Objective To investigate the therapeutic effect of Euryale ferox seed shell extract on oral ulcer in rats and its underlying mechanism. Methods The contents of polyphenols and flavonoids in Euryale ferox seed shells were determined by Folin-phenol assay and aluminum nitrate colorimetry, respectively. DPPH · , ABTS+· , · OH and · O2- scavenging experiments were performed to evaluate the antioxidant activities of Euryale ferox seed shell extract in vitro. In a rat model of oral ulcer induced by burning with glacial acetic acid, the therapeutic effect of Euryale ferox seed shell extract was assessed by detecting changes in serum levels of oxidative factors by enzyme-linked immunosorbent assay (ELISA) and observing pathological changes of the ulcerous mucosa using HE staining; the therapeutic mechanism of the extract was explored by detecting the expression levels of Keap1, Nrf2, Nes-Nrf2 and HO-1 proteins in ulcerous mucosa using Western blotting. Results The ethyl acetate extract of Euryale ferox seed shells contained 306.74±1.04 mg/g polyphenols and 23.43±0.61 mg/g flavonoids and had IC50 values for scavenging DPPH · and ABTS+· free radicals of 3.42 ± 0.97 μg/mL and 3.32 ± 0.90 μg/mL, respectively. In the rat models, the ethyl acetate extract significantly ameliorated oral mucosal ulcer, increased serum CAT level, and decreased serum MDA level. The protein expression levels of Nes-Nrf2 and HO-1 were increased and Keap1 protein expression was lowered significantly in the ulcerous mucosa of the rats after treatment with the extract (P<0.05 or 0.01). Conclusion The therapeutic effect of Euryale ferox seed shell extract on oral ulcers in rats is mediated probably by activation of the Keap1/Nrf2/HO-1 signaling pathway.

Objective To investigate the therapeutic effect of Euryale ferox seed shell extract on oral ulcer in rats and its underlying mechanism. Methods The contents of polyphenols and flavonoids in Euryale ferox seed shells were determined by Folin-phenol assay and aluminum nitrate colorimetry, respectively. DPPH · , ABTS+· , · OH and · O2- scavenging experiments were performed to evaluate the antioxidant activities of Euryale ferox seed shell extract in vitro. In a rat model of oral ulcer induced by burning with glacial acetic acid, the therapeutic effect of Euryale ferox seed shell extract was assessed by detecting changes in serum levels of oxidative factors by enzyme-linked immunosorbent assay (ELISA) and observing pathological changes of the ulcerous mucosa using HE staining; the therapeutic mechanism of the extract was explored by detecting the expression levels of Keap1, Nrf2, Nes-Nrf2 and HO-1 proteins in ulcerous mucosa using Western blotting. Results The ethyl acetate extract of Euryale ferox seed shells contained 306.74±1.04 mg/g polyphenols and 23.43±0.61 mg/g flavonoids and had IC50 values for scavenging DPPH · and ABTS+· free radicals of 3.42 ± 0.97 μg/mL and 3.32 ± 0.90 μg/mL, respectively. In the rat models, the ethyl acetate extract significantly ameliorated oral mucosal ulcer, increased serum CAT level, and decreased serum MDA level. The protein expression levels of Nes-Nrf2 and HO-1 were increased and Keap1 protein expression was lowered significantly in the ulcerous mucosa of the rats after treatment with the extract (P<0.05 or 0.01). Conclusion The therapeutic effect of Euryale ferox seed shell extract on oral ulcers in rats is mediated probably by activation of the Keap1/Nrf2/HO-1 signaling pathway.

Objective　To elucidate the molecular characteristics of two Acinetobacter baumannii strains producing NDM-1, OXA-23, and OXA-51 carbapenemases through whole genome sequencing technology, explore the mechanism of drug resistance, evolutionary pathways, and transmission potential, and provide data support for the formulation of clinical infection control strategies. Methods　Two strains of Acinetobacter baumannii producing class B and class D carbapenemases, sourced from the ICU environment of two hospitals in Shanghai, were selected as study subjects. Next-generation sequencing technology was used to obtain the whole genome sequences of the strains. The whole genome map of the strains was drawn based on GCskew and Prokka tools on the Proksee website. Drug susceptibility experiments and BacWGSTdb 2.0 online analysis platform were used to screen for drug resistance genes to analyze the drug resistance of strains. Virulence genes, multilocus sequence typing (MLST), capsule serotype, and plasmid migration were evaluated based on the VFDB database, PubMLST database, OriTfinder, Kptive, and other tools, and an evolutionary tree was drawn by Neighbor-Joining method. Results　Whole genome data showed that both strains belong to ST164_Pasteur/ST1418_Oxford-KL47/OCL5 type. All of them carry seven resistance genes (blaADC-25, blaCARB-5, blaCARB-16, blaCARB-49, blaNDM-1, blaOXA-23, blaOXA-91) and non-mobile plasmids. They possess 45 virulence genes related to outer membrane proteins and efflux pumps and are closely related to 5 strains from Malaysia and China (Changsha, Nanchang, and Hangzhou). Conclusions　For the first time, the coexistence of OXA-23, OXA-51, NDM-1 producing Acinetobacter baumannii has been detected in the ICU environment in Shanghai, potentially posing a serious threat to public health. It is necessary to strengthen the monitoring and research of such strains to develop effective prevention and control strategies.

ObjectiveTo observe the effects of Dendrobium polysaccharides on the secretion of inflammatory cytokines and Toll-like receptor 4 （TLR4）/nuclear factor （NF）-κB pathway in 16HBE cells exposed to cigarette smoke extract （CSE）. MethodThe 16HBE cells were classified into the control， CSE， and CSE+ Dendrobium polysaccharides （100， 200， 400 mg·L^-1） groups. The cell-counting kit-8 （CCK-8） assay was employed to measure the cell viability， and a microscope was used to observe the cell morphology. The enzyme-linked immunosorbent assay was employed to measure the levels of interleukin （IL）-8， IL-1β， IL-4， IL-13， and transforming growth factor （TGF）-β in cell culture supernatants. Real-time PCR was carried out to determine the mRNA levels of Toll-like receptor 4 （TLR4）， nuclear factor-κB （NF-κB）， and IL-4. Western blot was employed to determine the protein levels of interleukin-4 receptor （IL-4R）， TLR4， myeloid differentiation primary response protein 88 （MyD88）， NF-κB， phosphorylated nuclear factor-κB （p-NF-κB）， and nucleoproteins nuclear factor-κB （NEs-NF-κB）. The immunofluorescence assay was employed to measure the nuclear translocation of NF-κB. ResultCompared with the control group， the CSE group showed elevated levels of IL-8， IL-1β， IL-4， IL-13， and TGF-β in the cell culture supernatants （P<0.05， P<0.01）， up-regulated expression levels of TLR4， MyD88， NF-κB， p-NF-κB， NEs-NF-κB， and IL-4 （P<0.01）， and significant nuclear translocation of NF-κB. Compared with the CSE group， Dendrobium polysaccharides increased the cell survival rate， recovered the cell activity， lowered the levels of IL-8， IL-1β， IL-4， IL-13， and TGF-β， down-regulated the expression of TLR4， MyD88， NF-κB， p-NF-κB， NEs-NF-κB， and IL-4 （P<0.05， P<0.01）， and reduced the nuclear translocation of NF-κB. ConclusionDendrobium polysaccharides showed significant protective effects on the 16HBE cells exposed to CSE by inhibiting the TLR4/NF-κB signaling pathway.

Objective To determine the in vitro recovery rate and influencing factors of cefradine microdialysis. Methods Two different methods (loss method, gain method) of microdialysis concentration and LC-MS/MS were used to determine the in vitro recovery rate of cefradine. The effect of flow rate and concentration of the perfusate on the recovery rate were investigated. To explore the feasibility of microdialysis technology for pharmacokinetic studies in cefradine. Results The LC-MS/MS analysis method was linear in the required range and the method was sensitive and reliable. There was no significant difference in the recovery rate measured by gain or loss method. Under the same conditions, the in vitro recovery of the probe decreased with increasing flow rate, independent of the drug concentration around the probe. Conclusion Microdialysis technique could be used to study the pharmacokinetics of cefradine, and loss method could be used to determine the in vivo recovery rate and pharmacokinetics of cefradine on microdialysis.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To investigate the clinical characteristics of pulmonary hypertension(PH) in patients with chronic obstructive pulmonary disease (COPD) and study the related risk factors.Methods Patients with stable COPD enrolled in this study,undergoing examinations including full pulmonary function tests (PFT),6-minute walk distance (6MWD),Exercise Oxyhemoglobin,Saint.George's respiratory questionnaire (SGRQ) and transthoracic echocardiography.Pulmonary artery systolic pressure (sPAP) ≥ 36 mmHg(1 mmHg =0.133 kPa) was defined as PH.Results A total of 251 patients were finally evaluable in this study.The frequency of PH was 55.4％ (139/251) in patients with stable COPD.Significant differences were seen between patients with PH and without PH respectively in the following factors (mean P ＜0.05):proportion of age ≥ 60 years (69.8％ vs 57.1％),forced expiratory volume in one second (FEV1)(％ predicted) [(47.5±8.2)％ vs(61.2±10.2)％ and(49.8±7.9)％ vs(66.4±11.3)％],sPAP [(41.9 ± 9.1) mmHg vs (28.2 ± 3.2) mmHg],exercise oxyhemoglobin desaturation [(-5.5 ± 3.2) ％ vs(-2.2 ± 1.2) ％],6MWD [(316.0 ± 55.2) m vs(390.0 ±75.2) m].The following variables were negatively correlated with sPAP:6MWD (r =-0.330,P =0.003),FEV1 (％ predicted) (r =-0.210,P =0.024 and r =-0.130,P =0.012,respectively).The following variables were positively correlated with sPAP:age(r =0.560,P =0.031),exercise oxyhemoglobin desaturation ＞ 3％ (r =0.540,P =0.001).Logistic regression test has showed that age≥ 60 years,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m were risk factors for PH in COPD.Conclusion The incidence of PH in COPD increases with age,yet the performance of lung function and the activity of endurance decrease in elder patients.Sixty years or older,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m are risk factors of PH in COPD.Echocardiography or right heart catheterization when needed should be considered to confirm the diagnosis.

Objective To explore the application effect of scenario simulation training to prevent and control Ebola virus disease spread among cleaners in Sierra Leone .Methods A total of forty local cleaners in Sierra Leone were given scenario simulation training program designed to resolve the problems of Ebola infection prevention and control , and they were required to be appraised by corresponding criteria after drilling and training.Results After training, all cases were significantly improved in anxiety , tense, fear, agrypnia and depression.There were statistical difference before and after training (χ2 =16.2,39.7,34.3,15.9,5.2, respectively;P<0.05).Seven of forty cleaners had satisfaction with environment layout modification before training compared with thirty nine of forty having satisfaction after training (χ2 =52.4,P<0.01).100% of participants presented the satisfaction of training contents and effects .The highest score of examination was 98 and lowest was 68 that 39 of them reached passed level .All cleaners showed excellent working status and there was no infections happened .Conclusions It is an effective way to take step-by-step and whole-procedure scenario simulation training to increase the knowledge and skills of infection prevention and control .

ObjectiveTo evaluate treatment of type 2 diabetes mellitus (T2DM) by laparoscopic Roux-en-Y gastric bypass (LRYGB) using different amastomoses. MethodsTwenty one T2DM patients were divided into two groups:transoral EEA (OrVil) and Endo-GIA according to ways of gastrointestinal anatomosis andunderwentLRYGB. Clinicaldataincluding outcomeof operation, complications,preoperative and postoperative oral glucose tolerance test (OGTT),Homa-IR,Homa-β,blood lipid and nutrition status were analyzed.ResultsLRYGB procedures were successfully performed in all the 21 patients with no conversion to open surgery.The difference of intraoperative blood loss,postoperative recovery time between two groups was not significant.The mean operation time in OrVil group ( 126 ± 29 )mins was shorter than that in Endo-GIA group ( 156 ± 28 ) mins ( P ＜ 0.05 ),but at the same time,the mean expenditure was higher. Evaluated on three months after operation,the T2DM cure rate was 78％,and effective rate was 100％ in OrVil goup and those were 83％,100％ respectively in Endo-GIA group.No postoperative malnutrition, anemia or severe complication occurred.ConclusionsThe efficiency of laparoscopic Roux-en-Y gastric bypass using different amastomoses was same in the treatment of type 2 diabetes mellitus.The operation time was shorter in OrVil group but the expenditure was higher.

Objective To investigate the technical difficulties and the avoidance of complications in delayed laparoscopic cholecystectomy (LC) for acute cholecystitis (AC).MethodsThe results of LC carried out on 133 consecutive patients with AC between February 2004 and August 2008 were retrospectively studied.The outcomes were compared between patients who received LC for AC within 72 hours (the early group) and those after 72 hours (the delayed group).There were 34 patients in the early group and 99 in the delayed group.During LC,Calot's triangle was carefully dissected,and the relationship of the cystic duct to the CBD and common hepatic duct was clearly identified.Retrograde cholecystectomy in 2 patients was used when the Calot's triangle was poorly identified.Laparoscopic subtotal cholecystectomy was carried out in 4 patients whose inflammation or fibrosis precluded dissection of the Calot's triangle.ResultsThere was no conversion to open cholecystectomy,biliary tract injury,biliary leak,or any other intraoperative or postoperative complications.There was no 30day readmission in the 2 groups.Patients who received delayed LC had a significantly longer operation time [(44.1±5.32) vs (66.4±3.05)rnin,P＜0.01].There was no significant difference in wound infection rates in the 2 groups (1/34 2.94 ％ vs 2/99 2.02 ％,P＞0.05).ConclusionsDelayed LC was as feasible and safe as early LC in the treatment of AC.Delayed LC was technically more demanding than early LC.