OBJECTIVE: To observe the effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome (IBS-D) and explore its underlying mechanisms. METHODS: Of 38 newborn rats from 4 healthy SPF pregnant rats, 12 neonatal rats were randomly selected in a normal group. IBS-D model was prepared by the combined measures for the rest rats, including neonatal maternal separation, acetic acid enema and chronic restraint stress. Twenty-four successfully-modeled rats were randomized into a model group and a moxibustion group, 12 rats in each one. In the moxibustion group, suspending moxibustion was delivered at bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37), 20 min each time, once daily and for 7 consecutive days. Separately, before acetic acid enema (aged 35 days), after modeling (aged 45 days) and after intervention (aged 53 days), the body mass, loose stool rate (LSR) and and the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were observed in the rats of each group. After intervention (aged 53 days), using HE and PAS staining, the morphology of duodenum was observed, the length of villus and the depth of crypt were measured, the ratio of the length of villus to the depth of crypt was calculated; and the numbers of mucosal intraepithelial lymphocytes (IELs) and goblet cells were counted. With ELISA adopted, the contents of γ-interferon (IFN-γ), interleukin-4 (IL-4) and secretory immunoglobulin A (sIgA) in duodenal mucosa of rats were detected. The proportion of T cell subsets in duodenal mucosa was detected using flow cytometry. The microvilli and tight junctions of duodenal mucosal epithelial cells were observed by transmission electron microscopy, and the integrity of duodenal mucosa observed by scanning electron microscopy. RESULTS: Compared with the normal group, for the rats in the model group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the the ratio of the length of villus to the depth of crypt, as well as the proportion of CD₈⁺ T subset were all reduced (P<0.01, P<0.05), the counts of goblet cells in duodenal mucosa decreased (P<0.01); LRS, the proportion of CD₄⁺ T subset and CD₄⁺/CD₈⁺, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were all elevated (P<0.01); and the numbers of IELs rose (P<0.01). The morphology of duodenal mucosa was irregular, the villi got shorter, sparse and scattered, with uneven density. The morphology of epithelial cells was destroyed and the tight junctions damaged, with larger spaces. When compared with the model group, in the moxibustion group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the ratio of the length of villus to the depth of crypt, as well as the counts of goblet cells in duodenal mucosa increased (P<0.01); LRS, the proportion of CD₄⁺ T subset, and CD₄⁺/CD₈⁺, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were reduced (P<0.01); and the numbers of IELs was dropped (P<0.01). The morphology of duodenal mucosa was more regular, the villi were grew, got longer and arranged regularly, with even density. The morphology of epithelial cells was slightly destroyed, and the tight junctions partially damaged. CONCLUSION Moxibustion at "Tianshu" (ST25) and "Shangjuxu" (ST37) can reduce visceral hypersensitivity in IBS-D rats and relieve abdominal pain, diarrhea and other symptoms. Its effect mechanism may be related to the repair of small intestinal mucosal immune barrier and the improvement in the immune function in IBS-D.
Animals ; Irritable Bowel Syndrome/immunology* ; Rats ; Moxibustion ; Intestinal Mucosa/immunology* ; Female ; Diarrhea/therapy* ; Intestine, Small/immunology* ; Male ; Humans ; Rats, Sprague-Dawley ; Disease Models, Animal

Objective:To explore the hypothesis of "pathogen storage pool" by analyzing the local microbial community of adenoids. Methods:Under the guidance of a 70° nasal endoscope, sterile swabs were used to collect secretions from the adenoid crypts of the subjects. The samples were sent to the laboratory for DNA extraction and standard bacterial 16S full-length sequencing analysis. Results:At the species level, the top three microbial communities in adenoid crypts were Bacillus subtilis（18.78%）, Fusobacterium pyogenes（11.42%）, and Streptococcus pneumoniae（9.38%）. Conclusion:The local microbial community of adenoids exhibits a high degree of diversity, including microbial communities from the oral cavity and gastrointestinal tract. Our research results support the hypothesis that adenoids act as a " pathogen reservoir".
Humans ; Adenoids/microbiology* ; RNA, Ribosomal, 16S/genetics* ; Microbiota/genetics* ; Streptococcus pneumoniae/isolation & purification* ; Bacillus subtilis/genetics* ; DNA, Bacterial/analysis*

Objective:To investigate the characteristics of multimodal ultrasound imaging in elderly hyperlipidemia patients with statin-related myopathy and to provide a reference of new method for non-invasive quantitative evaluation on statin myopathy.Methods:We collected 20 elderly hyperlipidemia patients with statin-related myopathy(the statin-related myopathy group), 20 elderly hyperlipidemia patients without statin-related myopathy after taking statins during the same period(the non-statin-related myopathy group), and 20 healthy volunteers who matched the age and sex of the above two groups during the same period(the healthy control group)in our hospital.Two-dimensional ultrasound, shear wave elastography and superb microvascular imaging were used to obtain thickness, echo, pinnation angle and shear wave velocity(SWV)values as well as vascular index(VI)values of the medial gastrocnemius during relaxation, dorsiflexion, and plantar flexion for each group, which were then analyzed.Results:There were no significant differences among the three groups in general conditions such as age, height, weight, and body mass index(all P>0.05). The mean thickness of the medial gastrocnemius in the statin-related myopathy group was about(1.04 ± 0.20)cm, which was less than(1.34 ± 0.16)cm in the non-statin-related myopathy group and(1.35 ± 0.15)cm in the healthy control group( F=22.03, P<0.001). The pinnation angle in the statin-related myopathy group was about(12.50 ± 1.10), which was less than(18.55 ± 1.28)in the non-statin-related myopathy group and(18.60 ± 1.35)in the healthy control group( F=158.03, P<0.001). Compared with the non-statin-related myopathy group and the healthy control group, SWV during resting, dorsiflexion and plantar flexion in the statin-related myopathy group decreased( F=61.71, 111.96 and 8.69, respectively, P<0.01). The average value of VI in the statin-related myopathy group was about(0.43 ± 0.12)%, which was less than that in the non-statin-related myopathy group(0.75 ± 0.20)% and in the healthy control group(0.93 ± 0.17)%( F=48.93, P<0.001). However, there was no significant difference in values from the parameters between the non-statin-related myopathy group and the healthy control group(all P>0.05). Conclusions:Multimodal ultrasound imaging of statin-related myopathy in elderly hyperlipidemia patients shows distinct characteristics and can be used to evaluate muscle damage of statin-related myopathy.

With multi-drug-resistant bacteria being more prevalent over years, diabetic foot complicated with multi-drug-resistant bacteria infection emerges as a significant challenge for clinicians and patients. Diabetic foot is predisposed to multi-drug resistant bacterial infection. Growing body of evidence shows that ulcer type, ulcer grade, ulcer area, history of antibiotics treatment, previous hospitalization history, osteomyelitis, and proliferative retinopathy are risk factors. Among multi-drug-resistant bacteria, methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase-producing bacteria are the most common strains. Infection with multiple drug-resistant bacteria contributes to the amputation rate and mortality in patients with diabetic foot ulcers. The aim of this review is to give an update on multi-drug resistant bacteria infection and clinical outcome of diabetic foot, with a goal to improve clinical awareness and management.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

OBJECTIVE:To provide reference for formulating drug price regulation policy and promoting reasonable drug price. METHODS:According to WHO and HAI drug price standard investigation,questionnaire survey(supplemented by field investigation)about sale price of 63 commonly used drugs with large consumption sum was conducted among 3 districts of different economic development levels in Hubei province. Median price ratio(MPR)was calculated statistically. Primary interview survey(supplemented by literature investigation)about drug distribution cost was conducted among managerial staff of pharmaceutical wholesale and retail enterprises,hospital pharmacy administrators. Suggestions were put forward to control distribution cost and standardizing drug price based on analysis and discussion. RESULTS:Totally 120 questionnaires were sent out,and 118 were effectively received,with effective recovery of 98.33%. Thirty managerial staff from drug wholesale and retail enterprises,hospital pharmacy department were interviewed for investigation of drug distribution cost. MPR of 63 drugs ranged 0.05-44.55 in different types of sample institutions. Among 67 specifications of 53 kinds of drugs,median retail price of 38 specifications(56.72%)was higher than international reference price in first-level sample medical institutions. Among 79 specifications of 63 kinds of drugs,median retail price of 57 specifications(72.15%)was higher than international reference price in second-level sample medical institutions. Among 80 specifications of 63 kinds of drugs,median retail price of 63 specifications(78.75%)was higher than international reference price in third-level sample medical institutions. Among 50 specifications of 37 kinds of drugs,median retail price of 42 specifications(84.00%)was higher than international reference price in sample pharmaceutical retail enterprises. In all sample institutions,maximum MPR of 13 specification were lower than 1;those of 12 specification ranged from 1 to <2;those of 23 specifications ranged from 2 to <5;15 specification ranged from 5 to <10;those of 17 specification were higher than 10. MPR of third-level medical institution samples were higher than those of second-level and first-level ones,and pharmaceutical retail enterprises(P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than those of first-level medical institutions(P<0.01). There was no statistical significance in the levels of MPR between second-level medical institutions and pharmaceutical retail enterprises(P>0.05). MPR of sample institutions in well-developed regions were higher than in medium-developed or less-developed regions(P<0.01). MPR of sample institutions in medium-developed regions were higher than in less-developed regions(P<0.01). MPR of original drugs were all higher than those of generic drugs in different types of sample institutions(P<0.01). There was no statistical significance in MPR of original drugs among different types of sample institutions(P>0.05). At the same time,MPR of generic drugs in third-level medical institution samples were higher than in second-level and first-level ones and pharmaceutical retail enterprises (P<0.05 or P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than in first-level ones(P<0.05). There was no statistical significance between second-level medical institution samples and pharmaceutical retail enterprises(P>0.05). Drug production and circulation cost,centralized bidding and purchasing price in Hubei province were higher than the national level. CONCLUSIONS:The drug price of Hubei province is in high level,especially that of three-level medical institutions is higher than other institutions;drug price of well-developed region is higher than those of medium-level and less-developed region;the price of original drugs are higher than those of generic drugs. The cost of pharmaceutical industry,drug circulation cost and the addition of drug price during application link eventually lead to the higher retailing price of drugs. Comprehensive policy measures need to be taken to control the cost of the whole process of drug distribution and to regulate the price of drugs.

Objective To observe the effects of pioglitazone on secretion of E2 and expressions of P450 aromatase (P450arom), insulin-receptor substrate-1 (IRS-1), and insulin-receptor substrate-2 (IRS-2) mRNA in polycystic ovary syndrome (PCOS) ovarian granulosa cells.Methods In this study, granulosa cells that were fertilization-embryo transferred from 27 PCOS patients were primary cultured in vitro with different concentrations of pioglitazone (0, 10, 102, 103 and 104nmol/L) (Group A), different concentrations of pioglitazone+FSH (50ng/L, Group B) and different concentrations of pioglitazone+insulin-like growth factor I (IGF-I, 50ng/L, Group C).Estradiol concentrations in the culture supernatant were detected by radioimmunoassay;P450arom, IRS-1 and IRS-2 mRNA expressions on granulosa cells were detected by Real-time PCR.Results The levels of E2 secreted by granulosa cells and the expression of P450arom mRNA on granulosa cells of PCOS for 48 hours were different among Groups A, B and C (P<0.05).With increase in pioglitazone concentration, the level of E2 and the expression of P450arom mRNA declined, some of which correlated negatively with the concentration of pioglitazone.Among these groups, the level of E2 secretion and the expression of P450arom mRNA were higher in Group C than in Group B (P<0.01) and Group A (P<0.01) at the same concentration of pioglitazone.The level of E2 secretion and the expression of P450arom mRNA were higher in Group B than in Group A (P<0.05) at the same concentration of pioglitazone.The expressions of IRS-1 and IRS-2 mRNA on granulosa cells of PCOS under pioglitazone stimulation for 48 hour were different among the groups of different pioglitazone concentrations (P<0.05).With increase inpioglitazone concentration, the expression of IRS-1 mRNA on granulosa cells of PCOS was decreased, but the expression of IRS-2 mRNA on granulosa cells of PCOS was increased.Conclusion Pioglitazone may decrease estrogen production by inhibiting p450 aromatase and adjusting the expressions of IRS-1 and IRS-2 on granulosa cells of PCOS to play a role in ovulation induction and ameliorate insulin resistance in ovary of PCOS.Pioglitazone can inhibit IGF-I and FSH in inducing E2 secretion by ovarian granulosa cells.

Objective To investigate the clinical and pathological characteristics of IgA nephropathy (IgAN) in association with active tubular interstitial lesions. Methods 148 patients who were diagnosed as IgAN by renal biopsy and admitted to Zhejiang Provincial People's Hospital from March 2014 to December 2014 were enrolled. They were divided into IgAN with active tubular interstitial lesions group (IgAN?ATIL group, 23 patients) and IgAN without active tubular interstitial lesions group (control group, 125 patients). Clinical and pathological characteristics were retrospectively analyzed. Multivariate logistic regression analysis was used to analyze the influence factors. Results The prevalence of ATIL in 148 IgAN patients was 15.5%. IgAN?ATIL group showed an older average age and more higher proportion of medication history (antibiotics, diuretics, nonsteroidal anti ?inflammatory drugs, etc) than those in control group. There were significant differences in Alb, eGFR, Scr, BUN, 24?hour urinary protein quantity, urinary NGAL and urinary RBC count between two groups (P<0.05, respectively). A moderate of tubulointerstitial lesions of IgAN?ATIL group was shown, while the control group was mainly mild lesions. Multivariate logistic regression analysis showed that age, medication history and the urinary NGAL level were independent risk factors of IgAN ? ATIL. Conclusions IgAN patients with active tubular interstitial lesions had more severe clinical manifestations and chronic interstitial lesions. The age, medication history (antibiotics, diuretics, nonsteroidal anti?inflammatory drugs, etc) and the urinary NGAL level were independent risk factors of IgAN?ATIL.

To detect the correlation between Interleukin-10 and CD4+CD25+Foxp3+regulation T cells ( Treg) and to explore the significance and mechanism of them in leprosy patients.Methods:We used the cytometric bead arra (CBA) to detect the serum Interleukin-10 in 30 leprosy patients and we used flow cytometry to test the Treg cells in 51 leprosy persons.Results:The con-centration of serum IL-10 in leprosy patients(130.00±54.27)pg/ml was higher than normal people(15.64±7.11)pg/ml,(P<0.05);The percentage of Treg cells in leprosy patients(17.626±8.1977)%was higher than normal people(9.998±1.7062)%,(P<0.05).The relevance between IL-10 and Treg is positive and linear ,( P<0.05 ).Conclusion: The imbalance between IL-10 and Treg cells may lead to immune abnormal in leprosy patients.

Objective To investigate the regulations of Bax , Bcl-2 in the protection of lipoic acid-niacin diad in acrolein-induced apoptosis in ARPE-19 cells. Methods The ARPE-19 cells were cultured in medium containing 10% fetal bovine serum , at 37 ℃ with 5% CO2. The ARPE-19 was transferred to 6-well plate after reaching to 70% confluence. After starvation for 24 h , the cells in 6-well plates were divided into three groups , including the blank control group , the acrolein treatment group with 50 μmol/L acrolein for 24 h , and the protection group with 100 μmol/L lipoic acid-niacin diad for 24 h and with the acrolein for another 24 h. The apoptotic cells were detected by flow cytometry assay , and expressions of Bcl-2 , Bax protein were detected by Western Blot assay. Results The percentages of normal healthy cells were 94.8%, 60.98%, and 91.34% in the blank control group , 50 μmol/L acrolein group and 100 μmol/L diad contained of lipoic acid and niacin group , respectively. The ratios of Bax/Bcl-2 protein expression were 0.293 9, 1.389 2, and 0.555 8 in the blank control group, 50 μmol/L acrolein group and 100 μmol/L diad contained of lipoic acid and niacin group, respectively. Conclusion The protective effect of lipoic acid-niacin diad on acrolein-induced apoptosis in ARPE-19 cell through promoting Bcl-2 expression and inhibiting Bax expression.