decreased,with statistical differences(P<0.05).As compared with the model group,iNOS,TNF-α and CXCL9 mRNA and protein levels in the berberine group,curcumin group,and berberine plus curcumin group were decreased,while P-STAT6/STAT6 levels were increased,and the changes were more obvious in berberine plus curcumin group,with statistical difference(P<0.05).After transfection of STAT6 siRNA in M1 macrophages in the berberine plus curcumin group,P-STAT6 levels were down-regulated,while expressions of iNOS,TNF-α and CXCL9 were up-regulated,with statistical differences(P<0.05).Conclusions Both berberine and curcumin can inhibit the activity of M1-type macrophages and reduce inflammatory response.The action of berberine combined with curcumin is more advantageous than that of either drug alone,which may be the main mechanism of action through activation of STAT6.

Objective To investigate the repairing effect and mechanism of Chinese patent medicine Weiyangning pill on gastric mucosal injury in rats induced by anhydrous ethanol,and to establish a high-performance liquid chromatography(HPLC)method to determine the five main components of Weiyangning pill.Methods The five components of paeoniflorin,psoralen,atractylenolide Ⅲ,liquiritin and hesperidin in Weiyangning pill were detected by HPLC.SD male rats were randomly divided into normal control group,model control group,Weinaian group,and large and small dose group of Weiyangning pill.All rats were fasted for 24 hours without water fasting.The normal control group and the model control group were given purified water by gavage.While Weinaian group was given Weinaian(3 g·kg-1),the test group were given intragastric perfusion of Weiyangning(3,1.5 g·kg-1)respectively.After 2 hours,all the rats,except the normal control group,were intragastrically administered with anhydrous ethanol(5 mL·kg-1)to establish the model of gastric mucosal injury.An hour later,the experimental materials were collected,and the gross score of gastric mucosal injury was observed and calculated.The gastric mucosal slices were stained by hematoxylin-eosin(HE)to calculate the pathological scores.Immunohistochemistry was employed to detect the expression of gastric mucosa-related proteins.Results The high-performance liquid chromatogram of Weiyangning pill was obtained,and the absorption peaks with the same retention time as the five standard substances(paeoniflorin,psoralen,atractylenolide Ⅲ,liquiritin and hesperidin)were observed.The general score and pathological score of gastric mucosal injury in Weiyangning groups(3,1.5 g·kg-1)were lower than those of the model control group(P<0.05 or P<0.01).Weiyangning pill(3,1.5 g·kg-1)ameliorated the decrease expression of tight junction protein(Claudin-7),adhesion junction proteins(E-cadherin and β-catenin),mucins(MUC1 and MUC5AC),and the gastric transcription factor SOX2 in the gastric mucosa of the rats modeled in anhydrous ethanol(P<0.05 or P<0.01 compared with the model control group).Conclusion The repairing effect of Weiyangning pill on gastric mucosal injury induced by anhydrous ethanol in rats is related to the increase of the expression of tight junction protein,adhesion junction protein,mucin and gastric transcription factor.