ObjectiveThrough a randomized， double-blind， double-simulation， positive-control， multicenter design， this study aimed to analyze the relationship between the dosage， efficacy， and safety of Pudilan anti-inflammatory oral liquid in treating acute pharyngitis/tonsillitis in adults caused by bacterial infection and validate the regulatory effect of Pudilan anti-inflammatory oral liquid on inflammatory markers such as serum amyloid A （SAA）， C-reactive protein （CRP）， white blood cells （WBC）， neutrophil percentage （NE%）， and erythrocyte sedimentation rate （ESR）， thereby exploring the feasibility of using Pudilan anti-inflammatory oral liquid as a substitute for antibiotics in the treatment of infectious diseases and providing a basis for rational clinical medication. MethodUsing a stratified randomized， double-blind， double-simulation， positive-control， multicenter design， 220 participants were enrolled from nine centers. The participants were randomly divided into three groups at 1∶1∶1 — a Pudilan anti-inflammatory oral liquid 20 mL group （73 cases）， a Pudilan anti-inflammatory oral liquid 10 mL group （73 cases）， and a control group （amoxicillin group， 74 cases）. The treatment course was 7 days. The study observed parameters including the total effective rate of sore throat， onset and disappearance time of sore throat， health status score， treatment time， and inflammation markers. Result①Dataset division： The 211 cases were included in the full analysis dataset （FAS）， 208 cases were included in the per-protocol dataset （PPS）， and 218 cases were included in the safety dataset （SS）. ② Efficacy evaluation： There were statistically significant differences （P<0.05） in the comparison of the three groups regarding the total effective rate of sore throat， disappearance time of sore throat， and health status. Both the 20 mL and 10 mL groups were non-inferior to the control group， and there was a statistically significant difference between the 20 mL and 10 mL dosage groups （P<0.05）. There was no statistically significant difference in the comparison of onset time of sore throat among the groups. CRP， WBC， and NE% of patients in all three groups significantly decreased on the 7^th day of treatment compared with those before treatment （P<0.01）. ③Safety evaluation： Adverse events mainly occurred in various examination indicators. There were no statistically significant differences in the comparison between groups， and no adverse reactions or serious adverse events occurred. ④Economic evaluation： The increased cost of the 10 mL and 20 mL dosage groups was entirely justified as compared with that in the control group. When comparing the 10 mL and 20 mL dosage groups， the 10 mL dosage group was deemed less advantageous. ConclusionPudilan anti-inflammatory oral liquid can be used alone as an alternative to antibiotics in the treatment of acute pharyngitis/tonsillitis caused by bacterial infection. It demonstrates good safety and can lower inflammation markers such as CRP， WBC， and NE%， suggesting its potential to reduce the body's inflammatory response. Its mechanism of action may be related to its multi-target regulatory mechanism.

Objective:To investigate the effect of long non-coding RNA (lncRNA) human histocompatibility leukocyte antigen complex P5 (HCP5) on the neuronal injury induced by oxygen glucose deprivation/reoxygenation (OGD/R), and to analyze its potential mechanism.Methods:SH-SY5Y cells were divided into control group (CON group, normal medium culture), model group (Model group, OGD/R), interference control group (si-NC group, OGD/R after HCP5 small interfering RNA negative control (si-NC)), HCP5 interference group (si-HCP5 group, OGD/R after HCP5 small interfering RNA (si-HCP5)), HCP5 interference+ inhibitor control group (si-HCP5+ anti-NC group, OGD/R after transfection of si-HCP5, miR-525-5p inhibitor negative control (anti-NC)), HCP5 interference+ miR-525-5p inhibitor group (si-HCP5+ anti-miR-525-5p group, OGD/R after transfection of si-HCP5, miR-525-5p inhibitor). qRT-PCR was used to detect the expression of lncRNA HCP5 and miR-525-5p in cells.The activity of SH-SY5Y cells was detected by MTT.The level of reactive oxygen species (ROS) in the cells was detected by fluorescent probe of dichlorofluorescein diacetate (DCFH-DA). The apoptosis of SH-SY5Y cells was detected by flow cytometry.Western blot was used to detect the expression of BTG2, Bcl-2 related X protein (Bax), B lymphocyte tumor 2 (Bcl-2) and cleaved caspase-3 protein.SPSS 25.0 software was used to analyze the data, and one-way ANOVA was used for comparison between multiple groups, and SNK- q test was used for further comparison between two groups. Results:There were statistically significant differences in lncRNA HCP5, miR-525-5p RNA levels and BTG2 protein expression levels among the 6 groups ( F=28.853, 59.241, 13.731, all P<0.001). Compared with the CON group, the Model group had higher level of lncRNA HCP5, lower level of miR-525-5p, and higher level of BTG2 protein (all P<0.05). Compared with the Model group, the si-HCP5 group had lower level of lncRNA HCP5, higher level of miR-525-5p, and lower level of BTG2 protein (all P<0.05). Compared with the si-HCP5+ anti-NC group, the si-HCP5+ anti-miR-525-5p group had higher level of lncRNA HCP5, lower level of miR-525-5p, and higher level of BTG2 protein (all P<0.05). There were statistically significant differences in cell activity and ROS levels among the six groups of cells ( F=16.180, 59.950, both P<0.001). The cell activity of the Model group was lower than that of the CON group (0.33±0.12, 0.63±0.11) ( P<0.05), and the ROS level was higher than that of the CON group (224.62±23.27, 100.00±0.00) ( P<0.05). The cell activity of the si-HCP5+ anti-miR-525-5p group was lower than that of the si-HCP5+ anti-NC group (0.38±0.08, 0.58±0.08) ( P<0.05), and the ROS level was higher than that of the si-HCP5+ anti-NC group (207.83±19.39, 135.27±14.36) ( P<0.05). There were statistically significant differences in the apoptosis rate and expression levels of apoptotic proteins Bcl-2, Bax, and cleared Caspase-3 among the six groups of cells ( F=27.994, 29.660, 45.000, 52.983, all P<0.001). There were no statistically significant difference in Bax, Bcl-2, cleared Caspase-3 protein levels, and apoptosis rate in SH-SY5Y cells between the Model group and the si-NC group, as well as between the si-HCP5 group and the si-HCP5+ anti-NC group (all P>0.05). Compared with the CON group, the apoptosis rate, levels of Bax and cleared Casase-3 protein in the Model group were significantly upregulated (all P<0.05), while the Bcl-2 protein level was significantly downregulated ( P<0.05). Compared with the Model group and si-NC group, the si-HCP5 group showed significant downregulation of cell apoptosis rate and levels of Bax and cleared Caspase-3 protein (all P<0.05), while the Bcl-2 protein level was upregulated ( P<0.05). Compared with the si-HCP5 group and si-HCP5+ anti-NC group, the si-HCP5+ anti-miR-525-5p group showed significant upregulation of cell apoptosis rate and levels of Bax and cleared Caspase-3 protein levels (all P<0.05), and significant downregulation of Bcl-2 protein levels ( P<0.05). Conclusion:lncRNA HCP5 may inhibit the expression of BTG2 by targeting up-regulation of miR-525-5p, thus leading to apoptosis of nerve cells in OGD/R models.

Oral and maxillofacial space infections (OMSI) are common diseases of the facial region involving fascial spaces. Recently, OMSI shows trends of multi drug-resistance, severe symptoms, and increased mortality. OMSI treatment principles need to be updated to improve the cure rate. Based on the clinical experiences of Chinese experts and with the incorporation of international counterparts′ expertise, the principles of preoperative checklist, interpretation of examination results, empirical medication principles, surgical treatment principles, postoperative drainage principles, prevention strategies of wisdom teeth pericoronitis-related OMSI, blood glucose management, physiotherapy principles, Ludwig′s angina treatment and perioperative care were systematically summarized and an expert consensus on the diagnosis and treatment of OMSI was reached. The consensus aims to provide criteria for the diagnosis and treatment of OMSI in China so as to improve the level of OMSI treatment.

Objective? To establish, implement and evaluate the pain control quality system for patients with total knee arthroplasty(TKA). Methods? Through literature search and interviews with medical staff and retrospective reviews of TKA cases in orthopedic wards, the problems in pain control of TKA patients during perioperative period were analyzed. According to the evidence-based practice guideline and the existing problems in pain nursing practice, the pain control quality system was constructed. From January to November 2018, 75 TKA patients in Orthopedic Department, Ningbo First Hospital were selected as the research objects and randomly divided into the control group (n=35) and the intervention group (n=40). The control group received the routine pain nursing mode, and the intervention group was managed by the pain control quality system. The static and dynamic VAS scores on the 1st, 3rd and 7th day after TKA, the incidence of analgesia-related complications and the quality of pain nursing were compared between the two groups. Results? There were significant statistical differences in static and dynamic VAS scores of knee joint between the two groups on the 1st, 3rd and 7th day after operation (P＜0.05). There was no statistical difference in the incidence of analgesia-related complications between the two groups (P＞ 0.05). The total score of TKA perioperative pain nursing quality in the intervention group was 84 (80, 85), while that of the control group was 56 (53, 58). The difference between the two groups was statistically significant (P＜0.01). Conclusions? The construction of pain control quality system can effectively improve the level of perioperative pain management of TKA, the quality of pain nursing care, and improve the perioperative pain of TKA patients.

Aging associated cognitive decline has been linked to dampened neural stem/progenitor cells (NSC/NPCs) activities manifested by decreased proliferation, reduced propensity to produce neurons, and increased differentiation into astrocytes. While gene transcription changes objectively reveal molecular alterations of cells undergoing various biological processes, the search for molecular mechanisms underlying aging of NSC/NPCs has been confronted by the enormous heterogeneity in cellular compositions of the brain and the complex cellular microenvironment where NSC/NPCs reside. Moreover, brain NSC/NPCs themselves are not a homogenous population, making it even more difficult to uncover NSC/NPC sub-type specific aging mechanisms. Here, using both population-based and single cell transcriptome analyses of young and aged mouse forebrain ependymal and subependymal regions and comprehensive "big-data" processing, we report that NSC/NPCs reside in a rather inflammatory environment in aged brain, which likely contributes to the differentiation bias towards astrocytes versus neurons. Moreover, single cell transcriptome analyses revealed that different aged NSC/NPC subpopulations, while all have reduced cell proliferation, use different gene transcription programs to regulate age-dependent decline in cell cycle. Interestingly, changes in cell proliferation capacity are not influenced by inflammatory cytokines, but likely result from cell intrinsic mechanisms. The Erk/Mapk pathway appears to be critically involved in regulating age-dependent changes in the capacity for NSC/NPCs to undergo clonal expansion. Together this study is the first example of using population and single cell based transcriptome analyses to unveil the molecular interplay between different NSC/NPCs and their microenvironment in the context of the aging brain.
Aging ; genetics ; Animals ; Astrocytes ; cytology ; metabolism ; Brain ; cytology ; metabolism ; Cell Differentiation ; genetics ; Cell Division ; genetics ; Cell Proliferation ; genetics ; Gene Expression Regulation ; genetics ; Mice ; Neural Stem Cells ; metabolism ; Single-Cell Analysis ; Stem Cells ; cytology ; metabolism ; Transcriptome ; genetics

Objective To investigate the value of DWI high b value and ADC value in the diagnosis of hyperacute cerebral is-chemia.Methods Adult SD rats were selected and divided into the control and ischemic group by adopting the random number table method,the ischemic group was re-divided into 0.25,0.50,2.00,4.00、6.00 h groups according to the ischemic time,6 cases in each group with a total of 42 cases.The ischemic group conducted the right middle cerebral artery occlusion(MCAO)for performing the head T2WI and DWI scanning(b values were 0,400,800,2 000,3 000 s/mm2),the CNR and SNR values were recorded,rs-T2WI, rs-DWI and relative apparent diffusion coefficient(rADC)were measured.Then the imaging change of ischemic area was observed. The sensitivity and specificity were detected.Results In b=2 000 s/mm2and 3 000 s/mm2,the diagnostic rates of DWI for hyper-acute cerebral ischemia were obviously higher than those in b=400 s/mm2and 800 s/mm2,and when the b values were 400,800, 2 000,3 000 s/mm2,the sensitivities were 16.7%,50.0%,100.0% and 100.0% respectively and the specificities were 16.7%, 50.0%,100.0% and 100.0% respectively.The difference of ADC values under different b values had statistical significance(P<0.05).Conclusion High b value DWI in the diagnosis of hyperacute ischemia is significantly better than that of low b value,espe-cially in the aspect of displaying the lesion at 0.25,0.50 h cerebral ischemia.

Objective To investigate the dynamic images of traumatic penumbra(TP)in a rat model of traumatic brain injury (TBI)treated with AQP4-RNAi using multimodal MRI(MM-MRI)at 7.0 Tesla.Methods A rat model of TBI was established by the improved Feeney's method.MRI scans were performed including T2WI,DWI,ADC and SWI.The pathological changes in penumbra area were observed.All statistical analyses were performed using SPSS 21.0 software package.Results Over time rs-T2WI,rs-DWI and rs-SWI in TBI group were gradually increased.The r-ADC began to increase at one hour after trauma and reached the peak at 6 h. Then it began to fall and reached the bottom at 12 h.At each time point,the difference was statistically significant(P<0.05).Compared with RNA interference group,the rs-T2WI and rs-DWI in TBI group were decreased significantly at 6 h and 12 h(P<0.05),the r-ADC was not decreased significantly at 1 h(P>0.05)and decreased significantly at 6 h and 12 h(P<0.05).At each time point,there was no significant difference in rs-SWI(P>0.05).The area of mismatch between rs-SWI and rs-DWI was the most obvious at 6 h and 12 h,and the area of mismatch was decreased in size after treatment with AQP4-RNAi.There was no significant difference between TBI group and placebo group(P>0.05).In two groups,similar pathological changes were observed,which was depicted as vasogenic edema predominantly at 1 h and mixed edema at 6 h and 12 h. In RNA interference group,intracellular edema was markedly reduced at 6 h and 12 h,and the vasogenic edema was relieved to some extent at 12 h.Conclusion The treatment with APQ4-RNAi markedly alleviates cerebral edema.MM-MRI can reflect its pathological changes.The area of mismatch between SWI and DWI can prompt early detection of traumatic penumbra,which may provide useful information for clinical treatment.

Objective To investigate the usefulness of different-b-value diffusion weighted imaging (DWI) in patients with early cerebral infarction and obtain the optimal b value of early cerebral infarction.Methods DWI at b-value of 1,000,2,000,and 3,000 s/mm2 was performed for 40 patients within 72 h after the onset of stroke using a GE Signa HDx 3.0T MRI scanner.Post-processing was done by the DWI specific software Function Tool to gain signal intensity and mean apparent diffusion coefficient in the lesions center and the contralateral normal brain tissue,respectively.The sensitivity of conventional MRI and different-b-value DWI was calculated in the diagnosis of early cerebral infarction.Results In 40 patients with early cerebral infarction,the sensitivity of b-values of 1,000,2,000,and 3,000 s/mm2 (DWIb=1 000,DWIb=2 000,DWIb=3 000) and conventional MRI in the diagnosis of early cerebral infarction were 100％,97.5％,97.5％,72.5％,respectively.With b value increased,signal intensity and ADC value declined.Under the condition of different b values,signal intensity and ADC value were statistically significant in region of interest (P＜0.05).Conclusion DWI is superior to conventional MRI scan in monitoring early cerebral infarction.With the increase of b value,the sensitivity is the higher to hyperacute cerebral infarction,the signal contrast is obvious,while signal to noise ratio of the image reduces.It is suggested that brain tissue contrast and the sensitivity to the new cerebral infarction is more predictable on b value =1,000 DWI than on the other DWIs.

Objective To investigate the relationship between the expression of glucose regulated protein 78 (GRP78) in the placental trophoblast cells and the pathogenesis of gestational diabetes mellitus (GDM).Methods All the patients were recruited from Qingdao Municipal Hospital from May 2013 to May 2014.Among them, fifty women with GDM were assigned to the GDM group, and fifty healthy women were defined as the control group.All of them received cesarean section because of breech presentation, contracted pelvis, scarred uterus or on mother's demand.Real-time PCR was conducted to analyze the expression of GRP78 mRNA in the trophoblasts.Immunohistochemistry was performed to detect the localization of GRP78 protein in the placentasl trophoblast cells.Results (1) GRP78 mRNA expressed in the cytoplasm of trophoblasts of both the GDM group and the control group.The GRP78 mRNA levels in the GDM group and the control group were 15.6±0.4 and 6.0±0.7, respectively.The relative expression level of GRP78 mRNA in the GDM group was 2.6 times of that in the control group, with statistically significant difference (P＜0.01).(2) The expression of GRP78 protein was found in the cytoplasm of the trophoblasts of the GDM group.It showed in deep, light brown or yellow after staining, according to the expression degree.The expression of GRP78 protein was also found in the cytoplasm of the trophoblasts of the control group, but it mainly showed yellow color (38/50).The strong positive rate of GRP78 protein in the GDM group (96％, 48/50) was higher than that in the control group (22％, 11/50;P＜0.01).Conclusion The expression of GRP78 increased in the placental trophoblast cells of GDM patients.It might suggest that GRP78 had some effect on the pathogenesis of GDM.

Objective To understand the risk factors of the elderly in community of Haining city in patients with Alzheimer's disease.Methods Take the elderly Chang street Haining city selected cluster sampling method 7 437 ≥60 years as the research subjects,by using a self-designed questionnaire Alzheimer's disease causes and clinical dementia rating scale,understanding the factors that may affect Alzheimer's disease and aggravating factors,and the data of multi factor regression analysis.Results Multivariate Logistic regression analysis showed that women (Wald x2 =19.96,P ＜ 0.01),aged (Wald x2 =96.01,P ＜ 0.01),widowed (Wald x2 =5.09,P ＜ 0.05),smoking/drinking (Wald x2 =47.77,P ＜ 0.01),living alone (Wald x2 =16.14,P ＜ 0.01),depression (Wald x2 =12.05,P ＜ 0.01) were the risk factors of Alzheimer's disease; Rural (Wald x2 =458.11,P ＜ 0.01) ; Lowculture (Wald x2 =121.39,P ＜0.01) were protective factors for Alzheimer's disease.According to the clinical dementia rating scale of disease severity assessment and pathogenesis of polytomous Logistic regression,the results showed that the elderly (Wald x2 =50.37,P ＜ 0.01),lowculture (Wald x2 =30.39,P ＜ 0.01),widowed (Wald x2 =5.20,P ＜ 0.05),living alone (Wald x2 =16.50,P ＜ 0.01),somatic diseases (Wald x2 =16.58,P ＜ 0.01) and large maternal age (Wald x2 =10.53,P ＜ 0.01) were risk factors for disease.Conclusion Age,widowed,solitude are common risk factors of Alzheimer's disease and aggravating factors,should be combined with risk factors for chronic disease management actively take measures to prevent and delay the occurrence,the development of Alzheimer's disease.