ObjectiveTo explore the potential mechanism of Erchen Decoction （二陈汤， ECD） in improving metabolic syndrome （MS） with phlegm syndrome. MethodsForty mice were randomly divided into a blank group of 10 mice and a modeling group of 30 mice. The MS model with phlegm syndrome was induced in the modeling group by high-fat diet. Thirty successfully modeled mice were randomly divided into a model group， a ECD group， and a metformin group， with 10 mice in each group. The ECD group was given 0.4 g/（kg·d） of ECD， while the metformin group was intervened with 11.1 g/（kg·d） of metformin solution， and the blank group and the model group were given 0.02 ml/（g·d） of sterilized drinking water， all by gavage， once daily for 4 weeks. Body weight， abdominal circumfe-rence， body length， Lee's index and food intake were recorded. Blood glucose and blood lipid levels including fasting blood glucose， triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） were measured. ELISA was used to detect serum leptin levels， while HE staining was used to observe liver pathological changes. Western Blot and q-PCR were used to detect protein and mRNA expression of hypothalamic leptin receptor （LepR）， pro melanocortin （POMC）， and neuropeptide Y （NPY） in the hypothalamus. Immunofluorescence was used to detect fluorescence expression of POMC and NPY in the hypothalamic arcuate nucleus region. ResultsPathological results showed that the mice in the model group had numerous fat vacuoles in hepatocytes and significant liver fat deposition， while the ECD and metformin groups showed reduced fat vacuoles and less liver fat deposition. Compared to those in the blank group， the mice in the model group mice showed liver fat deposition， increased body weight， abdominal circumference， Lee's index and food intake； fasting blood glucose， TG， TC， LDL-C， and serum leptin levels were elevated， while HDL-C was decreased； the expression of LepR， POMC protein levels and their mRNA expression decreased， while the protein level and mRNA expression of NPY increased； the fluorescence expression of POMC in the arcuate nucleus was reduced， while NPY fluorescence expression increased （P＜0.05 or P＜0.01）. Compared to the model group， the ECD group and metformin group showed significant improvements in the above indicators （P＜0.05 or P＜0.01）. Compared to the ECD group， the metformin group showed a reduction in body weight and NPY fluorescence expression， and an increase in HDL-C levels （P＜0.05 or P＜0.01）. ConclusionECD can downregulate serum leptin levels and improve glucose and lipid metabolism in the MS of phlegm syndrome. Its mechanism of action may be to reduce liver fat deposition and thereafter affect the expression of neuropeptides related to feeding activity in the hypothalamus.

Objective To explore the influencing factors of disability degree in elderly hospitalized patients with disability and the correlations of disability with malnutrition and sarcopenia. Methods A total of 234 elderly hospitalized patients with disability were selected as study subjects. The Activities of Daily Living (ADL) scale, Mini-nutritional Assessment Short Form (MNA-SF), and Sarcopenia Five-item Criteria with calf circumference (SARC-CalF) were used to investigate the status of disability, nutrition, and sarcopenia in patients. The clinical characteristics of different types of patients were compared, and correlations of disability with malnutrition and sarcopenia were analyzed using Pearson correlation analysis. Multiple linear regression analysis was used to explore the influencing factors of the degree of disability in patients. Results Of the 234 patients, 46.58%(109/234) had mild disability, 45.30%(106/234) had moderate disability, and 8.12%(19/234) had severe disability. The results of Pearson correlation analysis showed that the degree of disability (ADL score) in elderly hospitalized patients with disability was significantly correlated with the degree of malnutrition (MNA-SF score) and sarcopenia (SARC-CalF score) (r=0.177, -0.193, P=0.007, 0.003). Multiple linear regression analysis showed that malnutrition and sarcopenia were influencing factors of the degree of disability in elderly hospitalized patients with disability (P < 0.05). Conclusion There are correlations of disability with malnutrition and sarcopenia in elderly hospitalized patients with disability. The risk of exacerbation of disability is significantly increased in patients with malnutrition and sarcopenia. Therefore, clinicians need to identify high-risk patients as early as possible and provide targeted intervention measures.

OBJECTIVE: To observe the clinical characteristics of mild and common COVID-19 patients infected with the Omicron variant, and to analyze related factors affecting the time to negative conversion of viral nucleic acid detection. METHODS: Clinical data of 1781 patients with coronavirus disease 2019 (COVID-19) admitted to a cabin hospital in Shanghai from April 12 to May 26, 2022, were retrospectively analyzed, including age, gender, height, weight, clinical symptoms, comorbid diseases, COVID-19 vaccination, treatment, and nucleic acid negative conversion time. Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of nucleic acid negative conversion time. RESULTS: Among the 1781 patients, 995 were male and 786 were female, with a median age of 39 (30, 52) years. There were 727 patients (40.8%) with overweight and obesity [body mass index (BMI) > 24 kg/cm ²) and 413 patients (23.2%) had comorbid diseases. 205 cases (11.5%) were not vaccinated while 1576 cases were vaccinated. There were 1233 cases (69.2%) with one or more symptoms. The main clinical symptoms were cough (60.3%), expectoration (50.4%) and fever (36.9%). 1444 cases (81.0%) were treated with Chinese medicine, 78 cases (4.4%) were treated with western medicine, 14 cases (0.8%) were treated with integrated Chinese and western medicine, and 245 cases (13.8%) did not receive any medical treatment. All patients improved and were discharged. The median nucleic acid negative conversion time was 10.3 (7.4, 12.4) d. Univariate and multivariate analysis showed that, age ≥ 60 years ( OR＝1.537, 95% CI: 1.116 - 2.115, P<0.01), BMI > 24 kg/cm ² ( OR＝1.344, 95% CI: 1.106 - 1.634, P<0.01 ) and hypertension ( OR＝1.518, 95% CI: 1.094 - 2.106, P<0.05) were independent risk factors for prolonged nucleic acid negative conversion. COVID-19 vaccination ( OR=0.548, 95% CI: 0.398 - 0.755, P<0.01) was a protective factor, that is, vaccination shortened the time for the nucleic acid test to become negative. CONCLUSIONS The symptoms of the Omicron variant infection were relatively mild and occult. Age ≥ 60 years old, comorbid hypertension, no vaccination and BMI > 24 kg/cm ² are independent influencing factors for prolonged nucleic acid negative conversion.
Humans ; Female ; Male ; Middle Aged ; SARS-CoV-2 ; COVID-19/epidemiology* ; COVID-19 Vaccines ; Retrospective Studies ; China ; Hypertension/epidemiology* ; Nucleic Acids

【Objective】 To investigate the prognosis of blood donors with occult hepatitis B virus infection (OBI) by long-term follow-up and repeated testing of HBsAg and HBV DNA. 【Methods】 From January 1, 2010 to December 31, 2020, voluntary blood donors were screened by both serological and viral nucleic acid(NAT) testing, then samples were further confirmed as HBV DNA positive by manual nested-PCR amplification.A total of 306 cases were detected as HBsAg negative /HBV DNA positive, then followed-up for a long time and re-examined of HBsAg and HBV DNA to confirm whether they had infected with OBI.The prognosis of patients with OBI who experienced long-term immunization was determined by repeated testing. 【Results】 A total of 306 HBsAg negative/ HBV DNA positive blood donors had been followed up, and 40(13.07%, 40/306) were recalled frequently for re-examination.Among them, 90%(36/40), 57.5%(23/40), 40% (16/40)were anti-HBc + , anti-HBs + and anti-HBe + , respectively, and 50%(20/40), 40%(16/40), 7.5%(3/40) and 2.5% (1/40)were anti-HBs+ / anti-HBc + , anti-HBc + / anti-HBs -, anti-HBc -/ anti-HBs + and anti-HBc -/ anti-HBs -, respectively.Those 40 blood donors were followed-up for 1-13 times, with the duration of 8-108 months (0.6~9 years).1 donor (2.5%) was followed-up less than 1 year, 11 (27.5%)>1 year and ≤3 years, 23 (57.5%) 23(57.5%)>3 years and ≤5 years, and 5 (12.5%) for more than 5 years.After long-term following up and repeated testing, 50%(20/40)of OBI blood donors turned negative for HBV DNA (HBsAg negative / HBV DNA negative), 42.5% (17/40)were confirmed as OBI infection (HBsAg negative / HBV DNA positive), and 7.5%(3/40) were hard to determine (after repeated testing, the results were either positive or negative). 【Conclusion】 After long-term following up and repeated screening, we found that none of the OBI patients turned into acute or chronic HBV infection, and most of them maintained OBI.However, OBI blood donors carry very low load of HBV DNA for a long time, which could lead to false negative results of NAT and bring a great challenge to the safety of blood transfusion.

Objective:To investigate the current status of doctor-patient communication of pediatric residents, and to explore the specific demand of communication skills training in clinical practice.Methods:A self-made questionnaire was conducted to investigate 77 residents taking standardized residency training of pediatrics in Beijing Children's Hospital training base, including basic information, self-satisfaction of communication ability and the needs of doctor-patient communication courses, etc. SPSS 22.0 statistical software was used for data processing and analysis.Results:In terms of the doctor-patient communication ability, the results showed that the satisfaction degree of pediatric resident surgeons was higher than that of pediatric resident physicians (78.9% vs. 58.5%, P=0.108) and the satisfaction degree of high-seniority residents was higher than that of low-seniority residents (78.6% vs. 62.5%, P=0.330; 78.6% vs. 58.9%, P=0.278). Besides, the importance of communication objectives and the degree of difficulty were sorted in order, and the top three were family members, superior and children for importance, and family members, children and nurses for difficulty, respectively. The main reasons of difficult communication included heavy work (41.6%) and lack of communication skills (46.7%), with no statistical difference between different majors and seniorities ( P >0.05). More than 80% residents agreed that effective doctor-patient communication could promote the clinical work. The lower of seniority, the higher demands for the class time allocation and teaching frequency of doctor-patient communication training courses. Conclusion:Pediatric residents have a good cognition of medical doctor-patient communication. There are some obvious communication problems in pediatric physicians and low-seniority pediatric residents. Therefore, it's necessary to adjust courses according to different majors and seniorities, so as to improve the training quality, thereby promoting the clinical work and reform of medical education.

OBJECTIVE： To study lung tissue injury induced by long-term aerosol inhalation of 4 kinds of non-aerosol drugs in healthy SD rats， and to evaluate the safety of aerosol inhalation of non-aerosol drugs. METHODS： Totally 40 healthy SD rats （♂） were randomly divided into 8 group， i.e. blank control group， normal saline group （solvent control）， budesonide group （non-aerosol drug control， 0.1 g/L） ，silicon dioxide group （lung injury drug control， 40 g/L）and 4 kinds of non-aerosol drugs [Dingchuan decoction group （15 g/mL， calculated by crude drug）， cefatriaxone group （200 g/L）， Qingkailing group （stoste） and Tangreqing group （stoste）]， with 5 rats in each group. Except that blank control group didn’t received any treatment， other groups received aerosol inhalation， 10 mL， twice a day， for consecutive 56 days. After medication， the number of white blood cells in peripheral blood were counted and classified， and the number of white blood cells in bronchus alveolar lavage fluid were counted. The pathological changes of lung tissue were observed by HE staining and the number of dust cells was counted. The expression of leukocyte differentiation antigen 163 （CD163） in lung tissue were determined by immunohistochemical method. RESULTS： The white blood cells in peripheral blood mainly included lymphocyte and neutrophil， of which lymphocyte is the main one. Compared with blank control group， there was no statistical significance in the number of white blood cells， lymphocyte or neutrophil in peripheral blood， the number of white blood cells in alveolar lavage fluid or the number of dust cells in lung tissue of rats in normal saline group （P＞0.05）； the structures of bronchus and lung tissue were intact， and the expression of CD163 was negative. Compared with normal saline group， there was no statistical significance in the above indexed of rats in budesonide group（P＞0.05）， the structures of bronchus and lung tissue were intact， and the expression of CD163 was negative， while the number of white blood cells， lymphocyte or neutrophil in peripheral blood， the number of white blood cells in alveolar lavage fluid or the number of dust cells in lung tissue of rats in other 5 groups were all increased significantly （P＜0.05）； alveolar wall thickening and alveolar interstitial edema occurred in different degrees in lung tissue. The expression of CD163 was positive or strongly positive. CONCLUSIONS： The long-term aerosol inhalation of 4 kinds of non-aerosol drugs can induce pathological changes of lung tissue and increase the number of inflammatory cell and dust cell in alveolin in healthy SD rats.

Purpose To explore the association of NET-1 expression with the angiogenesis of cervical squamous cell carcinoma and the related molecular mechanism.Methods Immunohistochemistry MaxVision was used to detect the expression of NET-1,NF-κB p65 and VEGF in 80 cases of cervical squamous cancer tissue and 10 cases of chronic cervicitis tissue.The microvascular density (MVD) was assessed by labeling endothelia with CD34-antibody and counted according to Weinner's standard.The eukaryotic expression plasmid pCMV6-NET-1 was transfected into cervical squamous cancer cells by cationic liposome in order to obtain over expression of NET-1 gene.In order to inhibit the activation of NF-kappa B,cervical squamous carcinoma cells were treated with NF-kappa B specific inhibitor PDTC.The protein expression in SiHa cells was assessed by Western blotting.Results The expression level of NET-1 in the cervical squamous carcinoma tissue was significantly higher than that in the tissue of control group.NET-1 expression was positively correlated to the MVD,NF-κB p65 and VEGF expression,respectively.Transient transfection of NET-1 gene significantly increased the nuclear expression of NF-κB p65 and cytoplasm expression of VEGF in the SiHa cells.However,pretreatment of SiHa cells with NF-inhibitor PDTC significantly inhibited NET-1 induced upregulation of VEGF expression.Conclusion NET-1 promotes the angiogenesis of cervical squamous carcinoma through the activation of the NF-κB signaling which upregulate the expression of VEGF in the cancer cells.

Objective To understand the anxiety among gerontal patients with osteoporosis,and to analyze the correlated factors of the anxiety.Methods The social information of the gerontal patients with osteoporosis were investigated,as well as by SAS for the anxiety,and by NRS,PSQI,AHSMSRS for their pain level,sleep quality and healthy management.Results The incidence rate of anxiety was 20.3%,and the average score was (41 .1 4 ± 9.71 )points.Some factors had influence upon the rate,which included sex,month income,sleep quality,self -care ability,pain level,self -management and exercise.Multivariate logistic regression analysis showed that exercise and pain level were the major risk factors.The differences were statistically significant(t =3.033,2.727,P =0.003, 0.007).Conclusion It's higher that the incidence rate of anxiety among gerontal patients with osteoporosis maybe influenced by species of factors,and the quality of life among them needs to be improved by intervention clinically implicated in those factors.

Objective To construct the Hut78 cell line with EZH2 gene knocked into by CRISPR/Cas9 system. Methods The EZH2 expression vector pMD-18T-EZH2 with homologous arm and the sgRNA expression vector pSpCas9 (BB)-2A-Puro-sgRNA, which could cut the double stranded genomic DNA, were constructed, and the two vectors were co-transfected into Hut78 cells. Then the expression of EZH2 mRNA was detected by qPCR, and the expressions of EZH2 and H3K27me3 proteins were detected by Western blot assay. Results The pMD-18T-EZH2 and pSpCas9(BB)-2A-Puro-sgRNA recombinant vectors were confirmed by DNA sequencing. When Hut78 cells were transfected with the two recombinant plasmid, qPCR results showed that the expression of EZH2 mRNA was significantly increased, and Western blot analysis showed that the expressions of EZH2 and H3K27me3 proteins were significantly increased. Conclusion EZH2 gene is successfully knocked into Hut78 cells by CRISPR/Cas9 system.

Objective To investigate the status and influence factors on mental health among young stuberculosis patients, and explore the correlation between mental health and social support, so as to provide scientific basis for the development of interventions.Methods A total of 200 young tuberculosis patients, aged ≤40 year, were selected in Xuzhou Infectious Hospital from May 2015 to August 2016,and investigated by self-designed general information questionnaire, Symptom Checklist (SCL-90) and Social Support Rating Scale (SSRS). The correlations were analyzed between mental health and social support.Results Compared with 1986 and 2006 national norm, the sum score of SCL-90 was (147.34±46.39) for involved youth (t=5.298, 5.280;P<0.05). In multiple regression analysis, the main influence factors included educational level, annual income for score of SCL-90. The score of SCL-90 was negatively correlated with scores of social support, subjective support and degree of support utilization (r=-0.232, -0.221, -0.407;P<0.05).Conclusions The mental health status of young patients with tuberculosis is poor, and social support is closely related to mental health. Medical staff should timely carry out psychological intervention measures to improve the mental health and promote the rehabilitation.