BACKGROUND:Liuwei Dihuang Wan takes"three tonifying and three reducing effects"as its compatibility feature to nourish yin and tonify the kidneys,while Zuogui Wan takes"seeking yin in yang"as its compatibility feature to nourish yin and tonify the kidneys by promoting yang.Both of them belong to the same method of nourishing yin and tonifying the kidneys,and have better curative effects at the symptomatic and cellular molecular levels. OBJECTIVE:To observe the effects of Liuwei Dihuang Wan and Zuogui Wan in bone metabolism,and to explore their mechanism of action in the osteoprotegerin(OPG)/receptor activator of nuclear factor-κB ligand(RANKL)osteoblastic pathway. METHODS:Thirty-two Sprague-Dawley rats were randomized into model,Liuwei Dihuang Wan,Zuogui Wan,and sham operation group,with eight rats in each group.Osteoporosis models were prepared using removal of both ovaries in the first three groups.Starting at 30 days postoperatively,rats in the Liuwei Dihuang Wan group were gavaged with Liuwei Dihuang Wan 1.125 g/kg/d;rats in the Zuoqui Wan group were gavaged with Zuogui Wan 2.25 g/kg/d;and rats in the sham operation group and the model group were gavaged with saline 10 mL/kg/d.After 12 weeks of gavage,the rat tibia was taken to measure bone mineral density.The serum levels of estrogen,bone alkaline phosphatase,and cAMP/cGMP were measured using ELISA,and the expression of OPG/RANKL in the femur was detected using western blot. RESULTS AND CONCLUSION:Compared with the sham operation group,the model group showed a decrease in bone mineral density and levels of estrogen and bone alkaline phosphatase(P＜0.05)and an increase in cAMP/cGMP level(P＜0.05).Compared with the model group,the Liuwei Dihuang Wan group and the Zuogui Wan group significantly increased bone mineral density(P＜0.05)and bone alkaline phosphatase levels(P＜0.05);the Zuogui Wan group significantly decreased cAMP/cGMP levels(P＜0.05)and upregulated OPG expression(P＜0.05);the Liuwei Dihuang Wan group upregulated OPG expression and downregulated RANKL expression(P＜0.05);and both groups were unable to significantly increase estrogen levels(P＞0.05).To conclude,Zuogui Wan,which seeks yin from yang,can effectively increase the expression of OPG but cannot downregulate the expression of RANKL.However,Liuwei Dihuang Wan,which has three tonifying and three reducing effects,can bidirectionally regulate the expression of OPG and RANKL.This result suggests that Liuwei Dihuang Wan can significantly inhibit osteoclastic function compared with Zuogui Wan,and further research is needed to verify this conclusion.

Objective To identify epidemiological characteristics and pathogen distribution of hand,foot,and mouth disease(HFMD)in Hebei Children's Hospital in order to support prevention and treatment of HFMD.Methods A total of 1 698 cases throat swab samples from children diagnosed as HFMD from 2016 to 2023 were collected.Real-time PCR was used to detect the specific classification of HFMD.Statistical analysis was performed according to the year,season,age,and sex and enterovirus type of HFMD in the children.Results From 2016 to 2023,the ratio of male to female patients among the 1 698 children admitted to Hebei Children's Hospital was 1.72∶1.Among them,the highest incidence rate in summer was 778 cases,accounting for 45.8%of all cases,followed by autumn,with a total of 614 cases,accounting for 36.2%of cases.The highest incidence was recorded in age group of 1-3 years,with a total of 1 032 cases(60.8%).The lowest incidence was 38 cases in age group＞6 years old(2.2%);There were 988 cases of HFM(58.2%)caused by different strains of enterovirus undefined(EVU)except enterovirus 71(EV71)and coxsackievirus A16(CA16).Conclusions HFMD found in Hebei Children's Hospital from 2016 to 2023 are mainly caused by enteroviruses except EV 71 and coxsackievirus A16.High morbid-ity is found in children aged 1-3 years,and summer and autumn are the main epidemic seasons.This result may facilitate and support decision making and strategy development in disease prevention and control as well as to strengthen public health resources.

Objective:To investigate the clinical efficacy and safety of pulmonary rehabilitation in elderly patients with chronic obstructive pulmonary disease(COPD)who are undergoing long-term home oxygen therapy.Methods:The study included a total of 60 elderly patients with COPD who were successfully discharged after receiving treatment at the First Hospital of Shanxi Medical University from November 2021 to October 2022.The enrolled patients were randomly divided into two groups: the pulmonary rehabilitation group and the control group, with 30 patients in each group.The allocation was determined using a random number table and prospective research methods.Patients in the pulmonary rehabilitation group underwent a 12-week pulmonary rehabilitation training program, while patients in the control group received pulmonary rehabilitation education and nutrition education.The general data of the two groups of patients were compared, including lung function parameters[forced expiratory volume in one second(FEV 1), forced vital capacity(FVC), forced expiratory volume in one second to forced vital capacity ratio(FEV 1/FVC), and percentage of predicted forced expiratory volume in one second(FEV 1%pred)], blood gas analysis[partial pressure of arterial oxygen(PaO 2), partial pressure of arterial carbon dioxide(PaCO 2), arterial oxygen saturation(SaO 2)], 6-minute walking distance(6MWD), grip strength, 5-round sit to stand test(5R-STST), modified British medical research council(mMRC)score, COPD assessment test(CAT)score, closed cycles test(CCT), Berg balance scale(BBS), and safety measures.These parameters were assessed before and after the intervention. Results:A total of 29 patients in the pulmonary rehabilitation group and 28 patients in the control group completed the study.The general data between the two groups showed no significant difference(all P>0.05).After the intervention, patients in the pulmonary rehabilitation group showed improvements in FEV 1/FVC, PaO 2, PaCO 2, SaO 2, 6MWD, grip strength, 5R-STST, CAT, CCT, and BBS( t=-2.242, -4.630, W=-3.439, t=-6.512, -10.563, -6.197, W=-3.968, t=10.847, -7.334, W=-4.189, all P<0.05).Additionally, 6MWD, CAT, and CCT showed significant improvement after the intervention compared to the control group( t=-2.104, 2.183, 2.106, all P<0.05).No training-related adverse effects were observed during the study. Conclusions:The 12-week pulmonary rehabilitation program is shown to be effective for elderly patients with COPD who are undergoing long-term home oxygen therapy.This program helps to improve respiratory function, systemic symptoms, exercise endurance, muscle strength, and balance function.It is designed to be simple and easy to implement, allowing patients to achieve their training goals and improve their clinical symptoms.Additionally, the program has been found to be safe and well-tolerated by patients, making it a valuable intervention that should be promoted and widely applied.

Objective To explore the effectiveness of building block assembly games in the upper limb functional exercise of school-aged children with peripherally inserted central catheter catheterization.Methods Using convenience sampling,90 catheterized children who met the inclusion criteria in the pediatric ward of a tertiary hospital in Henan Province from November 2022 to April 2023 were selected as research subjects.They were randomly divided into an experimental group and a control group,with 45 cases in each group.The experimental group participated in building block assembly games in addition to conventional ball-gripping exercises,while the control group engaged solely in conventional ball-gripping exercises.The compliance rates of upper limb exercises,time average peak flow rate of axillary vein of the catheterization side,and the incidence of catheter-related complications were compared between the 2 groups.Results During the study,2 cases in the experimental group and 3 in the control group dropped out,resulting in 43 cases in the experimental group and 42 in the control group.The compliance rate of upper limb exercises in the experimental group during hospitalization was 93.03％,significantly higher than 64.29％in the control group(P＜0.001).On the third day after catheterization,the time average peak flow rate of axillary vein of the catheterization side was(5.58±1.24)cm/s and(5.37±1.24)cm/s on the seventh day in the experimental group,compared to(3.87±1.06)cm/s and(3.56±0.81)cm/s,respectively,in the control group.These differences were statistically significant(P＜0.001).The incidence of catheter-related thrombosis in the experimental group was 4.65％,significantly lower than 21.43％in the control group(P=0.021).The rates of bleeding at the puncture site and catheter displacement in the experimental group were both 4.65％,compared to 7.14％and 4.76％,respectively,in the control group.These differences were not statistically significant(both P＞0.05).Conclusion Incorporating building block assembly games into routine ball-gripping exercises can improve the compliance of upper limb exercises in children with PICC placement,improve the blood flow velocity in the axillary vein of the catheterization upper limb,and reduce the incidence of catheter-related thrombosis,without increasing the risk of bleeding at the puncture site or catheter displacement.

Objective To investigate the overweight and obesity of primary and middle school students in Sijing area of Shanghai from 2020 to 2022,so as to provide scientific basis for the intervention of childhood obesity.Methods In October 2020 and October 2022,all primary and middle school students in Sijing area underwent physical examination by cluster sampling method.A cross-sectional study was conducted to investigate the obesity and overweight in primary and middle school students of different ages and genders in Sijing area.Results In 2020 and 2022,7 766 and 10 594 students completed physical examination,respectively,and 4 626 of them underwent two consecutive physical examinations.The incidences of overweight and obesity were 15.14%and 21.89%in 2020,respectively.The incidences of overweight and obesity were 15.41%and 21.11%in 2022,respectively.There were no significant differences in the incidences of overweight or obesity between 2020 and 2022(P>0.05).In 2020,the incidences of overweight and obesity of male students were 14.91%and 24.70%;the incidences of overweight and obesity of female students were 15.40%and 18.80%,respectively.In 2022,the incidences of overweight and obesity of male students were 15.04%and 24.14%;the incidences of overweight and obesity of female students were 15.82%and 17.82%,respectively.There was no significant difference in the overweight rate between males and females(P>0.05).The incidence of obesity of male students was significantly higher than that of female students in both 2020 and 2022(P<0.05).In the students aged 12 years old,the incidence of obesity was 27.42%in 2022,which was significantly higher than that in 2020(P<0.05).There was no significant difference in the incidence of obesity between other age groups(P>0.05).Among the 4 626 children who participated in two consecutive physical examinations,the overweight/obesity rates were 14.46%/21.25%in 2020 and 16.04%/21.78%in 2022;there was significant difference in the overweight rates(P<0.05),while no significant difference was found in obesity rates(P>0.05).Among the 4 626 children,there were 2 402 boys and 2 224 girls.In 2020,the overweight/obesity rates were 13.70%/24.48%in these boys and 15.29%/17.76%in these girls.In 2022,the overweight/obesity rates were 16.07%/25.44%in these boys and 16.01%/17.72%in these girls.There was no significant difference in the incidence of overweight between these girls and boys in 2020 and 2022(P>0.05),but the obesity rate of boys was significantly higher than that of girls(P<0.05).Conclusion There are high incidences of overweight and obesity among primary and middle school students in Sijing area of Shanghai,and dietary and exercise guidances should be strengthened.Meanwhile,the incidences of overweight and obesity are higher among boys,and obesity prevention and control measures should be strengthened for boys.

Objective To discuss the application value of video health education mode in patient's self-maintenance of totally implantable venous access port(TIVAP).Methods A total of 208 patients,who received implantation of TIVAP at the Second Affiliated Hospital of Naval Military Medical University of China From September 2021 to December 2022,were enrolled in this study.The patients were divided into control group(n=108)and observation group(n=100).Traditional health education was conducted for the patients of the control group,while on the basis of traditional health education an additional video health education based on visual communication theory was carried out for the patients of the observation group.Evaluation of self-care ability(ESCA)was used to evaluate the self-care ability before the intervention and 6 months after the implantation of TIVAP in the two groups.The complications,the incidence of adverse events,and the indwelling duration of the infusion port were compared between the two groups.Results Before intervention,the differences in each dimension score and total score of ESCA table between the two groups were not statistically significant(all P＞0.05).After intervention,the each dimension score and total score of ESCA table in the observation group were significantly higher than those in the control group(all P＜0.05).After intervention,both the total incidence of complications and the total incidence of adverse events in the observation group were remarkably lower than those in the control group(both P＜0.05),besides,the indwelling duration of the infusion port in the observation group was obviously longer than that in the control group.Conclusion The use of video health education mode can significantly improve the self-care ability of patients carrying a TIVAP,reduce the incidence of complications and adverse events,and extend the effective duration of TIVAP.Therefore,it is an effective health education mode.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective:To analyze the intestinal preparation effect of dimethicone oil combined with polyethylene glycol electrolyte powder in painless gastrointestinal endoscopy.Methods:The study included 380 patients undergoing painless gastrointestinal endoscopy in Nanjing Qixia District Hospital from January 2020 to June 2021. They were randomly grouped into observation group and control group, with 190 patients in each group. The control group was given polyethylene glycol electrolyte powder + 0.9% sodium chloride for intestinal preparation before gastrointestinal endoscopy, and the observation group was given polyethylene glycol electrolyte powder + dimethicone silicone oil. The intestinal cleanliness, antifoam effect, colonoscopy index, detection rate of polyps, adenomas and advanced adenomas, and adverse drug reactions were compared between the two groups.Results:The satisfaction rates of intestinal cleaning and defoaming in the observation group were 92.11% (175/190) and 90.53% (172/190) respectively, which were obviously higher than those in the control group: 84.71% (161/190) and 83.16% (158/190) ( P>0.05). The entering time of colonoscopy and the time of colonoscopy inspection in the observation group were obviously shorter than those in the control group: (3.35 ± 1.05) min vs. (6.02 ± 1.68) min, (11.86 ± 1.93) min vs. (15.22 ± 2.10) min. The rinsing amount of 0.9% sodium chloride was obviously reduced: (35.68 ± 7.64) ml vs. (50.34 ± 10.30) ml ( P<0.05). The detection rate of <5 mm polyps in the observation group was obviously higher than that in the control group: 15.79% (30/190) vs. 5.79% (11/190) ( P<0.05). The detection rate of adenomas in the observation group was obviously higher than that in the control group: 24.74% (47/190) vs. 15.79% (30/190) ( P<0.05). The detection rate of advanced adenomas in the observation group was obviously higher than that in the control group: 20.53% (39/190) vs. 9.47% (18/190) ( P<0.05). The total incidences of abdominal distension and adverse reactions in the observation group were obviously lower than those in the control group: 1.05% (2/190) vs. 5.26% (10/190), 9.47% (18/190) vs. 18.42% (35/190) ( P<0.05). Conclusions:The application of polyethylene glycol electrolyte powder combined with dimethicone oil in painless gastrointestinal endoscopy can effectively improve the intestinal cleanliness, the satisfaction of removing bubbles and the detection rate of polyps and adenomas, reduce the incidence of adverse reactions, and have high clinical application value.

【Objective】 To investigate the distribution of plasma donors with high titer neutralizing antibodies against human cytomegalovirus (HCMV) in the general plasma donor population. 【Methods】 920 plasma samples of Taibang were tested in April 2014 to investigate the distribution of anti-HCMV neutralizing antibodies. After further testing of mixed plasma, the threshold for screening plasma was determined. From October 2019 to May 2020, neutralizing anti-HCMV in 40 078 plasma samples from 11 plasma stations in Shandong province were screened by the microcytopathic method (modified high-flux neutralization test method). The proportion of neutralizing anti-HCMV enriched in high titer and the distribution in the donor population were analyzed by SPSS 26 and Minitab19 analysis software. 【Results】 Among 920 samples, 73.26%, 0.43%, and 8.69% of them had neutralization titer<1∶15, ≥1∶60 and ≥1∶30, respectively. The neutralization titer of mixed plasma was detected, and 1∶30 was determined as the high titer. The yielding rate of high titer neutralizing anti-HCMV in Shandong was 9.06% (3 633/40 078). The proportion of plasma donors with high-titer neutralizing anti-HCMV in the donation population from plasma stations was 4.95%~13.03% (9.06±2.07) %. The proportion of plasma donors with high-titer neutralizing anti-HCMV by gender was 15.67% (2 185/13 951) in women and 5.54% (1 448/26 127) in men(P<0.05). 【Conclusion】 There was a certain proportion of plasma donors wiht high titer neutralizing anti-HCMV in the population of plasma donors in Shandong, and they can constantly serve neutralizing anti-HCMV to ensure the production of anti-HCMV immunoglobulin preparations.

Extracellular vesicles (EVs), also known as membrane vesicles, are vesicular bodies secreted by eukaryotic cells and bacteria. EVs can carry proteins, DNA, RNA, and various metabolites for the exchange and transmission of substances between cells. They play contents-dependent physiological functions, such as delivering nutrients, participating in immune response, and treating cancers. Currently, most studies focus on the exploration of vesicles secreted by eukaryotic cells and gram-negative bacteria, while few studies focus on gram-positive bacteria. This review summarized the production, content composition, physiological function, and engineering of EVs secreted by gram-positive bacteria, and prospected future perspectives in this area.
Bacteria/metabolism* ; Extracellular Vesicles/metabolism* ; Gram-Negative Bacteria ; Gram-Positive Bacteria/metabolism* ; Proteins/metabolism*