Objective:To analyze and compare rehabilitation research funded by China′s National Natural Science Foundation (NSFC) with that funded by America′s National Institutes of Health (NIH) so as to provide references for future funding.Methods:Articles reporting rehabilitation research funded by the NSFC and the NIH were retrieved from the NSFC′s Science Output Service website and the NIH′s Project Report website and analyzed.Results:From 2009 to 2018 the NSFC funded 421 rehabilitation studies which resulted in a published report while the NIH funded 312. In 2018, the NSFC budget (US$3.89 million) was 8.46 times that of 2009 (US$460, 000), while the NIH′s grant budget (US$36.08 million) was 2.17 times that of 2009 (US$16.62 million). The number of published papers resulting from the Chinese and American studies was 1111 and 2571 respectively. Their impact factors mainly ranged between 0 and 3 points. Among the journals with an impact factor of 6 or more, published papers from the United States (297) were much more numerous than those from China (18). The number of SCI papers per million US dollars increased by 2.25 times in China and 0.05 times in the US.Conclusions:Both China and the United States have been investing more in rehabilitation medicine research, and that has resulted in more published papers. There is still a gap in funding and output between the two countries.

Objective: To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions. Methods: All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed. Results: A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ). Conclusions Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

Objective To observe the 24-week survival status of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) treated with plasma exchange (PE) and double plasma molecular adsorption system (DPMAS) alone or in combination, and to establish a predictive model for 24-week prognosis. Methods Related clinical data were collected from 133 patients with HBV-ACLF who received PE and DPMAS alone or in combination in The Affiliated Provincial Hospital of Anhui Medical University from January 2015 to December 2019, and according to the survival status at the 24-week follow-up after treatment, they were divided into survival group with 71 patients and death group with 62 patients. A total of 55 patients with HBV-ACLF who received PE and DPMAS alone or in combination in The Second Affiliated Hospital of Anhui Medical University from January 2018 to January 2020 were enrolled as validation group to validate the performance of the model. Related clinical data included mode of artificial liver support therapy, age, sex, total bilirubin (TBil), international normalized ratio (INR), creatinine (Cr), serum sodium, platelet count (PLT), albumin (Alb), and presence or absence of ascites, hepatorenal syndrome, hepatic encephalopathy, and gastrointestinal bleeding. The t -test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of continuous data with skewed distribution between two groups; the chi-square test and the Fisher's exact test were used for comparison of categorical data between groups. The Cox regression model was used to analyze the influencing factors for the prognosis of HBV-ACLF patients after PE and DPMAS alone or in combination and establish a predictive model; the receiver operator characteristic (ROC) curve was plotted and the DeLong method was used to compare the area under the ROC curve (AUC) between the new predictive model and Model for End-Stage Liver Disease (MELD)/MELD combined with serum sodium concentration (MELD-Na) scores. Results At 24 weeks after treatment, 71 patients survived and 62 patients died in the modeling group. The Cox regression analysis showed age (hazard ratio [ HR ]=1.030, P =0.013), TBil ( HR =1.018, P < 0.001), INR ( HR =1.517, P < 0.001), and PLT ( HR =0.993, P =0.04) were independent influencing factors for 24-week survival. According to the results of the Cox regression analysis, a prognostic model for HBV-ACLF patients treated with PE and DPMAS alone or in combination was established as ATIP=0.029×age (years)+0.018×TBil (mg/dL)+0.417×INR-0.007×PLT (10 9 /L). Both the modeling group and the validation group showed that the ATIP model had a better predictive performance than MELD and MELD-NA scores(all P < 0.05). Conclusion Age, TBil, INR, and PLT are independent influencing factors for the 24-week survival of HBV-ACLF patients treated with PE and DPMAS alone or in combination, and the ATIP model has a good performance in predicting the 24-week prognosis of HBV-ACLF patients treated with PE and DPMAS alone or in combination.

Objective:To explore the effect and safety of the improved treatment of severe neonate hyperbilirubinemia by the automatic and synchronous exchange transfusion of peripheral artery and vein.Methods:From January 2016 to December 2019, 25 newborns with severe hyperbilirubinemia treated by automatic and synchronous exchange transfusion of peripheral artery and vein were selected in the research.During the operation of exchange transfusion, there were two pathways, the bloodletting one through the arteries and the transfusion one through the veins [the latter was connected to the blood-conveying leather pipeline special for Graseby 3000 syringe pump by the indwelling needle.The filter of the leather pipeline is Y-shaped and had two parallel blood transfusion plugs, one inserted into the red blood cell(RBC) bag, and the other into plasma bag.After infusion of 100 mL of RBC, clamped the RBC bag, and infused 500 mL of plasma.Then clamped the plasma bag and infused 100 mL of RBC.They were alternately operated]. The artery and the vein form a blood circuit, which was controlled by three infusion pumps (the first pump was for bloodletting, the second for transfusion, and the third for heparin sodium infusion). Hence the exchange transfusion became full-automatic.The changes of blood routine, total blood bilirubin(TBIL), blood gas analysis, blood glucose, electrolytes, blood culture and vital signs before and after transfusion were observed.Results:A total of 25 patients were studied, and the exchange transfusion time was controlled between 90-120 minutes.After transfusion, there were no statistically significant changes in breathing, heart rate, blood pressure, electrolytes and blood gas analysis(all P>0.05), while the serum TBIL and platelets(PLT) levels were significantly decreased[the amount of TBIL before and after blood transfusion: (485.8±126.5)μmol/L vs.(207.9±68.4)μmol/L; the amount of PLT before and after blood transfusion: (301.6±118.3)×10 9/L vs.(125.3±60.2)×10 9/L] ( t=-6.924, P<0.01; t=-7.986, P<0.01), and white the blood cells(WBC) was decreased [before blood transfusion: (12.57±6.11)×10 9/L, after blood transfusion: (8.98±3.24)×10 9/L, t=-2.922, P<0.05]. The trace blood glucose(TBG) was higher than normal after blood transfusion, with a significant change[before blood transfusion: (4.9±0.7)mmol/L, after blood transfusion: (7.1±1.5)mmol/L, t=3.866, P<0.01]. TBG restored within 24 h after exchange transfusion, PLT and WBC backed to normal within 72 h. Blood bacterial culture was negative in all cases after the exchange transfusion.No serious complications occurred and all patients were cured. Conclusion:It is simple, safe and reliable to treat severe neonate hyperbilirubinemia by the peripheral automatic exchange transfusion controlled by infusion pumps.The treatment is worthwhile to be recommended for clinical use in primary hospitals.

Objective To compare the stereotactic hematoma drainage and conservative therapy in the treatment of a small amount of bleeding in patients with hypertensive cerebral,and analyze its effects on serum matrix metalloproteinase 9(MMP-9),tumor necrosis factor alpha (TNF-alpha) effect.Methods 60 cases of patients with hypertensive cerebral small as the research object from January 2014 to 2016 10 in our hospital were bleeding,according to treatment methods are divided into operation group and non operation group,30 cases in each group,operation group by stereotactic hematoma drainage treatment,non operative group by con-servative therapy,changes of comparative analysis of the efficacy of the two groups and serum MMP-9,TNF-alpha.Results the operation of hematoma clearance time was (3.4 ± 0.9)d,which was significantly lower than the surgery group hematoma time (12.2 ± 2.5)d(P<0.05);surgery hospitalization time was (16.7 ± 4.5)d,which was significantly lower than the surgery group hospitalization time (23.6 ± 5.1)d(P<0.05). Before treatment,there was no significant difference in NIHSS score between the two groups (P>0.05).Af-ter 2 weeks and 1 months treatment,the NIHSS score of the operation group was significantly lower than that of the non operation group (P<0.05).Before treatment,the serum MMP-9 and TNF-alpha levels were not significantly different between the two groups (P>0.05).1 month after treatment,the serum levels of MMP-9 and TNF-in the operation group were significantly lower than those in the non operation group (P<0.05). The complication rate of the operation group was 13.3%,which was lower than that of the non operation group,and the complication rate was 26.7% (P<0.05).Conclusion stereotactic hematoma drainage is supe-rior to conservative therapy in the treatment of hypertensive intracerebral hemorrhage.It can shorten the time of hospitalization,reduce complications,and reduce the levels of serum MMP-9 and TNF-alpha.

Objective To investigate the effect of lidocaine on Staphylococcus aureus exotoxin-stimulated peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD).Methods Peripheral blood samples were collected from 6 patients with AD,and PBMCs were isolated by a routine method.Then,the PBMCs were stimulated by the Staphylococcus aureus exotoxin toxic shock syndrome toxin-1 (TSST-1) in the absence or presence of lidocaine at varying concentrations.The 3H-TdR incorporation method was performed to detect the proliferation of monocytes,and enzyme-linked immunosorbent assay (ELISA) to quantify the levels of T helper type 1 (Th1) and Th2 cytokines released by PBMCs.Human HaCaT keratinocytes were co-cultured with lidocaine-and TSST-1-stimulated PBMCs from patients with AD for 72 hours,then,Western blot was conducted to examine the expression of filaggrin protein in HaCaT cells.Results TSST-1 (100 μg/L) significantly enhanced the proliferation of PBMCs from patients with AD (stimulation index =75 ± 2.12,P ＜ 0.05),as well as the release of tumor necrosis factor-α (TNF-α),interferon (IFN)-γ,interleukin (IL)-2,IL-12,IL-4,IL-5 and IL-13 by the PBMCs (all P ＜ 0.05).Compared with the blank control group,100 μmol/L lidocaine significantly inhibited the TSST-1-stimulated proliferation of PBMCs from patients with AD (stimulation index =58 ± 3.14,P＜ 0.05),as well as the release of IL-4,IL-5,IL-13,TNF-α and IFN-γ by the stimulated PBMCs (all P ＜ 0.05).Western blot showed that 100 μmol/L lidocaine significantly blocked the down-regulation of filaggrin expression in HaCaT cells (P ＜ 0.01).Conclusion Lidocaine has a significant inhibitory effect on the activation of TSST-1-stimulated PBMCs from patients with AD.

Objective To quantify the temporal changes in the volume of blood flow to the skin of the forearm and lower leg during static maximum inspiratory breath-holding of different durations.Methods Blood flow to the skin of the forearm and lower leg were continuously measured with laser Doppler flowmetry in 12 healthy subjects.They were randomly selected to hold their breath for 10,20 or 40 seconds,or as long as possible.The volume of skin blood flow,the onset latency and the recovery latency were measured before,during and after the breath holding.Results Blood flow decreased significantly during each breath-hold with any durations.The magnitude of the decrease and its latencies were similar with all the durations.The average volume of skin blood flow and it's minimum value during each breath-hold were significantly lower in the forearms than in the lower legs.However,the average onset latency (4.41 ±0.44 s) and the average recovery latency (5.95 ±0.59 s) in the forearms were significantly shorter than in the lower legs (4.83 ± 0.70 s for onset and 7.33 ± 0.91 s for recovery).Conclusion The volume of skin blood flow decreases during a static maximum inspiratory breath-hold,and the magnitude of the increase is not related to the duration of the breath-hold.The generalized increase in skin sympathetic vasoconstrictor activity during a static breath-hold is greater in the forearm than in the lower leg.

Objective: To evaluate the clinical effectiveness of multi-directional mechanical traction (MT) for the treatment of patients with lumbar disc herniation (LDH) compared with longitudinal traction (LT) as control. Method: This prospective, single-blind, randomized clinical trial was performed in Qi Lu Hospital, Shandong University from January 2008 to December 2008. One hundred and twenty outpatients with LDH were randomly divided into MT group or LT group. MT group was treated with computer-controlled multi-directional mechanical traction.LTgroupwastreatedwithlongitudinaltraction.RolandMorrisLowBackPainandDisability Questionnaire (RMDQ), visual analogue scale (VAS), and straight leg raising (SLR) angle were measured for every patient pre-, 4 weeks post-, and 1 year post-treatment.Result: The results of clinical observations showed significant improvements inRMDQ, VAS, and SLR angle assessments (all P＜0.05) in both groups 4 weeks post- and 1 year post-treatment compared with pre-treatment. Score of RMDQ in MT group was significantly lower than that in LT group(P＜0.05), however, there was no significant difference between two groups in VAS score and SLR angle (P＞0.05). The differences in improvement ratios between two groups were not significant (all P＞0.05). The clinical outcomes were negatively correlated with patient's age and disease duration.Conclusion: The effect of MT is equivalent and probably superior to that of LT in improving the symptoms and clinical findings of patients with LDH.

Objective To evaluate the efficacy and safety of tiotropium bromide in treating stable mild and moderate chronic obstructive pulmonary diseases. Methods A randomized,double-blind,parallel comparison clinical trial was conducted in 40 patients with COPD. Twenty patients in tiotropium bromide group were treated by tiotropium bromide powder,and another twenty patients in controll group were given ipratropium,in contrast. The spirometry of both groups was conducted. 4 weeks after treatment. Results The forced expiratory volume in one second ( FEV1 ) and forced vital capacity(FVC) in two groups were significantly increased after treatment( P<0.01 ). The increase of FEV1 in tiotropium bromide group was higher than that in controll group after 4-week. There was no significant differ-ence in rescue medication consumptions. The incidence of adverse effects has no statistical difference between two groups. Conclusion Tiotropium bromide is an effective and safe bronchodilator in treating patients with COPD.

OBJECTIVETo construct the specific stable expression and high efficiency small interfering RNA(siRNA) expression vector that can block DNMT1 gene function.

METHODSUsing vector-based RNA interference technique, the authors constructed a vector to transcribe functional short interfering RNA (RNAi). After transfection by lipofectmine (TM) reagent, the treated cells were selected by G418. The expression levels of RNA and protein of DNMT1 were analyzed by reverse transcription polymerase chain reaction(RT-PCR) and Western blotting. The status of methylation of E-cadherin was analyzed by methylation-specific PCR(MSP).

RESULTSThe expression level of endogenous DNMT1 mRNA in transfected SMMC-7721 cell lines with DNMT1 RNAi construct was 43% less than that in control cell 7721-pSU cell lines. The protein level in the former was about 10% less than that in the latter. The efficiency of the siRNA of DNMT1 was found to be higher than 90%. Demethylation of promoter of E-cadherin was obtained due to the inhibition of DNMT1.

CONCLUSIONDNMT1 siRNA stable expressing vector was obtained by gene-recombined technology. There was no complete sameness between the levels of protein and RNA in gene silenced cell lines. The efficiency of the siRNA should be confirmed by Western-blotting.

Blotting, Western ; Cell Line, Tumor ; DNA (Cytosine-5-)-Methyltransferase 1 ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; metabolism ; DNA Methylation ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Microscopy, Fluorescence ; RNA Interference ; RNA, Small Interfering ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection