The non-alkaloid chemical constituents of dried Phellodendron chinense barks were investigated. A total of 14 phenolic compounds (1-14) were isolated from the 95% ethanol extract of Phellodendron chinense by the utilization of silica gel, medium pressure liquid chromatography, Sephadex LH-20 column chromatography, and preparative liquid chromatography. Among of the isolated compounds, isophellolactone (1) was identified as a new compound. The isolated 14 compounds were further tested the activity on α-glucosidase inhibition. The results for the first time demonstrated that quininic acid ester 3-6 and 8 exhibited good α-glucosidase inhibitory activity. Polyhydroxy hexa-membered carbon ring in quinine ester derivatives is possibly the essential group for the α-glucosidase inhibitory activity.

Objective To investigate the therapeutic effect of CTLA4Ig gene on experimental autoimmune thyroiditis (EAT) by the use of portable synthetic costimulatory molecules of cytotoxic T lymphocyte antigen 4 (CTLA-4) antagonist (CTLA4Ig) eukaryotic expression vector.Methods Thirty C57BL/6J female mice were divided into three groups,named EAT model group (EAT,n =10),CTLA4Ig-treatment group (CTLA4Ig-EAT,n =10) and control group(n =10).At 28 day after first immunization,plasmids mixture with pCI or pCI/CTLA4Ig were injected into thyroid tissues of EAT and CTLA4Ig-EAT by surgery,respectively.Serum,thyroid tissues and spleens were collected as samples.Thyroid autoantibody and expression of interleukin (Th)1,Th2 related cytokinesby were measured by real-time quantitative PCR and ELISA.Results Compared with EAT group,the expression of CTLA-4 in thyroid of CTLA4Ig-EAT group was elevated double folds (P =0.038),and the expression of Th1 cytokine interferon γ and intercellular adhesion molecule-1 decreased significantly (P =0.016,0.042).Meanwhile,Th2 cytokine IL-4 was increased after CTLA4Ig treatment (P =0.044).The same changes were seen in spleen tissues and serum.There was no significant difference in terms of TPOAb between EAT and treated group.Conclusion Local thyroid injection of CTLA4Ig gene shows the therapeutic effect to same degree on EAT through adjusting the underlying Th1/Th2 imbalance.

Objective To investigate the potential role of T follicular helper cells (Tfh) in the pathogenesis of autoimmune thyroid diseases by comparing the expression of C-X-C chemokine teceptor type 5 (CXCR5) and CD57 in Hashimoto's thyroiditis (HT) and Graves' disease (GD) thyroid tissues.Methods The expression of CXCR5 and CD57 proteins was determined by immunohistochemical analysis in 15 HT thyroid samples,18 GD samples and 10 normal thyroid samples.Results Immunohistochemical staining showed that CXCR5 and CD57 were mainly positive in cytomembrane and cytoplasm of the infiltrated lymphocytes both in HT and GD tissues,with much higher levels than that of normal thyroid tissues ( P ＜ 0.05 ).Both CXCR5 and CD57 were not significantly different between the HT and GD tissues.Conclusion CXCR5 and CD57 expressions were increased with a similar expression pattern in both of the two main autoimmune thyroid diseases( AITD),indicating that Tfh may participate inthe development and progression of AITD.

OBJECTIVETo investigate the effects of asymmetric dimethylarginine (ADMA) on ACAT-1 expression and cholesterol content in THP-1-derived macrophages and foam cells.

METHODSTHP-1 cells were induced to differentiate into macrophages and further into foam cells. The macrophages and foam cells were exposed to different concentrations (0, 3.75, 7.5, 15, and 30 µmol/L) of ADMA for varying time lengths (6, 12, and 24 h), and the changes in ACAT-1 mRNA and protein levels in the cells were measured with RT-PCR and Western blotting. The cellular cholesterol content was measured with enzyme-linked colorimetry assay.

RESULTSIn THP-1-derived macrophages and foam cells, the expression levels of ACAT-1 mRNA and protein and cellular cholesterol content increased significantly in response to ADMA treatment in a time- and concentration-dependent manner.

CONCLUSIONADMA may play an important role in inducing foam cell formation from macrophages. ACAT-1 inhibition targeting the macrophages and foam cells may serve as a potential therapeutic target in the treatment of atherosclerosis.

Acetyl-CoA C-Acetyltransferase ; metabolism ; Arginine ; analogs & derivatives ; pharmacology ; Cell Line ; Cholesterol ; analysis ; Foam Cells ; cytology ; metabolism ; Humans ; Macrophages ; cytology ; drug effects ; metabolism ; Monocytes ; cytology ; drug effects ; RNA, Messenger ; genetics ; Up-Regulation

Objective To investigate the incidence and its secular trends of gastroschisis in Chinese perinatal infants.Methods Data on perinatal infants was collected at hospitals under surveillance program in Chinese Birth Defects Monitoring Network from 1996 to 2007.Data on incidence,trend and related factors of gastroschisis in perinatal infants were carried out.Both x2 test and Poisson regression model were used to test the differences between residential areas,sex and maternal age.Both x2 trends test and Poisson regression model were applied to analyze the trends.Results A total of 6 308 594 perinatal infants were monitored during 1996-2007,including 1601 infants with gastroschisis to show the incidence as 2.54 per 10 000 births.The overall prevalence of gastroschisis in China did not change remarkably during the period of our research.The incidence rates of gastroschisis were significantly different between urban and rural areas,between different sex and different maternal age groups.The incidence of gastroschisis was lower in urban area than in rural area (RR=0.58) and lower in female fetuses than in male fetuses (RR=0.76),highest in the group younger than 20 years of age,which was 11.43 times than incidence of the 30-34 age group (RR=11.432).Conclusion The overall prevalence of gastroschisis in China did not show remarkable change during 1996-2007 but the incidence of gastroschisis a bit increased in the area of study and significant differences were seen in different sex,regions and maternal age groups.Mothers aged younger than 20 years old appeared to be a significant risk factor for the occurrence of gastroschisis.

OBJECTIVETo study the effect of low- and intermediate-dose factor VIII (FVIII) for prophylactic treatment of severe hemophilia A in children by comprehensively evaluating the outcomes of the joints.

METHODSForty-seven children with severe hemophilia A (FVIII activity ≤2%) were enrolled in this study. Eighteen of the children received prophylactic treatment with low-dose FVIII (10 U/kg, 2-3 times a week), 20 received prophylactic treatment with intermediate-dose FVIII (15-30 U/kg, 3 times a week), and 9 received on-demand treatment with FVIII infusion when bleeding occurred according to the Chinese Expert Consensus on the Diagnosis and Treatment of Hemophilia. The children were followed up for 180 days to observe the changes in the indexes of clinical bleeding phenotype, joint structure, joint function, and joint mobility, and the correlation of these indexes were analyzed.

RESULTSCompared with on-demand treatment, prophylactic treatment with low- and intermediate-dose FVIII significantly improved the clinical hemorrhage phenotype (P<0.01), and the improvement was significantly more conspicuous with intermediate-dose prophylactic treatment (P<0.05). Comprehensive evaluation of the joint structure and function changes showed that compared with on-demand treatment, prophylactic treatment with low- and intermediate-dose FVIII resulted in significant improvements in the total score of Hemophilia Joint Health Score (HJHS), Functional Independence Score in Hemophilia (FISH), the single most severe target joint ultrasound and HJHS score of the target joint (P<0.05) and prophylactic treatment with intermediate-dose FVIII appeared to produce better outcomes of the joint than low-dose FVIII. No correlation was found between annual target joint bleeding rate (ATJBR) and ultrasound score, between ATJBR and HJHS change, or between annual joint bleeding rate (AJBR) and the total score of FISH (P>0.05).

CONCLUSIONCompared with on-demand treatment, prophylactic treatment with low- and intermediate-dose FVIII can significantly improve the bleeding phenotype and delay the progression of joint injury, but the clinical hemorrhagic phenotype is not sufficient to monitor the disease progression.

Objective:To understand the current level of work engagement of new nurses and analyze the relationship between the variables of emotion regulation difficulties, job crafting, and work engagement, to provide a theoretical basis for nursing managers to develop interventions to enhance the level of work engagement of new nurses.Methods:The convenience sampling method was applied to select a total of 637 new nurses from 11 tertiary levels A hospitals in Beijing City, Zhejiang Province, Guangxi Zhuang Autonomous Region, Anhui Province, and Hubei Province from April to June 2022 as the respondents, and the general information questionnaire, Emotion Regulation Difficulties Scale, Job Crafting Scale and Work Engagement Scale were used to conduct a cross-sectional survey. The mediation effect was analyzed by AMOS 26.0 structural equation model.Results:Finally, 626 new nurses were included, and scored (31.08 ± 10.94) points on the Work Engagement Scale, with a mean entry score of (3.45 ± 1.22) points. Work engagement was significantly negatively associated with difficulties in emotion regulation ( r=-0.291, P<0.01) and positively associated with job crafting ( r=0.724, P<0.01). Analysis of mediating effects revealed that job crafting partially mediated the relationship between difficulties in emotion regulation and work engagement ( β=-0.424, P<0.001). Conclusions:New nurses' work engagement was at an intermediate level, and job crafting partially mediated the relationship between emotion regulation difficulties and work engagement. Nursing managers should strengthen training on emotion regulation strategies for new nurses and construct intervention strategies based on job crafting, to improve new nurses′ work engagement.

Objective To investigate the clinical characteristics of chronic invasive fungal rhinosinusitis.Methods Clinical features and outcomes of 46 proven cases of chronic invasive fungal rhinosinusitis admitted in Huashan Hospital,Fudan University from January 2009 to December 2016 were retrospectively reviewed.Results Of the 46 patients enrolled,left sphenoid sinus,ethmoid sinus and maxillary sinus were affected in 24,23 and 20 cases,respectively,while right maxillary sinus,ethmoid sinus and sphenoid sinus were affected in 18,16 and 15 eases,respectively.Left and right frontal sinus were affected in 9 and 6 cases,respectively.The central nervous system and orbit were the most commonly affected sites in external nasal involvements,noted in 22 cases respectively.Left sphenoid (17 cases) and ethmoid sinus (15 cases) involvements were most common in central nervous system affected patients.Left sphenoid (14 cases) and ethmoid sinus (13 cases) involvements were most common in orbit affected patients.Aspergillus species were the primary pathogens observed in 42 eases.Zygomycete,candida and dark filamentous fungus were observed in two,one and one case,respectively.Pathologically,37 of the cases were chronic nongranulomatous type and the left 9 were chronic granulomatous type who were all immunocompetent hosts.The initial symptoms usually included headache,dizziness and nasal discomforts including nasal obstruction and purulent secretion.The chief complaints usually included headache,dizziness,and visual disturbances including blurred vision,vision loss or even blindness.Antifungal treatment combined with surgical interventions for removal or drainage focus lesions achieved significant effect,and 42 patients were cured.Conclusions Chronic invasive fungal rhinosinusitis should be taken into consideration in the presence of nasal discomforts or nonspecific symptoms such as headache and dizziness.The possibility of chronic invasive fungal rhinosinusitis should be cautious after the emergence of vision abnormalities.

Objective To explore the value of short from health survey-36 (SF-36) in evaluating quality of life and pain care in patients with cervicogenic headache treated by coblation.Methods Thirty patients with cervicogenic headache accepted coblation treatment in our hospital from February 2017 to August 2018 were chosen in this retrospective analysis. The changes of visual analogue scale (VAS) scores, self-rating anxiety scale (SAS) scores and SF-36 scores (quality of life) before and after treatment were analyzed, and the correlations of these scale scores were determined by Pearson correlation analysis .Results After the 10 weeks of follow-up, the VAS scores of these 30 patients decreased from 7.70±0.88 to 3.30±1.12, SAS scores decreased from 62.47±4.59 to 49.20±6.48, and SF-36 scores increased from 38.50±4.15 to 78.64±6.39, with significant differences (P<0.05). VAS scores were positively correlated with SAS scores (r=0.720,P=0.012), but negatively correlated with SF-36 scores (r=-0.850,P=0.001); SAS scores were negatively correlated with SF-36 scores (r=-0.940,P=0.000). Conclusion SF-36 can be used as a reference for pain nursing intervention in patients with cervicogenic headache after coblation.

OBJECTIVETo investigate the characteristics of breakthrough bleeding in adult patients with severe hemophilia A (SHA) receiving low- and intermediate-dose FVIII for tertiary prophylaxis and explore the factors affecting the outcomes of the treatment.

METHODSForty-nine patients (mean age 31.53∓7.33 years) with SHA receiving tertiary prophylaxis FVIII treatment were divided into low-dose group (n=15) and intermediate-dose group (n=34). The data including clinical bleeding phenotype (Pre?AJBR), 72 h FVIII trough activity, and Functional Independence Score in Hemophilia (FISH) were recorded in all the patients, and Hemophilia Steward APP was used to record the bleeding episode and the treatment data. All the patients were followed up for at least 6 months.

RESULTSIn the low-dose and intermediate-dose groups, the number of joint bleeding (AJBR) episodes were 18.79∓13.03 and 9.28∓7.02 per year (P=0.016), and the proportions of spontaneous bleeding were 75.0% and 47.7%, respectively. The proportions of patients with target joint were 80% and 44%, target joint bleeding occurred in 59% and 41%, and cataract bleeding after 0-12 h of prophylactic injection occurred in 4.86% and 5.18% of the patients with a median breakthrough bleeding time of 40.08 h and 46.08 h (P=0.008), respectively. The proportions of patients with 72 h FVIII trough activity <1% were 44.4% and 34.8% in the two groups, respectively. AJBR was negatively correlated with the preventive dose consumed (r=-0.57, P=0.000, n=49) and FISH, but positively correlated with Pre-AJBR in the two groups (P<0.05).

CONCLUSIONTertiary prophylaxis with low- and intermediate-dose FVIII is not sufficient to achieve the goal of preventing progression of joint disease in Chinese adult patients with SHA. Although the prophylactic dose is the most important factor to affect the treatment efficacy, other non-factor approaches may also help to improve the efficacy of the treatment.