Objective To evaluate the clinical outcome of severe ulcerative colitis(UC)and to find the factors related to treatment and outcome.Methods Forty one hospitalized patients with UC during 1988-2004 were retrospectively reviewed.Data were recorded including the onset,symptoms,signs, laboratory,endoscopic,radiologic and pathologic findings,as well as the processes of clinical treatment. The patients who undergone surgery were also analysed.Results Forty one of 144(28.5%)hospital ized patients were suffered from severe UC,and among them 92.7%(38/41)had pancolitis.The patients who had first onset,chronic persistent,chronic recurrent type were account for 36.9%(15/41),36.9%(15/41) and 26.8%(11/41),respectively.The steroids treatment played the main role in the inducing remission of severe UC(61.0%).Thirty one cases(75.6%)could be relieved by drug therapy.Seven cases(17.1%) were progressed to have operation.The age of early onset,pancolitis,low hemoglobin and serum albumin levels and need of intravenous steroids treatment were associated with the need of surgery.Conclusions Most of the severe UC patients respond well to the medical therapy,but for some non-responding or steroids depending individuals,after a reasonable duration of treatment,surgery should be considered.

Partial nature of "promoting blood circulation and dieresis" of Salvia Miltiorrhizain was initially demonstrated by investigating the regulation effect of AQP2 expression in kidney of trauma blood stasis model rats with the Salvia Miltiorrhizain so as to provide guidance for its clinical deployment of administration. Random allocation was taken to averagely divide 30 SD rats into two groups: 10 rats in normal group and 20 rats in blood stasis syndrome group. Trauma blood stasis rat model was established by quantitatively beating. Then the rat model group was divided into model group and salvia group. After 7 days of treatment, the rat kidney AQP2 expression was detected, the content of urine AQP2 was compared and the damaged local muscle and kidney pathological changes were observed by immunohistochemical method and western blot method. Compared with that of the normal group, rats in model group had inflammatory cells infiltration, blood stasis and edema of the injured local muscles and up-regulated AQP2 expression, decreasing urinary output, and kidney tissues blood stasis and edema (P < 0.05). On the other hand, compared with that of the model group, those parameters of rats in salvia group were all decreasing except urine output (P < 0.05). Such result indicated that Salvia Miltiorrhiza can reduce trauma blood stasis rat content of urine AQP2 and down-regulated AQP2 expression in kidney tissue, so as to reduce the reabsorption of water by renal tubular and increase urine output. The promoting blood circulation effect of Salvia Miltiorrhizain can alleviate the degree of the damaged tissue edema and encourage urine drainage. This therapy is closely related to the effect of regulating AQP2 in kidney by salvia, so the purpose of this study by verifying "promoting blood circulation and diuresis" as the mechanism for the regulation effect of the salvia on AQP2 expression.
Animals ; Aquaporin 2 ; genetics ; metabolism ; Blood Circulation ; drug effects ; Diuresis ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Kidney ; blood supply ; drug effects ; metabolism ; physiopathology ; Kidney Diseases ; drug therapy ; genetics ; metabolism ; physiopathology ; Male ; Rats ; Salvia miltiorrhiza ; chemistry

Objective To construct wtp53/junB fusion gene and its eukaryotic expression vector in order to provide the basis for further application of polygene union therapy in hepatocellular carcinoma. Methods Polymerase chain reaction (PCR), reverse transcription-PCR (RT-PCR) and gene recombination techniques were used to construct the eukaryotic vector of pEGFP-C1-wtp53/junB fusion gene, which carries the enhanced green fluorescent protein (EGFP). The transfection of pEGFP-C1-wtp53/junB in hepatoma HepG2 cells was detected by the location of green fluorescence. Results The DNA sequence of wtp53/junB fusion gene was successfully cloned into the pEGFP-C1 plasmid and the sequence was the same as what we expected. Green fluorescence located on cell nucleus proved that pEGFP-C1-wtp53/junB was transfected into HepG2 cell line successfully. Conclusion We successfully constructed the eukaryotic vector of pEGFP-C1-wtp53/junB fusion gene, which carries the EGFP, and transfects it into human hepatoma cell nucleus. It may lay the basis for studying the synergetic effect of wtp53 and junB in hepatocellular carcinoma.

This study explored the double lethal effects of pEGFP-C1-wtp53/junB fusion gene on hepatocellular carcinoma (HCC) cells. wtp53/junB fusion gene was constructed and transformed into HepG2 cell line. Expression of KAI1 was detected by quantitative real-time PCR and Western blotting, cells apoptosis rate was detected by flow cytometry, proliferation of cells was detected byMTT chromometry, cell transmigration was detected by using transwell systems. The results showed that after transformation with pEGFP-C1-wtp53/JunB, the expression level of KAI1 protein was up-regulated, being 8.13 times the blank control group in HepG2 cells and significantly higher than 2.87 times which transformed with pEGFP-C1-JunB, 3.11 times which transformed with pEGFP-C1-wtp53 (P<0.001). Apoptosis rate of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly higher than that of other groups (P<0.001), and invasive ability of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly lower than other groups(P<0.001). It was concluded that the fusion gene of wtp53 and JunB could not only inhibit the growth of hepatoma cells and promote tumor cell apoptosis, but also suppress the invasive ability of tumor cells by up-regulating the expression of KAI1.

Objective To investigate the value of color Doppler flow imaging(CDFI) in diagnosing lower limb artery in-stent restenosis (ISR), and to provide the evidences for clinical application. Methods Patients with lower limb artery percutaneous transluminal stent insertion in 12 months were enrolled in this study and divided into two groups, CT angiography (CTA) or digital subtraction angiography (DSA) was applied to diagnose ISR, 31 patients with 47 stenting which were diagnosed ISR was named as restenosis group, 63 patients with 89 stenting which were diagnosed no ISR was named as no stenosis group, and 30 normal person was enrolled and named as normal control group. Ultrasonic characteristics and peak systolic blood flow velocity (PSV), systolic blood flow acceleration time (AT) of proximal part, inner stents, distal part were recorded in restenosis group and no stenosis group, then compared with data in normal control group. Regression and receiver operator (ROC) curve were applied to analyse the correlation between PSV and AT. Results PSV of no stenosis group in common femoral artery, femoral artery, superifcial, popliteal artery stent respectively were (146.71±35.59) cm/s, (120.11±25.67) cm/s, (96.44±32.87) cm/s. PSV of normal control group in common femoral artery, femoral artery, superifcial, popliteal artery respective were (119.67±15.34) cm/s, (91.17±15.09) cm/s, (71.13±21.23) cm/s. There was statistically signiifcant difference between the two groups (t=2.457, 2.459, 2.321, all P<0.05). AT of no stenosis group in common femoral artery, femoral artery, superficial, popliteal artery stent respectively were (84.98±13.77) ms, (87.33±16.36) ms, (90.77±12.05) ms. AT of normal control group in common femoral artery, femoral artery, superficial, popliteal artery respective were (78.23±21.24) ms, (82.31±18.24) ms, (84.29±23.01) ms. There was no statistically signiifcant difference between the two groups (t=1.696, 1.904, 1.835, all P>0.05). PSV of restenosis group in proximal part, restenosis part, distal part respectively were (87.67±23.34) cm/s, (218.17±72.09) cm/s, (54.13±21.23) cm/s. PSV of no stenosis group in proximal part, inner stents, distal part respectively were (91.71±25.59) cm/s, (131.11±45.67) cm/s, (96.44±32.87) cm/s. There was statistically significant difference between restenosis part/inner stents, distal part (t=3.412, 3.511, both P<0.05). There was no statistically signiifcant difference between the two groups in proximal part (t=1.901, P>0.05). AT of restenosis group in proximal part, restenosis part, distal part respectively were (98.31±14.09) ms, (109.54±21.03) ms, (158.23±45.21) ms. AT of no stenosis group in proximal part, inner stents, distal part respectively were (84.98±13.77) ms, (86.34±19.36) ms, (83.77±17.05) ms. There was statistically signiifcant difference between restenosis part/inner stents, distal part (t=2.319, 3.610, both P<0.05). There was no statistically signiifcant difference between the two groups in proximal part (t=1.833, P>0.05). ROC curve showed that in ISR lower limb artery, PSV>168 cm/s had a sensitivity of 89.4%, speciifcity of 92.1%, the area under the ROC curve was 0.949;AT>127 ms, had a sensitivity of 86.8%, speciifcity of 98.0%, the area under the ROC curve was 0.867. Conclusions CDFI can detect the changes of PSV and AT, ISR can be detected and diagnosed earlier in lower limb artery. By combining PSV>168 cm/s with AT>127 ms, the value of ISR diagnosis can be increased.

Objective:Taking Chongyang county of Hubei Province as an example, the paper describes the in-tegration of the maternal and child health ( MCH) and family planning ( FP) service system and analyses the key ele-ments to provide reference for promoting integration. Methods: qualitative interviews and quantitative questionnaire were used to collect data. The software QSR Nvivo 8. 0 and SPSS 17. 0 were used for qualitative and quantitative data analysis. Results:Based on the correct understanding of integration, Chongyang implements the supporting policies actively, maintains the original compensation mode unchanged, follows the principle of“no reducing headcounts and no downsizing” strictly, promotes the merger of institutions rapidly, adjusts the service contents and methods reasona-bly, and integrates the maternal and child and family planning information platform. Conclusion:The correct concept of integration, appropriate staffing, and stable funding in Chongyang provide rich experiences for future research. However, there is room for improvement in staffing, incentive mechanisms, service content, and forms.

Objective To explore the prognostic value of speckle tracking imaging (STI) for left ventricular remodeling(LVR) in acute myocardial infarction (AMI) patients with the analysis of the relation between regional wall motion abnormality after AMI and LVR by STI in association with wall motion score index (WMSI).Methods Eighty-three patients with first onset AMI were enrolled from January 2012 to May 2015 and underwent echocardiography within 24 h of the onset and at 6-month follow-up.LVR was defined as more than 20％ of the percentage change of left ventricular end-diastolic volume (△LVEDV％) from baseline to 6-month follow-up (divided as LVR and non-LVR group).Standard long-axis and shortaxis views were stored and analyzed for longitudinal (LS),radial (RS) and circumferential (CS) strain of STI metrics as well as scores of WMSI.Segments of WMSI≥2 were selected and calculated for the mean values of LS (LS_WMSI),RS (RS_WMSI) and CS (CS_WMSI).Results LVR occurred in twenty-seven AMI patients at 6-month follow-up.No difference has shown for demographics,electrocardiogram,lab tests,coronary angiography as well as the measurements of two-dimensional echocardiography between the two groups from baseline,while all STI metrics had statistical difference when the comparisons (P ＜0.05,all),especially the WMSI selected STI metrics (P ＜0.001,all).Linear regression analysis demonstrated that CS_WMSI (r =0.716,P ＜0.001) was best correlated to △LVEDV％ among all STI metrics and also the best predictor of LVR by receive operator curve analysis (sensitivity of 92.6％,specificity of 87.5 ％ and area under the curve of 0.9563).Conclusions Baseline STI metrics can precisely predict LVR at 6-month follow-up.Among the STI metrics,CS_WMSI has shown preferable predictive and diagnostic value,which indicates that the impairment of segmental circumferential wall motion is closely correlated to LVR after myocardial infarction.

Objective:To explore the monitoring value of left ventricular functional parameters obtained by bedside ultrasound combined with clinically relevant indicators in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:A retrospective study was conducted. A total of 24 patients receiving VA-ECMO adjuvant support in Renmin Hospital of Wuhan University from June 2018 to January 2020 were selected. The bedside ultrasound was performed on the first day of ECMO support, the day before weaning, the clinical indicators before weaning were obtained. The differences in clinical indicators and the left ventricular functional parameters between the two groups of whether weaning successfully were compared; univariate Logistic regression analysis was used to screen out the related factors affecting weaning.Results:Sixteen patients were successful weaned and 8 patients failed. Compared with the weaning failure group, patients in the weaning success group required less continuous renal replacement therapy (CRRT, cases: 4 vs. 6, P < 0.05), mean arterial pressure (MAP) before weaning was higher [mmHg (1 mmHg = 0.133 kPa): 84.64±9.55 vs. 62.30±8.79, P < 0.05], and the pulse oxygen saturation (SpO 2) was also higher (0.966±0.670 vs. 0.866±0.061, P < 0.05), while vasoactive-inotropic score (VIS), serum creatinine (SCr) and serum lactic acid (Lac) were lower [VIS score: 7.27±1.42 vs. 16.93±8.52, SCr (μmol/L): 123.60±83.64 vs. 213.10±117.39, Lac (mmol/L): 1.94±0.91 vs. 5.62±5.48, all P < 0.05]. Univariate Logistic regression analysis showed that the MAP, VIS, SCr, Lac, SpO 2 before weaning were the related factors affecting weaning [odds ratio ( OR) were 0.306, -0.740, -0.011, -0.632, -4.069; 95% confidence interval (95% CI) were 1.065-1.732, 0.235-0.899, 0.979-0.999, 0.285-0.992 and 0.001-0.208; P values were 0.014, 0.022, 0.038, 0.047, 0.002]. In the weaning success group, left ventricular ejection fraction (LVEF), velocity of mitralannulus in systolic (LatSa), maximum flow velocity of aortic valve (AV-Vmax), velocity-time integral (VTI), left ventricular global longitudinal strain (LVGLS), left ventricular global longitudinal strain rate (LVGLSr) were all increased on the day before ECMO weaning compared with the first day of ECMO support [LVEF: 0.40±0.05 vs. 0.28±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.62±1.02, AV-Vmax (cm/s): 104.81±33.98 vs. 64.44±16.85, VTI (cm): 14.56±3.11 vs. 7.96±1.98, LVGLS: (-8.95±2.59)% vs. (-5.26±1.28)%, LVGLSr (1/s): -0.48±0.11 vs. -0.29±0.09], whereas the ECMO flow was significantly reduced (L/min: 1.46±0.47 vs. 2.64±0.31), the differences were statistically significant (all P < 0.05). There was no significant difference in left ventricular functional parameters between the first day of ECMO support and the day before ECMO weaning in the weaning failure group. Compared with the weaning failure group, the weaning success group had higher LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr on the day before ECMO weaning [LVEF: 0.40±0.05 vs. 0.26±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.31±1.03, AV-Vmax (cm/s): 104.81±33.98 vs. 67.67±18.46, VTI (cm): 14.56±3.11 vs. 7.75±2.77, LVGLS: (-8.95±2.59)% vs. (-4.81±1.81)%, LVGLSr (1/s): -0.48±0.11 vs. -0.30±0.10, all P < 0.05] and lower ECMO flow (L/min: 1.46±0.47 vs. 2.20±0.62, P < 0.05). Conclusion:Bedside echocardiographic left ventricular function parameters (LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr) combined with clinical indicators (MAP, VIS, SCr, Lac, SpO 2) were helpful to evaluate the therapeutic effect of patients receiving VA-ECMO support and can provide important guiding value in the selection of VA-ECMO weaning timing and the judgment of prognosis.

To develop and validate a novel 6-dye STR(short tandem repeat) 25-plex DNA typing system for forensic DNA profiling and databases. In this study, a novel STR 25-plex DNA typing system that includes 24 autosomal STRs (D1S1656, D2S1338, D2S441, D3S1358, D5S818, D6S1043, D7S820, D8S1179, D10S1248, D12S391, D13S317, D16S539, D18S51, D19S433, D21S11, D22S1045, CSF1PO, FGA, Penta D, Penta E, TH01, TPOX, vWA, D11S4463) and Amelogenin was developed. Validation studies demonstrated the sensitivity, accuracy, and reproducibility of our novel STR 25-plex DNA typing system. The sensitivity of the STR 25-plex DNA typing system was demonstrated by the ability to obtain complete profiles from as little as 0.125ng of human DNA. Specificity testing was demonstrated by the lack of cross-reactivity to a variety of commonly encountered animal species and microbial pool. For stability testing, full profiles were obtained with humic acid concentration ≤60ng/μL and hematin ≤600μM. For forensic evaluation, the selected 24 autosomal STRs followed the Hardy–Weinberg equilibrium. Since 24 autosomal STRs were independent from one another, PM (Probability matching) was 3.5434×10-28, TDP (Total Probability of Discrimination Power) was 0.999999999999999999999999969863, and CEP (Cumulative probability of exclusion) was 0.99999999375. The new STR 25-plex typing system is sensitive, reproducible, and stable, therefore it is highly applicable for use in national DNA database and can help to facilitate international data sharing.

With the universal two-child policy implementation, the birth rate increased, posing challenges to pediatrician allocation. Based on the birth rate, we calculated pediatrician demands and gaps during the period from 2016 to 2020 by the method of health service demand. The results showed that except Beijing and Shanghai, the ped-iatrician supply and demand ratios are less than 0 . 80 and additional numbers of pediatricians ranging from 191 981 to 198 287 are needed to meet the service demands. We recommend increasing the number of pediatricians taking both national supply-demand ratios and gaps by rationally using reasonable enrolment quota and improving the treatment and other reasonable ways to increase pediatricians. In addition, we should enhance information disclosure and guid-ance, and improve the hierarchical hospital visit system to alleviate the pressure of big cities.