Objective:To retrieve and summarize the evidence regarding the non-surgical treatment and management of patients with pelvic organ prolapse (POP) .Methods:According to the "6S" evidence pyramid model, clinical guidelines, expert consensus, systematic reviews, clinical decisions, and clinical best practices related to the non-surgical treatment and management of patients with POP were systematically searched in databases and websites such as UpToDate, National Institute for Health and Clinical Excellence, Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guidelines International Network, National Guideline Clearinghouse, PubMed, China National Knowledge Infrastructure. The search period was from the establishment of the database to January 31, 2024. Two investigators independently conducted literature quality assessment and extracted relevant information according to the Appraisal of Guidelines for Research and EvaluationⅡ and the Australia JBI Evidence-Based Health Care Center evaluation tools. The Australia JBI quality level of evidence and grade of recommendation (2014 version) were used for evidence integration and grading.Results:A total of 15 papers were finally included, including three clinical decisions, eight guidelines, two best practices, one expert consensus, and one systematic review. A total of 39 pieces of best evidence were summarized in nine areas of examination and assessment, treatment plan, lifestyle, expectant therapy, functional exercise, physical therapy, pessary, drug therapy, and follow-up observation.Conclusions:This study summarizes the best evidence on the non-surgical treatment and management of POP patients, which is scientific and comprehensive, and provides an evidence-based basis for medical and nursing staff to develop non-surgical treatment and management protocols for POP patients and self-management of POP patients.

Objective:To retrieve and summarize the evidence regarding the non-surgical treatment and management of patients with pelvic organ prolapse (POP) .Methods:According to the "6S" evidence pyramid model, clinical guidelines, expert consensus, systematic reviews, clinical decisions, and clinical best practices related to the non-surgical treatment and management of patients with POP were systematically searched in databases and websites such as UpToDate, National Institute for Health and Clinical Excellence, Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guidelines International Network, National Guideline Clearinghouse, PubMed, China National Knowledge Infrastructure. The search period was from the establishment of the database to January 31, 2024. Two investigators independently conducted literature quality assessment and extracted relevant information according to the Appraisal of Guidelines for Research and EvaluationⅡ and the Australia JBI Evidence-Based Health Care Center evaluation tools. The Australia JBI quality level of evidence and grade of recommendation (2014 version) were used for evidence integration and grading.Results:A total of 15 papers were finally included, including three clinical decisions, eight guidelines, two best practices, one expert consensus, and one systematic review. A total of 39 pieces of best evidence were summarized in nine areas of examination and assessment, treatment plan, lifestyle, expectant therapy, functional exercise, physical therapy, pessary, drug therapy, and follow-up observation.Conclusions:This study summarizes the best evidence on the non-surgical treatment and management of POP patients, which is scientific and comprehensive, and provides an evidence-based basis for medical and nursing staff to develop non-surgical treatment and management protocols for POP patients and self-management of POP patients.

Objective:To improve the ability of aviation physicians and physical examiners in differential diagnosis of primary angiitis of the central nervous system (PACNS) and the level of aeromedical assessment by exploring the diagnosis and treatment of PACNS.Methods:The clinical diagnosis and treatment of a pilot with PACNS were reported and the related literatures were reviewed.Results:The clinical manifestation of the fighter trainer pilot was numbness of the left finger, and then gradually appeared numbness and weakness of the left face and left upper limb more than 1 month. The initial diagnosis was viral encephalitis and acute disseminated encephalomyelitis and the hormonal shock treatment was ineffective. The final diagnosis was PACNS. The patient′s condition was improved by cyclophosphamide shock treatment. Aeromedical assessment concluded that the pilot was temporarily grounded.Conclusions:Pilot with PACNS is rarely reported and easy to be misdiagnosed due to the clinical and imaging findings are lack of specificity. The aeromedical assessment of PACNS pilots should be individualized according to the severity of illness, type of aircraft and flight duties.

Objective:To improve the ability of aviation physicians and physical examiners in differential diagnosis of primary angiitis of the central nervous system (PACNS) and the level of aeromedical assessment by exploring the diagnosis and treatment of PACNS.Methods:The clinical diagnosis and treatment of a pilot with PACNS were reported and the related literatures were reviewed.Results:The clinical manifestation of the fighter trainer pilot was numbness of the left finger, and then gradually appeared numbness and weakness of the left face and left upper limb more than 1 month. The initial diagnosis was viral encephalitis and acute disseminated encephalomyelitis and the hormonal shock treatment was ineffective. The final diagnosis was PACNS. The patient′s condition was improved by cyclophosphamide shock treatment. Aeromedical assessment concluded that the pilot was temporarily grounded.Conclusions:Pilot with PACNS is rarely reported and easy to be misdiagnosed due to the clinical and imaging findings are lack of specificity. The aeromedical assessment of PACNS pilots should be individualized according to the severity of illness, type of aircraft and flight duties.

Pear is one of the main fruits with thousands of years of cultivation history in China. There are more than 2000 varieties of pear cultivars around the world, including more than 1200 varieties or cultivars in China (Legrand et al., 2016). Xinjiang Uygur Autonomous Region is an important pear production region in China with 30 of varieties or cultivars. Pyrus sinkiangensis is the most popular variety, which is mainly distributed in Xinjiang (Zhou et al., 2018). Chlorogenic acid (CGA), p-coumaric acid, and arbutin are the main polyphenols in pear fruit, and their levels show great differences among different varieties (Li et al., 2014). CGA is a potential chemo-preventive agent, which possesses many important bioactivities including antioxidant, diabetes attenuating, and anti-obesity (Wang et al., 2021). Therefore, the specific CGA content of a variety is considered the embodiment of the functional nutritional value of pears.
Chlorogenic Acid ; Fruit ; Gene Expression Profiling ; Pyrus/genetics* ; Transcriptome

Objective To analyze the clinical characteristics of children tsutsugamushi infection in order to strengthen understanding,reduce the misdiagnosis rate,reduce the complications and improve the level of diagnosis and treatment.Methods To analyze retrospectively the clinical data and treatment outcome of 22 cases of children tsutsugamushi disease,including symptoms,physical signs and laboratory examination.Results All the cases with fever onset,high fever (＞ 39 ℃) was 72.7％ (16/22),all cases were typical eschars and ulcers,while 8 cases (36.4％,8/22)had lymphadenectasis.Merger multiple organ damage in 14 cases (63.6％,14/22),anemia in 11 cases (50.0％,11/22)and liver function abnormal in 4 cases (18.2％,4/22).All of 22 cases were treated with azithromycin.All cases after treatment with azithromycin heal,no recurrence.Conclusions The manifestation of tsutsugamushi disease is diversity,much complications,among which hematology and liver are the most common cases.Physical examination roundly might reduce missed diagnosis and misdiagnosis as greatly as possible.Azithromycin has good therapeutic effects on children tsutsgamushi disease.

BACKGROUND: +Gz-induced acute dysencephalia and its protection is one of the significant topics in Aero-medical researches. Its pathological mechanism, however, is still unclear and protective measures should be developed further. OBJECTIVE: To observe the expression of inducible nitricoxide synthase (iNOS) in brain tissue after +Gz exposure and to analyze the protective effects of danshen and basic fibroblast growth factor (bFGF) on repeated +Gz exposure-induced brain injury. DESIGN: Randomized controlled animal study. SETTING: Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA.MATERIALS: The experiment was carried out at the Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA from April to August 2000. A total of 20 healthy SD rats of clean grade were divided into 5 groups according to randomly digital table, including control group, +Gz exposure group, bFGF group, danshen group and saline group with 4 in each group.METHODS: All rats were fixed on rotatory arm of centrifugal apparatus,and their heads were towards core of the apparatus. Except the rats in control group, the value of +Gz exposure was +14 Gz, and the growth rate was 1.5 G/s. The exposure at peak value lasted for 45 s. +Gz exposure was done for three times, and the interval was 30 minutes. Rats in the control group were also treated with the same +Gz exposing procedure, but the G value was +1 Gz. Rats in bFGF group and danshen group were intraperitoneally injected with 100 μg/kg of bFGF and/or 15 g/kg of danshen solution, respectively, at 30 minutes before centrifugation and immediateness after centrifugation; moreover, rats in saline group were injected with the same volume of saline. Six hours after exposure, rats were cut off their heads to obtain the brains which were maintained in liquid nitrogen for RNA extraction. The expression of iNOS mRNA in brain tissues of the rats in each group was detected with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and calculated on the basis of ratio between iNOS and glyceraldehyde-3-phosphate dehydrognase.MAIN OUTCOME MEASURES:Expressed level of iNOS mRNA in brain tissue of rats.RESULTS: Expression of iNOS mRNA in brain tissue was higher in repeated +Gz exposure group than that in control group (0.452 ±0.014,0.065±0.008, P ＜ 0.01); however, that was lower in bFGF group and dan-shen group than that in +Gz exposure group (0.196±0.010, 0.183±0.011,0.452±0.014, P ＜ 0.01).CONCLUSION: Repeated +Gz exposure can increase the expression of iNOS mRNA, this plays an important role in cerebral injury induced by repeated +Gz exposure. Moreover, bFGF and danshen have protective effects on cerebral injury induced by +Gz exposure.

BACKGROUND: Brain injury can be induced by repeated high positive acceleration ( + Gz) exposure, but the mechanism was still unclear.OBJECTIVE: To investigate the role of apoptosis in higher + Gz exposures induced brain injury by observing the changes of mRNA expression of bcl-2,bax, p53, and interleukin-1β(IL-1β) hydroxylase in rat brain.DESIGN: Randomized control experimental study based on experimental SD rat model.SETTING: Aviation medicine research center of a hospital.MATERIALS: Twenty-six healthy male SD rats, weighed from 180 to 220 g,were randomly divided into control group(4 rats) and + Gz exposure group (22 rats).INTERVENTIONS: Rats were fixed on the rotating arm of animal centrifuger with their heads towards axis. Rats in + Gz exposure group were exposed to + 14 Gz for three times, each for 45 seconds with 30 minutes interval in between. Rats in control group were subject to the same experiment in + 1 Gz. The rat brains were taken 30 minutes, 6 hours, 24 hours and 48 hours after the last centrifuge run, and then fixed and embedded. Changes of bcl-2, bax, p53, and IL-1β hydroxylasein mRNA expressions in rat brain were measured with semi-quantitative reverse transcription polymerase chain reaction(RT-PCR) . Apoptotic cells were detected by terminal deoxynucleotide(correction of deoxynuleotide) transferase-mediated dUTP nick end labeling(TUNEL) technique.MAIN OUTCOME MEASURES: The changes of bcl-2, bax, p53, and IL-1 β hydroxyalse mRNA expressions at each time points.RESULTS: After repeated + Gz exposures for 6 hours, bcl-2 mRNA expression in rat brain tissue(0. 32 ± 0. 08) was found significantly lower than in control group(0. 69 ± 0. 15), while mRNA expressions of bax, p53, and interleukin-1β converting enzyme(ICE) 0.55 ±0. 09, 0. 48 ±0. 12, 0.79 ±0. 12were significantly higher than in control group 0.33 ±0. 09, 0. 31 ±0.05,0.51 ± 0.09 ( P ＜ 0. 01 ) . After 24 hours of exposure, mRNA expression of bcl-2 in rat brain tissue (0. 28 ± 0.05) was significantly lower than in control group, while the mRNA expressions of bax, p53, and ICE 0.61 ±0. 15,0.54 ± 0. 07, 0. 84 ± 0. 15 were significantly higher than in control group ( P ＜ 0.01); but the difference of brain bcl-2, bax, p53 and ICE mRNA expressions had no statistical significance when exposed for 0.5 hour and 48 hours( P ＞ 0.05). Partly apoptotic cells were observed at exposure for 6 hours and 24 hours.CONCLUSION: Changes of bcl-2, bax, p53 and ICE mRNA expressions, as well as apoptosis in rats brain can be induced by repeated + Gz exposures and may be involved in the molecular mechanisms of brain injury.

To study changes in mRNA expression of induced nitric oxide synthase (iNOS) in the brain of rat repeatedly exposed to +Gz, and to explore the prevention and treatment effect of basis fibroblast growth factor (bFGF) and radix salviae miltiorrhizae (RSM) on the brain injury induced by repeated +Gz exposures. The mRNA expression levels of iNOS in brain were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR). The results showed the iNOS mRNA expression level in brain of rats repeatedly exposed to +Gz was significantly higher than that of control, but bFGF and RSM could alleviate the expression change of iNOS. It suggested that the iNOS mRNA expression in rat brain was induced by repeated +Gz exposures and it might play an important role in the pathologic course of brain damage induced by +Gz exposures.The bFGF and RSM possessed prevention and treatment on the brain injury induced by repeated +Gz exposures.

The purpose of this study is to observe the changes in gene expressions of bcl 2, bax, p53 and interleukin 1? converting enzyme (ICE) in the cerebral tissue of rat exposed to repeated +Gz, and to explore the pathogenetic role of apoptosis in brain damage induced by repeated +Gz exposures. The expression levels of bcl 2, bax, p53 and ICE in cerebral tissue of rats exposed to repeated +Gz were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR), and the apoptotic cells in brain tissue were detected by terminal deoxynuleotidyl transferase mediated dUTP nick end labeling technique. The results showed that the bcl 2 expression levels in the brain 6h and 24h after repeated +Gz exposures were significantly lower than those of control group, whereas the bax, p53 and ICE expression levels in the brains tissue 6h and 24h after repeated +Gz exposures were significantly higher than those of control group. Apoptotic cells could be observed in cerebral cortex, CA1 subregion of hippocampus and striatum at 6h and 24h after repeated +Gz exposures. It is suggested that the changes in bcl 2, bax, p53 and ICE expressions in rat brain can be induced by repeated +Gz exposures and apoptosis might be one of the molecular mechanisms of brain damage induced by repeated +Gz exposures