Objective:To study the feasibility of using bedside ultrasound in evaluating gastric residual volume in critical ill patients with enteral nutrition support.Methods:From May 2019 to August 2019, 60 patients were selected to receive enteral nutrition via gastric tube in ICU of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Patients were divided into the experimental group and the control group according to the odd and even number of beds, 30 patients in the experimental group with odd number of beds and 30 patients in the control group with even number of beds. Gastric residual volume was evaluated at 0, 4, 8, 12, 16, 20, 24 h of enteral nutrition. In the experimental group, the gastric residual volume was evaluated by bedside ultrasound and syringe suction at each time point. In the control group, only bedside ultrasound was used to evaluate gastric residual volume. The results of operation time, monitoring results at different time points, diarrhea and the utilization rate of gastrointestinal motility drugs target feeding time, vomiting, were compared between the two groups.Results:There was no statistical difference between the gastric residual amount monitored by ultrasound and the gastric residual amount monitored by suction ( P>0.05). The operating time of bedside ultrasound monitoring was (62.40 ± 4.00) s, the operating time of suction monitoring was (78.39 ± 12.15) s, and the operating time of bedside ultrasound monitoring was less than that of suction ( t value was 6.633, P<0.01). There was no significant difference in the rate of vomiting, diarrhea and gastrointestinal motility drugs between the two groups( P>0.05). The time to reach the target feeding amount in the control group was (3.04 ± 0.31) d, and the time to reach the target feeding amount in the experimental group was (4.19 ± 0.33) d. The time to reach the target feeding amount in the control group was less than that in the experimental group ( t value was 13.42, P<0.01). Conclusions:Bedside ultrasound can be used to evaluate the residual gastric volume of enteral nutrition support patients, guide the implementation of enteral nutrition, shorten the operation time, reduce the workload of nurses, and avoid the contamination of enteral nutrition preparation.

Objective: To explore the status of seroepidemiology on hepatitis A, B and C among students and residents aged equal or greater than 18 years in south Xinjiang, and to provide scientific evidence for prevention and control of viral hepatitis. Methods: Uyghur students in four towns and villages were selected by cluster random sampling from Feb to May, 2015, and Uyghur residents aged 18 to 69 years were selected by stratified cluster sampling from May to September, 2016. 4 507 middle and primary Uygur students and 4 833 Uyghur resides equal or greater than 18 years attended this survey. Self-designed questionnaire was used to collect the demographic information. And Elisa test was adopted to detect HAV-IgG, HBsAg, HBsAb and HCV-IgG. Chi-square test was used to calculate the difference on antibody positive rate of three types of hepatitis among the participants. Results: The overall HAV-IgG positive rate was 99.45% (9 289/9 340). The positive rates were 99.70% (4 006/4 018) in male and 99.27% (5 283/5 322) in female (χ²=7.95, P=0.005). The HAV-IgG positive rate among people aged 10 to 14 years was the highest (99.91%, 2 233/2 235), and the difference between the age specific HAV-IgG positive rates was statistical significant (χ²=38.21, P<0.001). The overall HBsAg positive rate was 4.11% (384 cases), with 4.55% (183 cases) for male and 3.78% (201 cases) for female. The HBsAg positive rate among participants 19 to 24 years old was the highest (9.46%, 21/222) and the differences between the age specific HBsAg was statistically significant (χ²=116.22, P<0.001). The HBsAb positive rate was 35.03% (3 272 cases), with 35.59% (1 430 cases) for male and 34.61% (1 842 cases) for female, and the HBsAb positive rate among participants aged 15 to 18 years was the highest, which was 69.12% (696/1 007). The differences between the age specific HBsAb rates appeared statistically significant (χ²=671.80, P<0.001). The overall HCV-IgG positive rate was 0.65%(61 cases). The HCV-IgG positive rate in female was 0.86% (46 cases) and 0.37% (15 cases) in male (χ²=8.51, P=0.004).The HCV-IgG positive rate among participants aged over 70 years was the highest (3.78%,9/238) , and the difference between the age specific HCV-IgG positive rates had statistic significance (χ²=70.30, P<0.001). The HAV-IgG positive rate in hepatitis A vaccinees (100%, 876/876) was higher than that among the non-vaccinees (99.40%, 8 413/8 464) (χ²=4.26, P=0.039). The HBsAb positive rate in hepatitis B vaccinees was 39.32% (1 816/4 619) which was higher than that among the non-vaccinees (30.84%, 1 456/4 721) (χ²=73.68, P<0.001). Conclusion The positive rate of overall HAV-IgG was high, male and participants aged between 10 to 14 had higher probability to be infected. But the infection rates of hepatitis B and C were low, with the low vaccination rate and the poor protective effectiveness of hepatitis B.

Objective To investigate the epidemiologic characteristics of diabetes mellitus (DM) in Uygur residents in Kashgar of Xinjiang.Methods The survey was conducted among the Uygur residents aged ≥ 18 years selected through stratified cluster sampling in Kashgar by means of questionnaire survey,physical examination and basic laboratory test.The prevalence of different groups were calculated and risk factors of DM was analyzed by logistic vegression model.Results A total of 4 608 adults were surveyed.The prevalence of DM was 11.31％ (standardized prevalence:10.59％) and the prevalence was 13.65％ (standardized prevalence:12.34％) in males and 10.04％ (standardized prevalence:9.83％) in females.The prevalence increased with age.The prevalence of DM was higher than the prevalence of impaired fasting glucose (IFG) in people aged ＞60 years,especially in females.The rates of awareness,treatment and control of DM were 28.02％,21.31％ and 5.57％,respectively.Multivariate logistic regression analysis indicated that people aged 45-55,55-65 and ＞65 years had higher risk of DM and the odds ratio were 2.08 (95％CI:1.24-3.48),2.73 (95％CI:1.63-4.56) and 3.90 (95％ CI:2.24-6.78) for men and 2.63 (95％ CI:1.71-4.02),3.14 (95％ CI:2.00-4.94) and 5.56 (95％CI:3.47-8.92) for woman,respectively.Family history of DM (OR=2.88 for men,95％Cl:1.45-5.72;OR=2.52 for women,95％CI:1.49-4.26) and BMI≥28.0 kg/m2 (OR=1.77 for men,95％CI:1.19-2.64,OR.=1.80 for women,95％CI:1.30-2.50) were also risk factors for DM.Conclusion The prevalence of DM was high in Uygur residents in Kashgar,but the rate of awareness,treatment and control of DM were low.It is necessary to improve the detection rate of DM and conduct targeted prevention and control of DM.

Objective To understand the prevalence of dyslipidemia and normal blood lipids level in Uygur diabetes patients in Kashgar prefecture in southern area of Xinjiang.Methods A total of 5 078 local residents aged ≥ 18 years (42.56％ were men) selected through cluster random sampling in Kashgar were surveyed by means of questionnaire survey,physical examination and laboratory test,and 521 diabetes patients were screened.Results The overall prevalence of dyslipidemia in diabetes patients was 59.50％ (310/521) with adjusted rate as 49.39％.Age ≥65 years,overweight,obesity and abdominal obesity increased the risk for dyslipidemia by 0.771 times (95％ CI:1.015-3.088),1.132 times (95％CI:1.290-3.523),1.688 times (95％CI:1.573-4.592) and 0.801 times (95％CI:1.028-3.155) respectively.Compared with males,female was a protective factor for dyslipidemia (OR=0.507,95％CI:0.334-0.769).The overall normal rate of blood lipids level including total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) for type 2 diabetes patients was 11.13％.Female,higher BMI and abdominal obesity were the factors influencing the overall normal blood lipids level.The normal rate of LDL-C level decreased with increase of age,BMI and waist circumferences (trend test x2=18.049,P＜ 0.001;trend testx2=10.582,P=0.001;x2=19.081,P＜0.001),but increased with educational level (trend testx2=9.764,P=0.002).Conclusion The prevalence of dyslipidemia in Uygur diabetes patients in Kashgar was high,however,the overall normal rate of blood lipid level was relatively low.Obesity was the most important risk factor for dyslipidemia in this area.More attention should be paid to dyslipidemia prevention in women.

Objective To investigate the prevalence of hypertension and risk factors in Uygur adults in Kashgar of Xinjiang.Methods A total of 4 748 Uygur adults aged ≥ 18 years selected through cluster random sampling in Shufu county of Kashgar prefecture were surveyed by means of questionnaire survey,physical examination and laboratory test.The prevalence,awareness,treatment and control rate of hypertension of different groups were calculated and risk factors of hypertension was analyzed by using non-conditional logistic regression model.Results The overall prevalence of hypertension was 15.73％ (age-adjusted prevalence was 13.75％).The prevalence rates of hypertension in men and women were 16.36％ (age-adjusted prevalence was 12.96％),15.39％ (age-adjusted prevalence was 14.34％),respectively.The rates of awareness,treatment and control of hypertension were 59.57％,52.74％,21.29％,respectively.The prevalence of hypertension increased with age.Compared with age group 18-34 years,the age groups 55-64,≥65 years had higher risk of hypertension and the OR values were 10.53,20.96 for men and 16.27,33.20 for women.The overweight (OR=1.47 for men,OR =1.82 for women,P＜0.05) and obesity (OR =1.88 for men,OR=2.66 for women,P＜0.05) also increased the risk of hypertension.The groups with family history of hypertension (OR=3.85 for men,OR=2.34 for women,P＜0.05) also had higher risk of hypertension.Hypertriglyceridemia was positively correlated with the prevalence of hypertension in men (OR=1.62,95％CI:1.09-2.41).Conclusions The prevalence of hypertension in Uygur adults in Kashgar area of Xinjiang was at relatively low level.The related risk factors were age,overweight,obesity,family history and hypertriglyceridemia in men and the risk factors were similar in women except hypertriglyceridemia.

Objective To investigate the knowledge,attitude and practice (KAP) to chronic diseases and associated influencing factors in Uygur adults in Kashgar of southern Xinjiang,and provide basic information for developing ethnic specific prevention and control strategies for chronic diseases.Methods With stratified cluster random sampling,investigations,including questionnaire survey,physical examination and laboratory tests were performed among local residents who were aged ≥ 18 years and selected in Shufu county in southern Xinjiang.KAP scores were calculated and unconditional logistic regression models were used to analyze influencing factors.Results A total of 4 772 Uygur adults were surveyed.The awareness rate of chronic disease related knowledge ranged from 4.32％ to 56.04％,while the awareness rate of preventive measures were from 1.76％ to 85.18％ and the participation rate of prevention program varied from 4.00％ to 97.99％.The average KAP score was 15.90 ± 4.20 and the rate of total KAP was 47.86％.Multi-factor analysis suggested the pass rate of total KAP score increased with educational level.Other factors positively associated with ‘KAP score pass rate’ were commercial insurance investment,hypertension,family history of common chronic diseases,female and abdominal obesity,while overweight was negatively associated with the KAP score pass rate.Conclusions The KAP level on chronic diseases was low in Uygur adults in Kashgar.It is necessary to continuously implement ethnic targeted health education and health promotion campaigns,especially in low education level,low income level,overweight and male groups.

The PEPC family proteins are ubiquitous in various plants and play an important role in the process of photosynthetic carbon assimilation and have many non-photosynthetic biological functions. However, PEPC genes have not been reported in apple. In this study, the members of apple MdPEPC family were identified based on the new apple genome data by bioinformatics analysis, and their expression patterns in different tissues and the apple axillary bud transcriptome treated by decapitation and TDZ (cytokinin) were analyzed in order to explore the role of MdPEPC genes in apple axillary bud outgrowth. The results showed that 6 MdPEPC family members were identified in apple, which distributed on 6 different chromosomes, and had similar physicochemical characteristics. Phylogenetic tree and sequence alignment analysis showed that the MdPEPC could be divided into two subgroups (Group Ⅰ and Group Ⅱ), in which four members in MdPEPC family were clustered into Group Ⅰ, belonging to plant-type PEPCs. However, MdPEPC4 and MdPEPC5 were clustered into Group Ⅱ with AtPPC4, belonging to bacterial-type PEPCs. There were 7 pairs of fragments repeats among MdPEPC members, but no tandem repeats existed. The promoter cis-acting element analysis showed that MdPEPC genes were not only affected by light and stress, but also regulated by multiple hormones. The expression profiles showed that all MdPEPCs except MdPEPC4 and MdPEPC5 were expressed in different apple tissues. Transcriptome data analysis showed that the expression levels of MdPEPC1 and MdPEPC3 were up-regulated after decapitation and TDZ treatment, whereas MdPEPC2 was significantly down-regulated at 48 h after treatments. In conclusion, MdPEPC1, MdPEPC2 and MdPEPC3 were selected as the candidate genes involved in axillary bud outgrowth regulation for further study.
Malus/metabolism* ; Gene Expression Regulation, Plant ; Phylogeny ; Decapitation ; Family ; Plant Proteins/metabolism*

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are essential causes of death and long-term disability and are difficult to cure, mainly due to the limited neuron regeneration and the glial scar formation. Herein, we apply extracellular vesicles (EVs) secreted by M2 microglia to improve the differentiation of neural stem cells (NSCs) at the injured site, and simultaneously modify them with the injured vascular targeting peptide (DA7R) and the stem cell recruiting factor (SDF-1) on their surface via copper-free click chemistry to recruit NSCs, inducing their neuronal differentiation, and serving as the nanocarriers at the injured site (Dual-EV). Results prove that the Dual-EV could target human umbilical vascular endothelial cells (HUVECs), recruit NSCs, and promote the neuronal differentiation of NSCs in vitro. Furthermore, 10 miRNAs are found to be upregulated in Dual-M2-EVs compared to Dual-M0-EVs via bioinformatic analysis, and further NSC differentiation experiment by flow cytometry reveals that among these miRNAs, miR30b-3p, miR-222-3p, miR-129-5p, and miR-155-5p may exert effect of inducing NSC to differentiate into neurons. In vivo experiments show that Dual-EV nanocarriers achieve improved accumulation in the ischemic area of stroke model mice, potentiate NSCs recruitment, and increase neurogenesis. This work provides new insights for the treatment of neuronal regeneration after CNS injuries as well as endogenous stem cells, and the click chemistry EV/peptide/chemokine and related nanocarriers for improving human health.