ObjectiveTo observe the clinical effectiveness and safety of Xuandi Ziyin Mixture （玄地滋阴合剂） for central precocious puberty （CPP） in girls with syndrome of yin deficiency and fire exuberance， and to analyse the effect of body mass index （BMI） on the effectiveness. MethodsA total of 236 girls with CPP of yin deficiency and fire exuberance syndrome were included， and all of them were given Xuandi Ziyin Mixture， 30 ml each time， twice a day， for a total treatment period of 6 months. Before and after treatment， children's weight， height and bone age were measured， BMI and BMI Z-score （BMI Z） and the difference between bone age and actual age were calculated； ultrasound was used to detect uterine and ovarian sizes， and to calculate uterine volume （V_uterus）， bilateral ovarian volume （V_{left ovary}， V_{right ovary}）， and bilateral maximal follicle diameters （r_{left follicle} and r_{right follicle}）； and serum sex hormones were measured， including follicle-stimulating hormone （FSH）， luteinising hormone （LH）， prolactin （PRL）， estradiol （E₂）， and testosterone （T）， and were scored for traditional Chinese medicine （TCM） syndrome. Multiple linear regression was used to analyse the influence factors of the difference between bone age and actual age， and changes in uterine volume. The children were divided into the normal weight group and the overweight/obesity group according to baseline BMI， and the bone age， the difference between bone age and actual age， V_uterus and BMI Z scores before and after treatment were compared between the two groups. ResultsFinally， 199 children entered the statistical analysis. Compared with pre-treatment， the bone age， BMI and BMI Z scores of the children increased after treatment， and the difference between bone age and actual age， TCM syndrome scores， V_uterus， V_{left ovary}， V_{right ovary}， r_{left follicle} and r_{right follicle} decreased； and the levels of serum FSH， LH， E₂， and T significantly decreased （P＜0.05 or P＜0.01）. The difference between bone age and actual age was negatively correlated with LH and V_uterus （P＜0.05）， and changes in uterine volume were positively correlated with LH （P＜0.01）. Comparing between the groups before and after treatment， the bone age， difference between bone age and actual age， and BMI Z scores of children in the normal weight group （100 cases） were significantly smaller than those in the overweight/obesity group （99 cases） （P＜0.01）. Compared with pre-treatment， the bone age of the children in both groups increased， but the difference between bone age and actual age and V_uterus were significantly smaller （P＜0.01）. Further comparison of Δ bone age and actual age difference and ΔV_uterus （Δ = post-treatment value - pre-treatment value） between the two groups showed no statistically significant difference （P＞0.05）. ConclusionsXuandi Ziyin Mixture can reduce bone age， sex hormone level， ovary and uterus size， and improve clinical symptoms in girls with yin deficiency and fire exuberance syndrome of CPP. It is also effective in overweight/obese children， and the inhibitory effect on bone age in girls with CPP is not affected by BMI， with good safety.

This research aimed to explore strategies to enhance the influence of major themed publicity in hospital party building within several prominent tertiary public hospitals in China,including one in Beijing,one in Zhejiang and four in Guang-dong.An analysis of themed publicity initiatives over the past five years,particularly during pivotal party events and key thematic activities,was undertaken.This assessment included both offline events and the online media coverage through various integrated media platforms.The study aimed to offer development suggestions for hospitals to amplify the influence of their major themed publicity strategies for Party building.Currently,hospitals are placing increased emphasis on the strategic planning of major themed publicity for Party building.Innovation in content and promotional tactics,along with strengthened integration with main-stream media,is essential.Effective dissemination that elicits empathy and presents high-quality publicity materials is crucial for achieving optimal dissemination outcomes and further elevating the hospital's Party building influence.

Objective:To observe the effects of sacubitril/valsartan (LCZ696) on viral replication and cardiomyocyte apoptosis in mice with coxsackievirus B3 (CVB3)-induced viral myocarditis (VMC) and to analyze the underlying mechanisms.Methods:Forty BALB/c mice were randomly divided into four groups with 10 in each group: Sham, Sham+ LCZ696, VMC, and VMC+ LCZ696 groups. VMC model was established by intraperitoneal injection of 0.1 ml of CVB3 with a concentration of 10 6 TCID 50/ml into BALB/c mice, while the sham intervention was an equal volume of saline. The day of virus injection was defined as day 0. LCZ696 was administered by gavage at a dose of 60 mg/kg every day for seven consecutive days starting from day 1. Mouse survival rates were calculated. Echocardiography was used to evaluate the cardiac function of mice. The level of creatine kinase-MB (CK-MB) was detected by ELISA. Western blot was used to detect the levels of inflammatory cytokines (IL-6, TNF-α), apoptosis-related proteins (caspase-3, cleaved-caspase-3, Bax, Bcl-2), CVB3 surface protein (VP-1) and p-AKT/AKT in the hearts of mice. CVB3 mRNA in mouse hearts was measured by PCR. Inflammatory cell infiltration and cell apoptosis in mouse hearts were observed by HE staining and TUNEL staining, respectively. Results:Compared with the Sham group, the mice in the VMC group had a decreased survival rate and impaired cardiac function ( P<0.05). The levels of CK-MB, IL-6, TNF-α, cleaved-caspase-3/caspase-3, Bax/Bcl-2, VP-1, and CVB3 mRNA in the hearts of VMC mice increased significantly ( P<0.05), accompanied by increased expression of AKT, decreased phosphorylation of AKT ( P<0.05) and increased cell apoptosis. LCZ696 reversed the above changes. It could increase the survival rate, improve the cardiac function ( P<0.05), decrease cardiac inflammation, cell apoptosis and viral replication ( P<0.05), and increase the phosphorylation of AKT ( P<0.05). LCZ696 had no significant effects on the survival rate, cardiac function, myocardial injury, cardiac inflammation, cell apoptosis, viral replication or the expression of PI3K/AKT signaling pathway-related proteins in normal mice. Conclusions:LCZ696 could significantly inhibit cardiomyocyte apoptosis and reduce CVB3 replication in the hearts of VMC mice by regulating the PI3K/AKT pathway, thereby improving mouse cardiac function and survival rate.

Objective:To analyze the difference between Z score and previous criteria in the diagnosis characteristics of coronary artery aneurysm (CAA) in Kawasaki disease, and to investigate the clinical distribution of Kawasaki disease CAA in the Z score group.Methods:This study retrospectively analyzed the clinical and echocardiographic data of 2 419 children with Kawasaki disease in Shenzhen Children′s Hospital from January 2009 to December 2019. The traditional criteria and Z score criteria were used to diagnose CAA, and the differences of diagnostic efficiency between the 2 diagnostic methods were analyzed. The clinical distribution characteristics of CAA in children with Kawasaki disease were analyzed by grouping their sex, clinical classification (complete Kawasaki disease, incomplete Kawasaki disease) the sensitivity to intravenous immunoglobulin (IVIG) (IVIG-sensitive Kawasaki disease,IVIG-unresponsive Kawasaki disease). And the course of the disease (≤6 weeks, >6-8 weeks, >8 weeks to 6 months) etc. The χ2 test or Kruskal-Wallis test was used for comparison between the groups, and the Kappa test was used for consistency evaluation.Results:Among the 2 419 children with Kawasaki disease, 1 558 were males and 861 were females. The age of onset was 1.8 (1.0, 3.2) years. The rate of CAA by Z score criteria was higher than that by traditional method (21.9% (529/2 419) vs. 13.9% (336/2 419), χ 2=1 074.94, P<0.001). Compared to the traditional method, the Z score criteria found higher rate of CAA in male patients, patients with incomplete Kawasaki disease, and IVIG-unresponsive patients (25.2% (392/1 558) vs. 16.0% (249/1 558), (32.7% (166/507) vs. 19.5% (99/507), 30.5% (95/312) vs. 24.0% (75/312), χ 2=694.05, 216.19, 184.37, all P<0.001). The Z score criteria was consistent with the traditional method in diagnosing CAA (κ=0.642, P<0.001). Moreover, in the Z score criteria, the rate of CAA in males (25.2%, 392/1 558) was higher than that in females (15.9%, 137/861), higher in incomplete Kawasaki cases (32.7%, 166/507) than that in complete Kawasaki case (19.0%, 363/1 912), and higher in IVIG-unresponsive cases (30.4%, 95/312) than that in IVIG-sensitive cases (20.6%, 434/2 107), with statistically significant differences (χ 2=27.76, 44.38, 15.43, all P<0.001). Coronary Z score of course ≤ 6 weeks was greater than that of course between>6-8 weeks and >8 weeks to 6 months (1.3 (0.7, 2.3) vs. 0.7 (0.3, 1.4), 0.7 (0.3, 1.3), Z=20.65, 13.70, both P<0.001). Conclusions:The rate of CAA in Kawasaki disease by Z score criteria is higher than that by traditional method. In the Z score group, most CAA occur within 6 weeks of the course of the disease, and the rate of CAA in male, incomplete Kawasaki disease, and IVIG-unresponsive is higher.

ObjectiveTo investigate the population with an advantage of clinical cure previously treated with nucleos(t)ide analogues (NAs), and to provide more methods for clinicians in pursuing the clinical cure of hepatitis B. MethodsA total of 42 chronic hepatitis B patients with low-level HBsAg who received NAs treatment in Hebi Third People’s Hospital from October 2017 to October 2019 were enrolled as subjects and divided into combination treatment group (group A) and NA monotherapy group (group B). The 22 subjects in group A were treated with NAs combined with PEG-IFN antiviral therapy for 48 weeks, and some patients withdrew from PEG-IFN after 24 weeks and continued to receive NA monotherapy, while the 20 subjects in group B received NA antiviral therapy alone. Both groups were observed till week 48, and the five makers for hepatitis B were measured to evaluate clinical outcome. The t-test was used for comparison of continuous data between two groups, and the Fisher’s exact test was used for comparison of categorical data between two groups; a multivariate logistic regression analysis was used to perform a multivariate analysis. ResultsCompared with group B at the 48-week treatment endpoint, group A had significantly higher HBsAg clearance rate (45.5% vs 0, P＜0.01) and HBsAg seroconversion rate (31.8% vs 0, P＜0.01). The population with HBsAg ＜1000 IU/ml, ＜500 IU/ml, ＜100 IU/ml, and ＜10 IU/ml had an HBsAg clearance rate of 52.6%, 61.5%, 66.7%, and 100%, respectively, and the population with an HBsAg level of 500-1000 IU/ml, 100-500 IU/ml, 10-100 IU/ml, and ＜10 IU/ml had an HBsAg clearance rate of 33.3%, 50%, 40%, and 100%, respectively. The 4 patients with baseline HBsAg ＜10 IU/ml (accounting for 18.2% in group A) achieved clinical cure at week 12 of combined treatment, and after observation to week 48, 2 patients had an anti-HBs level of ＞100 IU/ml and 2 had an anti-HBs level of ＞1000 IU/ml. The multivariate logistic regression analysis of HBsAg clearance showed that age at the initiation of combined treatment affected HBsAg clearance (odds ratio ［OR］=0.877, 95% confidence interval ［CI］: 0.781-0.985, P=0.026), and most of the patients with HBsAg clearance had an age of 36-49 (44.20±4.49) years; baseline HBsAg level also had an impact on HBsAg clearance (OR=0.996, 95% CI: 0.992-1.000, P=0.050). ConclusionThe addition of interferon therapy in chronic hepatitis B patients with low-level HBsAg previously treated with NAs can significantly improve the clinical cure rate. The younger the age and the lower the HBsAg level, the shorter the duration of combined treatment. Age and baseline HBsAg level are more important than the duration and type of NA medication.

Objective To evaluate the effect of awake tracheal intubation with intubating larynegeal mask airway (ILMA) on stress responses of hypertensive patients.Methods Sixty hypertensive patients,aged 45-64 yr,with body mass index of 20.3-27.5 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective abdominal surgery under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:direct laryngoscope group (group D) and ILMA group (group I).At 3 min after topical anesthesia (T1),while epiglottis and glottis were exposed with direct laryngoscope in group D or during ILMA insertion in group I (T2),immediately after completion of intubation (T3),when the maximum change in hemodynamics after intubation appeared (at about 15 s after tracheal tubes were placed,T4),and at 5 min after completion of intubation (T5),mean arterial pressure (MAP) and heart rate (HR) were recorded,and blood samples were collected for determination of plasma epinephrine concentrations by radio-immunity method.Successful intubation at first attempt was recorded.Results Compared with the parameters at T1,the MAP,HR and plasma epinephrine concentrations were significantly increased at T2-4 in group D (P＜0.01),and no significant change was found in the parameters mentioned above at the other time point in group I (P＞0.05).Compared with group D,the MAP,HR and plasma epinephrine concentrations were significantly decreased at T2-4 (P＜0.01),and no significant change was found in the success rate of intubation at first attempt in group I (P＞0.05).Conclusion Awake tracheal intubation with ILMA does not induce strong stress responses and is helpful in avoiding the occurrence of cerebrovascular accidents,thus increasing the safty of awake tracheal intubation in hypertensive patients.

Objective To observe the clinical therapeutic effect of oral solution of Huaixue Shenshu for treatment of patients with IgA nephropathy and explore its mechanism. Methods A prospective study was conducted. Forty patients with IgA nephropathy diagnosed by pathology were selected, and they were randomly divided into treatment group and control group, 20 cases in each group. The two groups were subjected to the routine treatment, and on this base, the control group also received cozaar 50-100 mg, while the treatment group additionally received oral solution of Huaixue Shenshu decoction (drug composition:Centellae herba 15 g, Sophorae Flos 20 g, Ecliptae Herba 20 g, Ligustri Lucidi Fructus 15 g, Cicadae Periostracum 15 g, Pyrolae Herba 20 g, Saposhnikoviae Radix 10 g, Astragali Radix 15 g, the above ingredients were immersed in water and boiled to form 200 mL decoction, as a dose, and then divided into two parts to take orally one of them each time, twice a day). Both groups took two therapeutic courses in total, 3 months constituting one course. After treatment, the integral changes of clinical symptoms and clinical efficacy were observed, and before treatment and 3 months and 6 months after treatment, the 24-hour urine protein, serum creatinine (SCr), and albumin (Alb) were measured in the two groups. Results Before treatment, there was no significant difference in integral of clinical symptoms between treatment group and control group (score: 18.42±5.41 vs. 19.95±6.25, P>0.05);after treatment, the integrals of two groups were significantly lower than those before treatment, and the degree of decrease in treatment group was more obvious (score: 6.35±2.11 vs. 9.45±3.55, P < 0.05). After treatment the total effective rate in treatment group was significantly higher than that in control group [75.0% (15/20) vs. 40.0% (8/20), P<0.05]. Before treatment, the differences in 24-hour urinary protein, SCr and Alb were not significant between the two groups (all P > 0.05); with the prolongation of treatment, the 24-hour urinary protein was decreased gradually, and Alb was increased gradually, reaching its peak after 6 months of treatment, and the changes were more obvious in treatment group [24-hour urinary protein (g):0.71±0.58 vs. 1.31±0.55, Alb (g/L):37.8±6.1 vs. 35.5±5.2, both P<0.01]. No significant difference in SCr was found before and after treatment between the two groups (both P > 0.05). Conclusion The effect of oral solution of Huaixue Shenshu in treatment of IgA nephropathy is good.

BACKGROUND:The researches about the effect of retinoic acid on the proliferation of adipose-derived stem cells are rare, and the researches on the testosterone are mainly on the inhibition of cellaging. OBJECTIVE: To study the effects of retinoic acid and testosterone or combination on the cellcycle of adipose derived stem cells. METHODS:Adipose derived stem cells were isolated from adult female Sprague Dawley rats with 2 months age and cultured in vitro til passage 3 adipose derived stem cells, and then the 3rd passage adipose-derived stem cells were performed with adipogenic induction, osteogenic induction and surface marker identification. The cells were divided into six groups:(1) Control group;(2) 10-5 mol/L retinoic acid group;(3) Retinoic acid group;(4) 10-5 mol/L retinoic acid+testosterone group;(5) 10-6 mol/L retinoic acid+testosterone group;(6) Testosterone group. The adipose-derived stem cells in the control group were cultured with Dulbecco’s modified Eagle’s medium+10%fetal bovine serum culture medium, and the adipose-derived stem cells in the other five groups were induced with corresponding dose of retinoic acid and testosterone on the basis of control group. After cultured for 36 hours, the flow cytometry was used to detect the changes of cellcycle. RESULTS AND CONCLUSION:Compared with the control group, cellproportions in phase G 1 of 10-5 mol/L retinoic acid group and 10-6 mol/L retinoic acid group were increased significantly, and the cellproportions in phase S were decreased. Compared with control group, the cellproportion in phase G 1 of testosterone group was significantly reduced, and the cellproportion in phase S was increased. Compared with 10-5 mol/L retinoic acid group and 10-6 mol/L retinoic acid group, cellproportions in phase G 1 of 10-5 mol/L retinoic acid+testosterone group and 10-6 mol/L retinoic acid+testosterone group were reduced significantly and the cellproportions in phase S were increased. Retinoic acid can inhibit the cellcycle of adipose-derived stem cells in phase G 1 , and delay the process of the cellcycle from phase G1 to phase S;while testosterone can promote the cellcycle of adipose-derived stem cells from phase G1 to phase S;the combination induction of retinoic acid and testosterone can accelerate the process of the cellcycle of adipose-derived stem cells from phase G 1 to phase S.

Objective This study established a model of acoustically evoked short latency negative response (ASNR) in guinea pigs.Stereotaxic coordinate guided electrolytic lesion was applied to animal brainstem nuclei,the vestibular nucleus and the cochlear nucleus,to define the neural origin of ASNR.Methods Twenty four guinea pigs with normal hearing were randomly divided into the control group (8 subjects,16 ears) and the deafened group (16 subjects,32 ears).Each animal experienced the auditory brainstem response (ABR) test.According to the presence of ASNR,the deafened group was further divided into ASNR group and non-ASNR group.Electrolytic lesion was conducted to the vestibular nucleus and cochlear nucleus respectively,followed by ABR test.The lesion structures were verified by brainstem slice and microscope.Results In deafened group,the ASNR was elicited in 10 ears (31.3％).The ASNR was eliminated due to the electrolytic destruction to the vestibular nucleus,but it remained unchanged after the same procedure to the cochlear nucleus.Conclusion It is clear that the ASNR is originated from the vestibular nucleus,but not the cochlear nucleus.

OBJECTIVETo investigate whether adipose-derived stem cells (ADSCs) induced by retinoic acid (RA) in vitro express primordial germ cell marker alkaline phosphatase (ALP) and vasa.

METHODSADSCs were isolated from adult female SD rats and cultured in vitro. The third passage of ADSCs was identified by adipogenic differentiation, osteogenic differentiation and cell surface marker detection. The ADSCs were treated with 1×10(-5), 1×10(-6), or 1×10(-7) mol/L RA for 7 or 14 days, and the cellular expression of ALP was detected. vasa mRNA expression in ADSCs treated with 1×10(-5) mol/L RA for 7 days was detected using RT-PCR.

RESULTSThe OD value of ADSCs treated with 1×10(-5), 1×10(-6), or 1×10(-7) mol/L RA was 0.59∓0.04, 0.27∓0.07, and 0.15∓0.03 after a 7-day treatment, and was 0.42∓0.02, 0.34∓0.01, and 0.19∓0.02 after a 14-day treatment, respectively, demonstrating significantly enhanced ALP expression in RA-treated ADSCs compared with that in the control cells (0.07∓0.01 and 0.07∓0.01 at 7 and 14 days, respectively, P<0.01). The ADSCs showed a negative vasa mRNA expression after 1×10(-5) mol/L RA treatment for 7 days.

CONCLUSIONRA-induced ADSCs express ALP, a marker of primordial germ cells, but does not express the primordial germ cell marker vasa.

Adipose Tissue ; cytology ; Adult Stem Cells ; cytology ; enzymology ; Alkaline Phosphatase ; metabolism ; Animals ; Cell Differentiation ; Cells, Cultured ; Female ; Germ Cells ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tretinoin ; pharmacology