Objective To study the relationship between the individualized nutritional intervention during pregnancy with childbirth way and neonatal birth weight , provide clinical data for nutrition intervention treatment . Methods The outpatient pregnant women were randomly divided into intervention group and control group according the nutritional intervention intentions from January to June in 2014.The incidence of pregnancy specific disease , childbirth way and neonatal birth weight were recorded .Results The incidence of special diseases during pregnan-cy, cesarean section and abnormal neonatal birth weight in intervention group were lower than the control group , and the differences were statistically significant (p<0.05).Conclusion Individualized nutritional intervention during pregnancy can reduce the incidence of pregnancy specific disease , macrosomia and cesarean section .

To express feruloyl esterase A from Aspergillus oryzae in Pichia pastoris expression system and study its hydrolysis function, explore the conditions and effects of purification for ferulic acid extracts by macroporos resin. Using the total RNA from A. oryzae CICC 40186 as the template, we amplified coding sequence AorfaeA encoding a mature feruloyl esterase A (AorFaeA) by RT-PCR technique. Then, the coding sequence AorfaeA was successfully expressed in Pichia pastoris GS115 mediated by an expression plasmid pPIC9K. The purified recombinant AorFaeA (reAorFaeA) showed one single band on SDS-PAGE with an apparent molecular weight of 39.0 kDa. The maximum activity of reAorFaeA to methyl ferulate, measured by high-performance liquid chromatography (HPLC), was 58.35 U/mg. Then, reAorFaeA was used to release ferulic acid from de-starched wheat bran in the presence of xylanase. The purification tests for ferulic acid from the enzymatic hydrolysate were carried out with preselected macroporous resins. The results showed that macroporous resin HPD-300 had much higher adsorption and desorption capacities. Ferulic acid could be quantitatively recovered by 50% of the eluent concentration at a flow speed of 1 mL/min. Under the purification condition, the recovery ratio of ferulic acid was 92%, and the content of ferulic acid was increased from 0.13% in the raw material to 10.55%. This work exploits the breakdown of ferulic acid by recombinant enzymeand provids a good strategy to its "green production".
Aspergillus oryzae ; enzymology ; Carboxylic Ester Hydrolases ; biosynthesis ; genetics ; Cloning, Molecular ; Coumaric Acids ; chemistry ; Electrophoresis, Polyacrylamide Gel ; Hydrolysis ; Molecular Weight ; Pichia ; genetics ; metabolism

Objective To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.Methods One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group.All patients received oral Saccharomyces boulardii 1.0 b.i.d, while patients in study group received additional Shuganjianpi decoction b.i.d for 4 weeks.The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.Results After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs.(11.70±2.88) points,t=16.707, P<0.01].Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs.(1.00±0.44) ng/L, t=11.609, P<0.01;TNF-α (41.26±5.29) ng/L vs.(24.13±3.27) ng/L,t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L,t=6.291,P<0.01].The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs.68.75% (55/80), x2=8.228, P<0.01].After treatment, the quality of life scores in both groups were improved;but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs.(193±60), t=4.579, (316±74) vs.(230 ± 69), t=7.603, (297±62) vs.(228±59), t=7.211;(284±62) vs.(230±54), t=5.874, all P<0.01].Conclusion The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.

Objective To investigate the effect and safety of primary percutaneous coronary intervention (PCI) of acute ST-segment elevation myocardial infarction (STEMI) in elderly patients.Methods 103 consecutive patients with STEMI treated by primary PCI were divided into two groups according to the age:the elderly group [aged≥65 years,with a mean age of (75.7 ±6.2) years(n =49],the non-elderly group [aged＜65 years,with a mean age of (43.0±8.6) years(n =54].Clinical characteristics,complications related to PCI procedure and success rate were analyzed,and major cardiovascular events (MACE) were followed up for(5.7 ± 1.2) months.Results The proportion of female,patients with Killip ≥ Ⅲ,three vessels disease and higher level of serum brain natriuretic peptide were higher in elderly group than in non-elderly group (all P＜0.05).No significant difference was observed between the two groups in success rate and complications of PCI procedure (both P＞0.05).Patients were followed up for (5.7± 1.2) months.The in-hospital and one-month mortalities were higher in elderly group than in non-elderly group [8.2％ (4 cases)vs.0％ (0 case),10.2％(5 cases) vs.0 ％ (0 case),respectively,all P＜0.05].There was no significant difference in six-month mortality and MACE between the two groups.Multivariate logistic regression analysis showed that Killip ≥ Ⅲ was related with the increase of one-month mortality in patients with STEMI undergoing primary PCI,whereas age was not.Conclusions Primary PCI is effective and safe in elderly patients with STEMI.

ObjectiveTo investigate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and MB isoenzyme of creatine kinase (CK-MB) for heart failure (HF) in pneumonia children.MethodsThe NT-proBNP and CK-MB were assayed in 132 pneumonia children with HF, 138 pneumonia children without HF and 62 healthy children were recruited into this study. A receiver operating characteristics (ROC) curve and a logistic regression model were employed to assess the diagnostic accuracy of NT-proBNP and CK-MB for HF in pneumonia children.ResultsPneumonia children with HF had higher blood NT-proBNP and CK-MB than those in pneumonia children without HF and healthy controls (P<0.01 for both). Pneumonia children with HF had higher blood NT-proBNP and CK-MB than the pneumonia children without HF. The area under curves (AUCs) of NT-proBNP and CK-MB for HF were 0.85 and 0.72, respectively. The AUC for their combinational usage was 0.87.ConclusionBoth NT-proBNP and CK-MB are effective markers as diagnostic adjuncts for HF in pneumonia children. Combination of NT-proBNP and CK-MB can improve the diagnostic accuracy for HF in pneumonia children.

Objective To explore the value of applyingcomprehensive design experiment evalua-tionin the evaluation of nursing experimental teaching. Methods In the nursing profession, and after the acute and severe cases were collected, comprehensive design experiment evaluation was carried out by using the first-aid and severe training programs, according to the patients needs. Then the simulation effect of students was evaluated by multi-subjects Afterwards, a questionnaire survey was conducted among 143 participants on clinical competency and experimental assessment. The data were analyzed through ratio. Result 121 nursing students' (84.6%) clinical competence was improved. 143 nursing students (100%) thought that the test was of great significance to achieve education target. 138 nursing students (96.6%) thought that general design and arrangement of satisfaction were high. 141 nursing students (98.7%) were satisfied with the multi-subject evaluation. 106 nursing students (74.1%) were willing to conduct self evaluation and give evaluation of others. Conclusion Comprehensive designing experiments evaluationcan significantly improve the critical clinical competence of nursing students, and can help the professional education target implementation. The operation mode is recognized by the students. The evaluation of the multi-subject evaluation is highly respected, but it needs to develop the students' ability of objective evalua-tion.

ObjectiveTo explore the effect of the individualized intervention for the anxiety-depression after cardiovascular diseases. Methods80 inpatients with cardiovascular diseases were surveyed with Hospital Anxiety and Depressions Scale (HAD). The patients with anxiety-depression received individualized psychological intervention. Results14 of them suffered anxiety-depression. 13 cases recovered after the intervention. ConclusionThe individualized psychological intervention can improve anxiety-depression in the inpatients with cardiovascular diseases.

Objective:To explore the application effect of Roy adaptation model combined situational teaching method in pediatric nursing teaching.Methods:A total of 108 nursing students interned in our hospital in 2019 were selected and randomly divided into two groups, among which, 54 nurses who accepted the traditional teaching method were taken as the control group, and 54 ones who adopted Roy adaptation model combined situational teaching method were taken as the research group. The scores of theory and operation skills of the two groups were evaluated before and after teaching, at the same time, the comprehensive ability was assessed and the satisfaction survey was conducted among the students after the teaching. SPSS 20.0 was used for data processing, the scores of theory and operation skills comprehensive ability and nursing students' satisfaction with teaching were described with ( ± s) and t test was performed. Results:After the teaching, the theoretical knowledge and operational skills scores of the two groups were significantly improved than those before the teaching ( P<0.05), and those of all students in the research group were significantly higher than those in the control group ( P<0.05). The scores of ability to integrate theory with practice, self-learning ability, communication ability, teamwork ability, independent thinking and problem solving ability, clinical thinking ability in the research group were higher than those in the control group, with statistical differences ( P<0.05). And students in research group had significantly higher overall satisfaction scores on the teaching than those in control group had ( P<0.05). Conclusion:Application of Roy adaptation model combined situational teaching method in pediatric practice teaching can improve the theoretical knowledge and operational level of nursing students, enhance their communication ability and other abilities, and help to improve their satisfaction with teaching.

Objective To analyze the clinical characteristics of childhood systemic lupus erythematosus (SLE) patients with severe gastrointestinal manifestations,especially cases with acute and severe abdominal pain,so as to improve the recognition of severe and acute gastrointestinal manifestations of SLE during pediatric diagnosis and treatment.Methods Medical records of 119 patients with SLE under the age 16 years old in Peking Union Medical College Hospital from Jan.2010 to Mar.2013 were reviewed and gastrointestinal manifestations were retrospectively analyzed.All patients were diagnosed as SLE according to 1997 American College of Rheumatology (ACR) revised classification criteria.Results Gastrointestinal involvement was recorded in 24 children (20.2％).The median (range) age at the time of initial gastrointestinal manifestations was (13.5 ± 2.0) years (6-15 years).The ratio of female to male was 1.0 ∶ 2.4.And in 4 cases,gastrointestinal manifestations occurred as the initial symptoms.Abdominal pain was the most frequent symptom,present in 13 patients (54.2％),11 cases (45.8％) had nausea and vomiting,4 cases (16.6％) had abdominal distension,and 3 cases (12.5％) had diarrhea.Abnormal liver function was found by lab test in 8 cases,without obvious symptoms or the proofs of any virus infection.Acute and severe abdominal pain was found in 9 cases,of whom 6 patients were diagnosed as intestinal pseudo-obstruction (2 cases with bilateral ureterohydronephrosis),1 case had acute peritonitis with surgery,1 case was diagnosed as protein losing enteropathy and 1 case had acute pancreatitis.Liver impairment also occurred in SLE.All cases got alleviated with the treatment of steroids and immunosuppressive drugs.Significant difference was found in the occurrence of hydroureter and hydronephrosis and albumin concentrations between SLE digestive and non-digestive system involvement children.However,there was no remarkable difference in the erythrocyte sedimentation rate,or the involvement of kidney and blood system and central nervous system between the 2 groups.Conclusions SLE is a common autoimmune disease in children involving multiple systems.The severity of gastrointestinal involvement is underestimated.Gastrointestinal manifestations can be initial symptoms of SLE.Intestinal pseudo-obstruction,protein losing enteropathy,and acute pancreatitis are uncommon but severe gastrointestinal manifestations of SLE patients should be fully recognized.It is vital for pediatric physicians to make early diagnosis and begin timely treatment on SLE with Corticosteroid and cyclophosphamide.

Objective To observe the therapeutic effect of Yougui Pills and its separate formula for the treatment of kidney-yang deficiency syndrome. Methods A total of 60 patients of kidney-yang deficiency syndrome were randomly divided into treatment group and control group, 30 cases in each group. Treatment group was treated with Yougui Pills, and the control group was given the separate formula from Yougui Pills which had the actions of warming kidney yang. Four weeks constituted one treatment course and the treatment covered 2 courses. The changes of major clinical symptom scores, total effectives rate and associated indexes such as peripheral white blood cells, serum antibodies, and complements were compared between the two groups following the treatment for 8 weeks. Results The total effective rate, and improvement of major clinical symptoms and the peripheral white blood cells in the treatment group were superior to those in the control group ( P<0.05 or P<0.01) . However, there were no significant differences of the levels of serum antibodies and complements between the two groups (P>0.05) .Conclusion Yougui Pills show better effect than its kidney-yang-warming separate formula for the treatment of kidney-yang deficiency syndrome, indicating that the method of generating yang by activating yin is superior to the method of simply nourishing kidney yang.