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The Fe-N-C composite catalyst was prepared by the thermal decomposition of the chelate precursors based on Fe central ions and o-phenylenediamine ligands.It was observed from the scanning electron microscopy that the crumpled carbon micro-and nano-sheets were intertwined to form a free-standing tremella-like 3D structure.The N2 adsorption/desorption experiments revealed that the composite contained ample micro-and meso-pores and had a specific surface area of 290 m2/g.Graphitic C and multi-crystal Fe3C as main components were confirmed by the X-ray diffraction, and N-doping in the general form of graphite N and pyridine N was also verified by X-ray photoelectron spectroscopy.The electrochemical measurement showed that the tremella-like Fe-N-C composite catalyzed oxygen reduction through a four-electron path in an alkaline solution, and its activity was comparable to the commercial Pt/C catalyst.After 2000 cycles, the limited current density of the Fe-N-C catalytic electrode only decreased less than 5%, and the half-wave potential shift negatively 5 mV, which suggested that the Fe-N-C composite catalyst had better catalytic stability than the commercially used Pt/C catalyst.

Objective To explore the effects of HAVCR2 siRNA on apoptosis and cell cycle in the radiation-caused genomic instable liver cells.Methods RNAi was used to inhibit HAVCR2 gene transcription.Cellular apoptosis and cell cycle distribution were detected by flow cytometry (FCM).Expression of p53 gene was assayed by real time fluorescence quantitative PCR.Results HAVCR2 gene was effectively inhibited by RNAi (t =19.21,P ＜ 0.05).After siRNA transferring,cell apoptosis (t =3.65,P ＜ 0.05) and p53 gene expression (t =4.82,P ＜ 0.05) were decreased,and G2-phase arrest was induced(t =-3.41,P ＜ 0.05).Conclusion HAVCR2 siRNA can decrease the generation of apoptosis in the genomic instable liver cells and blocks the cells at G2 phase.

Objective To investigate the effect of CDT1 gene over-expression on the apoptosis and cell cycle distribution in liver cells with a characteristic of genomic instability induced by radiation(GIR).Methods Lentivirus particles were transferred into liver cells of GIR to up-regulate the expression of CDT1 gene.The apoptosis and the cell cycle were detected by flow cytometry (FCM).The expression changes of p53,ATM,ATR,Bcl-2,and Caspase-3 genes were analyzed by real-time fluorescence quantitative PCR.Results CDT1 gene was efficiently increased by the gene transfection(t =15.56,P ＜ 0.05).In the CDT1 over-expressed cells,while the apoptosis ratio was increased (t =4.19,P ＜ 0.05),the expressions of p53 and Bcl-2 gene were decreased (t =-4.21,-2.06,P ＜ 0.05),but the expression of ATM,ATR and Caspase-3 changed with no significant difference compared with control.Conclusions Over-expression of CDT1 could regulate genomic instability through apoptosis pathway and checkpoint independent of p53.

Objective To investigate the predictive factors of no early improvement and their impact on outcomes after alteplase intravenous thrombolysis in patients with acute ischemic stroke.Methods Between March 2015 and March 2016,the clinical data of the patients with acute ischemic stroke admitted to the Department of Neurology,Fengcheng People's Hospital and treated with intravenous thrombolysis were analyzed retrospectively.The National Institutes of Health Stroke Scale score declined ＜4 within 24 h after admission was defined as no early improvement,and the modified Rankin Scale score ＞ 2 at 3 months was defined as poor outcome.Multivariate logistic regression analysis was used to determine predictors of no early improvement and their impact on outcomes.Results A total of 85 patients were enrolled,aged 63.88 ± 11.12 years,63 (74.1％) were males;45 (52.9％) had no early improvement,40 (47.1％) had early improvement;48 (56.5％) had good outcome at 3 months,and 37 (43.5％) had poor outcome.The proportion of hypertension (73.3％ vs.45.0％;x2 =7.083,P =0.008) and diabetes mellitus (33.3％ vs.15.0％;x2 =3.826,P =0.051),as well as the baseline fasting blood glucose (8.74 ± 4.28 mmol/L vs.6.87 ±2.57 mmol/L;t=2.471,P=0.016) in the no early improvement group were significantly higher than those in the early improvement group.Multivariate logistic regression analysis showed that hypertension alone was an independent risk factor for no early improvement after intravenous thrombolysis with ateplase (odds ratio 2.896,95％ confidence interval 1.108-7.570;P =0.030).The proportion of early improvement in the good outcome group was significantly higher than that in the poor outcome group (58.3％ vs.32.4％;x2=5.626,P=0.018).Multivariate logistic regression analysis showed that early improvement might be a independent predictor of good outcome (odds ratio 3.187,95％ confidence interval 1.099-9.242;P =0.033).Conclusion In patients treated with alteplase thrombolytic therapy,hypertension was an independent risk factor for no early improvement,and no early improvement was independently associated with poor outcome.

Objective To study effects of oxycodone post-operative early analgesia on stress re-sponse with in diabetics undergoing uvulopalatopharyngoplasty (UPPP).Methods Eighty patients undergoing UPPP,53 males,27 females,aged 28-65 years,ASA Ⅰ or Ⅱ were randomly divided in-to two groups(n =40).1 5 minutes before the end of the operation,group O was intravenously given oxycodone 0.07 mg/kg;Group F fentanyl 0.7 μg/kg.The patients of the two groups were sampled venous blood 3 ml in the morning of operation (T1 ),postoperative 1 hour (T2 ),postoperative 3 hours (T3 )for determination of serum cortisol (Cor),serum insulin(Ins),serum C-peptide(C-P)u-sing electrochemical luminescence method.Results Cor at T2 ,T3 was lower than that at T1 , C-P was higher than that at T1 (P <0.05)in group O,respectively;Cor at T2 ,T3 was higher than that at T1 , respectively,C-P was lower than that at T1 (P <0.05);Cor in group F was higher than that in group O,C-P in group F was lower than that in group O(P <0.05).Ins at T2 ,T3 was lower than that at T1 and was lower than that in group O(P <0.05).Conclusion Oxycodone 0.07 mg/kg early analgesia for UPPP significantly inhibits the occurrence of stress response.

Objective:To explore the impact of the clinic-pharmacy separation reform in Beijing on the outpatients with medical insurance.Methods:A segmented regression model of interrupted time series(ITS)data was used, to analyze the changes from April 2017 to May 2019 in outpatient visits, average cost per visit, out-of-pocket burden, with a tertiary hospital in Beijing as an example before and after the reform.Results:Segmental regression analysis showed that since the reform, the out-of-pocket burden of outpatients fell by 5.2% in the first month. After the reform, the medicine expenses decreased 0.50 yuan monthly instead of increasing 0.24 yuan before, and the surgery expenses, examination and laboratory fees, and materials expenses have increased from an average monthly increase of 0.14 yuan, 0.64 yuan and 0.36 yuan to 0.15 yuan, 0.70 yuan and 0.17 yuan respectively. Meanwhile, the growth rate of outpatient services slowed down, with an increase number dropping from 855 visits/month to 523 visits/month.Conclusions:The reform had reduced the out-of-pocket expenses of outpatients.

Objective To compare the effects of CalliSpheres drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)and conventional TACE(c-TACE)on liver fibrosis and liver function in the treatment of primary hepatocellular carcinoma(HCC).Methods A total of 40 patients diagnosed with HCC at Xuzhou Municipal Cancer Hospital of China between October 2020 and October 2022 were enrolled in this study.According to therapeutic scheme,the patients were divided into DEB-TACE group(n=20)and c-TACE group(n=20).The preoperative,and postoperative 5-day and one-month hyaluronidase(HA),type Ⅲ procollagen peptide(P Ⅲ NP),type Ⅳ collagen(CⅣ)and laminin(LN),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),albumin(Alb),and prothrombin time(PT)were compared between the two groups.Results The technical success rate was 100％in both groups,and tumor staining completely disappeared immediately after TACE in all patients.The postoperative 5-day levels of HA,LN,P Ⅲ NP,and CⅣ in both groups were remarkably higher than the preoperative ones(P＜0.05).One month after TACE,HA level in the DEB-TACE group was prominently higher than its preoperative value(P＜0.05);HA and LN levels in the c-TACE group were obviously higher than their preoperative values(P＜0.05);and the HA and LN levels in c-TACE group were significantly higher than those in DEB-TACE group(P＜0.05).Five days after TACE,in the DEB-TACE group the AST and PT levels were higher than their preoperative values while the Alb level was lower than its preoperative value(P＜0.05);in the c-TACE group the ALT,AST,TBiL and PT were higher than their preoperative values while the Alb level was lower than its preoperative value(P＜0.05);the ALT and AST levels in the c-TACE group were strikingly higher than those in the DEB-TACE group while Alb level was strikingly lower than that in the DEB-TACE group(P＜0.05).Conclusion Both CalliSpheres DEB-TACE and c-TACE can aggravate liver fibrosis and cause liver function damage.However,the degree of liver fibrosis and liver function damage caused by CalliSpheres DEB-TACE is less than that caused by c-TACE.(J Intervent Radiol,2024,33:259-263)

OBJECTIVETo understand status of health literacy among diabetics and their health management behaviors, and analyze the relationship of health literacy and health management.

METHODSA two-staged cluster randomized sampling method was used to investigate 1 130 diabetics in Beijing, Ningbo and Xiamen from October to November in 2012. All participants should be diagnosed by primary hospital and above and have lived in the community over six months. Diabetic patients who indicated that they had severely impaired vision or cognitive disorder, or had severe physical deterioration, or did not live in the address provided were excluded. A total of 1 130 questionnaires were sent out and 1 083 eligible questionnaires were taken back, accounting for 96.87%. Multivariate logistic regression was adopted to analyze the association between health literacy and health management behaviors and blood glucose level.

RESULTSAmong those participants, 47.7% (517) were men, 52.3% (566) were women, the age was (67.0 ± 9.5). According to diabetes health literacy scores, 73.7% (798/1 083) of them were classified as poor health literacy and 26.1% (283/1 083) as essential health literacy. Health literacy was associated with health management behaviors independently, demonstrating that the probability of utilizing health education, free physical examination, lifestyle guidance, monitoring blood glucose on their own, measuring blood glucose more than once a week and taking hypoglycemic agent regularly among diabetics with essential health literacy were 1.40 (95%CI:1.03-1.91), 1.65 (95%CI: 1.19-2.28), 2.70 (95%CI:1.98-3.69), 2.05 (95%CI:1.34-3.15), 2.56 (95%CI:1.85-3.56) , 1.48 (95%CI:1.07-2.06) times of those in diabetics with poor health literacy (P < 0.05).

CONCLUSIONHealth literacy may affect health management behaviors among diabetics. More activities targeted on diabetics with low health literacy were suggested to improve their' health literacy and their skills about diabetes mellitus management.

Aged ; Blood Glucose Self-Monitoring ; statistics & numerical data ; Diabetes Mellitus ; therapy ; Female ; Health Behavior ; Health Literacy ; statistics & numerical data ; Humans ; Logistic Models ; Male ; Medication Adherence ; statistics & numerical data ; Middle Aged ; Surveys and Questionnaires

Objective: To observe the efficacy and safety of CTD (cyclophosphamide, thalidomide, dexamethasone) and PCD (bortezomib, cyclophosphamide, dexamethasone) regimens in treatment of patients with newly diagnosed multiple myeloma (NDMM) . Methods: A retrospective analysis was carried out on 88 cases of NDMM patients admitted to our hospital from July 2013 to January 2016, including 49 cases in CTD group and 39 cases in PCD group. The outcomes of two different regimens were analyzed, including response, prognosis, and adverse events. Results: The total overall remission rates (ORR, better than PR) of CTD and PCD were 65.3% (32/49) and 84.6% (33/39) , while very good partial response (VGPR) were 30.6% (15/49) and 53.8% (21/39) , and differences were statistically significant (P=0.041, P=0.028) . The median follow-up was 11.5 (3-33) months. The median progression-free survival (PFS) was (23.0±4.5) months in CTD groups, but it was not achieved in PCD group, with statistically significant differences (P=0.050) . Medial overall survival was not achieved in both two groups, without statistically significant difference (P=0.257) . There were statistical differences between patients with minor response (MR) and patients without MR in medium OS in CTD group (P=0.005) , and there were statistical difference between patients with VGPR and without VGPR in medium OS in CTD group (P=0.042) . Infection was a common adverse event in two groups. The incidences of peripheral neuropathy and herpes zoster were markedly higher in PCD group than CTD group, and the incidences of thrombus, palpation and rash, etc., were higher in CTD group. Conclusion Both CTD and PCD regimens were effective first-line induction chemotherapy choice for NDMM. PCD regimen is better than CTD in treatment power and deep remission.