Fish oil is an important nutrient component in rainbow trout bone, and the optimization of extraction by enzymatic hydrolytic method is of great significance.This study selected the alkaline protease as the hydrolytic enzyme, and optimized the process conditions of enzymatic hydrolysis of rainbow trout fish using single factor analysis method.Effects of several factors on the extraction of fish oil were studied, including the ratio of material to liquid, pH, enzymatic hydrolysis time, enzymatic hydrolysis temperature and amount of enzyme.Fatty acids were identified by gas chromatography-mass spectrometry (GC-MS).Results showed that the optimum extraction parameters of enzymatic hydrolysis were as follows: 2000 U/g alkaline protease, ratio of material to liquid of 1∶1 (w/w), pH 7.5, and extraction at 55℃ for 3h.It was found that the main composition of rainbow trout bone oil was unsaturated fatty acid with the content of 80.4% (w/w).The relative content of monounsaturated fatty acid and polyunsaturated fatty acid was about 76.9% (w/w) and 23.1% (w/w), respectively.The total content of EPA and DHA was 3.4% (w/w).This study optimized the extraction method of rainbow trout fish oil, analyzed and identified the main volatile compounds, and identified the main substances contributing to fish oil flavor.The method thus was of significance for the analysis and identification of fish oil products.

Objective To evaluate the clinical efficacy and safety of ABO incompatible living kidney transplantation(ABOi-KT). Methods Clinical data of 11 donors and recipients with ABOi-KT were retrospectively analyzed. All the recipients were treated with desensitization before operation. The recovery condition of renal function and blood type antibody titer of the ABOi-KT recipients were monitored after operation. The incidence of complications and clinical prognosis of ABOi-KT recipients were observed. Results The serum creatinine (Scr) of 11 recipients were well recovered after ABOi-KT. No delay in recovery of graft renal function. Among them, 2 recipients experienced a significant increase in the Scr level at postoperative 14 and 45 d respectively, 1 recipient showed criticality cellular rejection after operation and 1 recipient presented with elevated Scr level at postoperative 33 d, accompanied by an increase in blood type antibody titer. The condition became stable after corresponding treatment. The remaining 7 recipients obtained normal graft renal function and postoperative blood type antibody titer did not rebound. During postoperative follow-up until November 2018, no recipient died or graft renal failure occurred. The survival rate of the recipient and graft renal was 100%. Among them, 3 patients suffered from postoperative complications, including pulmonary infection, BK viruria and granulocytopenia, which were cured after symptomatic treatment. Conclusions ABOi-KT is safe, feasible and yields high long-term clinical efficacy, which can increase the source of living donor kidney and relieve the shortage of donor kidney.

The Asian expert working group completed the 2022 consensus on vernal keratitis (VKC), which provides detailed information on the definition, classification, clinical manifestation, diagnosis and treatment of VKC in Asia and identifies unmet treatment needs, including: (1) lack of clear criteria for the diagnosis and treatment of patients with VKC.The pathogenesis of the disease is unclear, and anti-allergy therapy is often ineffective in patients with moderate or severe VKC; (2) the need for standardized treatment and management strategies.Treatment and management of patients with the same severity varies widely among Asian countries, with a lack of clear, standardized guidelines and grading systems; (3) safety and iatrogenic complications; (4) optimal dosing regimen for pharmacologic treatment.In this article, the aspects mentioned above were interpreted and analyzed in the context of the Expert Consensus on the Diagnosis and Treatment of Allergic Conjunctivitis in China ( 2018), with a view to helping the prevention and treatment of VKC in China.

Objective To investigate the effects of Lactobacillus rhamnosus GG (LGG) colonization in early life on intestinal barrier and intestinal development in offspring mice and its possible mechanism.Methods Six C57BL/6 pregnant mice with the same conception time of 6 weeks were selected and randomly divided into experiment group given 108 cfu/ml LGG live bacteria and control group given LGG inactivated bacteria by gavage from the 18th day of pregnancy until natural birth.The progeny mice in the two groups were continued to be gavaged with 107 cfu/ml of LGG live bacteria or LGG inactivated bacteria on days 1-5 of birth.The body weight changes of 3 week'progeny mice were recorded.The colonization of LGG bacteria in offspring mice was detected at 2nd and 3rd weeks.The mRNA of intestinal proinflammatory cytokines and tight junction molecules were evaluated by real-time PCR method.HE,immunohistochemistry,immunofluorescence staining and enzyme-linked immunosorbent assay were used to evaluate the intestinal barrier of 3-week old off spring mice.Results Compared with the control group,the progeny mice of the experiment group showed no significant difference in body weight at the first week,and the body weight increased at the second week and the third week [2ndweek:(3.790±0.240) g vs.(4.326±0.140) g,t=3.707,P=0.006;3rd week:(7.295±0.326) g vs.(8.040±0.370) g,t=3.130,P=0.011].LGG colonization can be detected only in the feces of progeny mice in the experiment group.Intestinal colonization can promote the growth of small intestine villi and colon crypt depth [jejunum:(320.000±22.514) μm vs.(265.100±15.611) μm,t=8.258,P＜0.001;ileum:(150.500±13.099) μm vs.(111.000±11.308) μm,t=9.958,P＜0.001;colon:(295.000±15.209) μm vs.(233.100±6.678) μm,t=9.129,P＜0.001].Compared with the control group,the number of goblet cells in the colonic crypt of the experiment group increased (11.62 ± 0.780 vs.35.24 ±1.370,t=15.000,P＜0.001),and the relative mRNA expression levels of pro-inflammatory factors as IFN-γ (1.280±0.232 vs.0.512±0.206,t=4.970,P=0.001),IL-6 (1.364±0.271 vs.0.941±0.215,t=2.452,P=0.040),IL-10 (1.341±0.320vs.0.744±0.294,t=2.762,P=0.025)andTNF-α (3.702±0.150 vs.2.581±0.500,t=2.553,P=0.034) in the experiment group decreased;the expression levels of the intimate tight junction molecules (Claudin3) (1.283±0.152 vs.1.881±0.172,t=4.932,P=0.001) and the atresia protein molecule (Occludin) (1.164±0.342 vs.0.812±0.224,t=3.67,P=0.016) significantly increased.Conclusion Early life LGG colonization protects the intestinal barrier by inhibiting lowgrade intestinal inflammation.This study will lay the experimental foundation for the supplementation of probiotics in early life so as to prevent intestinal diseases.

Objective:To explore the change trend of patients′ recognition of the medical reform effect and medical staff′s occupation and its relationship with medical experience, since the implementation of the China Healthcare Improvement Initiative(CHII), so as to provide reference for exploring the breakthrough point of consolidating the reform effect.Methods:Four indicators of the third-party assessment of patients were selected, which were " I think the medical reform has benefited patients" , " I think the doctor-patient relationship is improving in the past three years" , " I think medical personnel deserve social respect and recognition" , and " I am willing to let my children join the medical profession" . Descriptive and trend analysis were carried out on the survey results, and correlation analysis was carried out between the survey results and patients′ medical experience.Results:Compared with the baseline evaluation results(76.9% and 69.9%for outpatients, 87.3% and 85.6%for inpatients), the patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship in the fifth evaluation(86.2% and 89.1%for outpatients, 91.4% and 92.6%for inpatients)were significantly improved. The proportion of patients who thought the medical staff was worthy of respect and willing to let their children work in the hospital in the fifth evaluation(97.4%, 79.1%for outpatients, 98.7%, 85.1%for inpatients)were higher than the baseline evaluation results(92.3%, 71.0%for outpatients, 98.1%, 81.6%for inpatients). The above indicators were positively correlated with the patient′s medical experience.Conclusions:Since the implementation of CHII, patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship has been continuously improved, and patients′ respect and recognition of professional identity of medical personnel is at a high level and continues to improve. Improving medical experience has a positive effect on the improvement of patients′ sense of medical reform.

Objective:To summarize the progress and achievement of outpatient experience improvement in tertiary public hospitals from 2016 to 2021, so as to provide basis for further improving outpatient experience and raising outpatient satisfaction.Methods:Based on 5 round third-party evaluations of the China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on the outpatient process and outpatient satisfaction, and stratified analysis was conducted on patient satisfaction in different regions and different types of institutions.Results:One hundred and thirty-six core sample hospitals were included in the 5 round evaluation, and 30 153 valid questionnaires were collected in the fifth evaluation in 2021.From 2016 to 2021, the overall satisfaction of outpatients in the 5 round evaluations was 91.4%, 87.3%, 90.1%, 91.1% and 95.4%, respectively. The satisfaction of outpatients to the medical services continued to improve. Outpatient treatment process has been continuously optimized, appointment registration has become the most commonly used way of outpatient registration. The satisfaction of outpatients to the process and environment of treatment in the western region was significantly improved.Conclusions:From 2016 to 2021, the overall satisfaction of outpatients has been consistently improved. Informatization helps to optimize the treatment process, but it is recommended that hospitals should provide special support for elderly outpatients.

Objective:To summarize the progress and achievement of inpatient experience improvement in public hospitals in China from 2016 to 2021, so as to provide basis for further improving hospitalization experience and raising inpatient satisfaction.Methods:Based on the five Third-party Evaluations of China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on inpatient process, cost and inpatient satisfaction, and the inpatient satisfaction in different regions and different types of institutions was compared.Results:The overall satisfaction of hospitalized patients in the fifth evaluation in 2021(98.5%)was higher than that in the first evaluation in 2016(96.2%). The western region and maternal and child institutions had the most obvious improvement in the comparison of regional and institutional types. The improvement of inpatients′ satisfaction with diet was not obvious. Inpatients were most dissatisfied with " high medical expenses" , " cumbersome procedures" and " long waiting time for bed" .Conclusions:From 2016 to 2021, the satisfaction of hospitalized patients has been consistently improved, but there is still room for improvement in non-medical services. Hospital meals for inpatient and relief of inpatient healthcare financial burden are the priorities for healthcare improvement and raising hospitalization satisfaction in the next stage.

Infancy is the most critical period for the formation and development of intestinal flora, which is an important stage for the rapid succession and stable colonization of intestinal flora involved in the health and establishment and improvement of the immune system.Breast milk is rich in human milk oligosaccharides (HMOs), which can effectively promote the growth of beneficial bacteria in the infant intestine.It inhibits the invasion of pathogen, improves the composition of the intestinal flora, increases its diversity, and promotes the growth and development of the infant.This study mainly reviews the research status of HMOs and its influence on the infant intestinal flora.

Objective:To observe the role of yogurt containing 2 type of Bifidobacterias in improving the intestinal comfort in children. Methods:A 4-week, single-arm, non-randomized study was conducted from October 23, 2021 to November 21, 2021, in which, healthy children aged 3-6 years in real life were provided with commercially available children′s yogurt supplemented with Bifidobacteriumlactis BL-99 and Bifidobacterium infantis YLGB-1496.The questionnaire on gastrointestinal symptoms in children and the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index were used to evaluate the intestinal comfort and skin sensitivity changes at baseline, week 1, week 2, and week 4, respectively. Kruskal- Wallis rank sum test was used for comparison at different time points. Results:A total of 39 children, involving 20 boys and 19 girls with the median age of 5.0 years completed the study.There were significant differences in intestinal comfort score and PO-SCORAD scores, distribution of stool consistency and night awakening frequency at different time points (baseline, week 1, week 2 and week 4) (all P<0.05). The total score of intestinal comfort at week 2 and 4 was 12.0 (10.0, 13.0) points and 10.0 (9.0, 10.0) points, which was significantly lower than that at baseline[17.0 (15.0, 21.0) points, P<0.05]. The total score of intestinal comfort at week 4 was significantly lower than that at week 1[13.0 (11.0, 15.0)points] and week 2 (all P<0.05). At week 4, all children had an ideal stool consistency (type 3-4). At week 4, 33 (84.6%) of the children woke up 0 times, and 6 (15.4%) of the children woke up once or twice.The PO-SCORAD scores at week 1, 2 and 4 were 10.2 (6.5, 14.7) points, 8.2 (5.5, 14.2) points and 5.5 (4.5, 9.0) points, respectively, which were all significantly lower than that at baseline[18.3 (11.6, 25.3) points, all P<0.05]. The total PO-SCORAD score at week 4 was significantly lower than that at week 1 ( P<0.05). Conclusions:After eating yoghurt supplemented with Bifidobacteriumlactis BL-99 and Bifidobacterium infantis YLGB-1496 for 4 weeks, the children′s intestinal comfort and stool consistency, night awakening and skin sensitivity are improved.

Objective:To examine the validity and reliability of the Pediatric Symptom Checklist(PSC)in suspended students in China(based on parent reports).Methods:A total of 184 parents were included in this study,PSC was used to assess students aged 10-19 who were suspended from primary and secondary school due to psy-chological problems.Results:After removing the fourth entry of the original scale("too active,non-active"),the confirmatory factor analysis showed that the three-factor model fit well(x2/df=1.57,RMSEA=0.06,CFI=0.93,TLI=0.91,SRMR=0.07).The Cronbach's alpha coefficients of the scale overall and the three dimensions of internalization,externalization and attention problem were 0.85,0.80,0.76 and 0.69,respectively.Conclusion:After removing the fourth entry,PSC has good construct validity and reliability evaluating psychological problems of suspended primary and secondary school students.