Objective: To evaluate the impact of loss of a spouse on self-rated health among middle-aged and elderly populations in China, so as to provide insights into health promotion among middle-aged and elderly populations with loss of a spouse. Methods: Based the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, married and separated individuals or individuals with loss of a spouse at ages of 45 years and older and with monthly household consumption of no less than 100 yuan were enrolled. Subjects' age, gender, educational levels, marital status, monthly household consumption, number of chronic diseases and self-rated health were collected. Subjects were classified according to loss of a spouse, and the impact of loss of a spouse on self-rated health was evaluated among middle-aged and elderly populations using propensity score matching (PSM). In addition, heterogeneity test was performed to evaluate the gender- and educational level-stratified impacts. Results: Totally 3 272 valid subjects were enrolled, including 1 618 men (49.45%) and 1 654 women (50.55%), and there were 512 subjects with loss of a spouse (15.65%). There were 656 subjects with very good self-rated health (20.05%), 622 with good health (19.01%), 1 534 with fair health (46.88%), 376 with poor health (11.49%) and 84 with very poor health (2.57%). There were 3 152 couples with successful nearest neighbor matching, and there was no significant difference between the subjects with and without loss of a spouse after adjustment for variables (P>0.05), while the overall fitting degree of the model was good following matching. PSM showed that the self-rated health became poor following loss of a spouse among middle-aged and elderly populations, with average treatment effect (ATT) of 0.055 to 0.061, and a remarkably negative effect of loss of a spouse on self-rated health was seen in women, with ATT of 0.192 to 0.223, while no remarkable effect was seen in men. Loss of a spouse showed a remarkably negative effect on self-rated health among individuals receiving junior and senior high educations, with ATT of 0.048 to 0.057, but presented no remarkable effect on self-rated health among individuals receiving primary educations. Conclusions Loss of a spouse presents a negative effect on self-rated health among middle-aged and elderly populations, and remarkably negative effects are seen among women and individuals receiving high educational levels.

Objective To study the therapeutical effect of glutathione(GL),a powerful antioxidant on the symptoms and ECG in patients with coronary heart disease and its mechanisms.Methods Eighty-five subjects with coronary heart disease were recruited(45 male and 40 female).The patients were randomized to receive GL (240 mg,ivgtt,qd,for 14 days,n=44)on the top of conventional treatment(aspirin+?-blocks+ACEI)or conven- tional treatement alone(control,n=41).The serum MDA,SOD,NO levels were determined.Electrocardio- graphy(ST stage,T wave)was examined.Results GL significantly improved clinical symptoms scores(2.0+0.5 vs control:1.5+0.5,P

Objective To evaluate the plasma level of amino-terminal pro-brain natriuretic peptide(NT-proBNP) before and after treatment in children with dilated cardiomyopathy (DCM) and explore the relationship between NTproBNP and heart functional classes.To evaluate the significance of dynamic change in NT-proBNP level in children with dilated cardiomyopathy.Methods The study comprised 49 children with DCM from Aug.2011 to Sep.2013 in Hunan Children's Hospital.NT-proBNP levels were measured before and after treatment.All the patients were evaluated under the modified Ross Heart Association functional class and echocardiographic determination of left ventricular ejection fraction(LVEF) and fractional shortening(SF).The patients were divided into improvement group(38 cases) and the non-improvement group(11 cases) according to cardiac function after treatment.Results The plasma level of NTproBNP was positively correlated with Ross heart failure classification (r =0.756,P ＜ 0.01),and much better than LVEF and SF.To identify mild heart failure,the cut-off value of 329 ng/L was 93.8％ sensitive and 90.9％ specific.To identify moderate heart failure,the cut-off value of 2 833 ng/L was 95.6％ sensitive and 92.9％ specific.To identify severe heart failure,the cut-off value of 12 125 ng/L was 80.6％ sensitive and 84.8％ specific.There was significant difference in the improvement group before and after treatment(t =2.357,P ＜ 0.05).In non-improvement group there was no significant difference (t =0.132,P =0.778) before and after treatment.Conclusions There is significant correlation between the plasma level of NT-proBNP and heart failure severity.The dynamic changes in NT-proBNP levels before and after treatment can help us to determine the effect of treatment and prognosis.

Objective To investigate the diagnostic and therapeutic experience in children with ulcerative colitis(UC) from clinical data.Met-hods The literature on UC in children publicated from 1995 to 2004 were retrieved by CBM,CNKI and VIP database.The clinical manifestations,X-ray,endoscopic and histologic features,management and prognosis of 172 patients in this hospital correspond with the inclusion criteria were retrospectively investigated and a definite diagnosis with UC was made.Results Of 172 patients,the ratio of maleold female was 1.07:1.0,and the age of patients ranged from 2 months to 15 years old.Thirty-six patients(36.7%)were less than 3 years-old;the course ranged from 3 days to 4 years.One patient had family history.The main manifestations were chronic diarrhea,mucus bloody stool,bloody purulent stool and abdominal pain.The systemic symptoms were fever,weight loss,malnutrition and anemia,no enteral symptoms and complications.The lesions were mainly seen in the whole colon with moderate to severe degree.The therapies based on salicylaxosulfapyridine(SASP) or 5-acetylsalicylic acid(5-ASA) together with corticosteroid in the short period have clinical remission in different levels.From long follow-up,the complete remittence was less than one third.Conclusions It is not rare to see UC in infantile.The clinical characteristics of UC in children are different from those in adults,the same is true before and after 3 year-old.The UC in children has high misdiagnosis and is difficult to manage.It is very necessary to establish a diagnostic and therapeutic guideline for children with UC in China.

Objective To investigate the effect of progesterone pretreatment of focal cerebral ischemic and reperfusion injury (fCIRI) and underlying molecular mechanisms.Methods A single intraperitoneal injection of progesterone (8 mg/kg) given 1 h,48 h and 96 h before fCIRI was established in male Sprague-Dawley rats.The number of survival of neurons in hippocampal CA1 region of the ischemiaside,as well as spatial memory function,was detected on days 3-8 after fCIRI.Extracellular-signalregulated kinase 1/2 phosphorylation (p-ERK1/2) and nuclear translocation of p-ERK1/2 in hippocampal CA1 region were examined using western blot.Results The number of survival of neuronal cells was significantly increased in ischemic groups treated with progesterone at 1 h and 48 h pre-fCIRI (164.3 ± 11.0,218.5 ± 9.1 and 142.7 ± 12.1,F =29.4,P ＜ 0.01) compared with fCIRI group treated with vehicle.Likewise,the escape-latency to reach the hidden-platform recorded in day 5 of Morris water maze test was reduced markedly in fCIRI-treatment groups compared with the vehicle group(10.3 ± 11.1,19.2 ±9.6 and 32.4 ± 14.3 ;F =35.8,P ＜0.01).The level of p-ERK1/2 was elevated notably during 24 h to 48 h postprogesterone by western blot,while restored to the baseline at 96 h post-progesterone.Improved nuclear translocation of p-ERK1/2 was observed from 2 h to 48 h post-progesterone.The progesterone receptor antagonist RU486 blocked the exaltation of either intracellular level or nuclear translocation of p-ERK1/2,which was induced by progesterone.Conclusions The pretreatment with progesterone exerts a neuroprotective effect against the ischemia-induced neuronal death and ameliorates the deficits in spatial memory through enhancing the activation of ERK1/2.The neuroprotection derived from pretreatment with progesterone achieves a time window of not less than 48 h,which is progesterone receptor-mediated ERK1/2 signaling pathway-dependent.

AIM:To optimize formulation of Xiao'er Magan Orally Disintegrating Tablet by central composite design-response surface methodology. METHODS:By two factors and five levels central composite design,independent variables were the proportion of optimized microcrystalline cellulose 50 and mannitol and the pressure,while disintegrating time and tensile strength were dependent variables. Binary linear and quadratic models were used to estimate the relationship between the dependent and the indepedent variables,and to delineate response surface method and overlay contour plots in order to select the optimal formulations. RESULTS:The binomial regression equation were TS =0. 096 88X1 + 0. 027 6X1X2(r = 0. 759),DT = 9. 845 4X1 -63. 196X2 + 40. 092 9X22 (r = 0. 838) which indicated the quantitative relationship between the factors and the evaluation indexes was characterized. The optimal formulation were the ratio of microcrystalline cellulose 50 and mannitol in the range of 0. 35 and 0. 6,and the pressure was in the range of 6 and 8 KN. CONCLUSION:The optimized formulation validation is close to the estimated value,indicating that the method has a good predictability and reliability.

BACKGROUND:Skin grafting is crucial for patients with deep burns, but limited source of autologous skin grafts is an existing difficulty.
OBJECTIVE:To investigate the effect of xenogeneic (porcine) acelular dermal matrix in the treatment of deep burn wounds and the feasibility of its application.
METHODS:Forty-one patients with deep burn were divided into two groups according to the intention of the patients, 21 cases in control group and 20 cases in observational group, folowed by autologous split-thickness skin grafting alone or combined with different (porcine) acelular dermal matrix, respectively. After 12 months of folow-up, the graft success rate at postoperative 1, 2, 3, 4 weeks and skin graft contraction rate and wound repair at postoperative 3, 6, 9, 12 months were observed and compared between two groups. Moreover, levels of inflammatory factors were detected and compared between two groups at postoperative 1, 2, 3 months.
RESULTS AND CONCLUSION: The skin graft success rates showed no difference between two groups at postoperative 1, 2, 3, 4 weeks (P > 0.05). The skin graft contraction rates also showed no difference between two groups at postoperative 3, 6, 9, 12 months (P > 0.05). After 12 months of folow-up, no serious scar hyperplasia, but soft texture appeared in the control group. In the observational group, three cases presented with local pigmentation at the early stage, but it gradualy subsided with time; no obvious scar, but only smal, point-like scar, was visible, and the repaired wound exhibited soft touch. No adverse events and death occurred in both two groups. Experimental results show that the treatment of deep burns with autologous split-thickness skin grafting combined with xenogeneic (porcine) acelular dermal matrix is safe and effective, which can improve the quality of wound healing.

[ ABSTRACT] AIM:To study the effect of thrombopoietin ( TPO) on chemical hypoxia-induced apoptosis of the Rattus norvegicus adrenal pheochromocytoma (PC12) cells.METHODS:The cultured PC12 cells were randomly divided into normal control group, cobalt chloride ( CoCl2 ) group, CoCl2 +TPO group and TPO group.The cell viability was mea-sured by MTT assay.The effect of TPO on CoCl2-induced cell apoptosis was analyzed by flow cytometry with Annexin V/PI double staining.The intracellular reactive oxygen species ( ROS) were detected by fluorescence microscopy, and the chan-ges of the mitochondrial membrane potential ( MMT) were determined by flow cytometry and fluorescence microscopy.RE-SULTS:Chemical oxygen agent CoCl2 significantly inhibited the growth of PC12 cells (P<0.01).The apoptotic rate in CoCl2 group was obviously higher than that in control group ( P<0.05) , while the apoptotic rate in CoCl2 +TPO group was obviously lower than that in CoCl2 group (P<0.05).TPO decreased the production of ROS, and inhibited the decrease in MMP induced by CoCl2(P<0.01).CONCLUSION: TPO has a protective effect against CoCl2-induced apoptosis of PC12 cells by decreasing the production of ROS and inhibiting the decrease in MMP.

AIM:To investigate the roles of ClC-3 chloride channels in the regulation of cell cycle and the re-lationship between ClC-3 chloride channels and the cell cycle regulators , such as cyclin D1, cyclin-dependent kinase (CDK)4, CDK6, P21 and P27 in the HeLa cells.METHODS:ClC-3 genes were silenced by the siRNA technique in the HeLa cells.The transfection efficiency of ClC-3 siRNA was detected by real-time PCR.The cell cycle distribution was ana-lyzed by the flow cytometry .The protein expression of ClC-3, P21, P27, CDK4, CDK6 and cyclin D1 was determined by Western blot .RESULTS:ClC-3 was knocked down by ClC-3 siRNA in the HeLa cells .Transfection of the cells with ClC-3 siRNA arrested the cells at G0/G1 phases, decreased the expression of cyclin D1, CDK4 and CDK6, and increased the expression of P21 and P27.CONCLUSION:ClC-3 plays an important role in the cell cycle of HeLa cells through the G 1-S transition point.ClC-3 may regulate the cell cycle progression by up-regulation of cyclin D1, CDK4 and CDK6 expression and/or by down-regulation of P21 and P27 expression.

Objective To compare proximal femoral nail(PFN)introduction by percutaneous K-wire through a small incision with conventional PFN introduction protocol in the treatment of intertrochanteric fractures. Methods From January 2004 to March 2005,51 patients with intertrochanteric fractures were randomly dis- tributed into a minimally invasive treatment group(group MI)and a conventional treatment group(group C).All the fractures were closely reduced.In group MI a K-wire was percutaneously inserted through the tip of the greater troehanter into the center of medullary canal of the pruximal femur before the PFN was inserted under the guidance of K-wire through a small incision made along the K-wire while in group C the PFN was introduced according to the conventional procedure.The operation time,intra-operative blood loss,length of incision,X-ray exposure,duration of in-patient stay and time of bone union in both groups were recorded and compared.Results The mean oper- ation time,mean intraoperative blood loss and mean length of incisions in group MI were 77.20 min,104.20 mL and 5.12 cm respectively and significantly lower than those in group C(P＜0.01).The X-ray exposure and the reduction time in group MI lasted longer than in group C(P＜0.01).The mean time of bone union and in-patient stay in both groups were nearly equal(P＞0.05).At the latest tollow-up,all the fractures united in both groups without nonuuion or delayed union.Conclusion Compared with the conventional protocol,introduction of PFN by a pereutaneuus K-wire inserted into the central medullary canal of the proximal femur is much more minimally in- vasive and effective.