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ObjectiveTo investigate the contamination status of Staphylococcus aureus in food and the presence of enterotoxin genes in Jiading District, Shanghai, and to provide a basis for the prevention and treatment of foodborne Staphylococcus aureus disease.MethodsFrom 2021 to 2023, 15 types of food were sampled for S. aureus testing, and the presence of five enterotoxin genes, including sea⁃see, was tested in the strains.ResultsOut of 705 food samples, 88 (12.48%) were positive for S. aureus. S. aureus was detected in 12 of the 15 food types, with the three food types with the highest positive rates being cold noodles (45.00%), raw poultry (26.25%), and vegetable salads (20.00%). The enterotoxin gene carriage rate was 32.95% in food strains. The carriage rates for sea, seb, and sec were 7.95%, 12.50%, and 14.77%, respectively. Neither sed nor see was detected. The detection rate of strains carrying two types of enterotoxin genes was 2.27%. The enterotoxin carriage rates in strains from vegetables, beverages, and raw meat were 57.14%, 40.00%, and 30.00%, respectively.ConclusionThe S. aureus detection rate in food in Jiading District is much higher than the national average. The enterotoxin gene carriage rates are high, with food strains carrying sea, seb, and sec, with sec being the most prevalent. There is a need to enhance monitoring of S. aureus and enterotoxins, especially in high-risk foods such as noodles, vegetables, and non-packaged beverages.

Objective To investigate the status and epidemiological characteristics of human immunodeficiency virus (HIV) infection in voluntary blood donors in Jinan, China, and to provide a basis for formulating reasonable HIV blood screening strategies and improving blood donation recruitment in this region. Methods A retrospective analysis was performed for the preliminary screening results of HIV antibody/antigen and nucleic acid of the blood samples of all voluntary blood donors in Jinan Blood Supply and Security Center from 2014 to 2020. According to the confirmation results of reactive samples from Jinan Center for Disease Control and Prevention, the epidemiological data and blood donation data of HIV-positive individuals were collected by consulting the information management system of Shinow Blood Station. Results Among the 284 778 samples, 277 were reactive for primary screening, resulting in a reactivity rate of 0.97‰. Among the 65 reactive samples based on dual-reagent ELISA, 46 were confirmed positive, with a confirmed positive rate of 0.16‰, while 9 samples were uncertain. Among the confirmed positive blood donors, there were 45 male individuals and 1 female individual, and most of the infected individuals were aged 21-40 years, especially 21-30 years. The highest proportion of the individuals with HIV infection was observed among the first-time blood donors (65.22%), the whole blood donors (95.65%), and the individual voluntary blood donors (95.65%). Conclusion There is a relatively high coincidence rate between ELISA dual-reagent reactivity and confirmation results, and ELISA and nucleic acid testing should be used in combination for blood screening to prevent the missed detection of HIV. HIV infection in voluntary blood donors shows the characteristics of sex, age, and occupation distribution, and targeted publicity of the knowledge of HIV prevention and treatment should be strengthened for different populations. Meanwhile, the internet information sharing system should be used to eliminate HIV-positive blood donors, so as to improve the quality of blood supply from the source.

In the era of evidence-based medicine, it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit all humanity. The proposal of a three-pronged evidence system combining TCM theory, human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods provides a strong support for the clinical guideline recommendations and evidence-based health decision-making in TCM. Based on the current methodological progress of international evidence synthesis and grading, this paper proposes a novel approach for integrating multi-evidence in TCM: the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and provide guidance for the advancement of evidence-based medicine framework in TCM.

Objective To investigate the clinical application value of blood heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein(CRP) in the early diagnosis of childhood sepsis. Methods A retrospective analysis was performed for 20 children with general sepsis (general sepsis group), 16 children with severe sepsis (severe sepsis group), and 12 children with septic shock (septic shock group) who were admitted to the pediatric intensive care unit and the neonatal intensive care unit of our hospital from November 2017 to May 2019, and 22 non-sepsis children with local infection (local infection control group) and 18 children with non-infectious disease (non-infection control group) who were admitted to the general ward during the same period of time were enrolled as control group. The levels of blood HBP, PCT, and CRP were measured and compared between groups, and the receiver operating characteristic (ROC) curve was used to investigate the value of each index in the early diagnosis of sepsis. Results The septic shock group had significantly higher levels of blood HBP and PCT than the severe sepsis group and the general sepsis group (P0.05), but all these three groups had a significantly higher level of blood CRP than the non-infection control group (P

It is of great importance that science educators teach COVID-19 and related pandemics to boost students' scientific literacy. A mixed methods research design (pre-post test instrument [N = 86] and semi-structured interviews [N = 11]--August 2020 to June 2021) evaluated the ability of an intervention (12 h, three-session, 3-day, online workshop) to augment middle school inservice science teachers' (Eastern Saudi Arabian province) ability to teach about medical terminology and the epidemiology of diseases. Teachers' cognitive gains were measured through evaluating their knowledge, comprehension, and application of workshop content before and after the intervention. Descriptive statistics and inferential t tests revealed statistically significant cognitive differences overall (p < 0.01) (posttest mean = 26.26/30, SD 2.83, t value 18.51) and along knowledge (posttest mean = 5.72/7), comprehension (mean = 7.50/8), and application (mean = 13.05/15). A high effect size coefficient n2 indicated a large effect on cognitive gains. Thematic analysis about participants' subsequent efforts teaching workshop content to students revealed positive and negative experiences. The former included improved student engagement with the curriculum, community connections via project-based learning, and opportunities to teach colleagues about COVID-19. The latter concerned insufficient time, an obligation to teach the current curriculum without adding COVID-19 content, and administrative resistance. Recommendations pertain to augmenting the workshop curriculum and likeminded research initiatives.

ObjectiveTo investigate the contamination status， serotype distribution and drug resistance of Salmonella in retail poultry in Jiading District， Shanghai.MethodsFour types of poultry （chicken， duck， goose and pigeon） have been sampled from commercial markets. Salmonella contamination has been isolated and identified using serotype analysis. Furthermore， resistance of isolated Salmonella strains towards 16 commonly used antibiotics has been determined.ResultsA total of 60 Salmonella strains were isolated from 80 poultry samples. The detection rates of Salmonella in pigeon， goose， duck and chicken were 86.67%， 81.82%， 72.73% and 59.38%， respectively. Contamination status has been categorized by storage conditions. Lowest detection rate （65.63%） has been noted in poultry samples under refrigeration storage. The majority serotypes of Salmonella have been revealed as Salmonella typhimurium， Salmonella enteritidis and Salmonella corvallis. Relatively higher drug resistance was discovered with tetracycline， nalidixic acid， ampicillin and chloramphenicol， with drug resistance rate of 60.00%， 58.33%， 50.00% and 48.33%， respectively. Low drug resistance was revealed with cefotaxime. In addition， these Salmonella strains were completely sensitive to imipenem. Significant difference in drug resistance was identified across the types of poultry or Salmonella serotypes. The 11.67% of Salmonella strains were non-resistant to any tested drugs. Multi-drug resistant strains accounted for 46.67% of isolated strains， which were resistant to 13 different antibiotics. Ampicillin-tetracycline or chloramphenirol-cefazolin drug resistance pattern suggested that the Salmonella strain was multi-drug resistant.ConclusionSalmonella contamination remains high in retail poultry in Jiading District， Shanghai. Drug resistance to antibiotics is increasing. Therefore， monitoring and control of Salmonella should be strengthened.

ObjectiveTo investigate the prevalence of Staphylococcus aureus in a hospital in Jiading District， Shanghai， and to determine the enterotoxin gene profiles of Staphylococcus aureus isolated from patients and environment.MethodsSpecimens were collected from environment and patients from a hospital for Staphylococcus aureus isolation and identification. Furthermore， enterotoxin genes （SEA‒SEE） of Staphylococcus aureus were detected.ResultsA total of 54 Staphylococcus aureus strains were isolated from 780 hospital environmental specimens from 2018 to 2021， with a prevalence of 6.92%. In the armrests in the wards， patient’s pillows/quilts， and bedside cupboards， the prevalence was determined to be 20.00%， 20.00% and 16.67%， respectively. In contrast， in the computer’s mouse and keyboard and work clothes of physicians and nurses， the prevalence was 17.42% and 16.67%， respectively. Meanwhile， from 2018 to 2021， a total of 75 strains were collected from patients， of which 36.00%， 14.67% and 14.67% were from the departments of intensive care medicine （ICU）， neurosurgery and orthopedics， respectively. The prevalence of Staphylococcus aureus enterotoxin genes were 48.15% and 61.33% in the environment and patients， respectively. Furthermore， the prevalence of SEA， SEB， SEC， SED， and SEE genes were 14.67%， 41.33%， 9.33%， 1.33%， 1.33% in patients， respectively ， whereas 20.37%， 25.93%， 1.85 %， 1.85% and 0% in environmental specimens， respectively. In the environmental specimens isolated from comprehensive ICU， the prevalence of enterotoxin genes was 77.27%. In the patient's specimens， Staphylococcus aureus was mostly isolated in sputum. Additionally， the prevalence of enterotoxin genes was high in the patients of departments of respiratory medicine， ICU， and orthopedics.ConclusionPrevalence of Staphylococcus aureus remains moderate in the hospital environment. Enterotoxin genes of Staphylococcus aureus are common， with seb gene as the most common gene， followed by SEA gene. It warrants strengthening the disinfection and control of Staphylococcus aureus in the hospital， especially in the ICU.

ObjectiveTo investigate the contamination status and drug resistance of Campylobacter spp. in poultry sold in Jiading District， Shanghai.MethodsFour types of poultry meats （chickens， ducks， geese and pigeons） were sampled from commercial markets， and potential Campylobacter spp. contamination was isolated and identified. Furthermore， resistance of isolated Campylobacter spp. to 15 commonly used antibiotics was tested.ResultsTotally 29 Campylobacter jejuni strains and 34 Campylobacter. coli were isolated from 236 commercial poultry samples. The most severe contamination of Campylobacter spp. was found in chicken samples， with a detection rate of 34.04%， while the lowest detection rate of Campylobacter spp. was found in duck （19.67%）. Contamination status was categorized with different storage conditions. The lowest detection rate of 6.67% was noted under frozen condition， while highest detection rate of 41.27% was noted under cold storage. Campylobacter jejuni was completely resistant to cefazolin， ciprofloxacin， nalidixic acid and tetracycline， and Campylobacter coli was completely resistant to cefazolin， cefoxitin and nalidixic acid； Campylobacter spp. showed the lowest resistance to imipenem. Multi-drug resistant strains accounted for 100.00% of the isolated strains. 96.83% of the strains were resistant to more than 5 drugs， with the highest number reaching 14 kinds of antibiotics.ConclusionThere is a significant difference in the contamination status and drug resistance of Campylobacter spp. isolated from four types of poultry meats sold in Jiading District， Shanghai， and the drug resistance is serious. It is strongly recommended that the use of antibiotics should be strictly controlled. Freezing can effectively reduce Campylobacter spp. pollution.

Objective To establish a fungal image-assisted classification model using deep learning technology. Methods The microscope images of people infected with Aspergillus, Saccharomyces and Cryptococcus neoformans were retrospectively collected from the Eighth Medical Center of PLA General Hospital from September 2020 to April 2021. The images were randomly divided into training set, validation set and test set according to the ratio of 7∶1.5∶1.5. The improved MobileNetV2 network structure was trained using the training set, a convolutional neural network (CNN) fungal image 11 classification model based on multi-scale attention mechanism was constructed and the parameters were debugged based on the validation set. Machine identification results were taken as the gold standard, the performance of the model on 11 fungal image classification tasks was evaluated, and the results were shown by precision, recall and F1 value. In addition, the performance of the proposed model with 5 classic CNN models were compared, and the results were measured in terms of model parameters, memory usage, frames per second (FPS), accuracy, and area under the curve (AUC) of receiver operating characteristic curve. Results A total of 7666 fungal microscope images were collected, including 2781, 4115, and 770 images of Aspergillus, Saccharomyces, and Cryptococcus neoformans, respectively. Among them, there were 5366 training images, 1150 validation images, and 1150 test images. The improved MobileNetV2 model had high performance for the classification of 11 fungal images in the test set. The precision rate was distributed between 96.36% and 100%, the recall rate was distributed between 96.53% and 100%, and the F1 value was distributed between 97.01% and 100%. The parameters, memory usage, FPS, accuracy, and AUC of the improved MobileNetV2 model were 4.22 M, 356.89 M, 573, (99.09±0.18)%, and 0.9944±0.0018, respectively, and the comprehensive performance was better than 5 kinds of classical networks. Conclusion The proposed fungal image classification model based on the improved MobileNetV2 can obtain higher fungal image recognition ability while maintaining low computational cost, with an overall performance better than classical CNN model.

ObjectiveTo investigate the contamination situation， serotype distribution and drug resistance of salmonella in poultry sold in Jiading District， Shanghai.MethodsBetween 2019 and 2020， four types of poultry meat （chicken， duck， goose and pigeon） were sampled from markets， and potential salmonella contamination was isolated and identified via serotyping. Furthermore， resistance detection of isolated salmonella to 13 commonly-used antibiotics was conducted.ResultsA total of 32 salmonella strains were isolated from 156 commercial poultry samples. No salmonella was identified in pigeon samples， while the most severe contamination was detected in goose samples， with a detection rate of 28.00%. Contamination situation was categorized with different storage conditions. The lowest detection rate of 12.90% was noted under cold storage， while the highest rate of 26.67% was detected under frozen condition. The major serotypes of salmonella were Salmonella typhimurium， Salmonella enteritidis and Salmonella Argonne. Relatively higher drug resistance was detected with nalidixic acid and tetracycline， with drug resistance rate of 59.38% and 40.63%， respectively. Low drug resistance was detected with cephalosporins， and no drug resistance was detected with imipenem. Significant difference in drug resistance was noted in the serotype of Salmonella isolated from meat of chicken， duck and goose. Three major salmonella strains had different drug resistance. 21.88% （7/32） of salmonella strains were non-resistant to any tested drugs. Multi-drug resistant strains accounted for 31.25% （10/32） of the isolated strains. At most， salmonella was resistant to 11 kinds of different antibiotics.ConclusionThere is a significant difference in the contamination situation and drug resistance of Salmonella isolated from four types of poultry meat sold in Jiading District， Shanghai. It is strongly recommended that different supervision strategies and management upon classification be implemented.

BackgroundChinese idioms have potential to act as preliminary training material in studies on post-stroke aphasia.ObjectiveTo explore an extension speech training program that takes Chinese idioms as context and expands them into characters, words, sentences and paragraphs and evaluate the effects of this program in patients with post-stroke non-fluent aphasia.MethodsThis was a randomized controlled trial. We recruited patients with post-stroke non-fluent aphasia from the Renmin Hospital of Wuhan University from January 2021 to January 2022. Participants were randomly assigned to group I and group II. Patients in group I had treatment with extension speech training based on Chinese idioms, and those in group II had treatment with conventional speech rehabilitation training. The training period in both groups was 40 min daily for 2 weeks.ResultsA total of 70 patients (group I, n = 34; and group II, n = 36) completed the trial and were analyzed according to protocol. There were no significant differences in baseline values between both groups. After intervention, the scores of oral expression, comprehension, and reading in the Aphasia Battery Of Chinese scale and the scores of the Comprehensive Activities of Daily Living questionnaire significantly improved in both groups (P ConclusionThis extension speech training program based on Chinese idioms can improve the language function and daily communication ability of the patients with post-stroke non-fluent aphasia.Trial registrationChinese Clinical Trial Registry ChiCTR2000031825.

Plagiarism is not an issue observed only among students; rather, it also occurs in the publications of researchers in academic journals. The current study explored how Nobel laureates, with the highest possible academic status in the world, engage in text borrowing. A list of 91 laureates in physics, chemistry, physiology and medicine, and economics from 2006 to 2015 were identified and their publications were collected and analysed using Turnitin software. The findings of the current study revealed that Nobel laureates' journal publications outperform those of their counterparts in terms of text borrowing, even though there are still incidences of extensive text borrowing and the lack of appropriate citations observed in their publications. Most of the text borrowing in question consists of self-plagiarism and methods section text, in agreement of earlier research findings. In addition, papers by authors whose affiliated institutions are located in English-speaking countries exhibit fewer incidences of text borrowing than papers by authors whose affiliated institutions are located in non-English-speaking countries, whereas the number of authors does not play a significant role in text borrowing.

Abstract Acanthamoeba castellanii, the causative agent of Acanthamoeba keratitis (AK), occurs mainly in contact lens users with poor eye hygiene. The findings of many in vitro studies of AK, as well as the testing of therapeutic drugs, need validation in in vivo experiments. BALB/c mice were used in this study to establish in vivo AK model. A. castellanii cell suspensions (equal mixtures of trophozoites and cysts) were loaded onto 2-mm contact lens pieces and inserted into mouse eyes that were scratched using an ophthalmic surgical blade under anesthesia and the eyelids of the mice were sutured. The AK signs were grossly observed and PCR was performed using P-FLA primers to amplify the Acanthamoeba 18S-rRNA gene from mouse ocular tissue. The experimental AK mouse model was characterized by typical hazy blurring and melting of the mouse cornea established on day 1 post-inoculation. AK was induced with at least 0.3 × 105 A. castellanii cells (optimal number, 5 × 104), and the infection persisted for two months. The PCR products amplified from the extracted mouse eye DNA confirmed the development of Acanthamoeba-induced keratitis during the infection periods. In conclusion, the present AK mouse model may serve as an important in vivo model for the development of various therapeutic drugs against AK.

Naegleria fowleri is a pathogenic free-living amoeba, commonly found around the world in warm, fresh water and soil. N. fowleri trophozoites can infect humans by entering the brain through the nose and causing usually fatal primary amebic meningoencephalitis (PAM). Trophozoites can encyst to survive under unfavorable conditions such as cold temperature, starvation, and desiccation. Recent technological advances in genomics and bioinformatics have provided unique opportunities for the identification and pre-validation of pathogen-related and environmental resistance through improved understanding of the biology of pathogenic N. fowleri trophozoites and cysts at a molecular level. However, genomic and transcriptomic data on differential expression genes (DEGs) between trophozoites and cysts of N. fowleri are very limited. Here, we report transcriptome Illumina RNA sequencing (RNA-seq) for N. fowleri trophozoites and cysts and de novo transcriptome assembly. RNA-seq libraries were generated from RNA extracted from N. fowleri sampled from cysts, and a reference transcriptome was generated through the assembly of trophozoite data. In the database, the assembly procedure resulted in 42,220 contigs with a mean length of 11,254 nucleotides and a C+G content of 37.21%. RNA sequencing showed that 146 genes in cysts of N. fowleri indicated 2-fold upregulation in comparison with trophozoites of N. fowleri, and 163 genes were downregulated; these genes were found to participate in the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. The KEGG pathway included metabolic (131 sequences) and genetic information processing (66 sequences), cellular processing (43 sequences), environmental information processing (22 sequences), and organismal system (20 sequences) pathways. On the other hand, an analysis of 11,254 sequences via the Gene Ontology database showed that their annotations contained 1069 biological processes including the cellular process (228 sequences) and metabolic process (214 sequences); 923 cellular components including cells (240 sequences) and cell parts (225 sequences); and 415 molecular functions including catalytic activities (195 sequences) and binding processes (186 sequences). Differential expression levels increased in cysts of N. fowleri compared to trophozoites of N. fowleri, which were mainly categorized as serine/threonine protease, kinase, and lipid metabolism-related proteins. These results may provide new insights into pathogen-related genes or environment-resistant genes in the pathogenesis of N. fowleri.

To solve the problems of poor permeability and low leaching rate in ore heap leaching, solid surface physical chemistry, seepage mechanics theory for porous media, CT scanning and SEM were used to carry out column leaching tests with a homemade segmented removable plexiglass column; the variation law for the permeability coefficients of each segment of the leaching column before and after leaching was analyzed. The experimental results showed that there was little difference in the permeability coefficient of ore at different heights before leaching. After leaching, the permeability coefficients were unevenly distributed along the column height, and the lowest value was located at the bottom of the leaching column. The addition of surfactant provided an obvious improvement in the permeability of the leaching column. The permeability coefficient at the bottom of the leaching column was 6% higher than that of the control group. At the same time, the addition of surfactant increased the leaching rate of ore by nearly 10%. A theoretical analysis showed that the surfactant improved the permeability of ore heaps mainly by preventing physical blockage by fine particles and inhibiting deposition of chemical products.

Traditional Chinese medicine (TCM) is an important component of China's medical system. How to educate TCM practitioners in China, therefore, has become a crucial issue. To contribute to this issue, the current research identified the competency model of TCM practitioners in China and developed an evaluation for TCM students. We combined Bloom's taxonomy with our model construction to examine the current TCM practitioners' requirements. Following the protocol of developing a measurement, we interviewed 20 TCM practitioners, conducted two rounds of surveys in China (n = 220/n = 489), ran exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and examined the correlation between the measurement and self-rated outcomes. The evaluation tool of TCM students consists of five factors: "modern medical knowledge and skills," "TCM medical knowledge and skills," "professional ethics," "communication and cooperation skills," and "clinical practices." The reliability and validity of our evaluation tool were testified. Our work may contribute to TCM education in China.

Objective To evaluate the expression of the receptor for advanced glycation end products (RAGE) in gingival tissue endothelial cells from type 2 diabetic rats with chronic periodontitis and to explore the role of RAGE in the pathogenesis of diabetes in cases with chronic periodontitis. Methods Sixty 7⁃week⁃old female Wistar diabetic obese rats were randomly divided into two groups. Periodontitis was induced in 30 rats by silk ligation, and the other 30 rats were used as the control group in which the periodontal tissues were not treated. One week after periodontal ligation and inoculation, the periodontitis and control group rats were randomly divided into two subgroups; the first subgroup was fed a high⁃fat diet, and the second group was fed a low⁃fat diet. Thus, 15 rats per group were included in the high⁃ fat diet periodontitis (HF/P), low⁃fat diet periodontitis (LF/P), high⁃fat diet periodontal health (HF/C), and low⁃fat diet periodontal health (LF/C) groups. Glucose tolerance tests were performed weekly to measure the fasting insulin and blood glucose levels and the insulin resistance index to verify successful construction of the rat diabetes model. After successful modeling of chronic periodontitis, the rats were sacrificed at the 13th week after measurement of the serum necrosis factor⁃α (TNF⁃α), interleukin⁃6 (IL⁃6) and leptin levels. The tooth periodontal tissues were prepared and sec⁃ tioned to observe histological changes. Immunofluorescence double staining was used to detect the density of RAGE⁃pos⁃ itive endothelial cells in the gingival tissues of the four groups. Results The serum fasting blood glucose and insulin levels and insulin resistance index were significantly higher in the HF/P and HF/C groups than in the LF/P and LF/C groups (P < 0.01). The serum TNF⁃α and IL⁃6 levels were significantly higher in the HF/P and LF/P groups than in the HF/C and LF/C groups (P < 0.01). The serum leptin levels were significantly higher in the HF/P group than in the other three groups. The density of RAGE⁃positive endothelial cells was significantly higher in the HF/P and HF/C groups than in the LF/P (P＝0.001) and LF/C groups (P＝0.040). The density of RAGE⁃positive endothelial cells in the HF/P group was higher than that in the HF/C group (P＝0.027). Conclusion Endothelial cells in type 2 diabetic rats with peri⁃ odontitis have increased gingival tissue RAGE and serum leptin levels.

ObjectivesThis study aims to investigate patient safety culture in secondary hospitals of Heilongjiang, Northeast China, and explore the implications of patient safety culture and practices through the perspectives of various healthcare workers.MethodsA cross-sectional survey using the Safety Attitude Questionnaire (SAQ) was conducted to ascertain the status of patient safety culture in nine secondary hospitals across the six dimensions of the SAQ. Among the 900 staff members who were invited to participate, 665 completed the questionnaire. Descriptive statistics were used to calculate the general means and standard deviations of the patient safety culture dimensions and other numerical variables, and F-test and a multivariate regression analysis were used to statistically analyze the differences in perceptions of safety culture considering the differences in demographic characteristics. All statistical analyses were performed using SPSS v. 22.0.ResultsThe respondents rated job satisfaction as the highest among all six dimensions of the SAQ, followed in order by teamwork climate, working conditions, and stress recognition (the lowest). There were significant differences among the dimensions of patient safety culture and other factors, such as gender, age, job position, and education. Compared with previous studies, teamwork climate and working conditions scores were quite high, while stress recognition score was very low. We also found differences in patient safety culture by demographic characteristics.ConclusionsThe findings revealed the patient safety culture attitudes of healthcare workers in secondary hospitals of Heilongjiang, and provided baseline data for related future research. This evidence may also help government health policymakers and hospital administrators understand related challenges and develop strategies to improve patient safety culture in secondary hospitals of China and perhaps also in other developing countries.

Portal/hepatic vein tumor thrombosis (PVTT/HVTT) in hepatocellular carcinoma (HCC) is a sign of advanced stage disease and is associated with poor prognosis. This study investigated the surgical outcomes of patients with HCC and PVTT/HVTT to determine the most appropriate surgical treatment strategy for these patients.The study population included 77 HCC patients from January 2004 to June 2009 who underwent hepatectomy in our department and were diagnosed with PVTT/HVTT based on pathological examination. The patients were divided into two groups: in group 1, PVTT/HVTT was located in the hepatic resection area and removed with the tumor en bloc (38 cases); in group 2, PVTT/HVTT was beyond the resection line and removed by suction or thrombectomy (39 cases). Concerning the factor of surgical margins, the patients were further divided into four subgroups: group 1A: patients in group 1 with surgical margins ≤1 cm (28 cases); group 1B: patients in group 1 with surgical margins >1 cm (9 cases); group 2A: patients in group 2 with surgical margins ≤1 cm (28 cases); and group 2B: patients in group 2 with surgical margins >1 cm (9 cases).Most of the characteristics of groups 1 and 2 were similar. Patients in group 2 had significantly higher median blood loss (p=0.002) and higher blood transfusion rate (p=0.002) during the operation, which were not considered prognostic factors (p=0.323 and 0.571, respectively). The median overall survival (OS) duration in group 1 was significantly longer than that in group 2 (14.3 vs. 10.4 months, p=0.047). The median OS durations in groups 1A, 1B, 2A, and 2B were 14.3, 42.7, 7.5, and 18.0 months, respectively, which were significantly different(p=0.018).When PVTT/HVTT is located in the hepatic resection area and removed with the tumor en bloc, the median OS duration is longer. Based on this finding, widening the surgical margins when technically possible may increase OS.

The precise mechanisms underlying dissections, especially those without connective tissue diseases or congenital vascular diseases, are incompletely understood. This study attempted to identify both the expression profile of the dissected ascending aorta and the interactome hotspots associated with the disease, using microarray technology and gene regulatory network analysis. There were 2,737 genes differentially expressed between patients with acute Stanford type A aortic dissection and controls. Eight interactome hotspots significantly associated with aortic dissection were identified by an integrative network algorithm. In particular, we identified a JAK2-centered expression module, which was validated in an independent gene expression microarray data set, and which was characterized by over-expressed cytokines and receptors in acute aortic dissection cases, indicating that JAK2 may play a key role in the inflammatory process, which potentially contributes to the occurrence of acute aortic dissection. Overall, the analytical strategy used in this study offered the possibility to identify functional relevant network modules and subsequently facilitated the biological interpretation in the complicated disease.

To investigate the contributions of carboxyl-terminal nucleic acid binding domain of HBV core (C) protein for hepatitis B virus (HBV) replication, chimeric HBV C proteins were generated by substituting varying lengths of the carboxyl-terminus of duck hepatitis B virus (DHBV) C protein for the corresponding regions of HBV C protein. All chimeric C proteins formed core particles. A chimeric C protein with 221-262 amino acids of DHBV C protein, in place of 146-185 amino acids of the HBV C protein, supported HBV pregenomic RNA (pgRNA) encapsidation and DNA synthesis: 40% amino acid sequence identity or 45% homology in the nucleic-acid binding domain of HBV C protein was sufficient for pgRNA encapsidation and DNA synthesis, although we predominantly detected spliced DNA. A chimeric C protein with 221-241 and 251-262 amino acids of DHBV C, in place of HBV C 146-166 and 176-185 amino acids, respectively, could rescue full-length DNA synthesis. However, a reciprocal C chimera with 242-250 of DHBV C ((242)RAGSPLPRS(250)) introduced in place of 167-175 of HBV C ((167)RRRSQSPRR(175)) significantly decreased pgRNA encapsidation and DNA synthesis, and full-length DNA was not detected, demonstrating that the arginine-rich (167)RRRSQSPRR(175) domain may be critical for efficient viral replication. Five amino acids differing between viral species (underlined above) were tested for replication rescue; R169 and R175 were found to be important.

Staphylococcal enterotoxin B (SEB) exposure triggers an exaggerated pro-inflammatory cytokine response that often leads to toxic shock syndrome (TSS) associated with organ failure and death. MyD88 mediates pro-inflammatory cytokine signaling induced by SEB exposure and MyD88(-/-) mice are resistant to SEB intoxication, suggesting that MyD88 may be a potential target for therapeutic intervention. We targeted the BB loop region of the Toll/IL-1 receptor (TIR) domain of MyD88 to develop small-molecule therapeutics. Here, we report that a synthetic compound (EM-163), mimic to dimeric form of BB-loop of MyD88 attenuated tumor necrosis factor (TNF)- α, interferon (IFN)-γ, interleukin (IL)-1β, IL-2 and IL-6 production in human primary cells, whether administered pre- or post-SEB exposure. Results from a direct binding assay, and from MyD88 co-transfection/co-immunoprecipitation experiments, suggest that EM-163 inhibits TIR-TIR domain interaction. Additional results indicate that EM-163 prevents MyD88 from mediating downstream signaling. In an NF-kB-driven reporter assay of lipopolysaccharide-stimulated MyD88 signaling, EM-163 demonstrated a dose-dependent inhibition of reporter activity as well as TNF-α and IL-1β production. Importantly, administration of EM-163 pre- or post exposure to a lethal dose of SEB abrogated pro-inflammatory cytokine responses and protected mice from toxic shock-induced death. Taken together, our results suggest that EM-163 exhibits a potential for therapeutic use against SEB intoxication.

BACKGROUND: The safflower, Carthamus tinctorius L., is a worldwide oil crop, and its flowers, which have a high flavonoid content, are an important medicinal resource against cardiovascular disease in traditional medicine. Because the safflower has a large and complex genome, the development of its genomic resources has been delayed. Second-generation Illumina sequencing is now an efficient route for generating an enormous volume of sequences that can represent a large number of genes and their expression levels. METHODOLOGY/PRINCIPAL FINDINGS: To investigate the genes and pathways that might control flavonoids and other secondary metabolites in the safflower, we used Illumina sequencing to perform a de novo assembly of the safflower tubular flower tissue transcriptome. We obtained a total of 4.69 Gb in clean nucleotides comprising 52,119,104 clean sequencing reads, 195,320 contigs, and 120,778 unigenes. Based on similarity searches with known proteins, we annotated 70,342 of the unigenes (about 58% of the identified unigenes) with cut-off E-values of 10(-5). In total, 21,943 of the safflower unigenes were found to have COG classifications, and BLAST2GO assigned 26,332 of the unigenes to 1,754 GO term annotations. In addition, we assigned 30,203 of the unigenes to 121 KEGG pathways. When we focused on genes identified as contributing to flavonoid biosynthesis and the biosynthesis of unsaturated fatty acids, which are important pathways that control flower and seed quality, respectively, we found that these genes were fairly well conserved in the safflower genome compared to those of other plants. CONCLUSIONS/SIGNIFICANCE: Our study provides abundant genomic data for Carthamus tinctorius L. and offers comprehensive sequence resources for studying the safflower. We believe that these transcriptome datasets will serve as an important public information platform to accelerate studies of the safflower genome, and may help us define the mechanisms of flower tissue-specific and secondary metabolism in this non-model plant.

Human neural progenitor cells (hNPCs) have been proposed as a potential source of cells for ex vivo gene therapy. In this pilot study, three 5-year-old female cynomolgus monkeys received a single intracarotid infusion of MPTP, followed 1 week later by MRI-guided stereotaxic intrastriatal and intranigral injections of male hNPCs transgenic for GDNF. Immunosupression with oral cyclosporine (30–40 mg/kg) began 48 h before hNPC transplants and continued throughout the study. We monitored the animals using a clinical rating scale (CRS). Three months postsurgery, we euthanized the animals by transcardiac perfusion, then retrieved and processed their brains for morphological analysis. Our findings include the following. 1) hNPCs survived and produced GDNF in all animals 3 months postsurgery. 2) hNPCs remained in the areas of injection as observed by GDNF immunostaining and in situ hybridization for the human Y chromosome. 3) A “halo” of GDNF expression was observed diffusing from the center of the graft out into the surrounding area. 4) We observed increased TH- and VMAT2-positive fibers in areas of GDNF delivery in two of the three animals. The two animals with TH- and VMAT2-positive fibers also showed reductions in their CRS scores. 5) Some GFAP-positive perivascular cuffing was found in transplanted areas. 6) General blood chemistry and necropsies did not reveal any abnormalities. Therefore, we conclude that hNPCs releasing GDNF may be a possible alternative for intracerebral trophic factor delivery in Parkinson's disease.

Endothelial cell (EC) activation is an early hallmark in the pathogenesis of chronic vascular diseases. MicroRNA-181b (Mir181b) is an important anti-inflammatory mediator in the vascular endothelium affecting endotoxemia, atherosclerosis, and insulin resistance. Herein, we identify that the drug methotrexate (MTX) and its downstream metabolite adenosine exert anti-inflammatory effects in the vascular endothelium by targeting and activating Mir181b expression. Both systemic and endothelial-specific Mir181a2b2-deficient mice develop vascular inflammation, white adipose tissue (WAT) inflammation, and insulin resistance in a diet-induced obesity model. Moreover, MTX attenuated diet-induced WAT inflammation, insulin resistance, and EC activation in a Mir181a2b2-dependent manner. Mechanistically, MTX attenuated cytokine-induced EC activation through a unique adenosine-adenosine receptor A3-SMAD3/4-Mir181b signaling cascade. These findings establish an essential role of endothelial Mir181b in controlling vascular inflammation and that restoring Mir181b in ECs by high-dose MTX or adenosine signaling may provide a potential therapeutic opportunity for anti-inflammatory therapy.

Background/aimXihuang Wan (XHW), a traditional Chinese medicine (TCM), has been used in China for a variety of cancers including lung cancer. The present study evaluated the efficacy of XHW on a Lewis lung mouse model and explored the potential mechanism via transcriptomics.Materials and methodsThe mice were randomized into 6 groups: 1) untreated control (n=10); 2) low-dose XHW; 3) medium-dose XHW; 4) high-dose XHW; 5) cisplatin; and 6) untreated blank (n=4). Lewis lung carcinoma (LLC) cells were injected subcutaneously except for the 4 mice in the blank group. The body weight and tumor length and width were measured every 3 days. RNA-sequencing was performed on tumors in the high-dose XHW group and the control group.ResultsXHW inhibited the growth of LLC in a syngeneic mouse model, without toxicity, with equivalent efficacy to cisplatin. RNA-sequencing demonstrated that many signaling pathways were involved in XHW-mediated inhibition of LLC, including tumor necrosis factor, estrogen, cyclic guanosine 3', 5'-monophosphate-protein kinase G, apelin and the peroxisome proliferator-activated receptor signaling pathways.ConclusionXHW inhibited LLC carcinoma through different pathways and shows clinical promise for patients who cannot tolerate platinum-based drugs.

Abstract Background Histone deacetylases and histone acetyl transferases covalently modify histone proteins, consequentially altering chromatin architecture and gene expression. Methods The effects of suberoylanilide hydroxamic acid, a HDAC inhibitor, on 320 HSR colon cells were assessed in 320 HSR colon cancer cells. Results Concentration and time-dependent inhibition of 320 HSR cell proliferation was observed. Treatment of 320 HSR cells with 5 μM SAHA for 72 h significantly inhibited their growth by 50% as compared to that of the control. Fluorescence-activated cell sorting analysis demonstrated significant inhibition of cell cycle progression (sub-G1 arrest) and induction of apoptosis upon various SAHA concentrations after 48 h. In addition, the anti-apoptosis proteins, survivin and Bcl-xL, were significantly inhibited by SAHA after 72 h of treatment. Immunocytochemistry analysis revealed that SAHA-resistant cells were positive for cyclin A (85%), ki-67 (100%), p53 (100%), survivin (100%), and p21 (90%) expression. Furthermore, a significant increase cyclin A-, Ki-67-, p53-, survivin-, and p21-positive cells were noted in SAHA-resistant tumor cells. Conclusion Our results demonstrated for the first time in 320 HSR colon adenocarcinoma cells that SAHA might be considered as an adjuvant therapy for colon adenocarcinoma.

Although heterogeneity is recognized within the murine satellite cell pool, a comprehensive understanding of distinct subpopulations and their functional relevance in human satellite cells is lacking. We used a combination of single cell RNA sequencing and flow cytometry to identify, distinguish, and physically separate novel subpopulations of human PAX7+ satellite cells (Hu-MuSCs) from normal muscles. We found that, although relatively homogeneous compared to activated satellite cells and committed progenitors, the Hu-MuSC pool contains clusters of transcriptionally distinct cells with consistency across human individuals. New surface marker combinations were enriched in transcriptional subclusters, including a subpopulation of Hu-MuSCs marked by CXCR4/CD29/CD56/CAV1 (CAV1+). In vitro, CAV1+ Hu-MuSCs are morphologically distinct, and characterized by resistance to activation compared to CAV1- Hu-MuSCs. In vivo, CAV1+ Hu-MuSCs demonstrated increased engraftment after transplantation. Our findings provide a comprehensive transcriptional view of normal Hu-MuSCs and describe new heterogeneity, enabling separation of functionally distinct human satellite cell subpopulations.

To explore advantages of Chinese medicine (CM) by analyzing differences in the origin of philosophy for human health between CM and Western medicine (WM). Methodologically, a distinctive feature of CM is its systems theory, which is also the difference between CM and WM. Since the birth of CM, it has taken the human body as a whole from the key concepts of "qi, blood, yin-yang, viscera (Zang-Fu), and meridian and channel", rather than a single cell or a particular organ. WM evolves from the Western philosophic way of thinking and merely uses natural sciences as the foundation. The development of WM is based on human structures, or anatomy, and therefore, research of WM is also based on the way of thinking of decomposing the whole human body into several independent parts, which is the impetus of promoting the development of WM. The core of CM includes the holistic view and the dialectical view. Chinese herbal medicines contain various components and treat a disease from multiple targets and links. Therefore, Chinese herbal medicines treat a diseased state by regulating and mobilizing the whole body rather than just regulating a single factor, since the diseased state is not only a problem in a local part of the body but a local reflection of imbalance of the whole body.

Objective: Lysophosphatidic acid mediates proliferative and/or morphologic effects on multiple cell lineages, which include ovarian cancer cells. Lysophosphatidic acid hydrolysis limits the duration of lysophosphatidic acid's action. We examined hormonal translocation of lipid phosphate phosphatase type 3 to the plasma membrane in gonadotropin-releasing hormone-responsive ovarian cancers. Study design: Ovarian cancers that were removed surgically and the ovarian cancer cell lines Caov-3 and SK-OV-3 were examined. Lipid phosphate phosphatase type 3 protein and activity in plasma membranes were assessed by immunohistochemical staining with lipid phosphate phosphatase type 3-specific antibodies and by the measurement of the conversion of exogenous [3H- oleoyl]lysophosphatidic acid to mono[3H-oleoyl]glycerol, respectively. Results: In ovarian cancers that were removed surgically, the cell surface staining and activity measurements indicated that a portion of the enzyme was localized to the plasma membrane. In Caov-3 cells and SK-OV-3 cells, lipid phosphate phosphatase type 3 protein was present both in the cytoplasm and at the plasma membrane. Treatment of the cells with a gonadotropin-releasing hormone agonist buserelin produced a rapid and progressive translocation of lipid phosphate phosphatase type 3 protein to the plasma membrane, with a concomitant loss of cytoplasmic staining. The enzyme activity in plasma membrane was also increased when the cell lines were exposed to the gonadotropin-releasing hormone agonist in intact cells before the assay of the cell membranes. [ABSTRACT FROM AUTHOR]