Objective: To develop a molecular screening test for genetic defects on hearing loss related genes has significant impacts on early identification of hereditary hearing loss and genetic susceptibility to aminoglycoside ototoxicity. Early identification of pre-lingual hearing loss is very important for patient's language development, academic achievement, and social skill. Two common mutations, the 235delC in GJB2 gene and the mutation A1555G in mitochondrial DNA, are included in the newly developed screening panel for Chinese population. Methods: A molecular genetic assay, based on fluorescent labeled multiplex PCR and automatic DNA fragment analyzing techniques, was developed to detect both mutations simultaneously. Results: This assay was able to detect both mutations from patient's samples, and pooled DNA tests, as well as suitable to detect mutation from the DNA extracted from dried blood spot and buccal swab. Conclusion: This assay could be a useful tool for newborn screening and carrier screening for the hereditary hearing loss for the Chinese population.

Objective: To establish HPLC method for determination of pterostilbene in Dragon's Blood with different extraction technology. Method: Applying a C 18 phase column and acetonitrile 1% acetic acid(41∶59) as mobile phase, detecting at 319nm and quantitating with external standard method. Results: The standard curves of pterostilbene was linear in the concentration range of 10.4～104ng, r =0.9992. The average recovery was 98.28%, RSD =1.97%. The content of pterostilbene in Dragon's Blood extracted with ordinary temperature was lower than that with heating technology. Conclusion: The content of pterostilbene extracted with ordinary temperature extraction in Dragon's blood have the advantage of heating extraction.

ObjectiveTo analyzing the psychological status of hospitalized patients of internal medicine and its impact factors.Methods Hospitalized patients of internal medicine underwent a survey by using Chinese Health Questionnaire (CHQ-12),Social Support Scale and Disease-Cognition Scale.Those with a score of ＞4 received further investigation of Symptom Check-List 90 (SCL-90).Correlation analysis was performed between all factors of SCL-90 and social support or disease-cognition scale score.Results There was no significant difference of psychological status between males and females ( P ＞0.05 ).All SCL90 factors were negatively correlated with social support,of which obsessive,paranoid,and phobic presented stronger negative correlations with social support and objective support (P ＜ 0.05 ).Furthermore,all factors were negatively correlated with disease-cognition scale score.A significantly negative correlation between phobic factor and disease-cognition scale score was identified ( P ＜ 0.05 ).Improvement was found in 26.2％ patients after intervention.Conclusion Patients tend to show unhealthy emotion when they are under the stress of hospitalization.Hospitalization support system may need to be improved and patients' cognition of disease should be increased.

ObjectiveTo optimize human Hexastatin gene,to express,purify protein and conduct activity experimental research,and to provide a theoretical basis for further study of Hexastatin.MethodsHuman Hexastatin gene was optimized and synthesized.It was connected to the pET28a expression vector,induced to express by isopropyl β-D-1-thiogalactopyranoside(IPTG),and optimized induction conditions.After the ultrasonication of bacterial cells and inclusion bodies,the recombinant fusion protein was purified with Ni-NTA chromatographic column,analyzed and identified by SDS-PAGE and Western Blot,and conduct activity experimental research in vitro by MTT.ResultsConstructed production was pET28a-Hexastatin expression plasmid.The human Hexastatin protein was expressed in E.coli BL21 the high level and accounted for 45.1％ of the total bacterial protein.The purification of recombinant protein purified with Ni-NTA chromatographic column reached 90％,and the concentration was 80 μg/ml.Human Hexastatin protein can restrain the growth of C6,MCF-7 and human vascular endothelial cell (HMEC) cells,and inhibition ratio reach to 72.9％±3.6％,48.8％±2.9％,52.7％±2.5％,respectively through MTT test.ConclusionThe optimized human Hexastatin protein was expressed successfully,which confirmed the inhibition to tumour cells.It is a new way for anti-angiogenesis therapy of tumour.

Objective To investigate the antitumor effect of 17aα-D-homo-ethynylestradiol-3-acetae on the mice transplanted with melanoma (B16) tumor cells,and to explore the possible synergistic effect with irradiation.Methods IRM-2 mice transplanted with B16 cells were randomly classified into control group,irradiation group,17aα-D-homo-ethynylestradiol-3-acetae drug ( high dose,medium dose,low dose) groups,and drug and irradiation combination group.Mice in drug group and the combination group were intraperitoneally injected with 5,7.5,and 10 mg/kg drug for 7 days.Mice in the irradiation and combination group received 1 Gy total body irradiation at 4 d after drug injection and then once a day for 5 days.The tumor inhibition efficiency,the number of bone marrow cells,thymus indices,and spleen indices were evaluated.Results Tumor weights in each drug group were significantly lower than those of the control( t =4.58,9.07,6.67,P ＜ 0.05 ).Drug combinated with 137Csγ-rays enhanced the antitumor effect so that the tumor weights in the combination group were significantly decreased ( t =8.06,10.35,6.71,P ＜0.05 ) in comparison with the control groups.Moreover,the numbers of marrow nucleated cells,thymus index and spleen index in the drug group were higher than those in the control group ( t =2.64,3.80,2.84,P ＜ 0.05 ).Conclusions 17aα-D-homo-ethynylestrudiol-3-acetae can inhibit cell growth of B16 melanoma in mice and may also have radioprotective effect on the hematopoietic system and immune system of mice.

Objective:To evaluate the effects of rocuronium on limb ischemia-reperfusion injury in the patients undergoing total knee arthroplasty.Methods:Ninety patients of both sexes, aged 50-80 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with body mass index<30 kg/cm 2, scheduled for elective unilateral knee arthroplasty under general anesthesia combined with femoral nerve block from January 2019 to October 2019, were divided into 3 groups ( n=30 each) using a random number table method: normal saline group (group S), rocuronium 0.6 mg/kg group (group RL) and rocuronium 1.2 mg/kg group (group RH). Anesthesia was induced by intravenous injection of midazolam, etomidate, sufentanil and rocuronium 0.6 mg/kg (group RL) or 1.2 mg/kg (group RH) or equal volume of normal saline (group S). Mechanical ventilation was performed after placement of laryngeal mask to maintain P ETCO 2 35-45 mmHg.Femoral nerve block was performed under ultrasound guidance.Anesthesia was maintained by inhaling 1% sevoflurane and intravenous infusion of propofol and remifentanil to maintain entropy index at 40-60 during operation.Patient-controlled intravenous analgesia was performed with sufentanil after surgery to maintain visual analogue scale score ≤ 4 points.When visual analogue scale score was > 4, flurbiprofen axetil 100 mg was intravenously injected.The vastus medialis muscle at the edge of the incision was obtained at 60 min after inflation to determine the expression of dystrophin by immunohistochemistry.Arterial blood samples were collected immediately after inflation of the tourniquet, at 60 min after inflation, and at 5 and 30 min after deflation for determination of the serum malondialdehyde (MDA) concentrations by the thiobarbituric acid method.The effective pressing times of the analgesic pump and consumption of sufentanil and flurbiprofen axetil were recorded within 48 h after operation.The occurrence of responses to tourniquet and residual muscle relaxation during recovery from anesthesia, the first postoperative off-bed time and postoperative length of hospital stay were recorded.The thigh girth was measured before operation and at 24 and 48 h after operation, and the difference after and before operation was calculated.The range of motion of knees of the operated limb and tourniquet-related complications in the early postoperative period (3 days) and in the long-term postoperative period (3 months) were recorded. Results:Compared with group S, the expression of dystrophin in skeletal muscle was significantly up-regulated, the concentration of serum MDA was decreased at 30 min after deflation, and the difference in thigh girth at 24 and 48 h after operation was decreased in group RH, and the range of motion of knees was significantly increased at 3 days and 3 months after operation, and the first postoperative off-bed time was shortened in group RH and group RL ( P<0.05). Compared with group RL, the range of motion of knees was significantly increased at 3 days and 3 months after operation, and the first postoperative off-bed time was shortened in group RH ( P<0.05). There was no significant difference in the incidence of responses to tourniquet, postoperative length of hospital stay, effective pressing times of the analgesic pump, postoperative consumption of sufentanil and flurbiprofen axetil, and the incidence of tourniquet-related complications in the early and long-term postoperative periods among the three groups ( P>0.05). No residual muscle relaxation was found during recovery from anesthesia in three groups. Conclusion:Rocuronium 1.2 mg/kg can reduce limb ischemia-reperfusion injury in the patients undergoing total knee arthroplasty.

Objective:To investigate the clinical efficacy of atomoxetine combined with cognitive-behavioral therapy (CBT) on children with attention deficit hyperactivity disorder (ADHD).Methods:Totally 104 children diagnosed with ADHD were randomly divided into atomoxetine group ( n=34), CBT group ( n=35) and atomoxetine combined with CBT group ( n=35). After 12 weeks of treatment, questionnaire-children with difficulties (QCD), Swanson child behavior checklist (SNAP-Ⅳ) and Conners parents rating scales (CPRS) were used to evaluate the efficacy and recorded the adverse reactions during the treatment. SPSS 23.0 software was used for statistical analysis. Paired sample t-test was used to compare the scores of the same group before and after treatment, and one-way ANOVA was used to compare the difference between the three groups after treatment. Results:(1)Compared with baseline, the score of QCD increased(32.96±3.01, 43.00±2.22) ( t=-13.35, P<0.01) , while the attention deficit(15.67±3.46, 6.07±1.73), hyperactivity/impulse(13.59±3.41, 7.30±2.43), opposition disobedience(9.85±3.98, 2.59±2.17) and total score(39.11±6.65, 16.59±3.91) of SNAP-Ⅳ decreased in atomoxetine combined with CBT group after treatment ( t=14.96, 10.87, 11.77, 21.49, all P<0.01). The factor scores of behavior problems(0.81±0.30, 0.70±0.26), learning problems(1.58±0.31, 0.32±0.13), psychosomatic disorders(0.22±0.25, 0.16±0.20), impulse hyperactivity(1.27±0.37, 0.71±0.18), anxiety(0.32±0.26, 0.23±0.17) and hyperactivity index(1.19±0.40, 0.79±0.22) of CPRS also decreased ( t=2.71, 21.23, 2.41, 8.87, 2.96, 6.19, all P<0.05) in atomoxetine combined with CBT group after treatment. (2) After treatment, the changes of QCD scores, attention deficit dimension in SNAP-Ⅳ scale, learning problems and impulse hyperactivity dimension in CPRS scale of the three groups before and after treatment were statistically significant (all P<0.05). (3) Post LSD comparison showed that the change in CBT group was significantly lower than that in atomoxetine group and atomoxetine combined CBT group in QCD score(both P<0.05). In the dimension of attention deficit of SNAP-Ⅳ, the difference in CBT group was significantly lower than that in atomoxetine combined CBT group ( P<0.01). In the learning problems and impulse hyperactivity dimensions of CPRS, the changes of atomoxetine combined with CBT group were significantly higher than those of atomoxetine group and CBT group (all P<0.01). Conclusion:Atomoxetine combined with CBT has better curative effect than atomoxetine or CBT alone in patients with ADHD. It can effectively improve the core symptoms and daily life function of ADHD children, and has high safety.

Objective:To construct a bowel preparation nursing guidance based on key point control theory and mind mapping in full abdominal enhanced CT examination to provide a basis for improving the intestinal preparation and image quality of intestinal patients.Methods:This was a randomized controlled trial, 104 patients were selected as the research subjects who underwent full abdominal enhanced CT examination in the Second Hospital of Shanxi Medical University from January to August 2022, and randomly divided into the control group and the intervention group by table of random numbers, 52 cases in each group. The control group was given routine nursing guidance, while the intervention group was given nursing guidance based on key-point control theory and mind mapping. Compare the differences in intestinal cleanliness, intestinal fullness and CT image quality between the two groups.Results:The proportion of patients with good intestinal cleanliness was 65.4% (34/52) in the intervention group, which was higher than 25.0% (13/52) in the control group ( χ2 = 22.32, P<0.01). The proportion of patients in the intervention group with grade I intestinal filling was 71.2% (37/52), which was higher than the 23.1% (12/52) in the control group ( χ2 = 27.76, P<0.01). The proportion of patients in the intervention group with excellent image quality was 80.8% (42/52), higher than 30.8% (16/52) in the control group ( χ2 = 28.56, P<0.01). The score of State Anxiety Inventory score of patients in the intervention group was (41.21 ± 5.08), lower than that of the control group (48.69 ± 6.40) ( t = 6.60, P<0.01). The satisfaction score of patients in the intervention group was 43.50(39.00, 46.00), which was higher than that of the control group 39.00(36.25, 43.00) ( Z = - 3.45, P<0.01). Conclusions:The bowel preparation nursing guidance based on key-point control theory and mind mapping can effectively improve bowel preparation of patients and the image quality of full abdominal enhanced CT examination.

OBJECTIVETo evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.

METHODSFive hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.

RESULTSBoth leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).

CONCLUSIONSLeflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.

Antirheumatic Agents ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Female ; Growth Inhibitors ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Isoxazoles ; adverse effects ; therapeutic use ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Middle Aged

Objective To scientifically measure the workload of basic public health services project on village level .Methods 257 village doctors and 24 public health administrators that work in rural health clinics in Qianjiang city ,Hubei province and Qianjiang distrcit ,Chongqing city were sampled ,with questionnaire survey and key informant in-depth interview methods used to screen basic public health service projects affordable on village level ,for workload measurement .Results 35 basic public health service projects were chosen as the measurement projects regarding their relative workload. Hypertension follow-up workload 100 was set as the benchmark ,finding the rest relative workload of other projects range from11～936 .Conclusions It is reasonable to use the relative value measurement based on RBRVS theory on village level basic public health service projects. Results of this study can offer support for the pricing and further dynamic modification of the basic public health service projects .