OBJECTIVES: To investigate the role of the BNIP3-PI3K/Akt signaling pathway in mediating the inhibitory effect of Buyang Huanwu Decoction (BYHWT) on mitochondrial autophagy in human synovial fibroblasts from rheumatoid arthritis patients (FLS-RA) cultured under a hypoxic condition. METHODS: Forty normal Wistar rats were randomized into two groups (n=20) for daily gavage of BYHWT or distilled water for 7 days to prepare BYHWT-medicated or control sera. FLS-RA were cultured in routine condition or exposed to hypoxia (10% O₂) for 24 h wigh subsequent treatment with IL-1β, followed by treatment with diluted BYHWT-medicated serum (5%, 10% and 20%) or control serum. AnnexinV-APC/7-AAD double staining and T-AOC kit were used for detecting apoptosis and total antioxidant capacity of the cells, and the changes in ROS, ATP level, mitochondrial membrane potential and Ca²⁺ homeostasis were analyzed. The changes in mRNA and protein expressions of BNIP3, PI3K and AKT and mRNA expressions of LC3, Beclin-1 and P62 were detected using RT-qPCR and Western blotting. RESULTS: Treatment with BYHWT-medicated serum dose-dependently lowered apoptosis rate of IL-1β-induced FLS-RA with hypoxic exposure. The treatment significantly decreased T-AOC concentration, increased ROS production, autophagosome formation and ATPase levels, and lowered mitochondrial membrane potential and Ca²⁺ level in the cells. In IL-1β-induced FLS-RA with hypoxic exposure, treatment with BYHWT-medicated serum significantly increased BNIP3 protein expression, decreased the protein expressions of PI3K and AKT, increased the mRNA expressions of BNIP3 and P62, and lowered the mRNA expressions of PI3K, AKT, LC3 and Beclin-1 without significantly affecting Beclin-1 protein expression. The cells treated with 5% and 10% BYHWT-medicated serum showed no significant changes in LC3 expression. CONCLUSIONS BYHWT inhibits mitochondrial autophagy in IL-1β-induced FLS-RA with hypoxic exposure possibly by inhibiting BNIP3-mediated PI3K/AKT signaling pathway.
Drugs, Chinese Herbal/pharmacology* ; Arthritis, Rheumatoid/pathology* ; Animals ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/metabolism* ; Autophagy/drug effects* ; Humans ; Fibroblasts/cytology* ; Rats, Wistar ; Membrane Proteins/metabolism* ; Rats ; Phosphatidylinositol 3-Kinases/metabolism* ; Mitochondria/metabolism* ; Cells, Cultured ; Proto-Oncogene Proteins/metabolism* ; Apoptosis/drug effects* ; Cell Hypoxia ; Synovial Membrane/cytology* ; Male ; Mitochondrial Proteins

Objective:To analyze the implementation of early essential newborn care (EENC) in baby-friendly hospitals in China.Methods:This is an investigation carried out using convenience sampling method. People in charge of labor ward, obstetric wards or neonatology department of the selected hospitals, such as baby-friendly hospitals with birth facilities, primary or higher level of hospitals, or general hospitals or those specialized in obstetrics and gynecology or materal and child health care centers, were selected as the subjects of the survey. Information about EENC practices in these hospitals was collected using a self-designed questionnaire sent through WeChat from April 1 to 30, 2021. Chi-square test was used for statistical analysis. Results:A total of 126 questionnaires were distributed and 124 (124 baby-friendly hospitals) were withdrawn. There were 74 hospitals in the eastern, 18 in the central and 32 in the western region. Among the 124 hospitals, tertiary hospitals, general hospitals, and maternity and child care hospitals accounted for 72.6% ( n=90), 64.5% ( n=80) and 35.5% ( n=44), respectively. There were no significant differences in the hospital type, levels, EENC coverage and training, or implementation of mainly recommended EENC practices among the hospitals in the eastern, central and western regions (all P>0.05). The implementation rate of at least one mainly recommended EENC practice was 79.0% (98/124) and there was no significant difference in the implementation rates among eastern, central and western regions [86.4% (64/74), 13/18 and 65.6% (21/32), χ2=6.60, P=0.159]. A total of 80 (64.5%) hospitals implemented 10 or more recommended EENC practices, and the implementation rates in eastern, central and western regions were 71.6% (53/74), 10/18 and 53.1% (17/32), respectively ( χ2=4.08, P=0.130). Among the 17 mainly recommended measures of EENC, in eastern, central and western hospitals, the implementation rates were 10.8% (8/74), 2/18 and 18.8% (6/32) for mother-infant skin-to-skin contact for 90 min after birth; 66.2% (49/74), 11/18 and 68.8% (22/32) for delayed umbilical cord clamping; and 25.7% (19/74), 7/18 and 21.9% (7/32) for delayed routine care following skin-to-skin contact, respectively ( χ2=6.57, 0.34 and 4.53, all P>0.05). Conclusions:There is a big gap between the implementation of EENC in most baby-friendly hospitals in eastern, central and western China and the recommendation of the World Health Organization. It is necessary to further strengthen and standardize the implementation of EENC practices in baby-friendly hospitals in our country to continuously improve the health of newborns.

OBJECTIVE To investigate the effects of β-sitosterol on the function of rheumatoid arthritis （RA） fibroblastic synoviocytes MH7A cells and its mechanism. METHODS Network pharmacology was adopted to screen the targets of β-sitosterol and the targets for the treatment of RA. After the intersection of them， topological analysis was performed to find the most critical target in the treatment of RA. MH7A cells were treated with different concentrations （0， 5， 10， 20， 40 μmol/L） of β-sitosterol， and CCK-8 was used to assay cell viability for screening the optimal concentration of β-sitosterol. MH7A cells were induced by 10 ng/mL TNF-α in vitro and treated with β-sitosterol （the optimum concentration）. CCK-8 and EdU were used to detect the ability of cell proliferation. Scratch experiment and Transwell invasion assay were used to analyze cell migration and invasion. The levels of interleukin-1β （IL-1β） and IL-6 in cell supernatant were detected by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expressions of peroxisome proliferator-activated receptor α （PPARα） were measured by qRT-PCR and Western blot， respectively. The siRNA targeting PPARα was transfected into MH7A cells， and the effects of β-sitosterol on cell proliferation， migration， invasion， the secretion of inflammatory factors and the expression of PPARα after PPARα knockdown were detected by the above experimental methods. RESULTS PPARα was the most critical target of β-sitosterol in the treatment of RA. The optimal concentration of β-sitosterol was 20 μmol/L. Compared with model group， β-sitosterol decreased the viability of MH7A cells， and the number of proliferating cells also decreased significantly （P＜0.05）； the cell migration rate and the number of cell invasion decreased significantly （P＜0.05）. The levels of IL-1β and IL-6 were also significantly decreased （P＜0.05）， and the mRNA 15 and protein expression levels of PPARα were significantly increased （P＜0.05）. Compared with negative control small interfering RNA group， after PPARα knockdown， the cell viability increased by about 35.6% （P＜0.05）， the number of cell proliferation， the cell migration rate and the number of cell invasion increased significantly （P＜0.05）， and the levels of IL-1β and IL-6 also increased significantly （P＜0.05）. CONCLUSIONS β-sitosterol could effectively inhibit the proliferation， migration， invasion and secretion of inflammatory factors in MH7A cells， the mechanism of which may be associated with activating PPARα pathway.

Objective:To systematically integrate the real experience of self-management needs of patients with non-alcoholic fatty liver disease (NAFLD) and provide evidence-based basis for nursing interventions.Methods:Relevant qualitative research was searched on China National Knowledge Infrastructure (CNKI) , VIP, Wanfang Data, SinoMed, PubMed, Web of Science, Embase, Cochrane Library, and CINAHL. The search period was from the establishment of the database to March 17, 2023. Literature screening was conducted based on inclusion and exclusion criteria, and quality evaluation was conducted using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia. The results were synthesized by integrating method, and the quality of the integration results was evaluated through the Confidence in the Evidence from Reviews of Qualitative research (CERQual) .Results:A total of 9 articles were included, 36 research results were extracted, summarized into 7 new categories, and integrated into 3 results, namely information support needs, solution support needs, and social support needs. The results of CERQual showed that the quality levels of information support needs, solution support needs, and social support needs were high, medium, and medium in order.Conclusions:NAFLD patients need a comprehensive self-management support system to improve their self-management and reduce the disease burden.

Objective: To translate the English version of the non-alcoholic fatty liver disease quality of life scale (CLDQ-NAFLD) into the Chinese version in order to test its reliability and validity. Methods: The English version of the CLDQ-NAFLD was translated according to the cross-cultural research tool debugging and validation guidelines to form the Chinese version of the CLDQ-NAFLD. A questionnaire survey was conducted on 515 NAFLD cases in a tertiary hospital in Hangzhou from September 2021 to April 2022 to evaluate the reliability and validity of the scale. Results: The Chinese version of the CLDQ-NAFLD contained six domains with a total of thirty-six items (X2/DF=3.105, RMSEA=0.064, TLI=0.905, CFI=0.912, and IFI=0.913). I-CVI, S-CVI/UA, and S-CVI/Ave was 0.83 to 1.00, 0.86 and 0.98, respectively. The 12-item Short-Form Health Survey (SF-12) was used as the calibration standard, and the correlation validity of the calibration standard was 0.704 (P<0.001). The Cronbach's alpha coefficient of the total scale and each dimension of the scale was 0.964 and 0.807-0.956, respectively. The test-retest reliability was 0.839. Conclusion: The Chinese version of the CLDQ-NAFLD has good reliability and validity. Thus, it can be used to evaluate the quality of life for NAFLD patients with a Chinese cultural background.
Humans ; Reproducibility of Results ; Quality of Life ; Non-alcoholic Fatty Liver Disease ; Surveys and Questionnaires ; Asian People ; China ; Psychometrics

Backgrounds::Inadequate sleep duration is associated with a higher risk of type 2 diabetes and the relationship is nonlinear. We aim to assess the curve relationship between night sleep duration and the incidence of type 2 diabetes in China.Methods::A cohort of 11,539 participants from the REACTION study without diabetes at baseline (2011) were followed until 2014 for the development of type 2 diabetes. The average number of hours of sleep per night was grouped. Incidence rates and odds ratios (ORs) were calculated for the development of diabetes in each sleep duration category.Results::Compared to people who sleep for 7 to 8 h/night, people with longer sleep duration (≥9 h/night) had a greater risk of type 2 diabetes (OR: 1.27; 95% CI: 1.01-1.61), while shorter sleep (<6 h/night) had no significant difference in risk of type 2 diabetes. When the dataset was stratified based on selected covariates, the association between type 2 diabetes and long sleep duration became more evident among individuals <65 years of age, male, body mass index <24 kg/m 2 or with hypertension or hyperlipidemia, no interaction effects were observed. Furthermore, compared to people persistently sleeping 7 to 9 h/night, those who persistently slept ≥9 h/night had a higher risk of type 2 diabetes. The optimal sleep duration was 6.3 to 7.5 h/night. Conclusions::Short or long sleep duration was associated with a higher risk of type 2 diabetes. Persistently long sleep duration increased the risk.

The ketogenic diet(KD) treatment program planned for a 2 years old and 5 months boy suffered from severe cerebral complications after ependymoma operation in the Children′s Hospital of Nanjing Medical University at December 2018 was analyzed retrospectively.The patient developed various complications, including cerebral hemorrhage, hydrocephalus and hernia after the operation of ependymoma, with coma, fever and convulsion, and 1 month of anti-infection and antiepileptic treatment was ineffective.After 2 weeks of 4∶1 KD, fever and convulsion were effectively relieved without obvious side effects.One month later, the patient regained consciousness, demonstrating that KD can be applied to treat severe cerebral complications after ependymoma operation.

Objective To explore the hemodynamic assessment after radical surgery in children with tetralogy of Fallot (TOF) by both echocardiography and Mostcare monitor. Methods Clinical data of 63 children with TOF who underwent radical surgery in our hospital from February 2016 to June 2018 were retrospectively analyzed, including 34 males and 29 females, aged 6-24 (9.82±5.77) months. There were 19 patients undergoing transannular patch reconstruction of the right ventricular outflow tract (a transannular patch group) while 44 patients retained the pulmonary valve annulus (a non-transannular patch group) . The echocardiography and Mostcare monitor parameters were recorded and brain natriuretic peptide was tested at the time points of 0, 8, 12, 24 and 48 hours after operation (T 0, T 1, T 2, T 4) to analyze their correlations and the change trend at different time points after radical surgery. Results The left ventricular ejection fraction at T 1 (43.49%±3.82%) was lower than that at T 0 (48.29%±4.55%), T 2 (45.83%±3.69%), T 3 (53.76%±4.43%) and T 4 (60.54%±3.23%, P<0.05). The cardiac index at T 1 (1.85±0.35 L·min−1·m−2) was lower than that at T 0 (2.11±0.38 L·min−1·m−2), T 2 (2.07±0.36 L·min−1·m−2), T 3 (2.42±0.37 L·min−1·m−2) and T 4 (2.82±0.42 L·min−1·m−2, P<0.05). The cardiac circulation efficiency at T1 (0.19±0.05) was lower than that at T 0 (0.22±0.06), T 2 (0.22±0.05), T 3 (0.28±0.06) and T 4 (0.34±0.06, P<0.05). The right ventricular two-chambers view fraction area change at T 1 (23.17%±3.11%) was lower than that at T 0 (25.81%±3.74%), T 2 (25.38%±3.43%), T 3 (30.60%±4.50%) and T 4 (36.94%±5.85%, P<0.05). The pulse pressure variability was the highest at T 0 (18.76%±3.58%), followed by T 1 (14.81%±3.32%), T 2 (12.44%±2.94%), T 3 (10.39%±2.96%) and T 4 (9.18%±1.92%, P<0.05). The blood brain natriuretic peptide was higher at T 1 (846.67±362.95 pg/ml) than that at T 0 (42.60±18.06 pg/ml), T 2 (730.95±351.09 pg/ml), T 3 (510.98±290.39 pg/ml) and T 4 (364.41±243.56 pg/ml, P<0.05). There was no significant difference in left ventricular ejection fraction, cardiac circulation efficiency and heart index between the two groups (P>0.05). The right ventricular two-chambers view fraction area change of the transannular patch group was significantly lower than that of the nontransannular patch group at each time point (P<0.05). The blood brain natriuretic peptide and pulse pressure variability of the transannular patch group were significantly higher than those of the non-transannular patch group (P<0.05). Left ventricular ejection fraction was positively correlated with cardiac index (r=0.637, P=0.001) and cardiac circulation efficiency (r=0.462, P=0.001) while was significantly negatively correlated with blood brain natriuretic peptide (r=–0.419, P=0.001). Conclusion Both methods can accurately reflect the state of cardiac function. Mostcare monitor has a good consistency with echocardiography. Using transannular patch to recontribute right ventricular outflow tract in operation has more influence on right ventricular systolic function. The Mostcare monitor can guide the hemodynamic management after surgery in real time, continuously and accurately.

Objective To observe and compare the function of peripheral blood derived dendritic cells (DC) in white hair black eyes (WHBE) rabbits and Japanese white (JW) rabbits with allergic rhinitis (AR) induced by ovalbumin (OVA),and to explore the mechanism of sensitivity to allergen in WHBE rabbits.Methods For the AR induction,rabbits were sensitized intraperitoneally everyday with OVA emulsified in Al(OH)3 followed from day 17 onward by 5 times nasal challenges with OVA in each nostril.General symptoms and histopathological changes of the nasal mucosa were observed.Expressions of CD86 on cell surface and antigen uptake of peripheral blood-derived dendritic cells were detected by flow cytometry at 6 days of culture.The mannose receptor (MR) mRNA expression was tested by real-time PCR.Proliferation of CFSE [5-(and 6-)-carboxyfluorescein diacetate succinimidyl ester]-labelled T cells stimulated by DC were observed by flow cytometry.Results The rabbits sensitized by OVA showed typical AR symptoms and pathological changes.Expressions of CD86 on the cell surface of dendritic cells in WHBE rabbits with AR were significantly upregulated not only compared with the normal control (NC) rabbits,but also with the JW rabbits with AR (P<0.01).The result of real-time PCR assay showed that MR mRNA expression of DC in the NC group of WHBE rabbits were significantly higher than that of the JWrabbits(P<0.01).Moreover,MR mRNA expression of DCs in the WHBE rabbits with AR were not only significantly higher than that in the NC rabbits (P<0.05),but also higher than that in the JW rabbits with AR (P<0.05).Meanwhile,OVA647 internalization percentages of DCs in the WHBE rabbits with AR were not only significantly higher than that in the NC rabbits,but also obviously higher than that in the JW rabbits with AR (P<0.01).Conclusions The sensitivity of WHBE rabbits to allergen may largely depend on the function of dendritic cells with high expression of mannose receptor and their strong ability of maturation and antigen uptake.

Objective:To evaluate the effects of resin infiltration in the treatment of post-orthodontic white spot lesions (WSLs)and compare it with microabrasion.Methods:1 0 subjects with 66 teeth with noncavitated and unrestored WSLs after multibracket treatment were recruited.A simple randomized,split-mouth and controlled design was used to allocate WSLs to the resin infiltration and micro-abrasion groups(n =33).The area of the WSLs were measured photographically by using image analysis software before treatment (T0),1 week(T2)and 3 months(T3)after treatment.Data were analyzed with multifactorial analysis of the variances with repeated measures at an a level of 5% and a power of 80%.Results:The area of the white spot lesions(R)decreased significantly in both groups(P <0.05).At T3 the success rate of resin infiltration group(88.68%)was significantly higher than that of microabrasion group (64.67%)(P <0.05).Conclusion:Resin infiltration is more effective than microabrasion in the treatment of post-orthodontic WSLs.