OBJECTIVE To explore the improvement mechanism of proanthocyanidins on acute kidney injury （AKI） induced by gentamicin in rats. METHODS Gentamicin sulfate was injected intraperitoneally to construct the AKI rat model； the model rats were randomly divided into model control group， benazepril hydrochloride 5 mg/kg group （positive control）， proanthocyanidins 50 mg/kg group， proanthocyanidins 100 mg/kg group， and proanthocyanidins 200 mg/kg group， with 10 rats in each group； in addition， 10 normal rats were selected to be treated as the normal control group. The rats in each administration group were given corresponding liquid intragastrically， and the normal control group and model control group were given equal volumes of normal saline intragastrically， once a day， for 28 consecutive days. After the last administration， the levels of serum creatinine （SCr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px） and 24 h urinary protein （UP） were detected； the renal index was calculated； the pathological changes of renal tissue were observed and the pathological score was calculated； the apoptotic rate of cells in renal tissue and the expression levels of Caspase-3 and Bcl-2 associated X protein （Bax）， as well as the phosphorylation levels of silent information regulator of transcription 1 （SIRT1） and AMP-activated protein kinase （AMPK） were detected. RESULTS Compared with the model control group， the levels of SCr， BUN， UP and MDA， the renal index， the pathological score of renal tissue， the apoptotic rate of cells in renal tissue， the protein expression levels of Caspase-3 and Bax in renal tissue of rats in each administration group were decreased significantly； SOD and GSH-Px levels， phosphorylation levels of SIRT1 and AMPK protein were increased significantly （P＜0.05）， and the effect of proanthocyanidins was in a dose-dependent manner （P＜0.05）. There were no significant differences in the above indexes between proanthocyanidins 200 mg/kg group and benazepril hydrochloride 5 mg/kg group （P＞0.05）. CONCLUSIONS The improvement effect of proanthocyanidins on AKI rats may be related to the activation of SIRT1/AMPK signaling pathway to inhibit oxidative stress.

ObjectiveTo evaluate the reliability and validity of the Dampness Syndrome Scale of Chinese Medicine （DSSCM） among patients with persistent asthma， and to explore the correlation between dampness syndrome and clinical characteristics of persistent asthma. MethodsA cross-sectional survey was conducted. Basic information， examination results， DSSCM， Asthma Control Test （ACT）， Generalized Anxiety Disorder-7 （GAD-7）， and Patient Health Questionnaire-9 （PHQ-9） scores were collected from 206 patients with persistent asthma to evaluate the reliability and validity of DSSCM and to explore the correlation between dampness syndrome and clinical characteristics. ResultsThe mean score of DSSCM among 206 patients was 14.59 ± 10.53. The overall Cronbach α coefficient and Spearman-Brown split-half reliability coefficient of the scale were both greater than 0.8， and the success rate of scale convergent and discriminant validity calibration were greater than 80%. The confirmatory factor analysis showed that the χ²/df was 2.309， and the root mean square error of approximation （RMSEA） was 0.08； the root mean square residual （RMR） was 0.049， whereas the comparative fit index （CFI）， the goodness of fit index （GFI）， the adjusted goodness of fit index （AGFI）， the normed fit index （NFI） and the incremental fit index （IFI） were less than 0.9. Correlation analysis showed that DSSCM scores were positively correlated with disease duration， GAD-7 scores， and PHQ-9 scores （P＜0.05）， and negatively correlated with ACT scores （P＜0.01）. The DSSCM scores were significantly different between patients with different disease severity （H = 10.92， P = 0.01）， and the DSSCM scores of allergic patients were higher than those of non-allergic patients （Z = -4.19， P＜0.001）. ConclusionDSSCM has acceptable reliability and validity for patients with persistent asthma. The scores of DSSCM correlated with the disease duration， ACT score， GAD-7 score， PHQ-9 score， disease severity and allergic status of persistent asthmatics.

Objective To investigate the effects of esketamine on respiration,complications and acute phase inflammatory factors in patients undergoing single-port thoracoscopic surgery under general anesthesia with preserved spontaneous respiration.Methods Ninety patients,aged 16～74 years,BMI 18～28 kg/m2,ASA physical status Ⅰ or Ⅱ,who were scheduled to undergo single-port thoracoscopic surgery under general anesthesia were selected.Patients were randomly divided into two groups by random number table:esketamine group(group E,n=45)and control group(group C,n=45).Esketamine 0.5 mg/kg was given for induction of anesthesia,and 0.25 mg/kg again before cutting skin.In group C,sufentanilwas given at 0.15 μg/kg for induction of anesthesia.Other anesthesia induction and maintenance durgs in both groups were the same.SP02,PaCO2 and PaO2 were recorded at the patient's entrance(T0),before pleuraopening(T1),15 min after pleuraopening(T2),30 min after pleuraopening(T3),and beforelaryngeal mask removal(T4).3 mL of blood was extracted from themedian cubital vein at T0 and 24 h after surgery(T5)todetect the concentrations of TNF-α and IL-6.The length of spontaneous respiration recovery and laryngeal mask removal,the number of respiratory intervention,the incidence of body movement during operation,nausea,vomiting,psychiatric symptom,awareness,the length of hospital stay was recorded.Results Compared with group C,PaO2was significantly decreased and PaCO2was significantly increased in group E at T1,PaO2was significantly increased and PaCO2was significantly decreased at T2(P<0.01).Compared with group C,the length of spontaneous respiration recovery was significantly shortened and the number of respiratory intervention was significantly decreased in group E(P<0.01).Compared with group C,the concen-trations of TNF-α and IL-6 in venous blood in group E at T5 was significantly decreased(P<0.01).There were no significant difference in the length of laryngeal mask removal,and the incidenceofcomplications,hospitalstay between the two groups.Conclusion Esketamine reducesintraoperative respiratory depression,shortens spontaneous respiration recovery,maintains respiratory stability and reduces acute inflammatory response in patients under general anesthesia with preserved spontaneous respiration for single-port thoracoscopic surgery.

Objective:To summarize the ultrasound manifestations of lung lesions in patients with coronavirus disease 2019 (COVID-19), and explore the clinical value of ultrasonography in assessing the severity of the disease.Methods:Thirty-one patients with COVID-19 admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 18 to February 5, 2020, were selected as the research subjects. All of them underwent dynamic lung ultrasound. Their lung lesions were observed, and the lung ultrasound score (LUS) was performed, respectively. The correlations between the LUS and the disease classification, the LUS and the blood oxygenation index (PaO 2/FiO 2) were analyzed, respectively. The relationship between the corresponding change of clinical classification and the LUS score when it progressed to moderate/severe was analyzed as well. Results:Among the 31 patients with COVID-19, two (6.5%) had no apparent lesions at the ultrasound, with the LUS score of 0. Twenty-nine (93.5%) showed abnormities at the ultrasound, with the LUS score from 1-26, and the main manifestations were B-line signs. Among them 6 (19.4%) had the "white lung signs" , and 13 (41.9%) had pulmonary consolidations. The LUS score was positively correlated with the clinical classification ( r s=0.683 2, P<0.001) and negatively correlated with PaO 2/FiO 2 ( r=-0.864 3, P<0.001). In the initial and dynamic ultrasonography, 13 patients were graded as moderate/severe according to their LUS scores, and the accuracy of the LUS in assessing severe/critical patients was 81.3% (13/16). It was 1-3 days earlier for the LUS progressing to moderate/severe than clinical classification. Conclusions:Pulmonary ultrasound manifestations of patients with COVID-19 have specific characteristics mainly showing as lung interstitial lesions, which can be combined with pulmonary consolidation. Ultrasound can be used in the assessment of the severity of COVID-19 noninvasively and guide clinical treatment.

Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P＜0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.

Objective To evaluate the efficiency and safety of micropulse laser trabeculoplasty (MLT) for open angle glaucoma ( OAG) patients and ocular hypertension ( OHT) patients. Methods A prospective self-controlled study was designed. Fifty-six eyes of 56 OAG and OHT patients in Peking University Third Hospital were recruited from June 2016 to June 2017,including 32 males and 24 females with the age of (50. 4±19. 0) years old. The diagnosis included 48 eyes of primary open angle glaucoma (POAG),3 eyes of normal tension glaucoma and 5 eyes of OHT. The best corrected vision acuity ( BCVA) was 0. 7 ±0. 3 before treatment. The intraocular pressure (IOP) before MLT was (20.4±5.8) mmHg,the average types of antiglaucoma medications was 1.7,including systemic medication and local drug use. The general information, BCVA, IOP and antiglaucoma medication were recorded. Only one eye of each patient was treated by MLT. The IOP at different follow-up time points (2 hours, 1 day,1 week, 1 month, 3 months post-treatment) and the number of antiglaucoma medication before and after treatment were compared. This study protocol was approved by Ethic Committee of Peking University Third Hospital (No. 2014166). Written informed consent was obtained from each subject prior to any medical examination. Results The IOP after MLT was (20. 2±6. 7),(17. 6±4. 4),(18. 1±4. 5),(17. 4±3. 4) and (17. 0±2. 1)mmHg at 2 hours, 1 day,1 week,1 month and 3 months,respectively,with significant difference among the different time points ( F=7. 320,P<0. 001). Compared with the IOP before treatment,the IOP at 1 day,1 week,1 month and 3 months after treatment were significantly decerased,with significant differences between them (all at P<0. 05). Three months after treatment,the average number of glaucoma medications used was 1. 5, and only local administration was used. Infection,hyphema,cornea injury,burns and other complications were not seen in all the patients. Conclusions MLT is effective and safety for OAG and OHT patients,and reduce the use of glaucoma drugs.

BACKGROUND: Studies have demonstrated that platelet-rich plasma can promote osteogenesis and proliferation of bone marrow mesenchymal stem cells, adipose-derived stem cells and skeletal muscle satellite cell, but whether it can promote the proliferation and osteogenesis of human umbilical cord mesenchymal stem cells (hUC-MSCs) is unclear. OBJECTIVE: To investigate the effects of different concentrations of platelet-rich plasma on the proliferation and osteogenic differentiation of hUC-MSCs. METHODS: Passage 5 hUC-MSCs were cultured in medium containing different concentrations of platelet-rich plasma (0, 250, 500, 750, 1000, 2000 ng/L), respectively. Cell proliferation was detected at 1, 3, 5, 7 days after culture, and the best platelet-rich plasma mass concentration was screened. Afterwards, passage 5 hUC-MSCs were divided and cultured in complete medium (blank control group), optimal concentration of platelet-rich plasma (platelet rich plasma group), osteogenesis induction medium (osteogenic induction group), or the osteogenesis induction medium containing the optimal concentration of platelet-rich plasma (combined group). Cell activity of alkaline phosphatase was detected after cultivated for 3, 7, 14 days. Osteopontin, bone specific transcription factor, and osteocalcin mRNA relative expression levels were detected after cultivated for 7, 14, 21 days. Mineralization of the extracellular matrix was detected after cultivated for 21 days. RESULTS AND CONCLUSION: After 5 and 7 days of culture, the cell proliferation was higher in 500, 750, 1000 ng/L platelet-rich plasma groups than 0 ng/L group (P < 0.05), and 750 ng/L platelet-rich plasma showed the best effect on cell proliferation, which was used in the following experiments. Compared with the other groups, the combined group had significantly increased alkaline phosphatase activity (P < 0.05), and up-regulated osteopontin, bone specific transcription factor and osteocalcin mRNA relative expression levels (P < 0.05) at different culture times. In addition, the degree of extracellular matrix mineralization in the combined group was also higher than that in the other three groups (P < 0.05).To conclude, 750 ng/L platelet-rich plasma can promote hUC-MSCs proliferation and osteogenic differentiation.

Objective To investigate job burnout and related influencing factors in community medical staff in Nanchong,China.Methods From June to July,2015,cluster random sampling was performed to select 181 medical staff members in Nanchong Community Health Service Center as study subjects.The Chinese Maslach Burnout Inventory (CMBI) was used to measure the level of job burnout.Results The overall detection rate of job burnout in community medical staff in Nanchong was 95.0％,and among these staff members with job burnout,119(65.7％) had mild job burnout,44(24.3％) had moderate job burnout,and 9(5.0％) had severe job burnout.There were significant differences in the scores of emotional exhaustion and reduced sense of personal accomplishmentbetween the medical staff members with different ages (F=5.820 and 3.180,both P＜0.05).There was a significant difference in the score of emotional exhaustion between the medical staff members with different working years(F=2.909,P＜0.05).There was also a significant difference in the score of reduced sense of personal accomplishment between the medical staff members with different types of work (F=5.797,P＜0.05),and the nurses had the lowest score.Conclusion The medical staff members in Nanchong have a high incidence rate of job burnout,with the feature of reduced sense of personal accomplishment.An old age,long working years,and nursing occupation are major risk factors for job burnout.

Objective To investigate job burnout and related influencing factors in community medical staff in Nanchong,China.Methods From June to July,2015,cluster random sampling was performed to select 181 medical staff members in Nanchong Community Health Service Center as study subjects.The Chinese Maslach Burnout Inventory (CMBI) was used to measure the level of job burnout.Results The overall detection rate of job burnout in community medical staff in Nanchong was 95.0％,and among these staff members with job burnout,119(65.7％) had mild job burnout,44(24.3％) had moderate job burnout,and 9(5.0％) had severe job burnout.There were significant differences in the scores of emotional exhaustion and reduced sense of personal accomplishmentbetween the medical staff members with different ages (F=5.820 and 3.180,both P＜0.05).There was a significant difference in the score of emotional exhaustion between the medical staff members with different working years(F=2.909,P＜0.05).There was also a significant difference in the score of reduced sense of personal accomplishment between the medical staff members with different types of work (F=5.797,P＜0.05),and the nurses had the lowest score.Conclusion The medical staff members in Nanchong have a high incidence rate of job burnout,with the feature of reduced sense of personal accomplishment.An old age,long working years,and nursing occupation are major risk factors for job burnout.

The purpose of this study was to study the effect of three different transfection reagents (Lipofectamine™ LTX & PLUS™, Lipofectamine 2000 and Nano-PAMAM-D) and three different testicular injection methods (rete testicular injection, seminiferous tubules injection and testicular interstitial injection) on the efficiency of production transgenic mice. After the mixtures of plasmid DNA (pEFP-C1) and transfection reagent were injected with different testicular injection methods, the sperm density, vitality, positive sperm rates and PCR positive transgenic mice rate were examined 30 days after injection. The results showed that the damage degree from slight to serious of three transfection reagents was Lipofectamine™ LTX & PLUS™, Lipofectamine 2000, and PAMAM-D. The sperm positive rates with green fluorescence of these three groups were 35.65%±0.69%, 12.86%±0.35% and 10.04%±0.20%, respectively. The PCR positive rates of transgenic newborn mice were 29.17%, 13.70% and 5.88%, respectively. Among the groups of different testicular injection methods, the damage degree from slight to serious was rete testicular injection, seminiferous tubules injection, and testicular interstitial injection, whereas the sperm positive rates with green fluorescence were 35.13%, 15.13%, and 0%, respectively. The PCR positive rates of transgenic newborn mice among different testicular injection groups were 33.3%, 12.5%, and 0.0%. The combination of rete testicular injection and Lipofectamine™ LTX & PLUS™ had the lowest toxicity and highest transgenic efficiency in the production of transgenic mice.
Animals ; Humans ; Indicators and Reagents ; chemistry ; Injections ; methods ; Lipids ; chemistry ; Male ; Mice ; Mice, Transgenic ; Plasmids ; Polymerase Chain Reaction ; Seminiferous Tubules ; Spermatozoa ; Testis ; Transfection