Pharmacokinetic Characteristics of Gualou-Xiebai Intragastric Floating Pellets in Rats by LC-MS / MS
Objective： To study the plasma concentration and pharmacokinetics of 3，29-dibenzoyl-karounitriol （3，29-DK） in Gualou-Xiebai intragastric floating pellets （hereinafter referred to as "Gualou-Xiebai pellets"） at different time points in rats by liquid chromatography tandem mass spectrometry（LC-MS/MS）. Methods： 12 SPF SD male rats were randomly divided into Gualou- Xiebai pellets group（2.0 g/kg） and Gualou-Xiebai extracts group（1.4 g/ kg）， the blood samples were taken from the orbit 0 h before administration and 0.5， 1， 2， 3， 4， 6， 8， 10， 12， 24， 36， 48 h after administration in Gualou-Xiebai pellets group， the blood samples were taken from the orbit 0 h before administration and 5，10，30 min， 1， 1.5， 2， 3， 4， 6 and 8 h after administration in the Gualou-Xiebai extracts group， and the pharmacokinetic parameters were calculated. Results： Compared with the Gualou-Xiebai extracts group， the 3，29-DK peak time， AUC and t1/2 in the Gualou-Xiebai pellet group were significantly prolonged （P<0.05）， and MRT was significantly increased （P<0.05）， CLz/F， Cmax was significantly reduced （P<0.05）. Conclusion： The release rate of 3，29-DK in Gualou-Xiebai pellets was stable in rats， without sudden release and rapid release， and the metabolic time was prolonged. Gualou-Xiebai pellets have sustained-release effect.
Application of Mixed Linear Model in QSAR Study of Flavonoids
Objective： To elucidate the structure-activity relationship between flavonoids and their antioxidant activities by constructing a quantitative structure-activity relationship（QSAR） model using mixed linear model（MLM）， hence to provide the basis for the design of these lead compounds. Methods： Literature that reported the half maximal inhibitory concentration（IC50） of flavonoids against DPPH was retrieved and collected from the PubMed database， and a database was established based on their molecular structure characteristics and IC50 values. The initial QSAR model was constructed through MLM， the five-fold cross-validation method was applied to optimize the model， and finally the prediction model was obtained. Results： The antioxidant activity of flavonoid compounds was positively correlated with the numbers of ortho-phenolic-dihydroxyl in A ring（X1） and the numbers of phenolic-hydroxyls in B ring（X2）， and negatively correlated with meta-phenolic-dihydroxyl in B ring（X3）. The optimized equation was that IC50 = 137.56-65.86X1-53.92 X2+70.85X3. Conclusion： The established QSAR model by MLM could explicitly predict the antioxidant activity of flavonoids， and provide reference for the design of antioxidants.
A Meta-Analysis of the Efficacy and Safety of Xinmailong Injection in the Treatment of Chronic Heart Failure Combined with Various Drugs
Objective： To further evaluate the efficacy and safety of Xinmailong injection in the treatment of chronic heart failure（CHF）. Methods： This study searched PubMed， the Cochrane Library，CNKI and other databases from the establishment of the database to 31 December 2019 for studies related to Xinmailong injection and various drugs in the treatment of CHF. Meta-analysis was carried out with RevMan 5.3 software， and indicators such as overall clinical efficacy， blood brain natriuretic peptide （BNP）， and left ventricular ejection fraction（LVEF）， ect. were included. Results： A total of 21 studies were included， and Meta-analysis showed that compared with the control groups， the Xinmailong groups can significantly reduce the patients' BNP， left ventricular enddiastolic dimension（LVEDD）， left ventricular end systolic diameter（LVESD）， C-reactive protein（CRP） levels and the total score of TCM syndromes， increase LVEF， 6 minutes' walking distance（6MWD） and cardiac index（CI）， and improve the total clinical efficacy （P< 0.05）. There was no significant difference in the incidence of adverse reactions between the Xinmailong groups and the control groups（P=0.15>0.05）. Conclusion： On the basis of conventional treatment， compared with the application of other therapeutic drugs for CHF， Xinmailong injection alone or in combination has a significant effect on CHF， but the safety aspect needs to be further confirmed by a more comprehensive， accurate and objective large sample study.
Analysis of the Use of Enteral and Parenteral Nutrition Drugs in Elderly Patients
Objective： To understand the use of enteral and parenteral nutrition drugs in the Geriatrics Hospital of Yunnan Province （hereinafter referred to as "the hospital"）， and to provide reference for the rational use of enteral and parenteral nutrition drugs in elderly patients. Methods：Retrospective research was used to statistically analyze the sales amount， number of users and dosage of enteral and parenteral nutrition drugs in the hospital from 2017 to 2019. Results： From 2017 to 2019， the sales amount， number of users and dosage of nutritional drugs in the hospital have shown an upward trend year by year. The sales amount and dosage of enteral nutrition（EN） drugs have increased significantly faster than parenteral nutrition（PN） drugs， but the PN drugs are still the major source of nutrition drugs. Conclusion：Nutrition drugs used for elderly patients in the hospital are mainly PN drugs， and the use ratio of EN drugs needs to be further improved. At the same time， it is necessary to avoid the abuse of nutrition drugs.
Study on the Correlation between Enterobacter cloacae and Body Mass Index of College Students
Objective：To investigate the colony ratio of Enterobacter cloacae in Enterobacteriaceae and its relationship with the body mass index （BMI） of college students. Methods： Smear and Gram stain were performed on stool specimens of healthy college students； the diluted stool specimens were cultured with eosin methylene blue medium， and the proportion of pink colonies on it was counted. The specific primers of Enterobacter cloacae were performed colony PCR identification； analysis of the correlation between the colony ratio of Enterobacter cloacae and the BMI of college students. Results： The pink colony on the eosin methylene blue medium was Enterobacter cloacae， and the specific 385 bp band of Enterobacter cloacae could be seen by colony PCR. The ratio of the BMI of college students to the number of Enterobacter cloacae colonies in their intestines was analyzed by Spearman's rank correlation， and the correlation coefficient rs= 0.529 （P＜0.001）. Conclusion： The proportion of Enterobacter cloacae in the Enterobacteriaceae of healthy college students is positively correlated with their BMI.
Isolation and Identification of Lactic Acid Bacteria with Strong Inhibitory Effects Against Enterobacter cloacae
Objective：To isolate and screen out lactic acid bacteria strains with inhibitory advantages against Enterobacter cloacae from pickles in Dali， and to enrich the potential weight loss function of traditional lactic acid fermented foods. Methods： Pickle samples were collected in Dali area， cultured and separated by BBL agar medium， Gram staining， PCR identification， and antibacterial activity analysis； strips were cut gel， mass amplified， TA clones constructed， and sequenced. The obtained gene sequence information was compared with the Blast data in NCBI to find the bacteria containing this band of information. Results： Among the 18 samples， the candidate strain with the best inhibitory effect was isolated. Through comparing the sequencing results， it was clear that it was Lactobacillus plantarum. Conclusion： A strain of lactic acid bacteria with high inhibitory effect on the standard strain of Enterobacter cloacae ATCC 700323 was successfully isolated.
Study on the Association between SPATA48 Gene Polymorphism and Male Oligospermia
Objective： To investigate the association between the polymorphism of SNP rs12672941 with SNP rs998928 inSPATA48 gene and male oligospermia. Methods： Snapshot genotyping technology was used to investigate the polymorphism distribution of SNP rs12672941 and SNP rs998928 in279 patients with oligospermia and 234 normal men. Results： The C allele frequency of rs12672941 inpatients with oligospermia （28.5% vs. 22.8%， P=0.040， OR=1.344，95%CI 1.013-1.785） and the genotype frequency of patients with C allele （TC/CC） （49.8% vs. 40.6%， P=0.037， OR=1.453， 95%CI 1.023-2.063） were significantly higher than those of normal male， while the frequency of TT genotype in patients with oligospermia （50.1% vs. 59.4%， P=0.037， OR=0.688， 95%CI 0.485-0.978） was significantly lower than normal male. There was no significant difference between the allele frequency and genotype frequency distribution of rs998928 between oligospermia patients and normal men（P>0.05）.Conclusion： The polymorphism of SPATA48 gene SNP rs12672941 is related to oligospermia and affects the risk of male oligospermia.
Expression and Clinical Significance of CD38 inthe Blood of Patients with Lupus Nephritis
Objective：The expression and clinical significance of CD38 inthe blood of patients with lupus nephritis （LN） were analyzed to predict the involvement of CD38 inthe LN signaling pathway.Methods： The expression difference of CD38 inthe blood of patients with LN was analyzed and visualized by R language. Pearson correlation analysis and multiple linear regression analysis were carried out by SPSS 23.0 software. GSEA 4.1.0software was used for enrichment analysis of CD38. Results： After immunotherapy， CD38 expression in the blood of patients with LN decreased significantly （P < 0.05）. With the prolongation of immunotherapy time， CD38 expression in the blood of patients with LN was gradually significantly down-regulated （P < 0.05）. CD38 expression was significantly correlated with ds DNA antibody and SLEDAI score （P < 0.05）， and was the main factor affecting SLEDAI score. CD38 is mainly concentrated on the MARK signaling pathway， WNT signaling pathway and JAK-STAT signaling pathway. Conclusion： CD38 can be used as a biomarker for early diagnosis or severity of symptoms in patients with LN， and as a specific target for potential biologic agents.
Comparison of Clinical Effects of TEP and TAPP on Unilateral Inguinal Hernia
Objective：To analyze the clinical effects of laparoscopic total extraperitoneal repair （TEP） and laparoscopic transabdominal preperitoneal repair （TAPP） on unilateral inguinal hernia. Methods： From April 2015 to May 2019，166 patients with unilateral inguinal hernia and laparoscopic hernioplasty in the First Affiliated Hospital of Dali University were selected as subjects， including 79 patients in the TEP group and 87 patients in the TAPP group. Operative times， intraoperative blood losses， incidences of postoperative related complications， lengths of stay， hospitalization cost， and recurrence rates in the following six months were investigated. Results： There was no statistical significance between the two groups in the operative times， intraoperative blood losses， incidences of postoperative related complications， lengths of stay and recurrence rates in the following six months （P> 0.05）. While the hospitalization cost in the TEP group were significantly lower than those of the TAPP group （P<0.05）. Conclusion：Both TEP and TAPP can treat inguinal hernia safely and effectively， but the hospitalization cost of the TEP group were lower than the TAPP group.
A Case of Pregnancy-Induced Cerebral Venous Sinus Thrombosis and Literature Review
Objective： To analyze the characteristics， clinical features， treatment methods and prognosis of a case of pregnancy complicated with cerebral venous sinus thrombosis（CVST） and review the relevant literature. Methods： Literature review was carried out on the relevant knowledge of the disease through the collection of relevant data of patients. Results： The patient was admitted with headache combined with poor right limb activity， given anticoagulation and endovascular intervention， and died of sudden respiratory circulation failure 7 days after surgery. Conclusion： CVST is most often diagnosed in young and middle-aged people and women of childbearing age. It usually starts with headache and easily affects the superior sagittal sinus， followed by transverse sinus and sigmoid sinus. Most of the patients had good prognosis with timely diagnosis and regular treatment.
A Case Report and Literature Review of Epithelioid Sarcoma of Testicular Sheath
Objective： To report a rare case of epithelioid sarcoma of testicular sheath and summarize the clinical manifestations， signs， diagnosis and treatment. Methods： The clinical manifestations， signs， diagnosis and treatment of a case of epithelioid sarcoma of testicular sheath were reported， the clinicopathological results were analyzed， and the disease was summarized in the form of literature review. Results：The patient was treated with "left orchiectomy" after admission. The postoperative pathological results showed that there were clustered nodular lesions composed of epithelioid cells in the left scrotal sheath and capsule wall like tissue. The cells were mild， the cytoplasm was red stained， the nucleus was medium in size， the nucleolus was obvious， and some local myxoid changes. It was diagnosed as epithelioid sarcoma of testicular sheath. Conclusion： The patient was confirmed by pathology and immunohistochemistry after operation and followed up for 12 months after discharge. At present， the survival condition is good. There is no metastasis of lung， liver and retroperitoneal lymph nodes through regular reexaminations.
Clinical Application of Balloon Occlusion of Bilateral Common Iliac Artery in Patients with
Pernicious Placenta Previa under Ultrasound Guidance
Application of Transesophageal Three-Dimensional Echocardiography in the Diagnosis of Cardiac Diseases
Objective： To assess the value of transesophageal echocardiography（TEE） in clinical diagnosis of heart disease. Methods：208 patients who underwent TEE and transthoracic echocardiography（TTE） in the First Affiliated Hospital of Dali University from November 2018 to July 2020 were included in the study to observe and compare the detection rate of the two diagnostic results and the difference in the diagnosis of atrial septal disease.Results： TEE had higher detection rates than TTE for atrial septal defect （ASD），patent foramen ovale（PFO），atrial septal aneurysm， intracardiac thrombus， patent ductus arteriosus， heart valve disease，ventricular septal defect and left atrial myxoma，the differences were statistically significant（P<0.05）； TEE was more sensitive and specific to the diagnosis of atrial septal lesions than TTE.Conclusion：TEE can improve the accuracy of diagnosis of congenital cardiovascular disease， heart valve disease， intracardiac tumors and thrombus， and reduce the rate of misdiagnosis.
Validation Study of Xpert MTB/RIF in Diagnosis of Pulmonary Tuberculosis and Detection of Rifampicin Resistance
Objective： By comparing the difference between Xpert MTB/RIF technology and proportional drug sensitivity test in the detection rates of Mycobacterium tuberculosis（MTB）， the application effects of the two methods on the detection of MTB and rifampicin resistance were evaluated. Methods： Xpert MTB/RIF detection， strain identification and proportional drug sensitivity test were performed on 546 cases of pulmonary tuberculosis and suspected patients with positive sputum culture specimens to evaluate the sensitivity， specificity and 95%CI of Xpert MTB/RIF detection. Results： In the drug sensitivity test， the total resistance rate of anti-tuberculosis drugs in initial treatment patients was 3.01% and that of rifampicin was 2.31%； the total resistance rate of anti-tuberculosis drugs in retreated patients was 76.47%， and that of rifampicin was 11.76%. The sensitivity of Xpert MTB/RIF for rifampicin resistance was 97.50% and the specificity was 97.41%. Conclusion： Xpert MTB/RIF has extremely high sensitivity and specificity in the diagnosis of pulmonary tuberculosis and the detection of rifampicin resistance， and it has great consistency with the proportional method. It is a rapid and effective method for the diagnosis and drug resistance screening of pulmonary tuberculosis.
Correlation Analysis of Peripherally Hematic Factors among AIDS Patients with Liver Damage
Objective：To investigate the correlation between alanine aminotransferase （ALT）， aspartate aminotransferase （AST） and peripherally hematic factors in AIDS patients in order to provide guidance for better treatment of liver damage. Methods：2 968 AIDS patients from database of a pilot project named Traditional Chinese Medicine Treatment for HIV in Yunnan， including 816 patients with abnormal ALT and 777 with abnormal AST， were enrolled in this study.General clinical information and measures of laboratory test were collected. Logistic regression analysis was performed to explore the factors related to liver damage. Results： The liver damage was significantly correlated with alterations of Hb， PLT and CD4+T lymphocytes. Logistic regression analysis showed that the levels of ALT and AST were positively correlated with Hb（P<0.05）， whereas negatively correlated with PLT and CD4+T lymphocytes. Conclusion：In AIDS patients with impaired liver function in Yunnan Province， the levels of ALT and AST are closely related to the levels of Hb， PLT， and CD4+T lymphocytes.
Objective： To investigate the effectiveness of "Questionnaire Star" platform in the teaching-learning process of "Laboratory Diagnostics" course. Methods： From October 2019 to June 2020， 539 undergraduates （273 in experimental group and266 inthe control group） majoring in clinical medicine of Dali University were enrolled in this study. "Questionnaire Star" platform was applied in the experimental group， while participants in the control group used traditional teaching method. The questioning rates， test scores and teaching satisfaction of the two groups of students were compared. Results： Students in the experimental group asked more questions before and after class， gained higher marks in process assessment，final exam and total score， and were also more satisfied than those in the control group， the differences were statistically significant（P<0.001）. Conclusion："Questionnaire Star" platform helps to improve students' learning initiative and the teaching effect of "Laboratory Diagnostics".
Effects of Arsenic and Its Metabolites on cIAP1、cIAP2 and XIAP Genes in A549 Cells
Objective： To investigate the effects of arsenic and its metabolites on the expression of cIAP1、cIAP2 and XIAP in human lung aocarcinoma cell A549. Methods： A549 cells were exposed to different concentrations sodium arsenite （NaAsO2）， 60 ?滋mol/L monomethylarsonic acid （MMA） and dimethylarsinic acid （DMA） for 48 h， and the cell viability was detected with CCK-8 reagent. Based on the results of cell viability， A549 cells were poisoned with different concentrations of NaAsO2， 60 ?滋mol/L MMA and DMA， and Caspase-3 active reagent was used to detect the apoptosis and necrosis of cells after being poisoned. The mRNA expression levels of cIAP1， cIAP2 and XIAP were detected by real-time fluorescent quantitative polymerase chain reaction（PCR）. Results： With the increase of arsenic concentration， cell viability decreased. With the increase of dose， apoptosis and necrosis increased in NaAsO2 group， meanwhile MMA and DMA could also induce a small number of cell apoptosis. The results of real-time fluorescent quantitative PCR showed that the expression of cIAP1， cIAP2 and XIAP mRNA in the NaAsO2 exposure group and its metabolite MMA was significantly lower than that in the control group（P<0.05）； but DMA had no significant effect on the mRNA expression of these three genes. Conclusion：NaAsO2 and its metabolite MMA can reduce the expression of cIAP1， cIAP2 and XIAP mRNA in A549 cells， but its metabolite DMA had no significant effect on the mRNA expression of these three genes.
Evaluation on the Construction and Practice of Canine Rabies Surveillance System in Chuxiong Yi Autonomous Prefecture， Yunnan Province
Objective：To evaluate the performance of the canine rabies surveillance system conducted in Chuxiong Yi Autonomous Prefecture, Yunnan Province from 2010 to 2013. Methods: Upon the occurrence of aggressive dog-attack incidents （ADAI）, medical intervention will be initiated to investigate the dogs and people involved. The dog brains were sampled and sent for laboratory testing using direct immunofluorescence assay and RT-PCR. The field investigation reports provided the material basis for the ADAI report surveillance system（ARSS）. Within 24 hours, the laboratory diagnostic reports were submitted to local authorities. Meanwhile, the non-ADAI dogs suspected with the signs of rabies were also sampled and tested. Based on the brain tissue specimens from ADAI and non-ADAI dogs, a lab-based canine-rabies case surveillance system（Lab-CCSS） was established. Results: From 2011 to 2013, a total of 89 ADAI reports were submitted; rural areas accounted for 94.38%. The sampling rate of ADAI dogs was 51.69% （46/89） and the positive rate was 91.30%（42/46）. The positive rate of the non-ADAI dogs sampled was 59.09%（13/22）. In ADAI, 336 people were potentially exposed to rabies and children ≤14 years of age were at the highest risk, accounting for 30.36% of the total, 80.00%（8/10） of the head and face bites and 40.54%（15/37） of multiple bites. Conclusion: ARSS has a high sensitivity in screening rabies dogs. The experience accumulated by Chuxiong Yi Autonomous Prefecture has significant reference value to establishing a canine rabies surveillance system inYunnanProvinceand even inChina.
Multi-Center Application Study of the Best Evidence for Low-to-Medium Ｆlow Oxygen Therapy
Objective： To implement the best evidence-based clinical practice of low-to-medium flow oxygen therapy for adult inpatients under the guidance of the evidence-based healthcare of Joanna Briggs Institute. Methods： The best evidence of low-to-medium flow oxygen therapy for adult inpatients was included in the guidelines and systematic evaluation， and the evidence was transformed into clinical practice through evidence-based practice. Results： The differences of the incidence of percutaneous arterial oxygen saturation（SPO2）， nasal mucosal bleeding and nasopharyngeal dryness between adult non humidified low-to-medium flow oxygen inhalation and humidified low-to-medium flow oxygen inhalation were not statistically significant （Ｐ＞0.05）. Through the analysis of obstacle factors and the implementation of countermeasures， adult non humidified low-to-medium flow oxygen inhalation therapy has been carried out smoothly in clinic， and the purpose of reducing the cost of oxygen therapy and reducing the workload of nurses has been realized. Conclusion： There is still a gap between the best evidence and practice of low-to-medium flow oxygen therapy for adult inpatients. In view of the obstacles to the transformation of evidence to clinical， providing support from the aspects of knowledge， system and material can effectively promote the transformation of evidence to clinical practice.
Experience of Conservative Treatment and Nursing of Closed Kidney Injury Caused by Trauma
Objective： To study the effective methods of clinical nursing of closed kidney injury caused by trauma， prevent the occurrence of complications such as secondary bleeding and infection， and improve the clinical nursing ability of closed kidney injury. Methods：The clinical data of 36 patients with closed kidney injury caused by trauma diagnosed and treated in the First Affiliated Hospital of Dali University from January 2016 to October 2019 were analyzed， and the clinical nursing experience was summarized retrospectively. Results：By closely observing the patient's vital signs， monitoring the color change of the patient's urine， and psychological care，33 cases of kidney preservation were successful. All patients recovered and were discharged from the hospital.Conclusion：It is of profound significance to strengthen the detailed observation and psychological counseling of patients with closed kidney injury during treatment and hospitalization， and provide meticulous and thoughtful clinical care for patients with bleeding， hematuria and pain care， dietary guidance and infection prevention. It is of great significance to promote the rehabilitation of patients.
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