Epidermal growth factor (EGF) is an epithelial cell growth factor that can stimulate intestinal development, repair the damage of epidermal cells as well as reduce the incidence of pathogen infection and diarrhea. In order to produce a recombinant Lactobacillus plantarum (L. plantarum) expressing porcine epidermal growth factor (pEGF), we constructed a recombinant vector stably expressing pEGF in L. plantarum strains. First, L. plantarum strain Lp-1 was isolated from intestinal contents of piglets. Then the functional domain of pEGF, M6 precursor protein signal peptide (SP) and super strong constitutive promoter (SCP) were connected with the backbone plasmid pIAβ8 to construct the recombinant vector that was transformed into Lp-1 by electroporation. Afterwards, pEGF was expressed in Lp-1 and detected by Tricine-SDS-PAGE and ELISA. After orally irrigated early-weaned BALB/c mice with the recombinant L. plantarum every morning and late afternoon for 10 consecutive days, body weight, villous height and crypt depth in the intestine were measured to examine the influence of the recombinant bacteria on the intestinal development of early-weaned mice in vivo. Finally, the results of our experiments demonstrated that pEGF was successfully expressed in Lp-1 and the molecular weight of pEGF was 6 kDa. In addition, the recombinant pEGF can enhanced the daily gain and exerted significance influence (P < 0.05) to the small intestinal morphology of early-weaned BALB/c mice. In conclusion, pEGF could be expressed in L. plantarum and the recombinant pEGF possesses good biological activity.
Animals ; Electrophoresis, Polyacrylamide Gel ; Epidermal Growth Factor ; biosynthesis ; Genetic Vectors ; Intestines ; microbiology ; Lactobacillus plantarum ; metabolism ; Mice ; Mice, Inbred BALB C ; Plasmids ; Promoter Regions, Genetic ; Protein Precursors ; Protein Sorting Signals ; Recombinant Proteins ; biosynthesis ; Swine

AIM:Nitroxyl ( HNO) increases myofilament Ca 2+responsiveness relative to increases in intracel-lular Ca2+in cardiac muscle.In this study, we further investigated this effect of HNO on trabecular muscles from phospho-lamban knockout ( PLB-KO) and wide-type ( WT ) mice using a novel HNO donor , 1-nitrosocyclohexyl acetate ( NCA ) . METHODS:Trabecular muscles were dissected from the right ventricles of the rat hearts and mounted between a force transducer and a motor arm.The muscles were superfused with K-H solution (pH 7.4) at room temperature.Fura-2 was loaded into the trabecular muscles via electrophoresis .The length of the sarcomere was set to 2.2~2.3μm.During stead-y-state activations, the maximal Ca2+-activated force and Ca2+required for 50% activation were measured.RESULTS:The intracellular Ca 2+transients and force of the PLB-KO muscles at baseline were higher than those of the WT muscles and exhibited a negative force-frequency relationship (FFR).NCA (2.5μmol/L) increased systolic force in both PLB-KO group and WT group at any given [Ca2+]o.However, there was more dramatic increase in the force development due to moderate increases in the intracellular Ca 2+transients in the WT muscles when external Ca 2+increased from 1.5 to 4.5 mmol/L under NCA.NCA did not affect the negative FFR in PLB-KO muscle.Steady-state force-Ca2+relations obtained from skinned muscles were not different between the 2 groups, while NCA increased Ca2+responsiveness in skinned mus-cles from both PLB-KO and WT mice.CONCLUSION:HNO increases force development in both PLB-KO and WT mus-cles as a result of increases in myofilament Ca 2+responsiveness .The increased intracellular Ca 2+transients are accompa-nied by greater force development in WT mice , suggesting that HNO improves Ca 2+activation and establishes HNO as a positive inotropic agent with novel mechanisms .

Objective:To explore the external factors of the development of cancer hospitals under normalized epidemic prevention and control, and to propose targeted strategies in accordance with existing practice.Methods:PEST model was used to analyze the political, economic, social and technological environment of specialized cancer hospitals, with an overall strategy proposed based on the specific analysis of a cancer hospital.Results:In the era of normalized epidemic prevention and control, cancer hospitals were facing a new environment that was common or unique to other types of medical institutions. In response, the case hospital had adopted such strategies as integrating prevention and control with medical services, integrating offline with online services, and integrating internal and external resources to promote its recovery and development.Conclusions:Cancer hospitals and government should fully leverage the environmental changes incurred by the normalization of prevention and control, and formulate a more integrated development strategy covering short, medium up to long term conditions, based on the two major objectives of epidemic prevention and control and cancer prevention and medical services.

Objective:To explore the correlation between prenatal clinical data with etiological diagnosis and neonatal outcome in isolated fetal ascites.Methods:Totally, 36 pregnancy cases diagnosed as isolated fetal ascites by ultrasound in Provincial Hospital Affiliated to Shandong University from June 22nd, 2016 to September 28th, 2018 were collected. Invasive prenatal diagnosis was performed by taking fetal cord blood, amniotic fluid, and fetal ascites respectively for cytogenetics, molecular genetics and biochemical examination and the impact of intrauterine therapeutic procedures on neonatal outcomes was evaluated as well. The correlation among prenatal examination, pathogeny and prognosis was analyzed by Fisher′s exact test.Results:(1) The prognosis of isolated fetal ascites initially presenting ≥28 weeks was better than that before 28 weeks, survival rate of 1-year-old were 13/15 and 9/17,respectively, the difference was statistically significant ( P<0.05). (2) The etiologic diagnosis rate of ascites before delivery was 31%(11/36), which increased to 53%(19/36) totally after birth. Characteristics of cases which were defined prenatally were as follows: 8 cases of digestive tract diseases showed ultrasonic abnormalities, including echogenic bowel, bowel dilatation and polyhydramnios; platelet level in umbilical cord blood of fetuses infected with cytomegalovirus were below 100 × 10 9/L in 2 cases; 1 case of urinary system malformation showed megalocystis and hydronephrosis. Cases which were defined causes after birth included: 3 fetuses with chyloperitonium presented persistent fetal ascites; 3 cases of digestive-related causes were rectal duplication with infection, mesentery stenosis, and intestinal atresia; other causes included Pierre-Robin syndrome and Budd-Chiari syndrome. (3) The live birth rate was 72% (26/36) and survival rate of 1-year-old was 61% (22/36). And 9/10 of infants who underwent surgeries got good outcomes. Fetal ascites due to abdominal or pelvic factors turned well in 13/16 of cases. Conclusions:The pregnancy outcome of fetal isolated ascites depends mainly on primary causes. Gastrointestinal abnormality is one of the most common causes. Excluded intrauterine infection, chromosomal abnormality and abnormal systemic ultrasonic findings, fetus with reduced ascites as the pregnancy progresses will get good outcome.

The study is to establish the administrative ward round system and its effect evaluation system under the modern hospital management conditions, and explore the formation of a standardized, scientific and replicable standard mode of Administrative Ward round. According to the annual ward rounds plan, clinical departments and administrative departments were organized to decide the major issues of a department according to the procedures of " hearing-evaluation-discussion-decision " , and to ensure the implementation of management. Since 2016, administrative ward round has been carried out in 9 departments, and the medical quality and operational efficiency have been improved significantly. The closed-loop administrative ward rounds mode can effectively promote the modernization of hospital management system through the joint decision-making of clinical departments and functional departments.

Value-based healthcare emphasizes the importance of taking patients′ needs and experiences into full consideration during the entire diagnosis and treatment process and providing patient-centered medical services, so as to improve population health and medical outcomes with manageable medical costs.From this perspective, it is particularly important to investigate how patients could take full advantage of their subjective value and central role to engage in healthcare-related activities. This article aims to summarize the concepts and specific pathways relevant to patient engagement in the entire healthcare process, and provide specific suggestions and recommendations on promoting participation in health self-monitoring, access to disease and consultation information, shared decision-making(SDM)between doctors and patients, patients for patient safety(PFPS), patient-reported outcomes(PROs), participation in self-management, and participation in patient organizations, etc. This article provided valuable reference and evidence on implementation of relevant medical practices and policies.