The accumulation of uremic toxins such as urea nitrogen, blood creatinine, and uric acid of patients with renal failure in vivo would lead to aggravated kidney damage. In this study, coated aldehyde oxy-starch (CAO) was used as an adsorbent to investigate its in vitro adsorption performance on renal failure indexes for urea, indoxyl sulfate (INS), monomethylamine (MMA), dimethylamine (DMA), uric acid (UA), and creatinine (Cr). The effects of variables such as pH, temperature, concentration, dosage, and time on the adsorption capacity of CAO were systematically investigated, employing analytical techniques of high-performance liquid chromatography (HPLC) and gas chromatography (GC). The results revealed that CAO exhibited a strong adsorption capacity for urea, INS, and MMA, alongside a moderate adsorption capacity for DMA, UA, and Cr. The adsorption kinetics and thermodynamic studies indicated that the adsorption of urea and UA by CAO were fitted in pseudo-first-order kinetics, and the adsorption isotherm aligned with the Freundlich adsorption model. The enthalpy change ΔH of urea in adsorption was in the range of 40 to 60 kJ·mol^-1, which demonstrated the presence of strong adsorption force due to the interactions of coordinating groups. The ΔH of UA was greater than 80 kJ·mol^-1, indicating the generation of chemical bonds during the adsorption. Both of them, Gibbs free energy ΔG was less than 0, within the range of -20 to 0 kJ·mol^-1, suggested that the adsorption of urea and UA by CAO occurred spontaneously as physical adsorption process. The adsorption entropy ΔS of urea and UA was > 0, which indicated an increase in entropy throughout the adsorption. The infrared spectroscopygram showed the formation of a chemical bond, specifically the imine bond, following the adsorption of urea by CAO, thereby indicating a chemical reaction during the adsorption. This study elucidates the adsorption mechanism of CAO on various indexes of renal failure, providing a scientific basis for its clinical usage.

Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

Objective:To compare the efficacy of articaine infiltration anesthesia and lidocaine nerve block anesthesia in pulpotomy of deciduous mandibular second molars.Methods:Single blind crossover test was used for the pediatric patients who required bilateral de-ciduous mandibular second molar pulpotomy were given articaine infiltration anesthesia and lidocaine nerve block anesthesia respectively before the 2 times of operation.After the injection of anesthetic drugs and dental pulp treatment,the patients'responses to pain were e-valuated through sound,eye and body movements,and Wong-Baker facial pain rating scales.Quantitative comparisons were made.Student's t-test and chi-square test were performed for the collected data.Results:50 pediatric patients who met the inclusion criteria and successfully completed 2 treatments without any missed visits or adverse events.During the process of articaine infiltration anesthe-sia,the scores of the 3 indicators of pain severity,namely sound,eye and body movements,were lower than those of lidocaine nerve block anesthesia(P＜0.05).The analysis of facial pain rating scales also suggested that patients'pain and discomfort during the infiltra-tion anesthesia process with articaine were milder(P＜0.05).During the treatment of pulpotomy,both pain assessment methods showed no statistically significant difference in pain perception between the 2 anesthesia injections(P＞0.05).Conclusion:Articaine infiltra-tion anesthesia may effectively replace lidocaine nerve block anesthesia in pulp treatment of mandibular primary molars.

Objective:To explore the intervention effects of repetitive transcranial magnetic stimulation on cognitive function of schizophrenia patients with methods using meta-analysis.Methods:CNKI,Wanfang Data,VIP,PubMed,Web of Science,the Cochrane Library and Embase were searched for randomized controlled trials of repetitive transcranial magnetic stimulation on cognitive function in schizophrenia.Quality assessment was per-formed with the Cochrane Handbook for Systematic Reviews.Effect sizes and heterogeneity were assessed using RevMan 5.3.Results:A total of 31 randomized controlled trials(2 421 patients)were included in this study.Meta-analysis showed that rTMS improved cognitive function in schizophrenia patients(SMD=0.73).Subgroup analyses showed that intervention intensity was less than or equal to 100％RMT,the intervention frequency was 1 Hz,the intervention time was lasted at least 20 min/time,and the intervention period was four weeks,the effect of rTMS was better.Subgroup analyses showed that rTMS was more effective in improving for patients with durations of 5 to 10 years.Conclusion:rTMS has more significant improvement effects on cognitive function in schizophrenia pa-tients.It is recommended to set the intervention intensity 100％RMT,the intervention frequency of 1 Hz,the in-tervention time ≥20 min,and the intervention period of 4 weeks in the clinic.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

This study was aimed at investigating the antimicrobial susceptibility and genomic characteristics of multidrug resistant diarrheagenic Escherichia coli isolated from human and food samples in Henan Province from 2017 to 2022.A total of 101 strains of multidrug resistant diarrheagenic E.coli were subjected to antimicrobial susceptibility testing with the broth di-lution method.Whole genome sequencing was performed to analyze the antimicrobial resistance genes,multilocus sequence typ-ing,and plasmid types.The sequencing data were used to construct a phylogenetic tree based on core genome single-nucleotide polymorphisms(cgSNPs).The isolates showed the highest resistance to ampicillin(87.1％),followed by tetracycline(79.2％)and nalidixic acid(64.4％).The resistance rate to cefotaxime was 38.6％.All 101 strains were classified into 60 STs,among which ST10,ST1491,and ST38 were dominant.Moreover,23 distinct plasmid replicons were identified,among which IncFIB was dominant.Diverse antimicrobial resistance genes(including quinolone,aminoglycoside,β-lactamase,and tetracycline)were identified.Insertion sequences(IS26,IS903B,and ISECP 1)were identified in upstream and downstream analysis of the gene context of the extended-spectrum β-lactamase bla CTX-M-14 and bla CTX-M-55 genes.In conclusion,multidrug resistant diarrhea-genic Escherichia coli isolated from clinical and food samples in Henan Province showed high genetic diversity and high antimi-crobial resistance.The dissemination of blaCTX-M carried by the strains was shown to be associated with the insertion sequence(IS).

Objective To investigate the characteristics of menopause-related symptoms and cognition status of menopausal hormone therapy(MHT)among menopausal women.Methods A total of 619 menopausal women with menopause-related symptoms who were admitted to The First Affiliated Hospital of Xi'an Jiaotong University were selected as the study subjects.Data were collected by questionnaire to analyze the characteristics of menopause-related symptoms,and the menopausal women's cognitive status of MHT and therapeutic effects were explored.Results Among 371 perimenopausal women,the menopause-related symptoms with the top three rates were fatigue(69.81％),insomnia(66.85％),and hot flush-sweating(58.22％).Among 248 postmenopausal women,the menopause-related symptoms with the top three rates were hot flashes and sweating(64.11％),bone and joint pain(60.89％),and fatigue(56.85％).The incidence of insomnia and fatigue in postmenopausal women was significantly lower than that in perimenopausal women(P＜0.01),while the incidence of bone and arthralgia,urinary system infection,vaginal dryness and painful intercourse was significantly higher than that in perimenopausal women(P＜0.01).There was no significant difference in Kupperman score between perimenopausal and postmenopausal women(P＞0.05),but score degree distribution differed significantly(P＜0.05).Perimenopausal women had the highest proportion of mild score while postmenopausal women had the highest proportion of moderate score.There were significant differences in Kupperman score among postmenopausal women with different menopause ages,menopause years and menopause mode(P＜0.05).The earlier menopause age and shorter menopause years,the higher Kupperman score was;the Kupperman score was significantly higher in surgical menopause than in natural menopause(P＜0.05).Multivariate Logistic regression analysis showed that age of 45-54 years old,retirement or unemployment,spouse's disease or death,abnormal sexual life,and high education level were the risk factors for the occurrence of menopausal symptoms(P＜0.05);high family income and＞3 times/week exercise were the protective factors for the occurrence of menopausal symptoms(P＜0.05).The Internet was the way that accounted for the highest proportion of menopausal women's understanding of MHT(39.92％),and the tumor accounted for the highest proportion of menopausal women's concern about MHT(33.67％).There were 465 menopausal women without MHT contraindications(89.77％)who used MHT under the guidance of professional doctors,and their symptoms improved significantly after treatment(P＜0.05).Conclusion Menopausal women have obvious menopause-related symptoms,and the earlier the age,the shorter the menopause years and the more severe symptoms in the surgical menopause.Therefore,it is necessary to pay attention to the impact of menopause on the health of menopausal women and increase the use rate of MHT to improve the quality of life of menopausal women.

Objective To evaluate the bioequivalence and safety of ibuprofen arginine granules test and reference formulations in Chinese healthy volunteers under fasting and postprandial conditions,and to provide evidence for consistency evaluation and clinical application of the drugs.Methods A single-center,single-dose,randomized,open-label,fasting and postprandial,two-period,two-crossover trial design was used.Twenty-four healthy Chinese volunteers were enrolled in the fasting and postprandial trial,respectively.The test preparation and reference preparation of ibuprofen arginine granules 0.4 g were taken orally in a randomized crossover single dose.Data analysis was performed using Phoenix WinNonlin 8.3.Results In the fasting group,the main pharmacokinetic parameters of ibuprofen in plasma after administration of the test and reference formulations of ibuprofen arginine granules were as follows:Cmax were(51.07±7.43)and(50.10±7.64)μg·mL-1;AUC0-,were(122.78±20.62)and(119.94±21.03)μg·h·mL-1;AUC0_∞ were(125.84±21.31)and(122.64±21.87)μg·h·mL-1,respectively.In the postprandial group,the main pharmacokinetic parameters of ibuprofen in plasma after administration of the test and reference formulations of ibuprofen arginine granules were as follows:Cmax were(17.47±3.56)and(17.89±4.47)μg·mL-1;AUC0-twere(114.33±17.12)and(122.13±29.46)μg·h·mL-1;AUC0_∞ were(134.04±36.72)and(133.96±30.35)μg·h·mL-1,respectively.The 90％confidence intervals of the geometric mean ratio of the two preparations were as follows:Cmax 97.96％-106.02％,AUC0_t 98.77％-105.14％,AUC0-∞ 99.34％-105.19％in fasting group;in postprandial group,Cmax was 92.37％-103.05％,AUC0-t was 93.31％-99.56％,AUC0-∞ was 93.89％-102.91％.Conclusion The test preparation and reference preparation of ibuprofen arginine granules in this study are bioequivalent in healthy adult Chinese volunteers.

Mutations in myosin heavy chain 7(MYH7)and myosin binding protein C3(MYBPC3)genes encoding thick filaments are the main cause of hypertrophic cardiomyopathy(HCM),while a small part of HCM is caused by mutations of troponin C1,slow skeletal and cardiac type(TNNC1),troponin T2,cardiac type(TNNT2),troponin I3,cardiac type(TNNI3),actin alpha cardiac muscle 1(ACTC1),and tropomyosin 1(TPM1)genes encoding thin filaments.In this review,we mainly introduce the detailed mechanism and research status of HCM caused by mutations of the gene encoding cardiomyocyte sarcomere in the past few years,in order to provide reference for further study of the pathogenesis and treatment of HCM.

Objective:To evaluate the effect of electroacupuncture on liver regeneration after partial hepatectomy in mice and the role of the Notch signaling pathway.Methods:Thirty-six SPF healthy male C57BL/6 mice, aged 6 weeks, weighing 20-22 g, were divided into 6 groups ( n=6 each) using a random number table method: sham operation group (group S), partial hepatectomy group (group PH), non-acupoint electroacupuncture+ partial hepatectomy group (group NPH), partial hepatectomy+ Fli-06 group (group PH+ F), acupoint electroacupuncture+ partial hepatectomy group (group EPH), and acupoint electroacupuncture+ partial hepatectomy+ Fli-06 group (group EPH+ F). All the mice except for group S underwent partial hepatectomy. Fli-06 4.8 mg/kg was intraperitoneally injected starting from 2 days before surgery, once a day, until the mice were sacrificed in group PH+ F and group EPH+ F, while the equal volume of 0.9% sodium chloride solution was injected in the other groups. In EPH group, electroacupuncture of bilateral " Zusanli" acupoints lasting for 15 min was performed using continuous waves with a frequency of 2 Hz and an intensity of 1 mA once a day starting from the time point immediately after surgery for 3 consecutive days. Mice were anesthetized at day 2 after partial hepatectomy, and blood samples were taken from the eyeball for determination of the serum alanine transaminase (ALT) and aspartate aminotransferase (AST) concentrations (using a fully automated biochemical analyzer) and concentrations of serum epidermal growth factor (EGF) and hepatocyte growth factor (HGF) (by enzyme-linked immunosorbent assay). The mice were subsequently sacrificed and liver tissues were taken for calculation of the liver mass to body mass ratio and for determination of the expression of liver proliferation marker Ki-67 (by immunohistochemical staining), proliferating cell nuclear antigen (PCNA), cyclin D1 (CCND1), Notch Intracellular Domain (NICD), and hypoxia-inducible factor-1alpha (HIF-1α) (using Western blot) and Notch1, jagged canonical Notch ligand 1 (Jagged1) and hairy and enhancer of split 1 (Hes1) mRNA (by real-time polymerase chain reaction). Results:Compared with group S, the serum ALT, AST, EGF and HGF concentrations were significantly increased, and the expression of hepatic Notch1, Jagged1 and Hes1 mRNA and Ki-67, PCNA, CCND1 and NICD was up-regulated in group PH ( P<0.05 or 0.01). Compared with group PH, the liver mass to body mass ratio and serum EGF and HGF concentrations were significantly increased, the serum ALT and AST concentrations were decreased, and the expression of hepatic Notch1, Jagged1, Hes1 mRNA and Ki-67, PCNA, CCND1, NICD and HIF-1α was up-regulated in group EPH, and the liver mass to body mass ratio and the serum HGF concentrations were significantly decreased, the serum ALT and AST concentrations were increased, and the expression of hepatic Jagged1 and Hes1 mRNA and Ki-67, PCNA, CCND1, NICD, and HIF-1α was down-regulated in group PH+ F ( P<0.05 or 0.01). Compared with group EPH, the liver mass to body mass ratio and serum EGF and HGF concentrations were significantly decreased, the serum ALT and AST concentrations were increased, and the expression of hepatic Notch1, Jagged1, Hes1 mRNA and Ki-67, PCNA, CCND1, NICD and HIF-1α was down-regulated in group EPH+ F ( P<0.01). Conclusions:Electroacupuncture at Zusanli acupoint promotes liver regeneration after partial hepatectomy in mice, and the mechanism may be related to the activation of the Notch signaling pathway.