Objective:To develop a self-efficacy scale of milk donation and test its reliability and validity, in order to provide a scientific evaluation tool for the corresponding study.Methods:According to Bandura′s self-efficacy theory and consensus-based standards for the selection of health measurement instruments, the scale was developed by means of literature search, article pool establishment and expert letter consultation. A pre-survey was conducted on 30 newborn bereaved women, a formal investigation was conducted on 231 newborn bereaved women, and 115 newborn bereaved women were selected for exploratory factor analysis. Confirmatory factor analysis was performed on 116 parturients with neonatal loss to determine the reliability and validity of the scale.Results:The final scale includes 3 dimensions and 13 items. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.962%. A scale with three dimensions, included breast milk donation resilience, breast milk donation cognition and breast milk donation motivation, and 13 items was determined. Confirmatory factor analysis showed that the model fit of the scale was good ( χ2/ df = 1.390, RMSEA = 0.063, RMR = 0.046, NFI = 0.924, NNFI = 0.971, GFI = 0.924, CFI = 0.977). The content validity index was 0.835. Cronbach′s α coefficient of the total volume table was 0.919, and the coefficients of each dimension were 0.892, 0.905 and 0.844, respectively. The broken half reliability of the scale was 0.893, and the broken half reliability of each dimension was 0.857, 0.881 and 0.711, respectively. The retest reliability of the scale was 0.814, and the retest reliability of each dimension was 0.803, 0.825 and 0.767, respectively. Conclusions:The scale has good reliability and validity, and can be used to evaluate the self-efficacy of milk donation in lost newborns.

Objective:To develop a self-efficacy scale of milk donation and test its reliability and validity, in order to provide a scientific evaluation tool for the corresponding study.Methods:According to Bandura′s self-efficacy theory and consensus-based standards for the selection of health measurement instruments, the scale was developed by means of literature search, article pool establishment and expert letter consultation. A pre-survey was conducted on 30 newborn bereaved women, a formal investigation was conducted on 231 newborn bereaved women, and 115 newborn bereaved women were selected for exploratory factor analysis. Confirmatory factor analysis was performed on 116 parturients with neonatal loss to determine the reliability and validity of the scale.Results:The final scale includes 3 dimensions and 13 items. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.962%. A scale with three dimensions, included breast milk donation resilience, breast milk donation cognition and breast milk donation motivation, and 13 items was determined. Confirmatory factor analysis showed that the model fit of the scale was good ( χ2/ df = 1.390, RMSEA = 0.063, RMR = 0.046, NFI = 0.924, NNFI = 0.971, GFI = 0.924, CFI = 0.977). The content validity index was 0.835. Cronbach′s α coefficient of the total volume table was 0.919, and the coefficients of each dimension were 0.892, 0.905 and 0.844, respectively. The broken half reliability of the scale was 0.893, and the broken half reliability of each dimension was 0.857, 0.881 and 0.711, respectively. The retest reliability of the scale was 0.814, and the retest reliability of each dimension was 0.803, 0.825 and 0.767, respectively. Conclusions:The scale has good reliability and validity, and can be used to evaluate the self-efficacy of milk donation in lost newborns.

BACKGROUND: MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia. METHODS: Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively. RESULTS: Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved. CONCLUSION The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.

BACKGROUND: To observe the effects of Chinese medicine (CM) Polygonum cuspidatum (PC) on adenosine 5'-monophosphate-activated protein kinase (AMPK), forkhead box O3α (FOXO3α), Toll-like receptor-4 (TLR4), NACHT, LRR and PYD domains-containing protein 3 (NLRP3), and monocyte chemoattractant protein-1 (MCP-1) expression in a rat model of uric acid-induced renal damage and to determine the molecular mechanism. METHODS: A rat model of uric acid-induced renal damage was established, and rats were randomly divided into a model group, a positive drug group, and high-, medium-, and low-dose PC groups (n=12 per group). A normal group (n=6) was used as the control. Rats in the normal and model groups were administered distilled water (10 mL•kg) by intragastric infusion. Rats in the positive drug group and the high-, medium-, and low-dose PC groups were administered allopurinol (23.33 mg•kg), and 7.46, 3.73, or 1.87 g•kg•d PC by intragastric infusion, respectively for 6 to 8 weeks. After the intervention, reverse transcription polymerase chain reaction, Western blot, enzyme linked immunosorbent assay, and immunohistochemistry were used to detect AMPK, FOXO3α, TLR4, NLRP3, and MCP-1 mRNA and protein levels in renal tissue or serum. RESULTS: Compared with the normal group, the mRNA transcription levels of AMPK and FOXO3α in the model group were significantly down-regulated, and protein levels of AMPKα1, pAMPKα1 and FOXO3α were significantly down-regulated at the 6th and 8th weeks (P<0.01 or P<0.05). The mRNA transcription and protein levels of TLR4, NLRP3 and MCP-1 were significantly up-regulated (P<0.01 or P<0.05). Compared with the model group, at the 6th week, the mRNA transcription levels of AMPK in the high- and medium-dose groups, and protein expression levels of AMPKα1, pAMPKα1 and FOXO3α in the high-dose PC group, AMPKα1 and pAMPKα1 in the mediumdose PC group, and pAMPKα1 in the low-dose PC group were significantly up-regulated (P<0.01 or P<0.05); the mRNA transcription and protein levels of TLR4 and NLRP3 in the 3 CM groups, and protein expression levels of MCP-1 in the medium- and low-dose PC groups were down-regulated (P<0.01 or P<0.05). At the 8th week, the mRNA transcription levels of AMPK in the high-dose PC group and FOXO3α in the medium-dose PC group, and protein levels of AMPKα1, pAMPKα1 and FOXO3α in the 3 CM groups were significantly up-regulated (P<0.01 or P<0.05); the mRNA transcription levels of TLR4 in the medium- and low-dose PC groups, NLRP3 in the high- and low-dose PC groups and MCP-1 in the medium- and low-dose PC groups, and protein expression levels of TLR4, NLRP3 and MCP-1 in the 3 CM groups were down-regulated (P<0.01 or P<0.05). CONCLUSION PC up-regulated the expression of AMPK and its downstream molecule FOXO3α and inhibited the biological activity of TLR4, NLRP3, and MCP-1, key signal molecules in the immunoinflammatory network pathway, which may be the molecular mechanism of PC to improve hyperuricemia-mediated immunoinflflammatory metabolic renal damage.
AMP-Activated Protein Kinases ; physiology ; Animals ; Chemokine CCL2 ; blood ; Disease Models, Animal ; Fallopia japonica ; Forkhead Box Protein O3 ; physiology ; Hyperuricemia ; complications ; Kidney Diseases ; drug therapy ; etiology ; Male ; Plant Extracts ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects ; Uric Acid

BACKGROUND: Current data is lacking about the progression of ascending aortic dilatation after transcatheter aortic valve replacement (TAVR) in aortic stenosis (AS) patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV). This study aims to assess the ascending aortic dilatation rate (mm/ year) after TAVR in patients with BAV versus TAV using a multidetector computed tomography (MDCT) follow-up and to determine the predictors of ascending aortic dilatation rate. METHODS: Severe AS patients undergoing TAVR from March 2013 to March 2018 at our center with MDCT follow-ups were included. BAV and TAV were identified using baseline MDCT. Baseline and follow-up MDCT images were analyzed, and the diameters of ascending aorta were measured. Study end point is ascending aortic dilatation rate (mm/year). Furthermore, factors predicting ascending aortic dilatation rate were also investigated. RESULTS: Two hundred and eight patients were included, comprised of 86 BAV and 122 TAV patients. Five, 4, 3, 2, and 1-year MDCT follow-ups were achieved in 7, 9, 30, 46, and 116 patients. The ascending aortic diameter was significantly increased after TAVR in both BAV group (43.7±4.4 mm vs. 44.0±4.5 mm; P<0.001) and TAV group (39.1±4.8 mm vs. 39.7±5.1 mm; P<0.001). However, no difference of ascending aortic dilatation rate was found between BAV and TAV group (0.2±0.8 mm/year vs. 0.3±0.8 mm/year, P=0.592). Multivariate linear regression revealed paravalvular leakage (PVL) grade was independently associated with ascending aortic dilatation rate in the whole population and BAV group, but not TAV group. No aortic events occurred during follow-ups. CONCLUSION Ascending aortic size continues to grow after TAVR in BAV patients, but the dilatation rate is mild and comparable to that of TAV patients. PVL grade is associated with ascending aortic dilatation rate in BAV patients post-TAVR.

BACKGROUND: Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in Chinese mainland. METHODS: Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE). RESULTS: Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge. CONCLUSION The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.

Chorismate synthase(CS, EC:4.2.3.5) catalyses 5-enolpyruvy-shikimate-3-phosphate to form chorismate, which is the essential enzyme for chorismate biosynthesis in organisms. The amino acid sequences of CS from 79 species of higher plants were reported in GenBank at present. 125 amino acid sequences of CS from Baphicacanthus cusia and other 78 species of plants were predicted and analyzed by using various bioinformatics software, including the composition of amino acid sequences, signal peptide, leader peptide, hydrophobic/hydrophilic, transmembrane structure, coiled-coil domain, protein secondary structure, tertiary structure and functional domains. The phylogenetic tree of CS protein family was constructed and divided into eight groups by phylogenetic analysis. The homology comparison indicated that B. cusia shared a high homology with several plants such as Sesamum indicum, Nicotiana tabacum, Solanum tuberosum and so on. The open reading frame(ORF) of all samples is about 1 300 bp, the molecular weight is about 50 kDa, the isoelectric point(pI) is 5.0-8.0 which illustrated that CS protein is slightly basic. The ORF of CS we cloned in B. cusia is 1 326 bp, the amino acid residues are 442, the molecular weight is 47 kDa and pI is 8.11. The CS in B.cusia showed obvious hydrophobicity area and hydrophilicity area, no signal peptide, and may exists transmembrane structure areas. The main secondary structures of CS protein are random coil and Alpha helix, also contain three main structural domains which are an active structural domain, a PLN02754 conserved domain and a FMN binding site. The acquired information in this study would provide certain scientific basis for further study on structure-activity relationship and structure modification of CS in plants in the future.
Acanthaceae ; enzymology ; Amino Acid Sequence ; Computational Biology ; Phosphorus-Oxygen Lyases ; chemistry ; Phylogeny ; Plant Proteins ; chemistry ; Protein Structure, Secondary

OBJECTIVETo evaluate the effect and safety of Kuanxiong Aerosol (, KA) on patients with angina pectoris.

METHODSBlock randomization was performed to randomly allocate 750 patients into KA (376 cases) and control groups (374 cases). During an angina attack, the KA group received 3 consecutive sublingual sprays of KA (0.6 mL per spray). The control group received 1 sublingual nitroglycerin tablet (NT, 0.5 mg/tablet). Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment (1, 2, 3, 4, 5, and >5 min). Logistic regression analysis was performed to observe the factors inflfluencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society (CCS) classes of angina.

RESULTSThe 5-min remission rates in the KA and control groups were not signifificantly different (94.41% vs. 90.64%, P>0.05). The angina CCS class signifificantly inflfluenced the rate of remission (95% confidence interval = 0.483-0.740, P<0.01). In the CCS subgroup analysis, the 3-and 5-min remission rates for KA and NT were similar in the CCSII and III subgroups (P>0.05), while they were signifificantly better for KA in the CCSI and II subgroups (P<0.05 or P<0.01). Furthermore, the incidence of adverse reactions was signifificantly lower in the KA group than in the control group for the CCSII and III subgroups (9.29% vs. 26.22%, 10.13% vs. 20.88%, P<0.05 or P<0.01).

CONCLUSIONSKA is not inferior to NT in the remission of angina. Furthermore, in CCSII and III patients, KA is superior to NT, with a lower incidence of adverse reactions. (Registration No. ChiCTRIPR-15007204).

Aerosols ; adverse effects ; therapeutic use ; Angina Pectoris ; drug therapy ; Case-Control Studies ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Remission Induction ; Treatment Outcome

Objective To investigate the effects of Yiqi Huoxue Xiaozheng Formula on cell apoptosis in rats with benign prostatic hyperplasia (BPH); To preliminarily explore its mechanism of action. Methods Totally sixty 8-week-old male SD rats were randomly devided into normal group, positive control group, Yiqi Huoxue XiaozhengFormula low-, medium-, and high-dose groups, with 10 rats in each group. Except for the rats in normal group, rats in other groups were treated with castrate and testosterone propionate injection to replicate BPH model. The normal group and the model group were given normal saline for gavage; Yiqi Huoxue Xiaozheng Formula low-, middle-, and high-dose groups were given Yiqi Huoxue Xiaozheng Formula 10, 20, 40 mg/100 g for gavage, respectively; rats in positive control group were given Longkai Granule suspension 11 mg/100 g for gavage, once a day, for 30 d. Twenty-four hours after the last administration, the rats were sacrificed by cervical dislocation. The prostate tissue was taken. The protein expressions of Bcl-2 and Bax in the prostate tissue were detected by immunohistochemistry. Results Compared with the normol group, the expression of Bax in the prostate tissue of the model group decreased significantly, while the expression of Bcl-2 increased significantly; Compared with the model group, the expression of Bax in the prostate tissue of rats in administration groups increased significantly, while the expression of Bcl-2 was significantly reduced, and Yiqi Huoxue Xiaozheng Formula high-dose group was superior to other groups. Conclusion Yiqi Huoxue Xiaozheng Formula can improve benign prostatic hyperplasia by promoting the apoptosis of rat prostate tissue, and its mechanism is related to the increase of the expression of Bax protein and the decrease of Bcl-2 protein expression in prostate tissue.

Bile acids play critical roles in the regulation of metabolism and absorption of lipids. The ileal apical sodium-dependent bile acid transporter (ASBT) located at the enterocyte brush border is responsible for the reuptake of bile acids and the maintenance of bile acid homeostasis. Recently, a number of investigations have been made concerning the regulation and control of ASBT and the relationship between ASBT and intestinal inflammation, tumorigenesis, diabetes mellitus and hyperlipemia, which suggests ASBT as a potential therapeutic target of these diseases. In this review, advances in the study of above-mentioned issues were summarized.