Objective:To translate the Triage Risk Screening Tool (TRST) into Chinese and to test its reliability and validity among older patients in the emergency department.Methods:The Brislin translation model was used to translate and back-translate the English version of the TRST. After cultural adaptation and pre-testing, and subsequently, the final Chinese version of the TRST (TRST-C) was formed. Using the convenience sampling method, a questionnaire survey was conducted on 174 elderly patients who visited the emergency department of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University to verify the reliability and validity of the scale.Results:The item-level content validity index and the scale-level average content validity index were 0.89-1.00 and 0.978, respectively. Exploratory factor analysis extracted 2 common factors, and the cumulative variance explanation rate was 63.095%. Using 2 points as the threshold for high risk of adverse outcomes. The sensitivity of TRST-C for 30-day death, emergency department readmission, rehospitalization and composite adverse outcomes were 94.4%, 81.8%, 84.6% and 84.9% respectively, and the negative predictive values were 98.3%, 86.4%, 86.4% and 76.3%, respectively. The Cronbach α coefficient and the Guttman split-half reliability of the TRST-C were 0.639 and 0.669, respectively. The Kappa coefficient was 0.911. Conclusions:The TRST-C has good reliability and validity, which can screen elderly patients of emergency department at risk of adverse outcomes.

Objective To explore the protective effect and related mechanism of Compound Baimai Powder(CBMP,a compound description of Mongolian medicine)on astrocytes after oxygen glu-cose deprivation and reoxygenation(OGD/R)injury.Methods Astrocyte model of OGD/R injury was subjected to simulate in vitro cerebral ischemia/reperfusion injury.Cultured astrocytes were randomly divided into normal group,OGD/R group,OGD/R+nimodipine group(10 μmol/L),OGD/R+low-and high-dose CBMP groups(25,50 μmol/L).Cell viability and apoptosis were de-tected with CCK-8 assay and flow cytometry,respectively.Western blotting was used to measure the expression levels of the proteins related to the nuclear factor erythroid-2-related factor-2(NRF2)/antioxidant response element and Janus kinase(J AK)/signal transducer and activator of transcription(STAT)signaling pathways.ELISA was employed to examine the levels of inflam-matory factors IL-1β,IL-6,and TNF-α,as well as oxidative stress molecules ROS,GSH,MDA and SOD.Results Compared to the normal group,the OGD/R group showed significant decreases in cell viability,NRF2 protein level,and SOD and GSH activities(P＜0.05,P＜0.01),and obvious increases in p-JAK and p-STAT proteins levels,contents of IL-1β,IL-6 and TNF-α,and ROS and MDA levels(P＜0.05,P＜0.01).High-dose CBMP treatment resulted in notably elevated cell via-bility and NRF2 protein level,while reduced levels of p-JAK[(1.20±0.20)vs(2.50±0.26)]and p-STAT[(1.15±0.25)vs(2.10±0.21)]proteins,IL-6[(30.33±5.20)vs(180.35±18.50)]and TNF-α[(50.12±8.24)vs(160.45±15.20)]when compared to the OGD/R group(P＜0.05,P＜0.01).Conclusion CBMP exerts protective effect on astrocytes against OGD/R injury.

Objective:To translate the Triage Risk Screening Tool (TRST) into Chinese and to test its reliability and validity among older patients in the emergency department.Methods:The Brislin translation model was used to translate and back-translate the English version of the TRST. After cultural adaptation and pre-testing, and subsequently, the final Chinese version of the TRST (TRST-C) was formed. Using the convenience sampling method, a questionnaire survey was conducted on 174 elderly patients who visited the emergency department of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University to verify the reliability and validity of the scale.Results:The item-level content validity index and the scale-level average content validity index were 0.89-1.00 and 0.978, respectively. Exploratory factor analysis extracted 2 common factors, and the cumulative variance explanation rate was 63.095%. Using 2 points as the threshold for high risk of adverse outcomes. The sensitivity of TRST-C for 30-day death, emergency department readmission, rehospitalization and composite adverse outcomes were 94.4%, 81.8%, 84.6% and 84.9% respectively, and the negative predictive values were 98.3%, 86.4%, 86.4% and 76.3%, respectively. The Cronbach α coefficient and the Guttman split-half reliability of the TRST-C were 0.639 and 0.669, respectively. The Kappa coefficient was 0.911. Conclusions:The TRST-C has good reliability and validity, which can screen elderly patients of emergency department at risk of adverse outcomes.

Objective To explore the protective effect and related mechanism of Compound Baimai Powder(CBMP,a compound description of Mongolian medicine)on astrocytes after oxygen glu-cose deprivation and reoxygenation(OGD/R)injury.Methods Astrocyte model of OGD/R injury was subjected to simulate in vitro cerebral ischemia/reperfusion injury.Cultured astrocytes were randomly divided into normal group,OGD/R group,OGD/R+nimodipine group(10 μmol/L),OGD/R+low-and high-dose CBMP groups(25,50 μmol/L).Cell viability and apoptosis were de-tected with CCK-8 assay and flow cytometry,respectively.Western blotting was used to measure the expression levels of the proteins related to the nuclear factor erythroid-2-related factor-2(NRF2)/antioxidant response element and Janus kinase(J AK)/signal transducer and activator of transcription(STAT)signaling pathways.ELISA was employed to examine the levels of inflam-matory factors IL-1β,IL-6,and TNF-α,as well as oxidative stress molecules ROS,GSH,MDA and SOD.Results Compared to the normal group,the OGD/R group showed significant decreases in cell viability,NRF2 protein level,and SOD and GSH activities(P＜0.05,P＜0.01),and obvious increases in p-JAK and p-STAT proteins levels,contents of IL-1β,IL-6 and TNF-α,and ROS and MDA levels(P＜0.05,P＜0.01).High-dose CBMP treatment resulted in notably elevated cell via-bility and NRF2 protein level,while reduced levels of p-JAK[(1.20±0.20)vs(2.50±0.26)]and p-STAT[(1.15±0.25)vs(2.10±0.21)]proteins,IL-6[(30.33±5.20)vs(180.35±18.50)]and TNF-α[(50.12±8.24)vs(160.45±15.20)]when compared to the OGD/R group(P＜0.05,P＜0.01).Conclusion CBMP exerts protective effect on astrocytes against OGD/R injury.

Objective To study the mechanism of the treatment of metabolism associated steatohepatitis(MASH)in rats with Xiaoyao Wan.Methods Twenty-four SD male rats were randomly divided into control group(CON group,n=8)and model group(n=8).The model group was given high-fat diet,carbon tetrachloride(CCl4)subcutaneous injection,hunger and satiety disorder and tail clamping for four weeks to establish the MASH model,and the rats were randomly divided into the MOD group and the Xiaoyao Wan group(XYW group),with 8 rats in each group.The rats of the XYW group were given Xiaoyao Wan,the other two groups were given normal saline.Four weeks after administration,the serum biochemical indexes and oxidative stress indexes of rats in different groups were detected.The pathological sections of rat liver tissue were observed by hematoxylin-eosin(HE)stai-ning and oil red O staining.The expression of cytochrome P450 2E1(CYP2E1),factor-related apoptosis ligand(FasL),tumor necrosis factor-α(TNF-α)and tumor growth factor-β1(TGF-β1)in rat liver were detected by Western blot method.The relative contents of CYP2E1,FasL,TNF-α and TGF-β1 mRNA in liver tissue were de-tected by RT-qPCR.Results The general condition of rats in the XYW group was significantly improved compared with the MOD group;the level of hepatic index was significant decrease compared with the MOD group(P＜0.01)and the level of body mass index was significant increase compared with the MOD group(P＜0.01);the serum levels of triglyceride,total cholesterol,low-density lipoprotein cholesterol,aspartate aminotransferase,alanine aminotransferase,malondialdehyde,monocyte chemotactic protein-1,TNF-α,and interleukin(IL)-18 were signif-icantly reduced compared with the MOD group(all P＜0.05),and the levels of high-density lipoprotein choles-terol,superoxide dismutase,and IL-10 were significantly elevated compared with the MOD group(all P＜0.05);the content of lipid droplets in hepatocytes of rats was significantly reduced compared with the MOD group under light microscope;the protein levels of CYP2E1,FasL,TNF-α and TGF-β1 in liver tissues were significantly re-duced compared with the MOD group(all P＜0.05),and the relative contents of CYP2E1,FasL,TNF-α and TGF-β1 mRNA were significantly reduced compared with the MOD group(all P＜0.05).Conclusion Xiaoyao Wan can regulate the expression of CYP2E1,FasL,TNF-α and TGF-β1 in the liver tissue of MASH rats by reduc-ing the accumulation of fat in the liver,so as to achieve the purpose of treating MASH.

BACKGROUND: Long-term remote ischemic conditioning (RIC) has been proven to be beneficial in multiple diseases, such as cerebral and cardiovascular diseases. However, the hyperacute and acute effects of a single RIC stimulus are still not clear. Quantitative proteomic analyses of plasma proteins following RIC application have been conducted in preclinical and clinical studies but exhibit high heterogeneity in results due to wide variations in experimental setups and sampling procedures. Hence, this study aimed to explore the immediate effects of RIC on plasma proteome in healthy young adults to exclude confounding factors of disease entity, such as medications and gender. METHODS: Young healthy male participants were enrolled after a systematic physical examination and 6-month lifestyle observation. Individual RIC sessions included five cycles of alternative ischemia and reperfusion, each lasting for 5 min in bilateral forearms. Blood samples were collected at baseline, 5 min after RIC, and 2 h after RIC, and then samples were processed for proteomic analysis using liquid chromatography-tandem mass spectrometry method. RESULTS: Proteins related to lipid metabolism (e.g., Apolipoprotein F), coagulation factors (hepatocyte growth factor activator preproprotein), members of complement cascades (mannan-binding lectin serine protease 1 isoform 2 precursor), and inflammatory responses (carboxypeptidase N catalytic chain precursor) were differentially altered at their serum levels following the RIC intervention. The most enriched pathways were protein glycosylation and complement/coagulation cascades. CONCLUSIONS One-time RIC stimulus may induce instant cellular responses like anti-inflammation, coagulation, and fibrinolysis balancing, and lipid metabolism regulation which are protective in different perspectives. Protective effects of single RIC in hyperacute and acute phases may be exploited in clinical emergency settings due to apparently beneficial alterations in plasma proteome profile. Furthermore, the beneficial effects of long-term (repeated) RIC interventions in preventing chronic cardiovascular diseases among general populations can also be expected based on our study findings.
Young Adult ; Humans ; Male ; Proteome ; Cardiovascular Diseases ; Proteomics ; Ischemia ; Blood Coagulation

Objective To assess the effectiveness of the Mulliken's method in bilateral complete cleft lip patients with 3dMD system and anthropometric landmarks.Methods Thirty-one infants with bilateral complete cleft lip received treatment in Hospital of Stomatology,Wuhan University between January 2014 and December 2016.Patients underwent primary cheiloplasty and nasoplasty by the same senior surgeon.Periodic review was taken to measure and record the 7 items in the nasolabial area with three-dimensional (3D) images.Results The labial and nasal deformities were restored after primary surgery.The upper lip and nose were corrected and obtained the symmetric shape.The columella was elongated to acquire favorable nasal tip.The arc of nasal fornix was upward.The ridge of the white lipwas continuous and integrated with full vermilion tubercle.Total length of upper lip (Sn-Sto),thickness of the vermilion tubercle (Ls-Sto),protrusion of the nasal tip (Nh) and columellar height (Ch) were markedly improved and there were no significant difference between the observation group and the control group.The significant differences between two groups occurred in values of the nostril width (Nw),which was greater than control group and white lip height (Sn-Ls) and lower than that of control group.Conclusions Mulliken's method during the primary cheiloplasty of the bilateral complete cleft lip shows better results in correction the nasal deformity and the ideal effects are achieved during follow-up.

Objective: To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction. Methods: Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups. Results: All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group. Conclusions Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.

Objective To observe the effect of conventional therapy plus trimetazidine on alcoholic cardiomyopathy (ACM) and plasma brain natriuretic peptide (BNP).Methods Eighty-six cases of ACM patients were divided into control group and observation group by random digits table method with 43 cases each.Control group was treated with conventional therapy,while observation group was added trimetazidine.Course of treatment was 3 months.The left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),6 min walk distance,plasma BNP before and after treatment and the efficiency in two groups was observed and compared.Results LVEF,LVEDD,6 min walk distance,BNP before treatment in control group were respectively (37.2 ±7.4)％,(57.6 ±7.4) mm,(312.8 ±21.6) m,(846.2 ±63.7)μg/L,and the indicators in observation group were respectively (38.5 ±8.1)％,(57.1 ±6.8) mm,(316.5 ± 23.9) m,(857.6 ± 61.4) μ g/L.All indicators between two groups was no statistically different (P＞0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in control group were respectively (43.5 ±8.6)％,(54.3 ± 6.4) mm,(511.6 ± 26.7) m,(679.4 ± 51.3) μg/L,and there were significant difference compared with those before treatment (P ＜ 0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in observation group were respectively (51.6 ± 9.2)％,(51.2 ± 6.3) mm,(579.3 ± 25.1) m,(536.5 ± 50.6)μ g/L,and there were significant difference compared with those before treatment (P ＜ 0.05).There were significant difference in LVEF,LVEDD,6 min walk distance and BNP after treatment between two groups (P ＜ 0.05).The total effective rate in observation group was 90.7％ (39/43),which was significantly higher than that in control group [72.1％ (31/43)] (x2 =4.914,P ＜ 0.05).Conclusion Adding trimetazidine on the basis of conventional therapy can improve the cardiac function and myocardial remodeling of ACM patients and improve clinical efficacy.

Objective To investigate the relationship of the1675A/G polymorphism of AT2 gene with the therapeutic effect of indapamide sustained release tablets in female patients with primary hypertension.Methods Two hundred and twenty female patients with primary hypertension were treated with Indapamide Sustained Release Tablets ( 1.5 mg · qd) for 8 weeks.The blood samples from the patients were collect to determine AT2 gene polymorphism by PCR combined with HRM and sequencing.Results Two hundred and five patients completed the test.In female patients,the therapeutic efficacy of indapamide sustained telease tablets among different AT2R genotypes( AA:70.6％,AG:71.6％,GG:71.4％ ) showed no significant difference ( x2=2.53,P=0.49 ),neither do the decline of BP after therapy ( F=0.39 and 0.19 respecrively,P ＞ 0.05).Conclusion The AT2 genotype was assumed to be not correlated to the blood pressure lowering response to Indapamide Sustained Release Tablets in female primary hypertension patients.