AIM:This study aimed to observe the analgesic effects of Hegu acupoint catgut embedding in a rat model of labor and investigate its influence on biomarkers such as calcitonin gene-related peptide(CGRP)signals at the Hegu acupoint.METHODS:Thirty-six pregnant rats were randomly divided into three groups:control group,Hegu acu-puncture group,and Hegu catgut embedding group.Pain threshold changes were assessed using the tail immersion test and paw withdrawal thermal latency at four time points:pre-induction,before the onset of labor,at the onset of labor,and at the mid-stage of labor.Tissue samples from the Hegu acupoint were collected at the mid-stage of labor to detect the ex-pression of CGRP,substance P(SP),and mast cells using immunofluorescence.The concentrations of ATP and ade-nosine were measured using ELISA.RESULTS:Before labor induction,there was no significant difference in tail immer-sion test and paw withdrawal thermal latency among the three groups(P>0.05).Before the onset of labor,both the acu-puncture and catgut embedding groups exhibited significantly higher tail-flick times and paw withdrawal latencies com-pared to the control group(P<0.05).At labor initiation and mid-labor,the catgut embedding group had significantly higher tail-flick times and paw withdrawal latencies compared to both the control and acupuncture groups(P<0.05).During mid-labor,the expression of CGRP,SP,mast cells,ATP,and adenosine concentrations in the catgut embedding group was significantly higher than that in the control and acupuncture groups(P<0.05),with co-expression of CGRP,SP,and mast cells observed.CONCLUSION:Hegu acupoint catgut embedding effectively alleviates labor pain,and its mechanism may involve increased local expression of CGRP and SP,promoting mast cell degranulation,and increasing ATP release and its conversion to adenosine.

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.

Background: Pyroptosis is involved in the occurrence of acute pancreatitis, but its role in remote organ injury remains unclear. Aims: To investigate the role and mechanism of NLRP3 inflammasome-dependent pyroptosis in acute pancreatitis- related lung injury. Methods: Thirty-two male Sprague-Dawley rats were randomly divided into four groups: control group, severe acute pancreatitis (SAP) group, Z-WEHD-FMK (caspase-1 inhibitor) group and disulfiram (GSDMD inhibitor) group. Experimental SAP was constructed by using 5% sodium taurocholate in the latter 3 groups. Serum levels of amylase, lipase, procalcitonin, and the myeloperoxidase (MPO) activity were determined; the severity of pancreatic and lung injuries was assessed by histopathology and lung wet/dry weight ratio; serum levels of pyroptosis-related inflammatory cytokines and the expressions of proteins involved in pyroptosis pathway in lung tissue were measured by ELISA method and immunohisto- chemistry and Western blotting, respectively. Results: Compared with the control group, the serum biochemical indices, MPO activity, and interleukin (IL)-1β, IL-18 levels in SAP group were significantly increased with aggravated pancreatic and lung tissue injuries; meanwhile, the expressions of NLRP3, caspase-1 and GSDMD in lung tissue were significantly up- regulated (all P<0.05). Pretreatment with caspase-1 or GSDMD inhibitors reduced the severity of pancreatic and lung tissue injuries, improved the serum biochemical indices and MPO activity, and ameliorated the increased pyroptosis - related inflammatory cytokines and pyroptosis pathway - related proteins (all P<0.05). Conclusions: NLRP3/caspase - 1/GSDMD pathway mediated pyroptosis plays an important role in acute pancreatitis-related lung injury, and inhibition of pyroptosis pathways might be a new direction for its treatment.

Background Essential and non-essential elements have an important impact on the development of the central nervous system during fetal development. Due to their less developed brain, preterm infants are more sensitive to element exposure, and are high-risk groups of neurodevelopmental abnormalities. However, it is not clear whether the effects of element exposure in utero on postpartum neurodevelopment are different between full-term infants and preterm infants. Objective To evaluate the effects of element exposure levels during pregnancy on neurodevelopment of children aged 6-24 months (of corrected age), and compare the effects between preterm and full-term children. Methods A prospective study design was adopted and this study was conducted based on the Maoming Birth Cohort Study (MBCS) in Maoming City, Guangdong Province. Twenty elements in cord blood of 197 preterm infants and 297 full-term infants were measured, including 11 essential trace elements [vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), selenium (Se), strontium (Sr), tin (Sn), and iron (Fe)], and 9 non-essential trace elements [aluminum (Al), arsenic (As), thallium (Tl), lead (Pb), uranium (U), cerium (Ce), antimony (Sb), cadmium (Cd), and yttrium (Y)]. The neurodevelopment of the children at 6, 12, and 24 months were evaluated by the Ages and Stages Questionnaires-the Third Edition (ASQ-3). A generalized estimating equation (GEE) model was adopted to evaluate the associations between elements and neurodevelopment in full-term and preterm children separately. Results The positive rates of 10 elements (Mn, Cu, Zn, Se, Sr, Fe, Sb, Tl, Pb, and As) in cord blood were greater than 80%. Among the preterm birth children, the results of GEE analysis showed that after adjusting for the covariates, for each increase of interquartile range (IQR) in ln-transformed concentration, As was associated with problems/delay in the communication and problem-solving sub-scales, with the adjusted odds ratios (OR) and 95% confidence intervals (CI) of 1.36 (1.03-1.80) and 1.55 (1.10-2.20), respectively; the adjusted OR (95%CI) of problems/delay in the fine motor and problem-solving sub-scales were 1.44 (1.00-2.07) and 1.76 (1.09-2.84) for Sb, respectively; the adjusted OR (95%CI) of problems/delay in the communication sub-scale was 1.37 (1.09-1.74) for Se. No statistically significant associations between umbilical cord blood element concentrations and neurodevelopment indicators were observed among full-term children. The results of stratified analysis by sex showed that the associations between umbilical cord blood element concentrations and neurodevelopment problems/delay were only significant among female preterm children. Conclusion Exposures to As, Se, and Sb during pregnancy may increase the risk of neurodevelopment problems/delay in preterm children aged 6-24 months, and female seem to be more vulnerable.

Objective:To evaluate the clinical efficacy and safety of oral mifepristone (10 mg/day) versus placebo in the preoperative treatment of uterine fibroids.Methods:This study was a multi-center, randomized, double-blind, placebo, parallel controlled trial. A total of 132 patients with uterine fibroids were randomly divided into study group and control group, with 66 cases in each group. The patients in the study group orally took 1 tablet/day of mifepristone (dose of 10 mg/tablet), the patients in the control group orally took 1 tablet/day of placebo, and both groups were treated for 3 months. The primary efficacy evaluation indicators were the change rate of maximum fibroid volume; the secondary efficacy evaluation indicators included amenorrhea rate, improvement of subjective symptoms and anemia; the safety evaluation indicators included the analysis of adverse events and changes in laboratory biochemical indicators.Results:At the end of treatment, the maximum leiomyoma volume was reduced by 25.97% (95% CI: -34.79%--15.95%) in the study group and reduced by 1.51% (95% CI: -13.03%-11.54%) in the control group. The change rate of the maximum leiomyoma volume before and after treatment in the study group was significantly greater than that in the control group, and the difference in the change rate of the maximum leiomyoma volume between the two groups was -24.84% (95% CI: -36.56%--10.94%), which was much higher than the 10% superiority threshold goal set by this study within the 95% CI interval. At the end of treatment, the complete amenorrhea rate [84% (52/62)], dysmenorrhea elimination rate [98% (61/62)], and menstrual blood loss disappearance rate [87% (54/62)] in the study group were significantly higher than those in the control group (all P<0.05). At the end of treatment, the mean hemoglobin [(131±13) g/L], red blood cell count [(4.5±0.4)×10 12/L] and hematocrit (0.39±0.03) in the study group were significantly increased compared with the baseline, and the differences had statistical significance (all P<0.05); after treatment, the differences in the above three indicators between the two groups had statistical significance (all P<0.01). The serum estradiol level in the study group was significantly lower than that in the control group at the end of treatment, and the difference was statistically significant ( P<0.01). There were no significant differences in follicle-stimulating hormone and cortisol levels before and after treatment between the two groups ( P>0.05). The overall incidences of any adverse event were not significantly different between the two groups (all P>0.05). Abdominal pain was the most common adverse event in the study group [9% (6/65)], but the incidence was not significantly increased compared with the control group [3% (2/64); P>0.05]. Conclusion:Compared with placebo, oral mifepristone 10 mg/day is significantly superior to placebo in reducing the size of uterine fibroids and improving anemia, without significant adverse reactions, and could be used as a drug treatment for patients with of uterine fibroids before surgery.

Objective:To study the influence of objective structured clinical examination (OSCE) assessment mode on learning interest and critical thinking of nursing students in operating room.Methods:There were 49 operating room nursing students from April 2019 to April 2020 who were selected as the observation group, receiving the teaching and assessment mode of OSCE. In addition, 49 operating room nursing students from March 2018 to March 2019 were included as the control group, receiving the conventional teaching and assessment mode. The nursing students' learning attitude scale was used to compare the learning interest of the two groups, and the critical thinking level of nursing students was recorded by Chinese critical thinking disposition inventory-Chinese version (CTDI-CV). SPSS 24.0 software was used to analyze the data with t test and chi-square test. Results:There were statistically significant differences in the scores of learning interest, learning experience, learning habits, professional cognition and the total scores of the learning attitude of nursing students after the assessment between the observation group and the control group ( t=4.861, t=4.885, t=3.466, t=4.206, t=8.292; all P<0.05). There were statistically significance of curiosity, truth seeking, open thinking, analytical ability, systematic ability, self-confidence in thinking, cognitive maturity and the CTDI-CV total scores after the assessment between the observation group and the control group ( t=4.262, t=4.311, t=2.754, t=4.854, t=3.984, t=2.864, t=4.267, t=2.729; P<0.05). Conclusion:The OSCE assessment mode used in operating room for nursing students is helpful to improve the learning interest and the cultivation of students' critical thinking.

Objective:To evaluate the effect of epidural block combined with general anesthesia on T helper (Th) cell balance and outcome after hepatectomy.Method:Seventy patients aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing hepatectomy in our hospital, were randomly assigned into combined epidural-general anesthesia group (E+ G group, n=35) and general anesthesia group (G group, n=35). The consumption of anesthetics during operation and analgesics after operation was recorded.Blood samples were obtained on the morning of the operation day (T 0) and morning of 2nd and 3rd days after operation (T 1, 2). The concentrations of interferon (IFN)-γ, interleukin-4 (IL-4), IL-17, IL-10 and transforming growth factor (TGF)-β 1 were determined by enzyme-linked immunosorbent assay.The ratio of IFN-γ/IL-4 was calculated.The patients were followed up for 3 yr after operation, and the survival and tumor-free survival were recorded.Multivariate COX proportional hazards model was used for multivariate analysis of the factors associated with survival and tumor-free survival. Results:Sixty-one patients were finally included in this study, including 31 patients in E+ G group and 30 patients in G group.Compared with G group, the consumption of fentanyl, sevoflurane and postoperative morphine was significantly decreased, the plasma concentrations of IFN-γ and IL-4 at T 1 and IL-17 and TGF-β 1 at T 2 were decreased, the ratio of IFN-γ/ IL-4 was increased, and the overall survival rate and tumor-free survival rate were increased in E+ G group ( P<0.05). The results of multivariate COX proportional hazards model analysis showed that vascular invasion was a risk factor for tumor-free survival and overall survival ( P<0.05), and anesthesia method was not a risk factor for tumor-free survival ( P>0.05). Conclusion:Compared with general anesthesia alone, epidural block combined with general anesthesia is more helpful in maintaining the balance of Th cells and in improving the outcome of hepatectomy.

Objectives To investigate the risk factors for rheumatoid arthritis in middle-aged and elderly residents in Luohe City,Henan Province.Methods Survey questionnaires and measurements of biochemical parameters were conducted in individuals 45 years old or above,using the two-stage cluster sampling method.Risk factors for rheumatoid arthritis were evaluated according to the criteria for the classification of RA by the American College of Rheumatology and European League Against Rheumatism(ACR/EULAR) (2010).Results Among the 8 610 residents covered by the survey,8,274 people responded,representing a response rate of 96.1％.There were 3 361 male (40.62％)and 4 913 female(59.38％)respondents,with an average age of 61.4±7.4(45-91)years.The age group of 60-64 years had the highest rates of joint involvement,with those scoring 2,3 and 5 points at 2.90％,2.02％ and 0.26％,respectively.The rheumatoid factor (RF)and the anti-cycliccitrullinatedpeptide(anti-CCP)antibody titer showed skewed distributions.The low titer-positive rate of RF and anti-CCP antibody,the ESR and CRP in female residents were evidently higher than in male residents(each P＜0.05).Smoking was an independent factor for RA(OR:1.79,95 ％CI:1.34～ 3.41,P＜0.01).The risk for RA occurrence increased with the frequency of drinking ＞1 time/d(OR:6.71,95 ％ CI:0.88 ～ 51.23,P＜ 0.01).The prevalence of RA was significantly higher in rural areas than in urban and suburb areas(0.93％ to 0.48％ and 0.53％,each P＜0.05).Living on higher floors was a protective factor for RA (OR:0.61,95 ％ CI:0.36 ～ 0.94,P =0.036).Family history was an independent risk factor for RA (OR:3.09,95 ％ CI:1.53 ～ 6.27,P ＜ 0.01),and being first degree relatives of RA patients was a risk factor(OR=6.45,95 ％ CI:1.67～ 17.83,P＜0.01).Multiple factor analysis showed that female gender,first floor of residential buildings,smoking and genetics were key risk factors for RA.Conclusions The risk factors for rheumatoid arthritis in middle-aged and elderly residents in Luohe City of Henan Province are female gender,smoking and genetics.

Objective To modified doxorubicin liposome with transferrin(TF),and to investigate its inhibition efficacy on the proliferation of human breast cancer cells.Methods The liposome was prepared by thin film ultrasonic,and doxorubicin liposomal was prepared by sulfuric acid gradient.The TF-doxorubicin lipo-some was prepared by the post insertion method.The uptake of TF-liposomal doxorubicin on breast cancer cells MCF-7 and MDA-MB-231 were detected by confocal microscopy.The killing ability of TF-doxorubicin liposomal targeting for MCF-7 and MDA-MB-231 were detected by MTT assay.Inhibitory effect of TF-doxorubicin lipo-some on the growth of MCF-7 and MDA-MB-231 were detected by soft agar colony assay.Results Confocal microscopy result showed that the uptake of TF-liposomal doxorubicin on MCF-7 and MDA-MB-231 were signifi-cantly higher than doxorubicin liposomal.Cell-killing ability on MCF-7 and MDA-MB-231 showed that the IC50 in TF-liposomal doxorubicin [MCF-7 cells:(20.8 ±3.2)μmol/L;MDA-MB-231 cells:(20.1 ±3.0)μmol/L)] were significantly lower than the liposomal [(1 58.6 ±24.6)μmol/L;(1 60.1 ±25.1 )μmol/L)]and free doxorubicin [(1 61 .7 ±26.2)μmol/L;(1 66.9 ±27.0)μmol/L)],with significant differences(F =1 1 6.03, P <0.001 ;F =75.29,P <0.001 ).Soft agar colony assay showed that the inhibition of TF-doxorubicin lipo-some on colony growth were significantly higher than doxorubicin liposome,free doxorubicin and control [dia-meter of MDA-MB-231 cells:(60.5 ±10.4)μm,(94.3 ±16.8)μm,(1 31 .8 ±22.6)μm,(162.8 ±30.3)μm;diameter of MCF-7 cells:(31 .8 ±5.5)μm,(62.1 ±11 .1 )μm,(108.6 ±1 8.6)μm,157.4 ±29.3)μm],with significant differences (F =87.17,P <0.000 1 ;F =178.23,P <0.000 1 ).Conclusion TF-doxorubicin lipo-some has a significant inhibitory effect on the proliferation of breast cancer cells in vitro,and can effectively and specifically kill the breast cancer cells,which provides theoretical basis for the treatment of breast cancer in vivo.

The aim of this paper is to explore the prevention of rabbit postoperative abdominal cavity adhesion with poly (lactic-co-glycotic acid) (PLGA) membrane and the mechanism of this prevention function. Sixty-six Japanese white rabbits were randomly divided into normal control group, model control group and PLGA membrane group. The rabbits were treated with multifactor methods to establish the postoperative abdominal cavity adhesion models except for those in the normal control group. PLGA membrane was used to cover the wounds of rabbits in the PLGA membrane group and nothing covered the wounds of rabbits in the model control group. The hematologic parameters, liver and kidney functions and fibrinogen contents were detected at different time. The rabbit were sacrificed 1, 2, 4, 6, 12 weeks after the operations, respectively. The adhesions were graded blindly, and Masson staining and immunohistochemistry methods were used to observe the proliferation of collagen fiber and the expression of transforming growth factor β1 (TGF-β1) on the cecal tissues, respectively. The grade of abdominal cavity adhesion showed that the PLGA membrane-treated group was significant lower than that in the model control group, and it has no influence on liver and kidney function and hematologic parameters. But the fibrinogen content and the number of white blood cell in the PLGA membrane group were significant lower than those of model control group 1 week and 2 weeks after operation, respectively. The density of collagen fiber and optical density of TGF-β1 in the PLGA membrane group were significant lower than those of model control group. The results demonstrated that PLGA membrane could be effective in preventing the abdominal adhesions in rabbits, and it was mostly involved in the reducing of fibrinogen exudation, and inhibited the proliferation of collagen fiber and over-expression of TGF-β1.
Abdominal Cavity ; surgery ; Animals ; Collagen ; metabolism ; Lactic Acid ; Polyglycolic Acid ; Rabbits ; Tissue Adhesions ; prevention & control ; Transforming Growth Factor beta1 ; metabolism