Objective To establish ecological suitability zone of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;To study the quality regionalization of Forsythia suspensa(Thunb.)Vahl from different producing areas in Shanxi Province;To provide reference for reasonable planting and wild tending of Forsythia suspensa(Thunb.)Vahl.Methods Maximum entropy(MaxEnt)model and ArcGIS software were used to study the ecological suitability of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;By screening the main environmental factors and combining them with the content of forsythoside and forsythoside A in Forsythia suspensa(Thunb.)Vahl of different regions,a quality zoning of Forsythia suspensa Thunb.Vahl medicinal materials in Shanxi Province based on forsythoside,forsythoside A and environmental factors was constructed.Results The ecological suitable areas of Forsythia suspensa Thunb.Vahl in Shanxi Province were mainly distributed in the southern part of Shanxi Province,mainly in Linfen,Yuncheng,Changzhi,and Jincheng.The general contents of forsythoside and forsythoside A in the Forsythia suspensa(Thunb.)Vahl medicinal material were gradually reduced from southern part to northern part of Shanxi Province.The comprehensive quality was high in southern part of Shanxi Province,mainly in Linfen,Changzhi,Yuncheng and Jincheng.Conclusion The results of this study are consistent with the actual survey.The southern part of Shanxi province is a suitable planting area for high quality Forsythia suspensa(Thunb.)Vahl,which provides a reference for the standardized planting and wild tending of Forsythia suspensa(Thunb.)Vahl.

Objective To explore the molecular mechanism of CAFs promoting energy metabolism of EC9706 cells by collecting conditioned media of cancer-associated fibroblasts(CAFs).Methods Cell viability was detected by MTT,and the CAFs conditioned medium(CAFM)most suitable for indirect co-culture was selected with EC9706 cultured in DMEM high glucose medium as control.The contents of lactic acid and glucose in the supernatant of EC9706 cells were determined by colorimetry.The energy metabolism of EC9706 cells in DMEM and CAFM was detected by seahorse system energy metabolism analysis system.Real time quantitative polymerase chain reaction(RT-qPCR)and western blotting were used to detect the mRNA and protein expression of energy metabolism related molecules.Results Compared with normal esophageal fibroblast conditioned medium(NFM),CAFs conditioned medium of 50%-60%and 70%-80%cell fusion degree promoted the proliferation of EC9706 cells(P<0.01),and CAFM groups with 70%-80%cell fusion degree promoted the proliferation of EC9706 cells compared with the control group.When the CAFM content was 60%,the proliferation of EC9706 cells was significantly increased(P<0.01).Compared with DMEM,CAFM could increase glucose uptake,superlactate content,basal respiratory value,basal glycolysis,compensatory glycolysis(P<0.05),non-mitochondrial oxygen consumption,maximum respiratory value,oxygen consumption for ATP synthesis,and reserve respiratory capacity(P<0.01)of EC9706 cells.RT-qPCR results showed that CAFM could also up-regulate the Hypoxic-inducible factor-1α(HIF-1α),Hexokinase-2(HK2)and Monocarboxylic acid transporter 1(MCT1)of EC9706 cells(P<0.05).Expression of Glucose transporter 1(GLUT1),Pyruvate kinase 2(PKM2)mRNA(P<0.01).Western blot showed that compared with DMEM,the protein expression of HK2,PKM2,MCT1 and GLUT1 was significantly increased(P<0.01).Conclusion CAFM can promote energy metabolism of EC9706 cells by promoting mRNA and protein expressions of HK2,PKM2,HK2,GLUT1,MCT1 and MCT4 under in vitro culture conditions.

Sepsis is a clinical syndrome of life-threatening organ dysfunction caused by infection. When an infection occurs, as the first line of defense of the body's immune system, neutrophils are first recruited to the site of infection to capture and kill pathogens by releasing neutrophil elastase (NE). However, a large amount of NE release will injury the surrounding normal tissues and induce organ dysfunction or failure. NE inhibitors can inhibit NE activity and reduce inflammatory response, which may be a promising drug for the treatment of sepsis. Currently, a variety of NE inhibitors have been developed and reported, but there is no systematic overview of their characteristics, and the role and underlying mechanisms of NE and related inhibitors in sepsis have not been thoroughly discussed. This article will make a review in this regard, in order to elucidate the effect of NE and its inhibitors in sepsis.

Humans ; Benzodiazepines ; Hypnotics and Sedatives/therapeutic use* ; Intensive Care Units ; Midazolam

Determining whether patients have volume-responsiveness is one of the frequently asked questions in the intensive care unit, especially in shock patients. Evaluating the volume status and volume responsiveness can help clinical medical staff accurately grasp the patient's cardiac preload, guide reasonable volume management, and help improve patient prognosis. Therefore, many non-invasive and invasive methods have been proposed to evaluate volume responsiveness. Inferior vena cava ultrasound has been widely used to guide the fluid management of critically ill patients due to its simplicity, non-invasiveness, and good repeatability. This article reviews the clinical applications of inferior vena cava ultrasound in fluid management of critically ill patients, so as to provide a reference for circulatory management of critically ill patients.

Objective? To explore the status quo and influencing factors of self-care ability of patients after laryngectomy, and to provide evidence for the formulation of targeted interventions in clinical practice. Methods? Using convenience sampling method, 126 patients who underwent laryngectomy for the first time in ENT & HN Surgery Department, Beijing Tongren Hospital, from January to December 2018 were selected as the research objects. The Exercise of Self-Care Agency (ESCA) was used in the study. Results? The total ESCA score of 126 patients after laryngectomy was (110.37±16.05). Univariate analysis showed that there were significant differences in ESCA scores among patients with different educational background, living conditions, place of residence, income and knowledge of laryngectomy (t=105.971, 2.173, -3.937, 41.166, 10.499;P＜0.05). Multivariate linear regression analysis showed that education level and income were the influencing factors of the self-care ability of laryngeal cancer patients after laryngectomy. Conclusions? The self-care ability of laryngeal cancer patients after laryngectomy is at a high level. Nurses can explain and demonstrate according to the characteristics of different patients, and further improve the self-care ability of laryngeal cancer patients after laryngectomy.

Objective To explore the specific contents and ways of extended care in patients with laryngopharyngeal reflux disease, so as to improve the compliance behaviors and promote the prognosis of the patients.Methods In the Ear Nose Throat & Head and Neck Surgery Department of Beijing Tongren Hospital, by convenience sampling method, a total of 48 patients with laryngopharyngeal reflux disease, who were admitted from January to June 2016, were assigned into the experimental group, and 48 patients who were admitted from July to December 2015 were assigned into the control group. All the patients were given routine discharge education, and the experimental group was given extended care after discharge. A self-designed compliance behaviors questionnaire of patients with laryngopharyngeal reflux was used to investigate the patients at the 1st month, and the 3rd month after discharge. Reflux Finding Score (RFS) and Reflux Symptom Index (RSI) were used at admission and 3 months after discharge to evaluate patients' situation.Results The scores of the compliance behaviors questionnaire in the experimental group at the 1st month and the 3rd month after discharge were (25.04±1.52) and (22.92±2.03) respectively, which were higher than those in the control group (16.06±1.45) and (14.96±1.30). The differences were statistically significant (t=29.67, 22.85;P<0.001). The differences in the scores of RFS and RSI between the two groups were statistical (t=4.96, 3.97;P<0.001). Conclusions Extended care can meet recovery demands of patients with laryngopharyngeal reflux, strengthen the health conceptions of patients in the disease recovery after discharge, and improve compliance behaviors and prognosis of patients.

Objective To investigate the differences of expression and activation of natural killer (NK) cell G2D (NKG2D) in patients with different immune status of chronic hepatitis B virus (HBV) infection, and to explore the significance of NKG2D-mediated immune injury in HBV infection.Methods Fifteen chronic HBV carriers (immune tolerance),15 chronic hepatitis B (CHB, immune activation) patients, 15 HBV-related acute/subacute-on-chronic liver failure (HBV-ACLF, immune over-activation) patients were enro1led in this study from January 2010 to December 2011 in the Third Hospital of Hebei Medical University.The frequencies of NK cells and NKG2D+ NK cells in peripheral blood mononuclear cells (PBMC) were detected by flow cytometry.The NKG2D mRNA expressions were measured by real-time fluorescent quantitative polymerase chain reaction.Localization and hemi-quantitative analysis of NKG2D+ cells in liver tissue were performed by immunohistochemistry staining.Concentrations of serum interferon(IFN)-γ, tumor necrosis factor(TNF)-α, perforin and granzyme B were quantified by enzyme 1inked immunosorbent assay (ELISA).Normally distributed continuous variables were analyzed using one-way analysis of variance (ANOVA), followed by Student-Newman-Keuls q test for evaluating variances between each two groups.For non-normally distributed data or heterogeneity of variance, differences between groups were analyzed using nonparametric Kruskal-Wallis H test, followed by Nemenyi test for pairwise comparisons.Pearson chi-square test was used to analyze categorical variables.Results The percentages of NK cells in PBMC were (13.58±3.24)% in healthy controls, (5.42±2.18)% in chronic HBV carriers, (7.92±2.85)% in HBV-ACLF group and (8.43±2.92)% in CHB group.The percentage of NK cells in PBMCs was lower in each chronic HBV-infected group compared with healthy controls (F=22.04, P<0.05).The frequency of NKG2D+ NK cells in HBV-ACLF group (18.92±5.85)% was the highest, followed by CHB group (12.85±3.39)%, healthy controls (8.45±2.86)%, and chronic HBV carriers (3.36±1.05%), with the statistically significant differences between each two groups (H=46.09, P<0.01).Intrahepatic NKG2D mRNA expression and NKG2D+ cells density were highest in HBV-ACLF group (6.58±1.86 and 30.69±6.67, respectively), followed by CHB group (3.25±0.95 and 17.36±4.13, respectively) and chronic HBV carriers (0.69±0.20 and 3.16±1.24, respectively), with the statistically significant differences between each two groups (H=52.10 and 52.73 respectively, both P<0.01).The similar patterns were observed in serum IFN-γ, TNF-α, perforin and granzyme B concentrations.Conclusions NKG2D expresses variously in patients with different immune status of chronic HBV infection.Activation of NKG2D may take part in the immune pathogenesis of chronic HBV infection.

To investigate the mutation site of pathogenic gene in patients with hypertrophic cardiomyopathy (HCM) and to analyze the relationship between the genotype and clinical phenotype. Methods: Targeted exon capture sequencing was conducted in a HCM proband for 30 coding exons related HCM gene by all exon amplification and high-throughput sequencing. Furthermore, Sanger sequencing was performed in other family member and in 200 healthy volunteers for verification. The familial investigation included in clinical presentation, physical examination, electrocardiogram and echocardiography. Results: There were 3/6 blood relatives carrying cardiac myosin-binding protein gene MyBPC3 G772A heterozygous mutation, the mutation site was at 258 amino acid of MyBPC3 as glutamic acid (Glu) was substitute to lysine (Lys), such mutation was not found in rest of family member and not in healthy volunteers. The onset of proband and her daughter was rather late, they had palpitation and chest tightness; echocardiography showed interventricular septum basal segment thickening (16-18) mm. Proband was complicating paroxysmal ventricular tachycardia, malignant arrhythmia and heart failure, the maximum pressure gradient of left ventricular outflow was 56 mmHg, which with the high risk for sudden death. Conclusion: Comprehensive gene test has been helpful for clinical stratification, early diagnosis and treatment. MYBPC3 site mutation c.G772A might be the pathogenic mutation in that specific HCM family.