Objective:To evaluate the reliability and validity of the Clinical Reception Attitude Scale .Meth-ods:Based on the survey of 311 outpatients from 4 first-class hospitals , the test-retest reliability , internal con-sistency , construct validity , criterion validities and discriminant validity of the scale was tested .Results:The test-retest reliability was 0.901, the internal consistency was 0.973, 4 common factors accounted for 80.0%of the total variation, the items of which matched the construct of the scale , the criterion validities were 0.856 and 0 .810 , the discriminant validity was good .Conclusions: The results indicated the Clinical Reception Attitude Scale had good reliability and validity .The adjusted scale is an effective tool for the investigation of clinical recep-tion attitude of doctors in China .

The final scale came into being through the process of compiling items with the use of document method and Delphi method, assessing the reliability and validity realized by application of multiple linear regression analysis, Crowns Bach coefficient, correlation coefficient methods and so forth.19 items and 4 dimensions contai-ning communication skills, care, respect and sense of responsibility comprise this clinical reception attitude scale. The scale is qualified to serve as an assessment tool for researching doctor′s attitude, having various merits inclu-ding high consistency among items and cogent dimension setting, whose total score can desirably represent clinical doctor′s attitude towards out-patients.

Objective To investigate the relationship of serum resistin and pancreatic necrosis in the patients with severe acute pancreatitis. Methods Twenty-eight patients with SAP admitted to our hospital from March 2008 to November 2008 were divided into two groups according to the CT scan imaging: necrotic group and non-necrotic group. The enzyme-linked immunosorbent assay (ELISA) was used to test the serum resistin levels. An ROC curve was depicted to predict the pancreas necrosis. Results There were 21 patients in the non-necrotic group and 7 in the necrotic group, and there was no significant difference in terms of sex, age and baseline disease (P>0.05). The resitin levels ranged from 0.1730 ng/ml to 7.4923 ng/ml, with a mean (3.7102±1.6987) ng/ml. The area under the curve of resistin values was 0.884±0.108 (95%CI:0.672～1.097), asymptote signals 0.003, then it was calculated that P=0.003, which was>0.50. Conclusions The serum resistin may be of clinical value to predict the pancreatic necrosis.

Background: Resistin level is high in patients with severe acute pancreatitis (SAP), and resistin is expected to be a new marker for evaluating the severity of acute pancreatitis. Objective: To explore the influence of integrated traditional Chinese and Western medicine therapy on serum resistin levels in SAP patients. Design, setting, participants and interventions: Twenty-eight SAP patients meeting inclusion criteria from Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University were included, and the patients were randomly divided into treatment group and placebo group. There were 13 patients in the treatment group and 15 patients in the placebo group. Patients in the treatment group were given traditional Chinese herbal medicine in addition to the conventional treatment. Patients in the placebo group were given placebo in addition to the conventional treatment. Main outcome measures: The serum resistin levels on admission, and days 1, 3, 5, and 7 after the admission were detected. Results: The serum resistin levels on admission in all the patients were higher than normal level, and there was no significant difference between the two groups (P>0.05). On days 1, 3, 5, and 7 after admission, the resistin levels in the treatment group were (3.29+/-1.66) mu g/L, (3.71+/-1.05) mu g/L, (3.08+/-1.47) mu g/L and (3.62+/-1.67) mu g/L, and in the control group (5.16+/-1.93) mu g/L, (5.07+/-1.53) mu g/L, (4.88+/-1.47) mu g/L and (5.12+/-1.48) mu g/L, respectively. The resistin levels were lower in the treatment group than in the control group (P<0.05). Conclusion: Serum resistin level in SAP patients can be decreased by integrated traditional Chinese medicine and Western medicine therapy.

Organoids are a novel disease model that is self-assembled from stem cells or malignant tumors and is used in clinical research.They are similar to tissues and organs in the body and have partially functional 3D cell structures.There are two types of traditional models for liver cancer research,i.e.,in vivo models(animal models of liver cancer established by induction)and in vitro cell experiments using corresponding cell lines.Organoids have the advantages of the two types of traditional models and show unique advantages in tumor research.Traditional models cannot fully reflect the microenvironment of cells,which often leads to the inconsistency with clinical research findings,and the emergence of new research models provides a new direction for the research on liver cancer.This article reviews the research advances in liver cancer organoids,in order to provide a new perspective for future research on liver cancer.

Objective To explore the mechanism of piper longum extract on liver fibrosis induced by carbon tetrachloride(CCl4)in rats.Methods Sixty SD rats were randomly divided into blank group,model group,low dose group(16.6mg/kg),middle dose group(33.3mg/kg)and high dose group(66.7mg/kg)of piper longum extract,with 12 rats in each group.Except the blank group,the other groups were subcutaneously injected with 50％CCl4 rapeseed oil solution for 8 weeks to establish liver fibrosis models.At the same time of modeling,the model group was given normal saline by gavage,and the low,middle and high dose groups of piper longum extract were given gavage for 8 weeks.After the experiment,serum alanine transaminase(ALT),aspartate aminotransferase(AST)and γ-glutamyl-transferase(γ-GT),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured;the pathological changes of liver tissue in rats was observed by hematoxylin eosin staining and Masson's trichrome staining.The tissue total RNA was extracted and qPCR method was used to detect the mRNA expression levels of Collagen Ⅰ,α-smooth muscle actin(α-SMA)and TNF-α.Tissue protein was extracted and Western blot method was used to detect the protein expression levels of Collagen Ⅰ,α-SMA and TNF-α.Results The results of HE staining and Masson staining showed that the liver fibrosis of rats in the model group was obvious,ALT,AST and γ-GT were increased,serum inflammatory mediator TNF-α and IL-6 secretion was increased.The mRNA and protein expression levels of Collagen Ⅰ,α-SMA and TNF-α in the model group were significantly increased.Piper longum extract can significantly improve the degree of liver fibrosis.ALT,AST,y-GT were decreased,and serum inflammatory mediator TNF-α and IL-6 were decreased,the mRNA and protein expression levels of Collagen Ⅰ,α-SMA,TNF-α in liver tissue were significantly decreased.Conclusion Piper longum extract has obvious therapeutic effect on CCl4 induced liver fibrosis in rats,which can be achieved by inhibiting the inflammatory factor TNF-α and IL-6 expression,and possibly by inhibiting the activation of hepatic stellate cell,thereby reducing Collagen Ⅰ andα-SMA synthesis exerts anti fibrosis effect.

Objective Exploring the protective effect and mechanism of piperlongumine(PL),an active ingredient in the extract of Piper longum,on hepatic stellate cell damage in vitro.Methods The liver stellate cells(HSC-T6)were activated by adding lipopo-lysaccharide(LPS),and the liver stellate cells were treated with different concentrations of piperlongumine,and the protein and mRNA expression levels of IL-18,GSDMD,NLRP3 and caspase-1 in the cells were detected by Western blot and qPCR.Immunofluorescence staining showed the localization and expression of IL-18,GSDMD,NLRP3 and caspase-1 in cells.Molecular docking technology was used to analyze the target molecules of the action of piperlongumine.Results In vitro experiments showed that piperlongumine could in-hibit the protein and mRNA expression of IL-18,GSDMD,NLRP3 and caspase-1 in a concentration-dependent manner.The results of molecular docking verified the correlation,and piperlongumine could bind to IL-18,GSDMD and caspase-1,but had a poor binding effect with NLRP3.Conclusion Piperlongumine can prevent pyroptosis by inhibiting the caspase-1 signaling pathway of HSC-T6 cells,thereby exerting a protective effect on liver injury.

OBJECTIVETo identify novel common mutations among patients with non-syndromic hearing loss (NSHL).

METHODSHigh-throughput gene capture technology was used to analyze 18 patients with NSHL in whom common mutations of deafness genes including GJB2, SLC26A4, GJB3, and mtDNA were excluded. Suspected mutation was verified with Sanger sequencing.

RESULTSNext generation sequencing has identified 62 mutations in 29 genes associated with hearing loss, which included 54 missense mutations, 4 splicing mutations, 3 deletional mutations, and 1 nonsense mutation. Mutations occurring more than twice in the 18 patients were verified by Sanger sequencing. This has confirmed 15 mutations in 8 genes, including 3 missense mutations (p.C2184G, p.L2825P, p.H1888Y) which have not been reported previously. Meanwhile, p.L445W, p.D866N, and IVS919-2A>G were common causative mutations.

CONCLUSIONA number of common causative mutations, e.g., p.L445W, p.D866N, IVS919-2A>G, have been identified by high-throughput capture technology, which may facilitate the research and genetic diagnosis for hearing loss.

DNA, Mitochondrial ; genetics ; Deafness ; genetics ; Female ; Hearing Loss ; genetics ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Male ; Mutation ; genetics

Objective:To investigate the effects of continuous renal replacement therapy (CRRT) on plasma concentration, clinical efficacy and safety of colistin sulfate.Methods:Clinical data of patients received with colistin sulfate were retrospectively analyzed from our group's previous clinical registration study, which was a prospective, multicenter observation study on the efficacy and pharmacokinetic characteristics of colistin sulfate in patients with severe infection in intensive care unit (ICU). According to whether patients received blood purification treatment, they were divided into CRRT group and non-CRRT group. Baseline data (gender, age, whether complicated with diabetes, chronic nervous system disease, etc), general data (infection of pathogens and sites, steady-state trough concentration, steady-state peak concentration, clinical efficacy, 28-day all-cause mortality, etc) and adverse event (renal injury, nervous system, skin pigmentation, etc) were collected from the two groups.Results:A total of 90 patients were enrolled, including 22 patients in the CRRT group and 68 patients in the non-CRRT group. ① There was no significant difference in gender, age, basic diseases, liver function, infection of pathogens and sites, colistin sulfate dose between the two groups. Compared with the non-CRRT group, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) were higher in the CRRT group [APACHE Ⅱ: 21.77±8.26 vs. 18.01±6.34, P < 0.05; SOFA: 8.5 (7.8, 11.0) vs. 6.0 (4.0, 9.0), P < 0.01], serum creatinine level was higher [μmol/L: 162.0 (119.5, 210.5) vs. 72.0 (52.0, 117.0), P < 0.01]. ② Plasma concentration: there was no significant difference in steady-state trough concentration between CRRT group and non-CRRT group (mg/L: 0.58±0.30 vs. 0.64±0.25, P = 0.328), nor was there significant difference in steady-state peak concentration (mg/L: 1.02±0.37 vs. 1.18±0.45, P = 0.133). ③ Clinical efficacy: there was no significant difference in clinical response rate between CRRT group and non-CRRT group [68.2% (15/22) vs. 80.9% (55/68), P = 0.213]. ④ Safety: acute kidney injury occurred in 2 patients (2.9%) in the non-CRRT group. No obvious neurological symptoms and skin pigmentation were found in the two groups. Conclusions:CRRT had little effect on the elimination of colistin sulfate. Routine blood concentration monitoring (TDM) is warranted in patients received with CRRT.

Objective To observe the effects of Renshen Yimai Prescription on oxidative stress and vascular aging in ApoE-/-mice;To explore its mechanism of intervention in vascular aging.Methods Forty ApoE-/-mice were divided into model group,Western medicine group(rosuvastatin,2.6 mg/kg),TCM low-and high-dosage group(Renshen Yimai Prescription,4.29,8.58 g/kg),with 10 mice in each group.Another 10 C57BL/6J mice were set as normal group.A vascular aging model was established by ApoE-/-mice fed with a Western diet.Each medication group was given corresponding drugs by gavage for 12 consecutive weeks,the normal group and model group were given equivalent volume of pure water.HE staining and Masson staining were used to observe the morphological changes of aortic tissue,and ox-LDL content in serum was detected by ELISA,the contents of ROS,GSH,GPX and NAD+in serum were detected by colorimetric method,the expressions of SIRT1,p53,p21 and NOX4 protein in aortic tissue were detected by Western blot.Results Compared with the normal group,the model group mice showed significant fat deposition in the aorta,thickening of the intima and media,a significant decrease in elastic fibers,and an increase in collagen fibers;the serum contents of ox-LDL and ROS significantly increased(P<0.01),while the contents of GSH,GPX and NAD+significantly decreased(P<0.01);the expression of SIRT1 protein in the aortic tissue significantly decreased(P<0.05),the expressions of p21 and p53 protein significantly increased(P<0.01,P<0.05).Compared with the model group,a small amount of lipid deposition was observed in the intima of aorta in each medication group,with clearer membrane structures in each layer and reduced collagen fiber;the serum contents of ox-LDL and ROS in each medication group were significantly decreased(P<0.01),while the GSH content significantly increased(P<0.05,P<0.01),the NAD+content in TCM low-dosage group significantly increased(P<0.05);the expressions of p21 and NOX4 protein in aortic tissue of the TCM high-dosage group significantly increased(P<0.05,P<0.01).Compared with the Western medicine group,the TCM high-dosage group showed a significant decrease in ROS content(P<0.01)and a significant decrease in p53 protein expression(P<0.05).Compared with the TCM low-dosage group,the TCM high-dosage group showed a significant decrease in p21 protein expression(P<0.01)and a significant increase in NOX4 protein expression(P<0.01).Conclusion Renshen Yimai Prescription may reduce vascular endothelial damage by regulating oxidative stress levels and related protein expression,thereby playing a role in improving vascular aging.