OBJECTIVE To investigate the potential mechanism of procyanidin on rats with gingivitis by regulating phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt）/vascular endothelial growth factor （VEGF） signaling pathway. METHODS The rat model of gingivitis was constructed by sewing the neck of the first maxillary molar with silk thread+applying maltose on the gum+feeding with 20% sucrose solution and soft food. Forth-eight model rats were randomly divided into model group， procyanidin group （160 mg/kg）， 740Y-P group （PI3K/Akt signaling pathway activator， 0.02 mg/kg）， and procyanidin+ 740Y-P group （procyanidin 160 mg/kg+740Y-P 0.02 mg/kg）， with 12 rats in each group； another 12 rats were selected as control group； each medication group was treated with corresponding drugs intragastrically or/and intraperitoneally， once a day， for 7 consecutive days. Twenty-four hours after the last administration， the gingival index of rats was measured； the levels of interleukin- 18 （IL-18）， inducible nitric oxide synthase （iNOS） and alkaline phosphatase （ALP） in gingival crevicular fluid， as well as the levels of superoxide dismutase （SOD）， catalase （CAT） and reactive oxygen species （ROS） in gingival tissues of rats were detected； the pathological changes in gingival tissues were observed； the expression levels of PI3K/Akt/VEGF signaling pathway- related proteins in gingival tissues of rats were detected. RESULTS Compared with control group， the gingival tissues of rats in the model group had severe pathological damage，which was manifested as local tissue expansion and congestion， new capillaries， degeneration and loss of collagen fibers and disorder of arrangement， and a large number of inflammatory cell infiltration in the gingival sulcus wall. The gingival index， the levels of IL-18， iNOS， ALP in gingival crevicular fluid， the level of ROS in gingival tissues， the phosphorylations of PI3K and Akt， as well as the protein expression of VEGF in gingival tissues were significantly increased； the levels of SOD and CAT in gingival tissues of rats in model group were significantly decreased （P＜0.05）. Compared with model group， the pathological damage to the gingival tissues of rats in procyanidin group was reduced， and all quantitative indicators were significantly improved （P＜0.05）； 740Y-P could reverse the improvement effect of procyanidin on various indicators （P＜0.05）. CONCLUSIONS Procyanidin may alleviate gingival tissue damage， and improve gingival inflammation and oxidative stress in rats with gingivitis by inhibiting PI3K/Akt/VEGF signaling pathway.

ObjectiveTo determine the optimal dose of Dachengqi Decoction （大承气汤， DCQD） for the treatment of acute intestinal obstruction （AIO） through a randomized， double-blind， dosage parallel controlled， multi-center clinical trial， and to providee evidence support for the reasonable dosage of DCQD in clinical practice. MethodsBased on the commonly used clinical dose of DCQD， three different groups were set up， including low-dose group which used Dahuang （Radix et Rhizoma Rhei） 12 g， Houpo （Cortex Magnoliae Officinalis） 9 g， Zhishi （Fructus Aurantii Immaturus） 9 g， and Mangxiao （Natrii Sulfas） 4.5 g， medium-dose group using Dahuang 36 g， Houpo 27 g， Zhishi 27 g， Mangxiao 13.5 g， and high-dose group using Dahuang 60 g， Houp0 45 g， Zhishi 45 g and Mangxiao 22.5 g. Initially， 149 AIO patients with Yangming （阳明） bowel excess syndrome were randomly assigned to three groups using a stratified randomization method， and both the patients and the doctors were blinded. In addition to conventional western medicine treatment， each group was given 12 bags of granules made from the raw herbs of DCQD at different doses， taken orally or injected through a gastric catheter once every 6 hours， 3 bags each time， for 3 consecutive days. After treatment， the indicators of the three groups of patients with primary AIO and non-primary AIO were evaluated respectively， and the full analysis set （FAS） and per-protocol set （PPS） were used for analysis. The primary outcomes were the time to recover voluntary bowel movements and voluntary flatulence. The secondary outcomes were the ideal rate of spontaneous defecation and the ideal rate of spontaneous flatus. The occurrence of adverse events during the study was recorded and analyzed using the safety analysis set （SS）. ResultsA total of 91 patients with primary AIO and 58 patients with non-primary AIO were included in the FAS and SS analysis， while 80 primary AIO patients and 56 non-primary AIO patients were included in the PPS analysis. Both FAS and PPS analysis showed significant differences in the time to recover voluntary bowel movements and voluntary flatulence among primary AIO patients in different dose groups of DCQD （P＜0.01）， and the high- and medium-dose groups assumed less time than the low-dose group （P＜0.05）. There was no statistically significant difference in the ideal rate of spontaneous defecation and spontaneous flatus among the three groups （P＞0.05）. And consistent results were seen in the non-primary AIO patients among the three groups. Five adverse events occurred in primary AIO patients （3 in the low-dose group， 1 in the medium-dose group， and 1 in the high-dose group）， mainly manifested as abdominal distension and abdominal pain， and there was no statistically significant difference in the incidence of adverse events （P＞0.05）. No adverse events occurred in patients with non-primary AIO. ConclusionDCQD， as an effective treatment for patients with AIO， is commonly used at a medium dose for patients with primary AIO and at a high dose for patients with non-primary AIO. The therapeutic advantage is mainly reflected in the shorter time to recover spontaneous defecation and spontaneous flatulence and the improvement of intestinal function.

Objective A feasible and stable mouse model of thoracic aortic dissection(TAD)combined with acute lung injury(ALI)was established using β-aminopropionitrile monofumarate(BAPN)1 g/(kg·d)administered in drinking water.The mouse model of TAD combined with acute lung injury(ALI)was established to provide a rational animal model to study TAD combined with ALI.Methods Forty-five SPF-grade 3-week-old C57BL/6J male mice were selected and randomly allocated to a CON group(normal dietary water;15 mice)or BAPN group(administration in sterile water at 1 g/(kg·d);30 mice)for 4 weeks.During the experimental period,the general condition and modeling rate of mice were observed.TAD model mice were validated,and the BAPN group was divided into TAD and non-TAD groups by measuring the maximum diameter of the thoracic aorta and HE staining of aortic tissues.HE pathological staining,the wet/dry weight(W/D)ratio,total protein level in bronchioalveolar lavage fluid(BALF),and interleukin(IL)-1 β,IL-6,and tumor necrosis factor-α(TNF-α)in BALF)were used to validate the TAD combined ALI model in mice.Results BAPN treatment significantly delayed the increase in body mass and water intake of mice.Compared with CON and non-TAD groups,the maximum diameter of the thoracic aorta of mice in the TAD group was significantly thickened(P＜0.05).HE staining of the aorta showed significant thickening of the middle aortic layer,and the structure of the aortic wall was damaged and disordered.HE staining of lung tissues showed significant interstitial edema and inflammatory exudation accompanied by enlargement of alveolar lumen,alveolar wall epithelial exfoliation and hyaline membrane formation,and a significant increase in the pathological scores of lung injury(P＜0.05).Total protein levels and expression of IL-1β,IL-6,and TNF-α in lung tissue,W/D ratio,and BALF were also significantly increased(P＜0.05),whereas no significant difference was observed in the above indexes between the other two groups.Conclusions A mouse model of thoracic aortic dissection combined with acute lung injury can be established by BAPN administration in drinking water.

In atherosclerosis, chronic inflammatory processes in local diseased areas may lead to the accumulation of reactive oxygen species (ROS). In this study, we devised a highly sensitive H₂O₂-scavenging nano-bionic system loaded with probucol (RPP-PU), to treat atherosclerosis more effectively. The RPP material had high sensitivity to H₂O₂, and the response sensitivity could be reduced from 40 to 10 μmol/L which was close to the lowest concentration of H₂O₂ levels of the pathological environment. RPP-PU delayed the release and prolonged the duration of PU in vivo. In Apolipoprotein E deficient (ApoE^‒/‒) mice, RPP-PU effectively eliminated pathological ROS, reduced the level of lipids and related metabolic enzymes, and significantly decreased the area of vascular plaques and fibers. Our study demonstrated that the H₂O₂-scavenging nano-bionic system could scavenge the abundant ROS in the atherosclerosis lesion, thereby reducing the oxidative stress for treating atherosclerosis and thus achieve the therapeutic goals with atherosclerosis more desirably.

Objective:To explore the relationship between vegetarian diets and vitamin B 12 levels in Chinese pregnant women. Methods:A cross-sectional survey was used to explore the relationship between vegetarian diets and vitamin B 12 levels in Chinese pregnant women based on data from the Chinese National Nutrition and Health Surveillance (2015-2017). Maternal serum vitamin B 12 concentration was determined by electrochemiluminescence. Background and diet information of all subjects were collected using general and food frequency questionnaires. General Linear Model was used to analyze the difference in serum vitamin B 12 levels between vegetarian and non-vegetarian pregnant women and multivariate logistic regression for examining the relationship between vegetarian diets and vitamin B 12 deficiency (vitamin B 12<150 pmol/L) in pregnant women. Results:A total of 8 366 pregnant women were included in the analysis, and vegetarians accounted for 1.2% (102/8 366). The median serum vitamin B 12 concentrations were 155.8(93.6-212.4) pmol/L and 187.2(127.4-267.6) pmol/L ( Z=－4.22, P<0.001), and the vitamin B 12 deficiency rates were 48.0% (49/102) and 35.0% (2 896/8 264) in vegetarian and non-vegetarian women, respectively. The vitamin B 12 deficiency rate in vegetarian women was 0.89-fold higher than in non-vegetarians (95% CI: 1.24-2.89). Among the vegetarian and non-vegetarian pregnant women, vitamin B 12 deficiency rates during the first, second, and third trimesters were 34.8%(16/46), 54.3%(19/35), 66.7%(14/21), and 20.4%(521/2 559), 32.6%(941/2 886), 50.9%(1 430/2 807), noting for an increasing trend ( Z=23.54 and 2.57, P=0.010 and P<0.001). Conclusions:Vegetarian pregnant women are at high risk of vitamin B 12 deficiency. Compared with non-vegetarian women, vegetarian pregnant women in China have lower vitamin B 12 levels and a higher risk of vitamin B 12 deficiency. Moreover, the risk of vitamin B 12 deficiency will gradually increase during pregnancy.

Objective    To evaluate the prognosis of interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma by single-arm meta-analysis. Methods    Related studies on treating retrograde Stanford type A aortic dissection and intramural hematoma with covered stent graft were retrieved from the databases by computer, including PubMed, EMbase, The Cochrane Library, Wanfang Data, VIP, CNKI and CBM, from inception to January 2020. Literatures were screened by researchers step by step according to the predefined inclusion and exclusion criteria. Quality of the enrolled literatures was evaluated, and data were extracted from the included studies. Afterwards, single-arm meta-analysis was carried out by the R3.6.3 software. Results    A total of 12 English and 5 Chinese studies were included, which were all case series, and the quality of all literatures was moderate evaluated by Newcastle-Ottawa Scale (NOS). After analyzing the clinical prognosis of 260 patients, the 30-day mortality was 6% (95%CI 0.04 to 0.11, P=0.97), the late mortality was 8% (95%CI 0.05 to 0.14, P=0.78), the incidence of endoleak was 21% (95%CI 0.16 to 0.29, P=0.06), the incidence of stroke was 5% (95%CI 0.03 to 0.09, P=0.99), the incidence of new aortic dissection was 7% (95%CI 0.04 to 0.11, P=0.96), the incidence of dissection progression was 10% (95%CI 0.07 to 0.16, P=0.24), and the absorption rate of intramural hematoma was 84% (95%CI 0.37 to 1.00, P<0.01). Conclusion    Interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma can obtain good early treatment results for some patients, and can be used as a safe and effective treatment for aged patient with high risk who cannot tolerate surgery. Endoleak, stroke and new aortic dissection are the early serious complications of this method.

BACKGROUND:Intestinal fibrosis is a common complication in inflammatory bowel disease and leads to functional damage and intestinal obstruction. Intestinal fibrosis is mainly related to the imbalance of deposition and degradation of extracellular matrix components, such as collagens and fibronectins. Studies have found that mesenchymal stem cells secreted soluble bioactive substance such as extracellular vesicles via paracrine action, which exerted marked anti-fibrosis effect. OBJECTIVE: To investigate the effect of human placenta mesenchymal stem cells-derived extracellular vesicles on collagen deposition in mice with colitis. METHODS: Totally 24 BALB/c mice were randomly divided into sham operation group, model group and extracellular vesicles group, with 8 mice in each group. Except the sham operation group, the remaining mice of model group and extracellular vesicles group were treated with trinitro-benzene-sulfonic acid to induce intestinal fibrosis, once a day for 6 weeks. The mice in the extracellular vesicles group and model group were administered with extracellular vesicles and phosphate-buffered saline, respectively, at 3 weeks, once a day for 6 weeks. The therapeutic effect of extracellular vesicles was evaluated by disease active index score and the colon weight/length ratio at 1-7 weeks. Diseased intestinal segment was subjected to histological staining. Western blot assay and RT-PCR were used to measure fibrosis related indicators so as to evaluate the degree of intestinal fibrosis. RESULTS AND CONCLUSION: (1) Compared with the model group, disease active index score and the colon weight/length ratio were significantly reduced, and colonic pathology was significantly improved in the extracellular vesicles group. (2) Compared with the model group, collagen deposition in colon mucosa of mice was significantly reduced, and the expression of collagen I, collagen III and transforming growth factor-β1 decreased significantly in the extracellular vesicles group. (3) Compared with the model group, expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 in mouse colon tissue were significantly increased, while the expression level of tissue inhibitor of metalloproteinase 1 was decreased in the extracellular vesicles group. (4) Results suggest that human placenta mesenchymal stem cells-derived extracellular vesicles can obviously improve the severity of colon injury and reduce the collagen deposition of intestinal mucosa in mice with enteritis.

ObjectiveTo explore and evaluate the application effect of scenario simulation teaching method in the standardized training of neurosurgery junior nurses. MethodsTotally 38 junior nurses in Neurosurgery Department of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 2016 to December 2018 were selected as the subjects in the study and randomly divided into control group (n=19) and observation group (n=19)by simple random sampling method. The control group was given the standardized training process of our hospital for stage training, while the observation group was added scenario simulation teaching method on that basis. The differences of theoretical and operational assessment scores, operational assessment time, emergency response ability, team cooperation ability and patient satisfaction between the two groups were compared. ResultsThe results of operation assessment, emergency response ability, patient satisfaction and team cooperation ability of junior nurses in the observation group were better than those in the control group (P＜ 0.05). There was no significantly statistical difference between the two groups in theoretical and operational assessment results (P＞0.05). ConclusionsOn the basis of standardized training and neurosurgery scenario simulation training, the operation ability, emergency response ability,medical cooperation ability and patient satisfaction of junior neurosurgery nurses can be improved.

Objective To assess the dietary intake status of Chinese lactating women during the first month postpartum. Methods Data were extracted from Chinese National Nutrition and Health Surveillance, children aged 0-5 years and lactating women (2013). A total of 55 counties from 30 provinces in China (excluding the Tibet Autonomous Region) were selected using a multi-stage stratified cluster randomization sampling method. A group of 3 623 lactating women, at 1-6 months after delivery, were investigated in the study. The semi-quantitative food frequency questionnaire (FFQ) was used to collect information on frequencies and amounts of food consumed. Differences in food consumption rates and dietary intake in lactating women having different characteristics were analyzed and compared. Results To eliminate abnormal values, 3 300 lactating women were included in the study. During the first month postpartum, food types with higher consumption rates were animal products (98.2%,3 239) and vegetables (90.7%,2 987), in addition to cereals (100%) and liquids (100%). The consumption rate of fruits was 67.4%(2 222) and the lowest consumption rate was for dairy products (38.3%, 1 262). The median intake of cereals, vegetables, fruits and animal products were 247.8, 150.0, 40.0 and 178.6 g/d, respectively. The daily median intake of dairy products and soybean/nut products was 0.0 g/d. Overall, the lactating women consumed 895.7 ml/d liquids. About 49.3% (1 627) of the subjects consumed less than the recommended intake for animal products in Chinese Dietary Guideline (2016). More than 50% of the lactating women consumed less than the recommended intakes for the other types of food, especially dairy, soybean/nut and liquids. The consumption rates for dairy products were 26.9%, 29.4%, 31.8% and 33.8% and those for soybean/nut products were 33.9% , 35.8% , 37.5% and 41.7% for the lactating women living in rural areas, with educations at junior high school level and below, with average family incomes under 15 000 yuan per capita in 2012 and who work as household mothers, respectively. These consumption rates for dairy and soybean/ nuts were significantly lower than those in women living in cities (48.4%, 55.0%), with an education level of senior high school or above (48.8%, 55.7%), with average family income over 15 000 yuan per capita in 2012 (45.5% , 52.8% ) and who work outside the home (43.7% , 49.4% ). P values were <0.05 for all comparisons. Conclusion The daily intake of all foods by lactating women during the first month postpartum was lower than the levels recommended in Chinese Dietary Guideline (2016). The consumption rate of dairy and soybean/nut products during this time period was low, especially for those living in rural areas, with education levels of junior high school and below, with average family incomes less than 15 000 yuan per capita in 2012 and who are housemothers.

Objective To analyze serum vitamin D levels in Chinese lactating women, in 2013, and to evaluate their vitamin D nutritional status and influencing factors. Methods Data were from the Chinese National Nutrition and Health Surveillance in 2013. Using the multistage stratified cluster sampling method, serum samples from lactating women, at 0-24 months postpartum, were obtained from 55 sites in 30 provinces of China, excluding the Tibet Autonomous Region. The concentration of serum vitamin D was determined by mass spectroscopy. A standard questionnaire was used to obtain basic information and the season of blood collection. Dietary information for one recent month was collected using a food frequency questionnaire. A total of 1 981 lactating women were included in the study. A multiple logistic regression model was used to analyze the factors related to vitamin D levels among lactating women. Results The mean vitamin D level was (16.6±6.5) ng/ml, the prevalence of vitamin D deficiency (VDD) (vitamin D<12 ng/ml) was 25.2% (499 cases) and the prevalence of vitamin D inadequacy (12 ng/ml≤vitamin D<20 ng/ml) was 45.4% (900 cases). Compared with in the Han ethnic group, the OR value of VDD was 13.37 for Muslim ethnic women. Compared with women having a junior high school education or below, the OR value of VDD was 1.40 for those women with an educational level of senior high, middle school or above. Compared with housewives or nonworking women, the OR value of VDD was 1.62 for professional women. Compared with women living in general rural settings, the OR values of VDD for women living in large cities, medium and small cities or poor rural settings were 1.99, 1.46 and 2.66 respectively. Compared with the women surveyed in the fall, the OR value of VDD was 2.19 for the women surveyed in winter or spring. The VDD prevalence increased with higher latitude (OR=1.12) and decreased with increased meat consumption per day (OR= 0.73). (P<0.05 for all comparisons). Conclusion Vitamin D deficiency and vitamin D inadequacy were common in lactating women in China. Those with increased risk of VDD included lactating women who were ethnic Muslims, with higher education levels, engaged in a professional occupation, living in higher latitude region and were surveyed in winter and spring.