Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit

ObjectiveTo determine whether attempts to prevent weight gain will increase success rates for stopping smoking.Design16 week, open, randomised study with 1 year follow up.SettingObesity unit.Subjects287 female smokers who had quit smoking before but started again because of weight concerns.InterventionCombination of a standard smoking cessation programme with nicotine gum and a behavioural weight control programme including a very low energy diet. A control group was treated with the identical programme but without the diet.ResultsAfter 16 weeks, 68/137 (50%) women had stopped smoking in the diet group versus 53/150 (35%) in the control group (P=0.01). Among these women, weight fell by mean 2.1 (95% confidence interval 2.9 to 1.3) kg in the diet group but increased by 1.6 (0.9 to 2.3) kg in the control group (P<0.001). After 1 year the success rates in the diet and control groups were 38/137 (28%) and 24/150 (16%) respectively (P<0.05), but there was no statistical difference in weight gain.ConclusionsCombining the smoking cessation programme with an intervention to control weight helped women to stop smoking and control weight.     

基于控制图的医院服务质量持续改进

目的 应用统计过程控制理论分析指导医院服务质量持续改进。方法 联合使用多个控制图方法对医院服务质量评价指标的变化趋势进行监控,及时发现过程中的异常波动,制定针对性措施实施过程改进。结果 找出了影响医院服务质量数据波动的主要原因,制定改进措施,取得了良好的管理效果。结论 控制图可以准确全面反映医院服务质量的总体情况和过程控制情况,根据数据异常分布状态找到潜在的影响服务质量的原因并进行持续改进,是有效的过程管理工具。     

流程重组在病案质量控制中的实践应用

??????? 目的 对病案质控流程重组,总结完善工作流程,提高工作效率,改善工作质量。方法 在分析病案出院前质控流程现状基础上,从缩短审核时间、增加病床合理使用和保证病历质量等方面阐述如何在现有条件下来改善病案质控流程。结果 加强病案质量控制,不断提高病历书写质量。结论 使病案质控最大限度服务于临床需要。     

基于休哈特控制图的临床路径指标预警管理实践

目的 运用休哈特控制图对科室临床路径运行指标（完成比例、变异率）实施预警控制管理。方法 选择某科室2016年1—12月份临床路径运行数据,绘制该科室临床路径完成比例、变异率休哈特控制图（P控制图）,结合临床诊疗特点自设预警控制指标及控制点。结果 利用休哈特控制图（P控制图）,实时对该科室临床路径完成比例、变异率预警控制,分别针对该二项指标给予2次预警控制,督促分析整改。结论 休哈特控制图可以全面展现科室临床路径运行趋势、增加不同科室间临床路径运行的可比性、实时预警纠偏科室临床路径的不良运行,降低运行惯性;作为一项精细化管理的重要工具,要求实施者具有统计、临床、管理等相关知识储备。     

拮抗菌群对烟草野火病的防治效果及叶际微生物群落多样性的影响

【背景】烟草野火病(Tobacco Wild Fire)是烟草上的主要病害之一,利用拮抗菌防治烟草野火病是具有较好前景的防治手段。【目的】分析烟草叶际微生物群落结构组成和多样性,阐释拮抗菌群施用对烟草野火病的防治效果及对叶际微生物群落的影响。【方法】在烟草上施用3种拮抗菌群,采用16Sr RNA基因高通量测序及生物信息学手段,分析拮抗菌群对烟草叶际微生物群落结构组成和多样性的影响,研究拮抗菌群在叶片上的定殖。【结果】拮抗菌群对烟草野火病的防治效果达到50.44%-68.58%。与对照相比,3种拮抗菌群处理叶际微生物群落结构和组成都产生了明显的变化,群落多样性显著增高。拮抗菌群处理后,烟草叶际微生物泛菌(Pantoea)、寡养单胞菌(Stenotrophomonas)和假单胞菌(Pseudomonas)等菌属所占比例发生显著变化,其中芽孢杆菌属(Bacillus)和寡养单胞菌属相比对照增加分别达到3.9倍和7.02倍,其丰度与病情指数显著负相关。【结论】拮抗菌群对烟草野火病有较好的防治效果,施用拮抗菌群显著影响叶际微生物群落的组成和多样性,假单孢杆菌和寡养单胞菌等优势菌属能够在烟草叶际定殖,起到防治烟草野火病的作用。     

The Pharmacological effects of novel 5-fluoro-N-(9,10-dihydro-9,10-dioxoanthracen-8-yl)-1H-indole-2-carboxamide derivatives on plasma lipid profile of Triton-WR-1339-induced Wistar rats

A novel series of 5-fluoro-N-(9,10-dihydro-9,10-dioxoanthracen-8-yl)-1H-indole-2-carboxamides (3c–3g) were synthesized. The present study was undertaken to investigate the possible antihyperlipidemic effect of these novel compounds on hyperlipidemic rats. Hyperlipidemia was induced by a single intraperitoneal injection of Triton WR-1339 (300 mg/kg). The tested animals were divided into normal control (NCG), hyperlipidemic control (HCG), compounds 3c-, 3d-, 3e-, 3f-, 3g- and bezafibrate (BF)-treated groups. At a dose of 15 mg/kg, compounds 3c–3g and BF (100 mg/kg) significantly (p < 0.0001) reduced elevated plasma triglycerides levels after 12 and 24 h compared to the hyperlipidemic control group. However, only compounds 3e and 3g obviously showed a significant (p < 0.0001) reduction in plasma total cholesterol levels after 12 and 24 h. Moreover, high-density lipoprotein cholesterol levels were significantly increased in all treated groups. The current study demonstrates that 5-fluoro-N-(9,10-dihydro-9,10-dioxoanthracen-8-yl)-1H-indole-2-carboxamides (3c–3g) have a definite antihyperlipidemic potential and these beneficial activities may contribute to their cardioprotective and antiatherosclerotic role.     

上海市医疗质量控制综合评分体系研究

目的 构建一套客观通用的医疗质量综合评分体系,从而加强对各医疗机构总体医疗质量的控制,促进医疗机构质量不断提升,为政府有关部门提供可操作性的政策建议。方法 在文献综述的基础上应用德尔菲法（Delphi Method）对医疗机构质量控制综合评分指标体系的重要性、评估难度以及理想评估次数进行评价,建立评价指标体系。结果 构建的指标体系包含三个层级结构,共32个指标,各级指标的重要性评价意见的协调系数均有统计学意义,专家们较一致的认为管理类别的评价指标评估难度较大,理想的评估频次是一年2次。结论 构建的评价指标体系符合上海市的实际情况,可以应用到实际质量控制综合评价工作中。     

马铃薯疮痂病菌Streptomyces scabies拮抗细菌的筛选及BKS104鉴定

[背景] 近年来,马铃薯疮痂病的危害态势逐渐上升,在全国各主要产区均有发生,目前由于缺乏有效的防治手段,已造成了严重的经济损失。生物防治是防治土传病害的有效途径,逐渐成为了研究热点。[目的] 筛选对马铃薯疮痂病菌具有较高拮抗效果的菌株,为生防菌剂的开发提供菌种资源,同时也为马铃薯疮痂病的防治奠定理论基础。[方法] 采用平板对峙法和牛津杯试验法对分离得到的菌株进行初筛和复筛,并通过形态特征、生理生化特征及16S rRNA基因、gyrB基因序列分析结果对菌株进行鉴定。通过平板对峙法测定菌株的抑菌谱。[结果] 获得一株具有明显拮抗效果的菌株BKS104,抑菌直径达到43 mm,防效达到85%。其菌落圆形、乳白色、不透明、表面有光泽,边缘整齐,菌体杆状,革兰氏阳性菌。结合16S rRNA基因、gyrB基因的测序结果将其鉴定为贝莱斯芽孢杆菌,并对8种植物病原真菌均具有抑制效果。[结论] 菌株BKS104为贝莱斯芽孢杆菌,可以有效抑制马铃薯疮痂病菌的生长,安全性高,具有良好的生防潜力。     

Deletion of the FHL2 gene attenuates the formation of atherosclerotic lesions after a cholesterol-enriched diet

AimsFHL2, a member of the four and a half LIM domain (FHL) family of proteins, may play an important role in the circulatory system and in particular atherosclerosis.Main methodsTo investigate the role of FHL2 in atherogenesis, FHL2-null and wild-type control male mice were fed either a normal chow (NC) or a cholesterol-enriched diet (CED).Key findingsAt 3 months post CED, aortic atherosclerotic plaques were observed in both control and FHL2-null mice. Lesions in control mice increased dramatically by 6 months of CED. In contrast, lesion size did not increase during this time in CED-fed FHL2-null mice. Relative to control mice on a normal chow of diet (NCD), control mice on a CED exhibited lower circulating nitric oxide (NO) levels, and decreased expression of connexin37 (Cx37) and Cx40 in aortic endothelium. In contrast, FHL2-null mice on a CED maintained similar levels of circulating NO as FHL2-null mice fed a NCD. Cxs levels in aortic endothelium of FHL2-null mutants on a NCD were lower relative to control mice on a NCD, and did not decrease with CED.SignificanceOur data demonstrate a role for FHL2 in atherogenesis, the regulation of circular NO release, and expression of gap junctions within aortic endothelium.     

Synthesis of Three New Carbocyclic Analogues of 3′-Deoxy Purine Ribonucleosides

Abstract

The 1-hydroxymethyl-3-cyclopentene (4) was converted, after epoxidation, to two new exocyclic amino carbocyclic nucleosides (1, 2), and a new cyclopentane nucleoside analogue (3), with potential biological activities. The regioselectivity of the epoxidation (4), which is the key step, is governed by steric control using aryl and silyl hydroxyl protecting groups.     

The impact of local control timing in Ewing sarcoma

AimTo assess the impact of delay in local control on survival outcomes of Ewing sarcoma (ES) patients.BackgroundThe cornerstone of therapy of localized ES includes chemotherapy and local control with surgery or radiotherapy. We sought to assess the impact of delay (>15 weeks) in timing of local control on survival outcomes of ES patients.MethodsData of consecutive patients with primary non-metastatic ES of the extremities, treated at a single institution were collected. The impact of delay of timing for local control, demographics, and disease characteristics on overall survival (OS) was analyzed.ResultsA total of 43 patients with ES of the extremity were included. All patients received neoadjuvant chemotherapy. Local control was by surgery in 36 patients and definitive radiation in 7. A total of 16 patients had delay in local control. At a median follow of up of 48 months, patients with delay in local control had significantly inferior OS compared to those with optimal local control timing (5-year OS 56% vs. 80%, respectively, p = 0.044). Other factors that predicted inferior OS included definitive radiation as opposed to definitive surgery (5-year OS 25% vs. 79%, respectively, p = 0.041) and tumor necrosis <90% as opposed to ≥90% (5-year OS 55% vs. 90%, respectively, p = 0.01).ConclusionDelay in definitive therapy, local control with radiation as opposed to surgery and poor post-chemotherapy tumor necrosis predict inferior OS in ES. Adopting strategies to minimize delay in local control could improve survival outcomes.     

Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). United Kingdom Prospective Diabetes Study Group

ObjectiveTo estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes.DesignIncremental cost effectiveness analysis alongside randomised controlled trial.Setting23 UK hospital clinic based study centres.Participants3867 patients with newly diagnosed type 2 diabetes (mean age 53 years).InterventionsConventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin.ResultsIntensive glucose control increased trial treatment costs by £695 (95% confidence interval £555 to £836) per patient but reduced the cost of complications by £957 (£233 to £1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was £478 (−£275 to £1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was £1166 (costs and effects discounted at 6% a year) and £563 (costs discounted at 6% a year and effects not discounted).ConclusionsIntensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications.     

Analytical strategies for the discovery and validation of quality-markers of traditional Chinese medicine

BackgroundQuality control of traditional Chinese medicine (TCM) is the basis of clinical efficacy. Due to the complexity of TCM, it is difficult to unify the quality control, and hinders the further implementation of the quality standardization of TCM. As a new concept, quality-marker (Q-marker) plays a powerful role in promoting the standardization of quality control system of TCM.Hypothesis/PurposeThe present review aims to provide reference and scientific basis for further development of Q-marker and assist standardization of quality control of TCM.MethodsExtensive search of various documents and electronic databases such as Pubmed, Royal Society of Chemistry, Science Direct, Springer, Web of Science, and Wiley, etc., were used to search scientific contributions. Other online academic libraries, e.g. Google Scholars, Scopus and national pharmacology literature were also been employed to learn more relevant information about Q-marker.ResultsQ-markers play vital role in promoting the standardization of quality control of TCM. The factors that affect the quality of TCM, the advantages and disadvantages of the analytical techniques commonly used in Q-marker research were reviewed, as well as the systematic research strategies, which were verified by practices.ConclusionThe proposal of Q-marker not only provided a new perspective to break through the bottleneck of current quality control, but also can be used in the evaluation of pharmacological efficiency, therapeutic discovery, toxicology, etc. In addition, the Q-marker analysis strategies summarized in this paper is helpful to standardize the quality control of TCM and promote the internationalization of TCM.     

Chaetominine, (+)-alantrypinone,questin, isorhodoptilometrin,and 4-hydroxybenzaldehyde produced by the endophytic fungus Aspergillus sp. YL-6 inhibit wheat (Triticum aestivum) and radish (Raphanus sativus) germination

Five phytotoxic substances with allelopathic activity were isolated from endophytic fungi Aspergillus sp. YL-6 habited in Pleioblastus amarus. The chemical structures of these substances were determined as chaetominine (1), (+)-alantrypinone (2), questin (3), isorhodoptilometrin (4), and 4-hydroxybenzaldehyde (5) by nuclear magnetic resonance and mass spectrometry data. The potential allelopathic effects of compounds 1–5 were evaluated on wheat (Triticum aestivum) and radish (Raphanus sativus). Under lab condition, at concentrations of 10 and 20 ppm, compounds 1–5 inhibit the germination and growth of the two tested seeds completely. An idole-3-acetic acid (IAA) derivative, (+)-alantrypinone (2) displayed the best inhibitory effects on radish seeds among these tested compounds with the similar activity as the positive control glyphosate, a broad-spectrum systemic herbicide. In the further evaluation of compounds 1–5, Questin (3), an anthraquinone derivative, can inhibit shoot and root elongation of wheat, the inhibitory effects assessed were similar to the positive control glyphosate.     

Incidence of malaria among children living near dams in northern Ethiopia: community based incidence survey

ObjectiveTo assess the impact of construction of microdams on the incidence of malaria in nearby communities in terms of possibly increasing peak incidence and prolonging transmission.DesignFour quarterly cycles of malaria incidence surveys, each taking 30 days, undertaken in eight at risk communities close to dams paired with eight control villages at similar altitudes but beyond flight range of mosquitoes.SettingTigray region in northern Ethiopia at altitudes of 1800 to 2225 m.SubjectsAbout 7000 children under 10 years living in villages within 3 km of microdams and in control villages 8-10 km distant.ResultsOverall incidence of malaria for the villages close to dams was 14.0 episodes/1000 child months at risk compared with 1.9 in the control villages—a sevenfold ratio. Incidence was significantly higher in both communities at altitudes below 1900 m.ConclusionsThere is a need for attention to be given to health issues in the implementation of ecological and environmental development programmes, specifically for appropriate malaria control measures to counteract the increased risks near these dams.

Key messages

• Environmental development may have important effects on the epidemiology of vector borne diseases such as malaria
• This may be particularly important where disease transmission is unstable—for example, in highland areas
• Children in villages near recently constructed microdams in northern Ethiopia had a significantly increased risk of malaria
• It seems that this irrigation development programme is leading to increased malaria transmission across a range of altitudes and seasons
• Intersectoral collaboration is necessary in development projects that may affect communities both positively and negatively

     

Inhibition of Real-Time PCR in DNA Extracts from Aquifer Sediment

Variation in inhibition of real-time PCR was investigated with DNA extracts from 50 aquifer sediment core samples of 5 cm length collected through a 2.5 meter vertical profile across a landfill leachate plume. The inhibition was quantified using an internal control of the green fluorescent protein ( gfp ) gene, which was spiked into the real-time PCR reactions. The inhibition was investigated at two gfp gene concentrations: at 1.7 · 10 ⁷ gfp gene copies/g sediment (5.1 · 10 ⁴ gfp gene copies/PCR reaction) and at 1.7 · 10 ⁵ gfp gene copies/g sediment (5.1 · 10 ² gfp gene copies/PCR reaction). Despite the low TOC content of the sediment (average 0.4 mg C/g dw) the average real-time PCR response was partially inhibited, compared to a reference (pure water), at both high and low gfp concentrations. The relative amplification (reference = 1) was 0.85 ± 0.20 (high) and 0.66 ± 0.23 (low), showing significantly (P < 0.05) stronger inhibition at the lower target gene concentration. The inhibition of the real-time PCR did not show a systematic variation in the vertical profile related to plume position but variations were significant on a small scale of 5–15 cm depth intervals. One of the 50 samples failed to produce a signal with either concentration of the gfp internal control and three other samples inhibited real-time PCR at both high and low gfp concentration. These 4 samples, which were the samples with the highest inhibition, were the only DNA extracts with a visible brown colouration, indicating contents of humic-like substances. Elevated absorbance at 400 nm of these samples also indicated that humic-like substances were responsible for inhibition. However, other factors not associated with either absorbance or TOC may have contributed to the inhibition in less inhibited samples since the variation in real-time PCR response could not be sufficiently explained by absorbance or TOC. The results of this study suggest that an internal control is needed in real-time PCR reactions with DNA from environmental samples due to variation in inhibition to correctly quantify the number of target genes, especially at low target gene concentrations, when dilution of DNA extracts is not practical.     

医院内部绩效改革对转变运行机制的影响分析

目的 探讨医院内部绩效考核与分配制度改革对医院内部运行机制的影响。方法 建立实施以工作量为基础,以加强质量控制、强化服务对象满意,重视成本控制,同时兼顾管理效率和持续发展能力的绩效考核体系绩效薪酬分配方案。结果 医院各项运行指标及质量指标同比明显提高。结论 内部绩效改革对医院医疗综合质量及服务能力的提升产生了积极的影响。     

Expression of cold and drought regulatory protein (CcCDR) of pigeonpea imparts enhanced tolerance to major abiotic stresses in transgenic rice plants

Main conclusion

Transgenic rice expressing pigeonpea Cc CDR conferred high-level tolerance to different abiotic stresses. The multiple stress tolerance observed in CcCDR -transgenic lines is attributed to the modulation of ABA-dependent and-independent signalling-pathway genes.

Stable transgenic plants expressing Cajanus cajan cold and drought regulatory protein encoding gene (CcCDR), under the control of CaMV35S and rd29A promoters, have been generated in indica rice. Different transgenic lines of CcCDR, when subjected to drought, salt, and cold stresses, exhibited higher seed germination, seedling survival rates, shoot length, root length, and enhanced plant biomass when compared with the untransformed control plants. Furthermore, transgenic plants disclosed higher leaf chlorophyll content, proline, reducing sugars, SOD, and catalase activities, besides lower levels of MDA. Localization studies revealed that the CcCDR-GFP fusion protein was mainly present in the nucleus of transformed cells of rice. The CcCDR transgenics were found hypersensitive to abscisic acid (ABA) and showed reduced seed germination rates as compared to that of control plants. When the transgenic plants were exposed to drought and salt stresses at vegetative and reproductive stages, they revealed larger panicles and higher number of filled grains compared to the untransformed control plants. Under similar stress conditions, the expression levels of P5CS, bZIP, DREB, OsLEA3, and CIPK genes, involved in ABA-dependent and-independent signal transduction pathways, were found higher in the transgenic plants than the control plants. The overall results amply demonstrate that the transgenic rice expressing CcCDR bestows high-level tolerance to drought, salt, and cold stress conditions. Accordingly, the CcCDR might be deployed as a promising candidate gene for improving the multiple stress tolerance of diverse crop plants.

     

草菇过氧化氢酶基因(VvCAT1)异源表达及耐温度胁迫功能分析

[背景] 过氧化氢酶（catalase,CAT）参与真菌的生长发育,逆境胁迫时保护真菌免受氧化损伤。[目的] 实现草菇过氧化氢酶基因（VvCAT1）的异源表达,分析VvCAT1耐温度胁迫的功能。[方法] 克隆VvCAT1,构建过表达载体pBAR GPE1/VvCAT1,转化到大肠杆菌（Escherichia coli）菌株Stbl3中,异源表达草菇过氧化氢酶。测定温度胁迫后重组菌（pBAR GPE1/VvCAT1/Stbl3）与对照菌（pBAR GPE1/Stbl3）的过氧化氢酶活性和生长情况,验证VvCAT1的功能。[结果] 重组菌的CAT酶活性显著提高,生长情况显著优于对照菌。[结论] VvCAT1的导入及表达显著提高了大肠杆菌Stbl3的耐温度胁迫功能。