Objective This study aimed to investigate the protective effects of ademetionine 1,4-butanedisulfonate (SMT) against radiation injuries.Methods ICR mice were randomly divided into 7 groups,including normal control,irradiation-only,SMT administration-only,low-,medium-and high-dosages (250,500,1 000 mg·kg-1) of SMT pre-irradiation and high-dose of SMT post-irradiation in experimental groups.Blood and immunological experiments,organs index experiment and 30-day''s survival experiment were carried out to observe the protective effects of SMT on peripheral blood and immune system,organ index and the whole body injuries.Results Compared with irradiation-only group (4.23±1.16) ×109·L-1,the number of nucleated cells in bone marrow was (11.20±4.63) ×109·L-1 in the high dose of SMT pre-irradiation.The difference between two groups was significant.Compared with irradiation-only group (19.25±9.36),the colony forming unit-spleen was (39.00±7.57) in the high-dose SMT pre-irradiation group,there was a significant difference between the two groups.The index of liver,spleen,kidney and pancreas were significantly higher than those of the irradiation-only group in SMT administration groups.The survival rate of mice treated with SMT was increased,especially for the high dose group (46% lifted) when compared with irradiation-only group.Conclusion SMT can protect mice from radiation injuries.

Objective To explore effects and potential mechanisms of high insulin environment on high density lipoprotein (HDL) generation-related functional protein ABCA1.Methods [3 H] labeled cholesterol efflux from mature 3T3-L1 adipocytes was detected by liquid scintillation counting.ABCA1 mRNA and protein expression in mature 3T3-L1 adipocytes post stimulation with various concentrations of insulin was detected by real-time fluorescence-based quantitative techniques and Western blot,respectively,in the absence and presence of CHX (cycloheximide,CHX),calpeptin (calpain pathway inhibitor) or MG-132 (proteasome pathway inhibitor).Results Cholesterol efflux rates were reduced post insulin stimulation in a dose-dependent manner ((7.06 ± 0.27) ％,(6.59 ± 0.30) ％,(6.34 ± 0.24) ％,(5.07 ± 0.40) ％,and (4.71 ±0.40)％ at 0,1,10,102,and 103 nmol/L of insulin,P ＜0.05).Cholesterol efflux rates decreased in a time-dependent manner post 103 nmol/L insulin stimulation (6.52 ± 0.30) ％,(5.59 ± 0.71)％,(5.44 ± 0.37)％,(4.52 ± 0.32)％,and (4.38 ± 0.33)％ at 0,2,4,6,12 h,respectively).ABCA1mRNA levels were not affected by insulin(P ＞ 0.05).ABCA1 protein level was significantly downregulated in 103 nmol/L insulin group compared to 0 nmol/L insulin group (P ＜ 0.01).Compared with the 0 h group,ABCA1 protein level was significantly reduced in 6 h group (P ＜ 0.05) and further reduced in 12 h group (P ＜ 0.01).Both calpeptin and MG-132 could partly reduce insulin-induced degradation of ABCA1.Compared with the negative control group,ABCA1 protein levels were significantly upregulated by cotreatment with calpeptin and MG-132,respectively (both P ＜ 0.01).Conclusion Our data suggest that high insulin level could promote the ABCA1 protein degradation and reduce cholesterol efflux from mature 3T3-L1 adipocytes through calpain and proteasome pathway,thus,produce a circumference not suitable for nascent HDL formation in 3T3-L1 adipocytes.

Objective To compare the effects of fixations with dynamic hip screw (DHS),percutaneous compression plate (PCCP) and proximal femoral nail anti-rotation (PFNA) for treatment of intertrochanteric femoral fractures with paries medialis defect.Methods We reviewed the 82 patients with femoral intertrochanteric fracture and paries medialis defect who had been treated at our department from January 2011 to July 2016.They were 42 men and 40 women,aged from 27 to 91 years (average,73.0 years).According to the AO classification,72 cases belonged to type 31-A2.2,10 to type 31-A2.3.Of them,9 cases were treated with DHS,17 cases with PCCP and 56 cases with PFNA-1].The 3 groups were compared in terms of intraoperative blood loss,blood infusion,fluid infusion,operation duration,time for fracture union,postoperative complications and Functional Recovery Score (FRS) of the hip 12 months after operation.Results The fluid infusion [1,100 (850,1,100) mL] and intraoperative blood loss [60 (5,100) mL] in the PCCP group were significantly less than in the PFNA group [1,100 (1,000,1,700) mL and 150 (50,300) mL] and the operation duration (91.4 ± 29.2 min) in the former was significantly shorter than in the latter [121 (85,185) min] (P ＜ 0.05).No significant difference was found between the 3 groups in blood infusion (P ＞ 0.05).Of the patients,57 (8 DHS,12 PCCP and 37 PFNA ones) were followed up for an average of 47 months (from 15 to 85 months).There were no statistically significant differences between the 3 groups in time for fracture union,complications,or average FRS score of the hip 12 months after operation (P ＞ 0.05).Conclusions For unstable intertrochanteric fractures with paries medialis defect,it is not clear that intramedullary nails are superior to extramedullary fixation.Intramedullary nails like PFNA may be suggested for patients with better preoperative conditions while extramedullary fixation like PCCP suggested for those with poor general conditions.

Objective To evaluate the tonic and health effects of Xuebijing injection,a traditional Chinese medicine injection,by means of corn low-nutritional mice model combined with benefit-damage index-general score (BDI-GS) evaluation system under a physiological dosage.Further,to investigate the scientific and practical benefits of the evaluation system in efficacy and safety re-evaluation of clinical traditional Chinese medicine injections.Methods Healthy ICR mice during growth period were randomly divided into blank control group and low,middle and high dose groups.All the mice were fed with corn diets,and treated by intraperitoneal injection once a day.The mice in the blank control group were injected with 0.4 ml 0.9％ sodium chloride injection,and the mice in the low,medium and high dose groups were injected with 0.2,0.4 and 0.6 ml Xuebijing injection,respectively,for seven days.On the 8th day,the mice were killed,dissected,and took nine kinds of organs including heart,lung,thymus,spleen,pancreas,kidney,gonad and femur.The weight BDI,index BDI and the corresponding weight BDI general score (GSw) and index BDI general score (GSI) were calculated,and the serum biochemical parameters were measured.Results Under the physiological dose,Xuebijing injection shows good safety of continuous infusion,tonic and health effects,and slight damages on the rest of organs.More specifically,the values of weight BDI and index BDI were all higher than 9.0,and values of GSw and GSI were all higher than the basic value of 9.0.Furthermore,these parameters increased in a dose-dependent manner.In addition,the total protein level of (47.6 ± 4.30) g/L in the high dose groups was significantly higher than (43.18 ± 2.60) g/L in the blank control group (P＜0.05).Conclusions The Xuebijing injection has a lower risk for conventional usage.This injection is safe under the physiological dosage and much safer in higher dosage designed in this study.The low-nutritional model combined with BDI-GS evaluation system can be used for re-evaluating the function and safety of clinical traditional Chinese medicine injections.

Objective:To evaluate the efficacy and safety of oral semaglutide versus sitagliptin in Chinese patients with type 2 diabetes mellitus(T2DM) inadequately controlled with metformin. Methods:The PIONEER 12 study was a phase Ⅲ clinical trial. Chinese patients were prospectively randomized to oral semaglutide(3mg, 7 mg, and 14 mg) or sitagliptin 100 mg. The primary endpoint was the change in HbA 1C from baseline to week 26, and the confirmatory secondary efficacy endpoint was the change in body weight from baseline to week 26. Results:Totally 1 084 Chinese participants(mean age 53 years, male 62.2%, mean duration of diabetes 5.5 years, HbA 1C 8.2%, and body weight 74.3 kg) were enrolled. The changes in HbA 1C at week 26 from baseline were -0.9%, -1.4%, and -1.6% for oral semaglutide 3 mg, 7 mg, and 14 mg, respectively, and -0.7% for sitagliptin. Compared to sitagliptin, oral semaglutide 3 mg, 7 mg, and 14 mg significantly reduced HbA 1C [estimated treatment difference(ETD), -0.2%(95% CI -0.4--0.0), -0.8%(95% CI -0.9--0.6), and -0.9%(95% CI -1.1--0.8), respectively; 3 mg, P=0.011, 7 mg and 14mg, P<0.001]. The estimated mean changes in body weight at week 26 from baseline were -1.1 kg, -2.5 kg, and -3.4 kg for oral semaglutide 3 mg, 7 mg, and 14 mg, respectively, and -0.4 kg for sitagliptin 100 mg. Compared with sitagliptin, oral semaglutide 3 mg, 7 mg, and 14 mg significantly reduced body weight [ETD, -0.8 kg(95% CI -1.3--0.2), -2.1 kg(95% CI -2.6--1.6), and -3.0 kg(95% CI -3.5--2.5), respectively; 3 mg, P=0.004, 7 mg and 14 mg, P<0.001]. The overall incidence of adverse events was similar across all treatment groups. The most common adverse events were gastrointestinal disorders, mostly mild or moderate in severity and transient in duration. Conclusions:Oral semaglutide resulted in significantly greater reduction in HbA 1C and body weight versus sitagliptin at week 26, with a favorable safety and tolerability profile in Chinese T2DM patients inadequately controlled with metformin.

Objective:To understand the status quo of nutrition knowledge, attitude and behavior of nurses in class A tertiary hospital and its influencing factors, and to provide reference for the development of reasonable and standard nutrition training courses.Methods:The knowledge, attitude and behavior of nutrition of 207 nurses in 28 class A tertiary hospitals from 17 provinces cities on October 25-26, 2019 were investigated Questionnaire on Nutritional Knowledge, Attitude and Behavior Cognition of Nurses.Results:The scores of nurses′ nutritional knowledge, attitude and behavior were (69.70 ± 2.92), (82.76 ± 4.97) and (64.90 ± 4.77) respectively. There were significant differences in nurses′ nutritional knowledge, attitude and behavior at different ages, nursing ages, whether they had children, the highest educational background, department rotation, technical titles, administrative positions, employment methods, article publication, whether they had participated in nutrition training courses and in different regions ( F values were 6.80-60.95, t values were 2.94-7.08, all P<0.05). The main factors affecting nutrition knowledge were region, nursing age, the highest educational background, department rotation and whether they had participated in nutrition training courses ( t values were -6.88-6.73, all P<0.05). The main factors affecting nutritional attitude were region, nursing age and the highest educational background ( t=-2.22, 6.84, 3.21, all P<0.05). The main factor affecting nutritional behavior was nursing age ( t=5.45, P<0.05). Conclusions:Nurses′ nutritional attitude level is excellent, but their mastery of nutritional knowledge and nutritional nursing behavior level need to be improved. Reasonable, scientific and feasible nutritional training courses should be formulated according to the influencing factors of their nutritional knowledge, attitude and behavior, so as to improve nurses′ nutritional knowledge, belief and behavior level and improve the nutritional status and prognosis of hospitalized patients.

Objective To explore the path and methods of deeply integrating party building with professional routine work in public hospitals through the creating of party building brands.Methods Taking the establishment of grassroots party brand in a hospital in shanghai as an example,using the brand creation as a starting point,we build a carrier,in order to explore the positive effect of Party building brand's creating on the integration and development of grass-roots Party building and profes-sional routine work in public hospitals.Results Through brand creation,the party building alliance was formed.The core unit was created to play a radiating role of the regional medical center,and a system disease was used as a breakthrough for the inte-gration of party building and professional routine work,where party building pays a great role in promoting business development.Conclusion As a carrier,Party building brand can play a leading role in Party building,deeply integrating Party building of governmental hospitals and medical work,thereby,improving the effectiveness of Party building and promoting high-quality devel-opment of public hospitals under the guidance of Party building.

Objective:To prepare the chitin/hyaluronic acid/collagen hydrogel loaded with mouse adipose-derived stem cells and to explore its effects on wound healing of full-thickness skin defects in rats.Methods:The research was an experimental research. Chitin nanofibers were prepared by acid hydrolysis and alkaline extraction method, and then mixed with hyaluronic acid and collagen to prepare chitin/hyaluronic acid/collagen hydrogels (hereinafter referred to as hydrogels). Besides, the hydrogels loaded with mouse adipose-derived stem cells were prepared. Thirty male 12-week-old guinea pigs were divided into negative control group, positive control group, and hydrogel group according to the random number table, with 10 guinea pigs in each group. Ethanol, 4-aminobenzoic acid ethyl ester, or the aforementioned prepared hydrogels without cells were topically applied on both sides of back of guinea pigs respectively for induced contact and stimulated contact, and skin edema and erythema formation were observed at 24 and 48 h after stimulated contact. Adipose-derived stem cells from mice were divided into normal control group cultured routinely and hydrogel group cultured with the aforementioned prepared hydrogels without cells. After 3 d of culture, protein expressions of platelet-derived growth factor-D (PDGF-D), insulin-like growth factor-Ⅰ (IGF-Ⅰ), and transforming growth factor β 1 (TGF-β 1) were detected by Western blotting ( n=3). Eight male 8-week-old Sprague-Dawley rats were taken and a circular full-thickness skin defect wound was created on each side of the back. The wounds were divided into blank control group without any treatment and hydrogel group with the aforementioned prepared hydrogels loaded with adipose-derived stem cells applied. Wound healing was observed at 0 (immediately), 2, 4, 8, and 10 d after injury, and the wound healing rate was calculated at 2, 4, 8, and 10 d after injury. Wound tissue samples at 10 d after injury were collected, the new tissue formation was observed by hematoxylin-eosin staining; the concentrations of interleukin-1α (IL-1α), IL-6, IL-4, and IL-10 were detected by enzyme-linked immunosorbent assay method; the expressions of CD16 and CD206 positive cells were observed by immunohistochemical staining and the percentages of positive cells were calculated. The sample numbers in animal experiment were all 8. Results:At 24 h after stimulated contact, no skin edema was observed in the three groups of guinea pigs, and only mild skin erythema was observed in 7 guinea pigs in positive control group. At 48 h after stimulated contact, skin erythema was observed in 8 guinea pigs and skin edema was observed in 4 guinea pigs in positive control group, while no obvious skin erythema or edema was observed in guinea pigs in the other two groups. After 3 d of culture, the protein expression levels of PDGF-D, IGF-I, and TGF-β 1 in adipose-derived stem cells in hydrogel group were significantly higher than those in normal control group (with t values of 12.91, 11.83, and 7.92, respectively, P<0.05). From 0 to 10 d after injury, the wound areas in both groups gradually decreased, and the wounds in hydrogel group were almost completely healed at 10 d after injury. At 4, 8, and 10 d after injury, the wound healing rates in hydrogel group were (38±4)%, (54±5)%, and (69±6)%, respectively, which were significantly higher than (21±6)%, (29±7)%, and (31±7)% in blank control group (with t values of 3.82, 3.97, and 4.05, respectively, Pvalues all <0.05). At 10 d after injury, compared with those in blank control group, the epidermis in wound in hydrogel group was more intact, and there were increases in hair follicles, blood vessels, and other skin appendages. At 10 d after injury, the concentrations of IL-1α and IL-6 in wound tissue in hydrogel group were significantly lower than those in blank control group (with tvalues of 8.21 and 7.99, respectively, P<0.05), while the concentrations of IL-4 and IL-10 were significantly higher than those in blank control group (with tvalues of 6.57 and 9.03, respectively, P<0.05). The percentage of CD16 positive cells in wound tissue in hydrogel group was significantly lower than that in blank control group ( t=8.02, P<0.05), while the percentage of CD206 positive cells was significantly higher than that in blank control group ( t=7.21, P<0.05). Conclusions:The hydrogel loaded with mouse adipose-derived stem cells is non-allergenic, can promote the secretion of growth factors in adipose-derived stem cells, promote the polarization of macrophages to M2 phenotype in wound tissue in rats with full-thickness skin defects, and alleviate inflammatory reaction, thereby promoting wound healing.

Objective To observe the effects of folic acid(FA)supplementation on the expression of Flotillin-1 and β-amyloid protein(Aβ)-metabolism-related proteins in the brains of inflammation-stimulated Alzheimer's disease(AD)mice.Methods Twenty-seven 6-month-old male APP/PS1 mice were randomly divided into AD,AD+LPS,and AD+LPS+FA groups,with nine mice in each group.Nine C57BL/6J male mice born within the same month were used as the Control group.The AD+LPS+FA group was given folic-acid-supplemented feed(8 mg/kg)for 3 months of intervention,while the other three groups were fed normal feed.Lipopolysaccharide solution(LPS,250 μg/(kg·d))was injected intraperitoneally into mice in the AD+LPS and AD+LPS+FA groups 1 week before the end of the experiment,and saline was injected into the remaining two groups.The serum inflammatory factors TNF-α and IL-6 levels and brain tissue Aβ1-40 and Aβ1-42 levels of mice in each group were detected by ELISA.Flotillin-1 protein expression in brain tissue was detected using Western blot,and the co-expression of Flotillin-1 and Aβ1-42/APP/PS1/BACE1 in the cortical region of the brain was detected via immunofluorescence double-labeling.Results After ANOVA analysis,we found mice in the AD group had elevated serum TNF-α and IL-6 levels(P＜0.05),elevated levels of Aβ1-40 and Aβ1-42(P＜0.05),increased expression of Flotillin-1 protein(P＜0.05),and increased co-expression of Flotillin-1 and Aβ1-42/APP/PS1/BACE1 in the cortical brain tissue(P＜0.05)compared with the Control group.Compared with mice in the AD group,those in the AD+LPS group had further increases in serum inflammatory factors and Aβ levels in the brain(P＜0.05)and increased co-expression of Flotillin-1 and Aβ1-42/APP/BACE1 double-labeled proteins in their cortical brain tissue(P＜0.05).Compared with mice in the AD+LPS group,those in the AD+LPS+FA group had lower in vivo inflammation levels and Aβ content in the brain(P＜0.05),lower brain tissue Flotillin-1 protein expression(P＜0.05),and lower Flotillin-1 and Aβ1-42/APP/PS1/BACE1 protein co-expression in cortical brain tissue(P＜0.05).Conclusions Folic acid supplementation may reduce Flotillin-1 protein expression and Aβ deposition in the brain of AD inflammatory mice.

Objective:To investigate the prognostic value of 18F-fluorodeoxygen-D-glucose-positron emission tomography /computerized tomography ( 18F-FDG-PET-CT) in Hodgkin′s lymphoma (HL) at the end of first-line treatment (PET-end), by comparing the ratio of maximum standardized uptake value (SUV max) of lesion and liver SUV (rLL), SUV max reduction between baseline PET (PET-0) and PET-end (ΔSUV max), and Deauville 5-point scale (5-PS). Methods:Patients with HL newly treated in our hospital from August 2006 to December 2015 were retrospectively analyzed. All the patients enrolled in the study underwent post-treatment FDG PET-CT. The rLL and ΔSUV max were calculated, and all the cases were scored using Deauville 5-PS. The receiver operating characteristic (ROC) approach was applied to identify the optimal cut-point value, and survival curves according to different PET-CT assessment methods were estimated using the Kaplan-Meier analysis. The prognostic efficacy of different PET-CT assessment methods was compared, and DeLong test was used to verify it. Kaplan-Meier method and multivariate analysis using the Cox proportional hazards model were performed to analyze the potential independent risk factors. Results:There were 5 patients progressed within a 3-year follow-up. In the three PET-CT assessment methods, the predictive value of rLL and Deauville 5-PS were significant effective. ROC analysis for rLL as a progression predictor showed an optimal cut-point of 1.29. Deauville 5-PS=4 and rLL=1.29 showed the best prognostic accuracy. The sensitivity of rLL and Deauville 5-PS were both 80.0%, and the specificity of each was 98.0% and 93.7%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of rLL were 66.7% and 98.7%, while the PPV and NPV of 5-PS were 44.4% and 98.7%. The 3-years progression-free survival (PFS) rates of rLL≥1.29 group and rLL<1.29 group were 33.3% and 98.7%, with significant difference ( P<0.001). The 3-years PFS rates of post-treatment Deauville 5-PS<4 group and Deauville 5-PS≥4 group were 98.7% and 55.6%, with significant difference ( P<0.001). The prognostic evaluation efficacy of rLL was positively correlated with that of Deauville 5-PS ( r=0.75, P<0.05). Area under curves (AUC) of rLL and Deauville 5-PS were 0.93 (95% CI: 0.825-1.000) and 0.91 (95% CI: 0.757-1.000), respectively. DeLong test showed the significant difference between the two methods ( P<0.05). The univariate analysis results showed that clinical baseline stage, post-treatment rLL and Deauville 5-PS were associated with the prognoses of HL patients ( P<0.05). The multivariate analysis results showed that post-treatment rLL and Deauville 5-PS were independent prognostic factors of HL ( P<0.05). Conclusions:The rLL and Deauville 5-PS are potential prognostic factors for HL response assessment. The new semi-quantitative method rLL has methodological advantages over visual analysis, and it is a good supplement for Deauville 5-PS. rLL can improve prognostic evaluation accuracy of PET-CT and is useful to early identify patients with HL at a high risk of relapsing after first-line treatment.