Objective To explore the application of Plan-Do-Check-Act(PDCA)cycle management to continuously im-prove the service quality of outpatient pharmacy and enhance patient satisfaction.Methods To address the problem of long wait-ing time for patients in outpatient pharmacy,we applied PDCA cycle to investigate the factors affecting patients'waiting time in the process of medicine collection,analyze the current situation,determine the expected goals,formulate the service quality im-provement plan of outpatient pharmacy,implement the improvement plan,follow up and supervise,and summarize and analyse the problems regularly until it was solved.Results After implementing the PDCA cycle in the management,the service quality of outpatient pharmacy was improved,the waiting time was significantly shortened and the satisfaction of medical treatment was in-creased.Conclusion The application of PDCA cycle method is effective in improving the service quality of outpatient pharmacy.Therefore,it is recommended for broader implementation.

Objective To develop an automatic urine volume detection and collection device to solve the problems of routine urine test.Methods An automatic urine volume detection and collection device was developed with the components of a main control system,a detection system,a prompting system and a grasping and moving system.The main control system consisted of two STM32 microcontrollers and a reset switch;the detection system was made up of a weighing module,an infrared module and indicator lights,which had its urine volume automatic detection algorithm developed based on the Keil5 platform;the prompting system realized voice broadcasting through the voice module fixed on the back panel of the box;the grasping and moving system was composed of a rail drive motor(86CM stepper motor),a photoelectric switch and a motorized gripper.Results The device developed tested urine samples with an accuracy of 99.44％,and could collect qualified samples automatically and quickly.Conclusion The device developed detects urine volume and collects samples automatically,and enhances the accuracy and efficiency of urine examination.[Chinese Medical Equipment Journal,2024,45(4):66-69]

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective:To investigate the molecular mechanisms by which SARS-CoV-2 accessory protein ORF7a mediating NF-κB activation and thus inducing inflammatory cytokines production.Methods:Effects of ORF7a on NF-κB promoter activity was analyzed by luciferase reporter assay.qRT-PCR was used to analyze expressions of inflammatory cytokines.Effects of ORF7a on phos-phorylation and nuclear-translocation of p65 were determined by Western blot and immunofluorescence.Co-immunoprecipitation and immunofluorescence assay were performed to investigate potential target s of ORF7a.Results:Luciferase reporter assay showed that ORF7a activated NF-κB promoter activity in a dose-dependent manner(P<0.001),while has no effect on activation of AP-1 reporter gene.ORF7a significantly upregulates expressions of TNF-α,IL-1β and IL-8 mRNA levels(P<0.05).Western blot showed that ORF7a markedly increased phosphorylation of p65 protein(P<0.05)and p65 nuclear localization(P<0.01).The interaction between ORF7a and IKKβ protein of NF-κB signaling pathway was found by immunoprecipitation assay,and the co-localization of ORF7a and IKKβ was also confirmed by immunofluorescence assay.Conclusion:SARS-CoV-2 ORF7a targets IKKβ to promote active NF-κB pathway to the release of inflammatory cytokines.

Abstract: Objective　This study aims to explore the roles of interferon-stimulated gene cholesterol-25-hydroxylase (CH25H) on the replication of Japanese encephalitis virus (JEV) and its underlying mechanisms, providing potential targets for developing anti-JEV drugs and theoretical support for the research. Methods　First, we investigated whether CH25H could be induced by type Ⅰinterferons or JEV infection in human kidney HEK293T cells through real-time fluorescence quantitative PCR. The cells were stimulated with different concentrations of interferon α (IFN-α), and 12 hours later, CH25H expression was measured via real-time fluorescence quantitative PCR. HEK293T cells were infected with JEV at different multiplicities of infection (MOI), and 24 hours later, changes in CH25H mRNA expression levels were assessed. Eukaryotic expression plasmid pcDNA3.1-CH25H-3×HA was constructed for overexpression of CH25H in HEK293T cells, and its effect on JEV replication was analyzed using real-time fluorescence quantitative PCR and plaque formation assay. The reasonable use concentration of 25-hydroxycholesterol (25HC), the enzyme active product of CH25H, in HEK293T, BHK21, and Vero cells was obtained by CCK8 assay, and the roles of 25-hydroxycholesterol (25HC), the enzyme active product of CH25H, in JEV replication and its impact on JEV life cycle, were further studied by qPCR, viral plaque assay, immunofluorescence assay and adsorption assay. Point mutation was employed to construct an enzymatically inactive mutant, CH25HM, which was transfected into HEK293T cells. After 24 hours of JEV infection, the dependence of CH25H-mediated impact on JEV replication on its enzymatic activity was revealed through qPCR and plaque formation assay. Results　CH25H could be induced by IFN-α in HEK293T cells, but after JEV infection, CH25H mRNA expression was downregulated. Overexpression of CH25H in HEK293T cells significantly inhibited JEV replication. 25HC, the enzyme product of CH25H, can inhibit JEV replication in HEK293T, BHK21, and Vero cells. In terms of mechanism, 25HC can inhibit JEV replication by affecting the virus adsorption process. Expressing the enzymatically inactive mutant CH25HM in HEK293T cells, also significantly inhibited JEV replication. Conclusions　JEV infection down-regulates the expression of interferon-stimulated gene CH25H, while CH25H inhibits JEV replication in a manner dependent on enzyme activity and non-enzyme activity.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

This study started from the effect of baicalin (BC), the main active component of the labiaceae plant Scutellaria baicalensis, on collagen-induced arthritis (CIA) in rats, to explore the mechanism of glucose metabolism reprogramming in fibroblast like synoviocytes (FLSs), a key effector cell of synovial inflammation in rheumatoid arthritis (RA). First of all, CIA rats and tumor necrosis factor-α (TNF-α)-induced RASFs in vitro and in vivo models were established, the arthritis index (AI) score and histopathological changes of CIA rats after BC administration were observed, and the levels of inflammatory factors in serum and cell supernatant were quantified by ELISA, immunocytochemistry and Western blot were used to detect the expression of G-protein-coupled receptor 81 (GPR81) and pyruvate dehydrogenase kinase 1 (PDK1) proteins. In addition, the kit was used to measure the levels of key products and enzyme activities in glucose metabolism reprogramming. The results showed that BC (50, 100 and 200 mg·kg^-1) could alleviate the symptoms of arthritis in CIA rats in a dose-dependent manner, inhibit synovial hyperplasia, alleviate the infiltration of inflammatory cells, down-regulate the levels of pro-inflammatory factors TNF-α and interleukin (IL)-1β, and up-regulate the levels of anti-inflammatory factor IL-10 in CIA rats. At the same time, the secretion levels of lactate, pyruvate, acetyl-CoA, citrate and the activity of lactate dehydrogenase B (LDH-B) were decreased, and the expressions of GRP81 and PDK1 were down-regulated, suggesting that BC mediated the reprogramming process of glucose metabolism. However, when GPR81 inhibitor 3-OBA inhibited lactate uptake, the activity of LDH-B was significantly increased, suggesting that BC inhibited the expression of PDK1, a key enzyme in the reprogramming metabolism from glycolysis to oxidative phosphorylation. All animal experiments in this study were conducted in accordance with the ethical standards of the Laboratory Animal Care Center of Anhui University of Chinese Medicine (approval number: AHUCM-rats-2021049). These studies revealed that baicalin mediated metabolic reprogramming of RASFs from glycolysis to oxidative phosphorylation by inhibiting PDK1 protein expression, and alleviated joint inflammation in CIA rats.

AIM: To evaluate macular light sensitivity and fixation stability in anisometropic amblyopia by microperimetry.METHODS: In this cross-sectional study, 39 children(39 eyes with amblyopia and 39 fellow eyes)who were initially diagnosed with monocular anisometropic amblyopia between July 2020 and January 2022 and 42 patients with normal best corrected visual acuity(BCVA)but suffered from improper refraction were selected, and the right eyes were selected as control group. Microperimetry(MP-3)was used to measure the average threshold(AT)of macular light sensitivity at 10°and fixation stability [including the percentage of fixation points within 2° and 4°(P1, P2), bivariate contour ellipse area(BCEA)for 68.2%, 95.4% and 99.6% of points] in amblyopic eyes, fellow eyes and normal control group. The AT and fixation stability of amblyopic eyes, fellow eyes and normal control group were compared.RESULTS: Children with amblyopia had significantly lower AT than fellow eyes and right eyes of normal control group(all P<0.017), and there were no differences in the macular light sensitivity of both fellow eyes and normal control group(P=0.555). The P1 was significantly lower in amblyopic eyes than in fellow eyes and normal control eyes(all P<0.017), and there were no differences in P1 between fellow eyes and normal control group(P=0.887).There were no differences in P2, 68.2%BCEA, 95.4%BCEA and 99.6%BCEA in patients among the three groups(all P>0.05). Moreover, there was no correlation between BCVA and AT, P1, P2, 68.2%BCEA, 95.4%BCEA and 99.6%BCEA in amblyopic eyes, fellow eyes and normal control eyes(all P>0.05).CONCLUSION: The macular light sensitivity and fixation stability within 2° may be decreased in eyes with anisometropic amblyopia.

Based on the androgen receptor(AR)/mammalian target of rapamycin(mTOR)signaling pathway, the effects of Xihuang Pills-medicated serum on the proliferation and apoptosis of prostate cancer LNCaP cells were investigated. The drug-containing serum of SD rats was prepared by intragastric administration of Xihuang Pills suspension. The effects of low-, medium-, and high-dose Xihuang Pills-containing serum on the in vitro proliferation of LNCaP cells were detected by cell counting kit-8(CCK-8). Flow cytometry was used to detect the apoptosis level of LNCaP cells after intervention with different concentrations of Xihuang Pills. Protein expression of cleaved cysteinyl aspartate-specific proteinase caspase-3(cleaved caspase-3), B-cell lymphoma-2(Bcl-2), and AR as well as the phosphorylation level of mTOR protein were detected by Western blot. The results showed that compared with the blank serum, the drug-medicated serum could blunt the activity of LNCaP cells. Low-, medium-, and high-dose Xihuang Pills-containing serum could significantly increase the cell apoptosis rate, increase the expression of cleaved caspase-3 protein, decrease the expression of Bcl-2 protein, reduce the expression of AR protein, and down-regulate the level of phosphorylated mTOR(p-mTOR). To study the effect of Xihuang Pills on the growth of LNCaP cells in vivo, different doses of Xihuang Pills were used to intervene in the subcutaneous graft model in nude mice inoculated with LNCaP cells. The expression levels of AR, mTOR, p-mTOR, Bcl-2, and cleaved caspase-3 were detected by Western blot. The results showed that the volumes of subcutaneous graft tumor in the low-dose, medium-dose, and high-dose Xihuang Pills groups significantly decreased compared with that in the model group. The weight of subcutaneous transplanted tumor in each group with drug intervention was significantly lower than that in the model group. Compared with the model group, the low-dose, medium-dose, and high-dose Xihuang Pills groups showed increased cleaved caspase-3 protein expression, decreased Bcl-2 and AR protein expression, and reduced p-mTOR protein expression. Further experiments showed that AR agonist R1881 could block the anti-proliferation and pro-apoptotic effects of Xihuang Pills. The mechanism of Xihuang Pills against prostate cancer is related to the inhibition of the AR/mTOR signaling pathway, inhibition of LNCaP cell proliferation, and induction of apoptosis in cancer cells.
Humans ; Male ; Mice ; Rats ; Animals ; Caspase 3/metabolism* ; Mice, Nude ; Cell Line, Tumor ; Rats, Sprague-Dawley ; Signal Transduction ; TOR Serine-Threonine Kinases/metabolism* ; Prostatic Neoplasms/pathology* ; Cell Proliferation ; Apoptosis ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Mammals/metabolism*