Objective To investigate the efficiency of ultrasound microbubble-mediated HGF gene transfer on liver fibrosis in rats. Methods The eukaryotic expression vector pMD18-T/HGF was constructed. The rats were randomly divided into 5 groups: normal group, model group, low dose group,middle dose group and high dose group. The rat liver fibrosis were induced. At day 14 after treatment, the rats were sacrificed, the ALT lever were evaluated, pathological evaluation of liver fibrosis were made,immunohistochemical evaluation of HGF protein expressions were observed, HGF mRNA expression were detected by RT-PCR. Results Liver 1function after the treatment showed that the treatment groups were better than model group ( P ＜ 0. 05). The difference between low dose group and normal group showed significant difference ( P ＜0.05), and the difference between middle/high dose groups and normal group showed no significant ( P ＞0. 05). Pathological results showed that the treatment groups could reduce liver fibrosis;treatment groups had the positive HGF expression by immunohistochemistry and the expression level increased with the increasement of the treatment dose ( P ＜0.05). RT-PCR showed HGF mRNA expression in the treatment groups were higher than in model group ( P ＜0.05). Conclusions Ultrasound microbubbles which carrying HGF can inhibit the process of hepatic fibrosis.

OBJECTIVE: To investigate the dynamic trends of activities of matrix metalloproteinase (MMP)-2/9 and protein expressions of their inhibitors-tissue inhibitor of matrix metalloproteinase (TIMP)-1/2 during the progression of pulmonary fibrosis in rats so as to get insight of the roles played by MMP-2/9 in lung injury and fibrogenesis. METHODS: Forty-eight SD rats were randomly divided into normal control group (n=18) and bleomycin (BLM)-treated group (n=30). The pulmonary fibrosis was induced by intratracheal injection of BLM once. At the consecutive time of 1 day, 3 days, 1 week, 2, 3, and 4 weeks after intoxication, the lung-to-body weight ratio was calculated and the inflammation and collagen deposition in lung tissue were checked by HE and Masson stainings respectively. Meanwhile, the content of hypdroxyproline (Hyp) in lung tissue was assayed with Jamall's method, the protein expressions of MMP-2/9, TIMP-1/2 were examined by Western blotting, and the activities of MMP-2/9 were detected by gelatin zymography. RESULTS: The histopathological changes in lung tissue in the BLM-treated group from 1 day to 2 weeks after intoxication presented local lesions, broadened alveolar wall and septum, infiltration with lots of inflammatory cells and few of fibroblasts inside alveolar space and septum. At this early stage in the BLM-treated group, the lung-to-body weight ratio was increased significantly, the protein expressions and activities of MMP-2/9 were obviously increased especially for activity of active MMP-2, and the protein expressions of TIMP-1/2 were also increased gradually, as compared with those in the normal control group. From 3 to 4 weeks after intoxication in the BLM-treated group, the alveolar structure was damaged, parts of the alveolar space collapsed and replaced by collagens and fibroblasts, and the alveolar wall and septum obviously widened with remarkable fibrotic characteristics, as compared with those in the normal control group. Meanwhile, the lung-to-body weight ratio and the activities of MMP-2/9 were decreased in the BLM-treated group as compared with those in the same group at 2 weeks after intoxication, but the content of Hyp and the protein expressions of TIMP-1/2 were both increased dramatically, especially at 4 weeks after intoxication. CONCLUSIONS: During the lung fibrogenesis induced by BLM in rats, the alveolar inflammation is the most important alteration with enhanced MMP-2/9 activities in the early stage. While in the late stage, the main change is displayed as pulmonary fibrosis, characterized by increased TIMP-1/2 and declined MMP-2/9 activities.

BACKGROUND: Our study was to investigate the prevalence of carbapenemase genes in strains of Enterobacteriaceae species exhibiting decreased susceptibility to carbapenems in our hospital. METHODS: The carbapenemase producing Enterobacteriaceae species were confirmed by modified Hodge test (MHT) and EDTA-disc synergy test which indicating the production of class B carbapenemases. PCR and sequencing analysis were used to identify the drug-resistant genes. DNA fingerprinting based on enterobacterial repetitive intergenic consensus (ERIC)-PCR was applied to investigate the homology of Enterobacteriaceae species. RESULTS: From a collection of 1,472 Enterobacteriaceae species, 18 isolates with decreased susceptibility to carbapenem treatment were identified and 9 of which were positive by MHT, and 6 of which produced class B carbapenemases. PCR and sequencing analysis of the 18 isolates revealed 4 different carbapenemase genes (blaIMP-8, blaoxa-1, blaIMP-26, and blaoxa-47) in 10 isolates, with the blaIMP-8 and blaoxa-1 genes being the most common (60-70% prevalence). ERIC-PCR showed 5, 2, and 2 unique genotypes for Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae, respectively. Three E. coli strains isolated from different patients from the urologic surgery department exhibited the same DNA banding pattern, suggesting a possible clonal dissemination. Majority (17/18) of the carbapenem-unsusceptible Enterobacteriaceae species isolates was obtained from the surgery department of our hospital. CONCLUSIONS: The main carbapenemase genes of Enterobacteriaceae species in our hospital were blaIMP-8 and blaoxa-1. Prevalence of carbapenem resistance may be existed in surgery department and infection control should be taken for preventing further dissemination of drug-resistant strains.
Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/*genetics ; Carbapenems/*pharmacology ; China ; DNA Fingerprinting ; Drug Resistance, Bacterial/drug effects/genetics ; Enterobacteriaceae/*drug effects/*enzymology/isolation & purification ; Enterobacteriaceae Infections/microbiology ; Genotype ; Hospitals, University ; Humans ; Microbial Sensitivity Tests ; Sequence Analysis, DNA ; beta-Lactamases/*genetics

Objective:To construct a "Five-in-one" blended teaching model in the course of fundamental nursing with ideological and political education as the core, integrated with online and offline, and complemented with theory and experiment, and to explore its application effect.Methods:Eight classes of nursing undergraduates in Batch 2019 were selected through convenience sampling method, and through random cluster sampling, Class 5 to 8 were divided into control group and Class 1 to 4 were divided into experimental group. The control group used the traditional teaching method, the experimental group used the "Five-in-one" mixed teaching model. After the course, the teaching effect was evaluated by the professional commitment scale, the recessive truancy scale for college students, the self-regulated learning ability scale and the examination results. SPSS 23.0 software was used for t test. Results:After teaching, the scores of professional commitment, self-adjustment in recessive truancy, autonomous learning ability and examination results of the experimental group were higher than those of the control group [(91.30±10.38) vs. (87.31±16.40), (23.30±4.50) vs. (21.23±4.51), (82.31±10.06) vs. (79.42±9.79), (72.31±10.13) vs. (70.14±9.67) and (87.93±4.60) vs. (86.50±4.67), respectively]. The scores of academic cognition, learning habit, classroom cognition and learning environment in recessive truancy of the experimental group were lower than those in control group, with statistical significance.Conclusion:The application of "Five-in-one" blended teaching model in the course of fundamental nursing can reduce students' recessive truancy and improve their professional commitment, autonomous learning ability and academic achievement.

Objective:To investigate the application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.

Pathophysiology is a comprehensive subject, which is very important to cultivate the clinical comprehensive thinking of medical students. Pathophysiology involves a wide range of subjects and contents, and is one of the major and difficult courses in basic medicine. Based on many years of research and practice, we have developed main-line-problem-based learning (ML-PBL). ML-PBL is a diversified teaching mode, including the main line teaching method, clinical case discussion method, and the main line synopsis explaining method. The analysis of application results shows that ML-PBL teaching improves the student performance. Furthermore, ML-PBL is more conducive to cultivating the comprehensive clinical thinking ability, improving the independent learning ability, and fully mobilizing the learning initiative.

Objective:To investigate the manifestations of liver injury in hospitalized patients with coronavirus disease 2019 (COVID-19), to investigate the prognosis indicators of the disease, and to provide the reference for clinical diagnosis and treatment.Methods:From January 10 to February 14, 2020, at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, the data of 333 hospitalized patients with COVID-19 were collected. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil) and albumin of the first liver function test after admission and the reexaminations of liver function test during hospitalization period in patients with liver injury were retrospectively analyzed. Student t test and Chi-square test were used for statistical analysis. Results:Liver injury occurred in 39.6% (132/333) of COVID-19 patients. There was no statistically significant difference in the rate of liver injury between patients in intensive care unit (ICU) and in general ward (45.6%, 26/57 vs. 38.4%, 106/276; χ2=1.026, P>0.05). 67.4% (89/132) of COVID-19 patients with liver injury presented with increased ALT or AST level on admission. During hospitalization, the level of ALT was higher than that of the first examination after admission ((60.28±50.44) U/L vs. (42.25±32.21) U/L), and the difference was statistically significant ( t=-3.230, P<0.05). The levels of ALT and AST of 71.2% (94/132) patients were both <80 U/L, which indicated that most of the patients showed mild liver injury. The patients with elevated level of TBil, DBil and IBil accounted for 3.9% (13/333), 5.4% (18/333) and 2.4% (8/333) of the COVID-19 patients, respectively. The albumin level of COVID-19 patients with liver injury during hospitalization was lower than that of the first examination after admission ((31.8±5.1) g/L vs. (33.7±5.4) g/L), and the difference was statistically significant ( t=2.712, P<0.05). The albumin levels at first examination on admission and reexamination during hospitalization of patients in ICU were both significantly lower than those of patients in general ward ((29.3±3.7) g/L vs. (34.8±5.1) g/L and (27.6±2.8) g/L vs. (32.9±5.1) g/L), and the differences were statistically significant ( t=4.928 and 4.783, both P<0.05). Conclusions:The incidence of liver injury in COVID-19 patients is high. A slight increase in aminotransferase levels is particularly common. Bilirubin abnormality is relatively rare and mild. The level of albumin may be one of the indicators for the severity and prognosis of COVID-19.

BACKGROUNDSelf-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health, yet numerous cultural, economic and health factors can reduce SMBG. Most studies on SMBG adherence have come out of the US and Europe, and their relevance to Asia is unclear. The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.

METHODSIn this multi-center, cross-sectional study, 5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics, education level, occupation, income, lifestyle risk factors, duration of diabetes, chronic complications, and frequency of SMBG. Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months. The most recent values for fasting plasma glucose, 2-hour postprandial blood glucose and HbA1c were recovered from medical records.

RESULTSOnly 1 130 respondents (18.98%) performed SMBG with the recommended frequency, while 4 823 (81.02%) did not. In fact, nearly 2 105 (35.36%) reported never performing SMBG. In the subset of 3 661 individuals on insulin therapy, only 266 (7.27%) performed SMBG at least once a day, while 1 210 (33.05%) never performed it. In contrast, 895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it. Multivariate Logistic regression identified several factors associated with SMBG adherence: female gender, higher education level, higher income, longer T2D duration and education about SMBG.

CONCLUSIONSSMBG adherence in our Chinese population with T2D was less frequent than that in developed countries. Several factors influence SMBG adherence: gender, education level, income, T2D duration, therapy regimen and exposure to education about SMBG.

Adult ; Blood Glucose ; metabolism ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; blood ; Female ; Humans ; Male ; Middle Aged

BACKGROUNDInsulin injection therapy is one of the most effective treatments for type 2 diabetes mellitus (T2DM). Many people with T2DM in western countries resist starting insulin therapy; whether the same is true in China is unknown. This survey-based study assessed acceptance and rejection of insulin therapy among individuals with T2DM in China and self-reported reasons for these therapy choices. It also examined what methods may be useful for increasing the rate of insulin acceptance.

METHODSA multi-center, cross-sectional survey was conducted between April and July 2010 to a convenience sample of inpatients and outpatients at 50 medical centers across 29 administrative divisions in China. Data were collected on sociodemographic and T2DM characteristics, therapy regime, and attitudes toward insulin therapy.

RESULTSA total of 6 043 patients were surveyed, and 5 961 complete questionnaires (98.6%) were used in the analysis. Just over half the respondents (3 460, 58.0%) reported negative attitudes to insulin therapy, including 2 508 of the 4 469 patients (56.1%) whose physicians had recommended it to them. Of the patients counseled to use insulin, 800 (17.9%) were unwilling to start therapy and cited the following reasons: inconvenience (64.3%); concerns over addiction (24.6%); pain (14.3%); side effects (14.1%); and high cost (13.6%). Logistic regression suggested that respondents would be more willing to undertake insulin therapy if they had received diabetes education, had positive attitudes to the treatment, had higher glycosylated hemoglobin level, or had suffered diabetes for a longer period or with more complications.

CONCLUSIONSPatients with T2DM in China are often resistant to insulin therapy if they have been diagnosed with the disease for a relatively short time or if the disease has been relatively mild. Educating patients on the benefits of insulin therapy, not only at the initial diagnosis with T2DM but also when insulin therapy becomes necessary, will likely increase their willingness to undertake it.

China ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; drug therapy ; Female ; Humans ; Insulin ; therapeutic use ; Male ; Middle Aged ; Patient Acceptance of Health Care ; statistics & numerical data ; Surveys and Questionnaires

Objective: Through research on the geriatric nursing related literature in Chinese journals and medical care and elderly care combination related keywords from 1979 to 2017, this study provides the development trend of geriatric nursing research. Methods: Searching articles in Wanfang, CNKI, VIP database, selecting the keywords and published time of the paper. Employing descriptive statistics to describe literatures information such as publication time, quantity of keywords, word frequency of keywords, heat degree of keywords, character of keywords and so on. Results: Totally 134 791 articles were got and 58 031 articles were included in the analysis. The amount of literature growth was slow before 2005, The cumulative amount of literature in 1979-2005 was only 12.75% of the total amount of literature. After 2005, the amount of literature increased rapidly year by year. The number of literature published in 2017 has exceeded 12%. The amount of the geriatric nursing related literature was proportional to the number of people aged 65 and over in China. In the research of geriatric nursing, the content related to medical care and elderly care combination was quite dispersed, and it did not involve research at the level of Medical Association. The medical care and elderly care combination and Medical Association were new areas in the research of geriatric nursing. Conclusion The amount of the geriatric nursing related literature from 1979 to 2017 was proportional to the number of people aged 65 and over in China. There are few researches on how to carry out geriatric nursing under the policy of medical care and elderly care combination and Medical Association, which should be the focus of future research and exploration to actively respond to the challenge of aging population.