Mortality in relation to changes in physical activity in middle-aged to older Chinese:An 8-year follow-up of the Guangzhou Biobank Cohort Study

Background:Physical activity(PA)is generally encouraged.Studies from developed countries in the West have shown that maintenance of adequate PA or increasing PA are associated with lower mortality risk.It is unclear whether these associations apply to an older Chinese population.Hence,we examined the changes in PA prospectively among a middle-aged and older Chinese population over an average of 4 years and explored their subsequent mortality risks.Methods:Metabolic equivalent scores of PA among participants in the Guangzhou Biobank Cohort Study were calculated.Participants were divided into 3 groups related to PA level,and changes in PA were classified into 9 categories.Information on vital status and causes of death from March 2008 to December 2012(the first repeated examination)until December 31,2017,was obtained via record linkage with the Death Registry.Results:Of 18,104 participants aged 61.21±6.85 years(mean±SD),1461 deaths occurred within 141,417 person-years.Compared to participants who maintained moderate PA,those who decreased PA from moderate or high levels to a low level had increased risks for all-cause mortality(hazard ratio(HR)=1.47,95%confidence interval(95%CI):1.11-1.96).Participants who maintained a high level of PA(HR=0.83,95%CI:0.70-0.98)or increased PA from low to high levels(HR=0.71,95%CI:0.52-0.97)showed lower all-cause mortality risks.Those who maintained low PA levels showed a higher all-cause mortality risk,whereas those who increased their PA levels showed a non-significantly lower risk.Similar results were found for cardiovascular disease risk.Conclusion:Even at an older age,maintaining a high PA level or increasing PA from low to high levels results in lower mortality risks,suggesting that substantial health benefits might be achieved by maintaining or increasing engagement in adequate levels of PA.The increased risk of maintaining a low PA level or decreasing PA to a low level warrants the attention of public health officials and clinicians.

Antiplasmodial,cytotoxic activities and characterization of a new naturally occurring quinone methide pentacyclic triterpenoid derivative isolated from Salacia leptoclada Tul.(Celastraceae)originated from Madagascar

Objective:To validate scientifically the traditional use of Salacia leptoclada Tul.(Celastraceae)(S.leptoclada)and to isolate and elucidate the structure of the biologically active compound.Methods:Bioassay-guided fractionation of the acetonic extract of the stem barks of S.leptoclada was carried out by a combination of chromatography technique and biological experiments in viro using Plasmodium falciparum and P388 leukemia cell lines as models.The structure of the biologically active pure compound was elucidated by 1D and 2D NMR spectroscopy and mass spectrometry.Results:Biological screening of S.leptoclada extracts resulted in the isolation of a pentacyclic triterpenic quinone methide.The pure compound exhibited both in vitro a cytotoxic effect on murine P388 leukemia cells with IC_(50)value of(0.041±0.020)μg/mL and an antiplasmodial activity against the chloroquine-resistant strain FC29 of Plasmodium falciparum with an IC_(50)value of(0.052±0.030)μg/mL.Despite this interesting anti-malarial property of the lead compound,the therapeutic index was weak(0.788).In the best of our knowledge,the quinone methide pentacyclic triterpenoid derivative compound is reported for the first time in S.leptoclada.Conclusions:The results suggest that furthers studies involving antineoplastic activity is needed for the development of this lead compound as anticancer drug.

SYNTHESIS AND CHARACTERIZATION OF PHENOTHIAZINE-BASED PPV-TYPE COPOLYMERS CONTAINING FLUORENE AND THIOPHENE MOIETIES

Copolymers of fluorene-co-phenothiazine (P1) and thiophene-co-phenothiazine (P2) were prepared respectively by Wittig reaction. The synthesis, photo-physical and electroluminescent properties of the resulting polymers were analyzed by FT-IR, GPC, 1H-NMR, UV-Vis, Photoluminescence (PL), Electroluminescence (EL) and Cyclic Voltammetry (CV). Their single layer devices with configuration of ITOpolymersCaAl were studied. GPC results revealed the weight-average molecular weight (Mw) was 3.0×103 and 5.4×103, respectively. The device with a single layer structure of ITOP1CaAl emits green light with the maximum peak at 552nm. However, the device with a single layer structure of ITOP2CaAl emit red light with the maximum peak at 616nm.

Evaluation of the anticonvulsant activity of the essential oil of Myrothamnus moschatus in convulsion induced by pentylenetetrazole and picrotoxin

Objective: To evaluate the anticonvulsant effect of the essential oil of Myrothamnus moschatus(M. moschatus) in convulsion induced by pentylenetetrazole and picrotoxin in rodent models.Methods: The essential oil of the aerial parts of M. moschatus was extracted by steam distillation. Thereafter, it was injected subcutaneously to rats and mice at escalating doses(0.1–0.8 m L/kg). Ten minutes after drug injection, pentylenetetrazole was injected intraperitoneally to rats and picrotoxin was administered to mice by the same route.Diazepam served as the positive control. Every single animal was placed into transparent cage and observed for convulsive behavior for 30 min by using ordinary security cameras connected to a video recorder. Death occurring for a period of 24 h was also recorded.Results: The essential oil at 0.8 m L/kg completely arrested the pentylenetetrazole-induced convulsion without any sedative effect and delayed its appearance at lower doses, but showed moderate activities on picrotoxin-induced convulsion. For the rats treated with pentylenetetrazole alone, the mortality was 100% within 1 h, but for the rats pre-treated with the essential oil, the mortality was 0%. For the mice treated with picrotoxin, the mortality rate was also 100%, while 20%–100% died in those that had been pre-treated with the oil.Conclusions: The results confirmed at least partly the traditional uses of the smoke of M. moschatus for the management of convulsion, and implied that the essential oil may inhibit the convulsion by GABAergic neuromodulation.

Effects of aqueous extract of Notobasis syriaca on lipopolysaccharide-induced inflammation in rats

Objective: To investigate the effects of a dry aqueous extract of Notobasis syriaca(N. syriaca)on lipopolysaccharide(LPS)-induced inflammation in rats. Methods: Rats were fed the dried extract [500 mg/(kg·d)] for three consecutive days and then were intraperitoneally injected with LPS(1 mg/kg). Two hours after LPS injection, rats were sacrificed and blood and brain regions were collected. Inflammatory mediators' levels in plasma and homogenates of brain regions were determined by ELISA. Results: Pretreatment with the N. syriaca extract resulted in significant anti-inflammatory effects(P<0.05), including: i) attenuated LPS-induced hypothermia; ii) decreased hypothalamus and hippocampus prostaglandin E_2 levels in the LPStreated rats; and, iii) reduced hypothalamus and hippocampus interleukin-6 and tumor necrosis factor-a levels in the LPS-treated rats. Conclusions: These results suggest that N. syriaca possesses anti-inflammatory properties. Thus, it is possible that long-term consumption of this plant may result in beneficial pharmacological effects.

Analysis of penicillamine using Cu-modified graphene quantum dots synthesized from uric acid as single precursor

A simple methodology was developed to quantify penicillamine(PA) in pharmaceutical samples, using the selective interaction of the drug with Cu-modified graphene quantum dots(Cu-GQDs). The proposed strategy combines the advantages of carbon dots(over other nanoparticles) with the high affinity of PA for the proposed Cu-GQDs, resulting in a significant and selective quenching effect. Under the optimum conditions for the interaction, a linear response(in the 0.10–7.50 μmol/L PA concentration range) was observed. The highly fluorescent GQDs used were synthesized using uric acid as single precursor and then characterized by high resolution transmission electron microscopy, Raman spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy, fluorescence, and absorption spectroscopy. The proposed methodology could also be extended to other compounds, further expanding the applicability of GQDs.

Proximal point algorithm for a new class of fuzzy set-valued variational inclusions with (H,η)-monotone mappings

We introduced a new class of fuzzy set-valued variational inclusions with (H,η)-monotone mappings. Using the resolvent operator method in Hilbert spaces, we suggested a new proximal point algorithm for finding approximate solutions, which strongly converge to the exact solution of a fuzzy set-valued variational inclusion with (H,η)-monotone. The results improved and generalized the general quasi-variational inclusions with fuzzy set-valued mappings proposed by Jin and Tian Jin MM, Perturbed proximal point algorithm for general quasi-variational inclusions with fuzzy set-valued mappings, OR Transactions, 2005, 9(3): 31-38, (In Chinese); Tian YX, Generalized nonlinear implicit quasi-variational inclusions with fuzzy mappings, Computers & Mathematics with Applications, 2001, 42: 101-108.

Isolation and structural elucidation of cytotoxic compounds from the root bark of Diospyros quercina (Baill.) endemic to Madagascar

Objective:To isolate and characterize the cytotoxic compounds from Diospyros quercina(Baill.)G.E.Schatz&Lowry(Ebenaceae).Methods:An ethno-botanical survey was conducted in the south of Madagascar from July to August 2010.Bio-guided fractionation assay was carried out on the root bark of Diospyros quercina,using cytotoxicity bioassay on murine P388 leukemia cell lines as model.The structures of the cytotoxic compounds were elucidated by 1D and 2D NMR spectroscopy and mass spectrometry.Results:Biological experiments resulted in the isolation of three bioactive pure compounds(named TR-21,TR-22,and TR-23)which exhibited very good in vitro cytotoxic activities with the IC_(50)values of(0.017 5±0.0060)μg/mL,(0.089±0.005)μg/mL and(1.027±0.070)μg/mL respectively.Thus,they support the claims of traditional healers and suggest the possible correlation between the chemical composition of this plant and its wide use in Malagasy folk medicine to treat cancer.Conclusions:The ability of isolated compounds in this study to inhibit cell growth may represent a rational explanation for the use of Diospyros quercina root bark in treating cancer by Malagasy traditional healers.Further studies are,therefore,necessary to evaluate the in vivo antineoplastic activity of these cytotoxic compounds as effective anticancer drugs.

Diagnosis and treatment of subsegmental pulmonary embolism

Subsegmental pulmonary embolism(SSPE) affects the 4 th division and more distal pulmonary arterial branches. SSPE can be isolated or affect multiple subsegments, be symptomatic or incidental(unsuspected) and may or may not be associated with deep vein thrombosis. Symptoms, clinical risk scores and biomarkers are less sensitive for diagnosing SSPE compared to more central pulmonary embolism. The diagnosis is confirmed using radiological imaging,predominately computed tomographic pulmonary angiogram(CTPA) or ventilation/perfusion scanning. The increasing utilization of CTPAs may have resulted in overdiagnosis driven by smaller pulmonary emboli. There is insufficient evidence of improved mortality or reduced venous thromboembolism recurrence with anticoagulation treatment for SSPE however,the major and clinically significant haemorrhage risks are well described. As the resolution of diagnostic imaging has improved, we may be viewing the natural physiological filtering process performed by the lungs that may not require treatment.

Managing panniculitis in alpha-1 antitrypsin deficiency: Systematic review of evidence behind treatment

AIM To systematically review literature for management of alpha-1 antitrypsin deficiency(AATD) panniculitis. METHODS Multiple databases were searched using combinations of pertinent terms. Articles were selected describing panniculitis treatment in patients with AAT < 11 μmol and/or PiZZ genotype, with no language limitation. All relevant articles were accessed in full text. Independent review of abstracts and full manuscripts was conducted by 2 reviewers, and quality assessment by one reviewer(checked by a second). Data extraction was conducted byone reviewer(checked by a second). Narrative synthesis only was conducted, as data were unsuitable for metaanalysis.RESULTS Thirty-two case reports and 4 case series were found. Augmentation therapy(infusions of plasma-derived AAT) was the most successful, with complete resolution of symptoms in all patients. Dapsone is a less expensive option, and it achieved clinical resolution in 62% of patients, but it is very poorly tolerated. Among other single-agent antibiotics, doxycycline was the most successful with complete clinical resolution seen in 33% of patients. Immunosuppressants were largely unsuccessful; 80% of patients exhibited no response. Liver transplantation and therapeutic plasma exchange displayed complete resolution in 66% of patients. Other strategies, such as non-steroidal anti-inflammatory drugs or antibiotics other than dapsone did not show sufficient response rates to recommend their use. Authors note the risk of bias imposed by the type of evidence(case reports, case series) available in this field.CONCLUSION Dapsone is the recommended first line therapy for AATD panniculitis, followed by augmentation therapy. Plasma exchange may be an alternative in the setting of rapidly progressive disease.

Understanding Health Care Professional-Patient Interactions in Multiple Sclerosis: A Systematic Review and Thematic Synthesis

Aim: To examine the experiences of health care professional (HCP)-patient interactions in Multiple Sclerosis (MS), identifying factors that can influence these interactions. Methods: A three-stage systematic review and thematic synthesis of qualitative and quantitative research was undertaken. Stage 1: the systematic literature search;Stage 2: methodological appraisal of the qualitative papers;Stage 3: thematic synthesis of all qualitative papers and the integration of quantitative findings into the synthesis. Results: Forty-nine qualitative studies were identified. This included 1014 individuals with MS (244 male, 755 female and 15 unknown) and 106 carers and 86 HCPs. Seventeen quantitative studies were identified which included 7680 (2008 male, 5812 females, and 40 unknown) participants as well as 224 carers. Two themes are discussed: 1) The expectations, experiences and perceptions of interactions with HCPs, and 2) The factors that influenced interactions and relationships. Discussion: There is need for improvement in the content and provision of information to patients with MS from HCPs. Specific strategies are suggested and implications for patients and health care providers are considered.

SOME INTERESTING REACTIONS OF AN N-BROMOMETHYL QUATERNARY AMMONIUM SALT WITH HALOPHILIC REAGENTS

N-Bromomethyl-N-methyl- 1,2, 3,4-tetrahydro-iso-quinolinium bromide(1)reacted with sodium 2, 6-di-tert-butylphenoxide to afford compound 2a. 3a. 4 and 5 via the benzylic N-ylide intermediate. Meanwhile, when compound 1 reacted with tri-n-butylphosphine the coupling compound 7 was obtained via demethylation reaction. The reaction mechanisms were discussed.

Autonomous landing scene recognition based on transfer learning for drones

In this paper, we study autonomous landing scene recognition with knowledge transfer for drones. Considering the difficulties in aerial remote sensing, especially that some scenes are extremely similar, or the same scene has different representations in different altitudes, we employ a deep convolutional neural network(CNN) based on knowledge transfer and fine-tuning to solve the problem. Then, LandingScenes-7 dataset is established and divided into seven classes. Moreover, there is still a novelty detection problem in the classifier, and we address this by excluding other landing scenes using the approach of thresholding in the prediction stage. We employ the transfer learning method based on ResNeXt-50 backbone with the adaptive momentum(ADAM) optimization algorithm. We also compare ResNet-50 backbone and the momentum stochastic gradient descent(SGD) optimizer. Experiment results show that ResNeXt-50 based on the ADAM optimization algorithm has better performance. With a pre-trained model and fine-tuning, it can achieve 97.845 0% top-1 accuracy on the LandingScenes-7dataset, paving the way for drones to autonomously learn landing scenes.

Scene image recognition with knowledge transfer for drone navigation

In this paper,we study scene image recognition with knowledge transfer for drone navigation.We divide navigation scenes into three macro-classes,namely outdoor special scenes(OSSs),the space from indoors to outdoors or from outdoors to indoors transitional scenes(TSs),and others.However,there are difficulties in how to recognize the TSs,to this end,we employ deep convolutional neural network(CNN)based on knowledge transfer,techniques for image augmentation,and fine tuning to solve the issue.Moreover,there is still a novelty detection prob-lem in the classifier,and we use global navigation satellite sys-tems(GNSS)to solve it in the prediction stage.Experiment results show our method,with a pre-trained model and fine tun-ing,can achieve 91.3196%top-1 accuracy on Scenes21 dataset,paving the way for drones to learn to understand the scenes around them autonomously.

应用名义小组技术构建基于初级保健服务需求的2型糖尿病患者健康教育框架

背景我国大部分指南的健康教育建议忽视初级保健特征及需求,基层门诊2型糖尿病(T2DM)健康教育存在随意、盲目等诸多问题。目的应用名义小组技术(NGT)构建基于初级保健服务需求的T2DM患者健康教育框架,并进行内涵拓展。方法于2020年9—10月,采用目的性抽样的方法,邀请国内具有不同医学背景的健康专业人员23例,分为3个小组开展NGT会议。对会议内容汇总、转录,产生定性与定量两部分数据,并行分析。通过定性数据对各组产生的关键词进行合并相似词等处理,以获得重编码关键词(NC)列表,同时对关键词进行内涵拓展和主题分析;定量数据确定关键词的组内和整体排序,并根据整体排序赋值的四分位数确定等级框架。结果群体决策产生符合我国初级保健服务需求的T2DM健康教育关键词28个。通过归纳主题及根据定性数据进行内涵拓展,28个关键词可归类为5个领域主题,分别为糖尿病相关知识、自我管理、社区管理、多病共病管理、治疗和用药。按照两轮排序、分层,最终确定具有4个等级的T2DM患者健康教育内容框架,其中A等级包括排名最高的4个关键词,平均综合得分之和占整体的45.69%。结论本研究应用NGT构建基于初级保健需求的T2DM健康教育指导性框架,以循证方式确定具备优先度的4层等级和内容。同时,初级保健属于复杂的群体决策环境,基于NGT的结果有助于指南与临床实践达成更高一致性。

Si基多孔SiO_2薄膜的驻极体性能

通过控制制备工艺条件和充电参数，利用相应条件下样品的等温表面电位衰减，开路热刺激放电电流谱等，考察了利用溶胶－凝胶（ｓｏｌ－ｇｅｌ）方法制备的Ｓｉ基多孔ＳｉＯ２薄膜的驻极体性能，分析了各种工艺参数与薄膜驻极体性质之间的联系，同时利用Ｇａｕｓｓ拟合及初始上升法对薄膜驻极体的电有陷阱深度进行了估算．实验结果表明，反应物中水的含量对薄膜驻极体的陷阱分布具有调节作用；估算出负电晕充电ＳｉＯ２薄膜驻极体电荷的活化能为０．３ｅＶ和１．０ｅＶ；环境湿度对电荷储存稳定性有一定的影响，降低栅压可以提高ＳｉＯ２薄膜驻极体的电荷储存稳定性．

定性研究方法在我国全科医学研究中的应用

背景定性研究方法已广泛应用于医学研究中,掌握该研究方法有助于全科医生更好地开展医学研究。目的本文对定性研究方法在中国全科医学中的应用进行归纳总结,并剖析其中存在的问题,提出改进建议,帮助全科医生更好地使用该方法进行研究。方法于2019年7月—2020年2月,以中国知网、万方数据知识服务平台、维普中文科技期刊数据库等中文数据库为数据来源,以"定性研究""质性研究""质的研究""访谈""全科医学""全科医生""家庭医生""基层及社区"为主题词和关键词检索相关中文文献,检索时间为2009—2019年。采用Excel录入数据,对纳入文献的发文时间、期刊、题名、研究方法等信息进行描述性统计分析。结果最终纳入100篇全科领域定性研究文献,2014年发文量最多,为18篇(18.0%);硕士学位论文5篇(5.0%),期刊论文95篇(95.0%),95篇期刊论文分布于38种期刊,发文量最多的期刊为《中国全科医学》,为28篇(29.2%);研究内容多有关教育培训,占52.0%(52/100);研究方法采用最多的是访谈法,占53.0%(53/100);56.0%(56/100)的研究未阐明抽样方法。定性研究在我国全科医学中的应用主要存在以下问题:对于该方法的英文单词没有统一的中文翻译;文章题目或者关键词中缺少"定性研究"等字眼;以发现临床问题为目的的定性研究较少;实践方法不够科学。结论定性研究方法在我国全科医学领域中的应用日益广泛,该方法多用于教育培训方面的研究,其中使用最多的方法为访谈法。定性研究方法在全科医学中的应用存在若干问题,使用方法有待规范。

P(VDF/CTFE)共聚物薄膜的驻极体行为

通过不同条件下的正负电晕充电,等温表面电位衰减测量,热刺激放电(TSD)电流谱分析和热脉冲技术,首次研究了偏氟乙烯(VDF)和三氟氯乙烯(CTFE)共聚物P(VDF/CTFE)的驻极体性质,结果指出:共聚物驻极体的空间电荷热稳定性明显优于PVDF;TSD谱分析说明这种材料驻极体也是极性驻极体,即体内同时包含有偶极和空间电荷。本文还对样品的正负电晕充电后的电荷储存稳定性做了对比;研究了材料的能阱分布,确定了样品在不同温度电晕充电时平均电荷重心的迁移规律。

全科医学师资对全科医学继续教育现状看法的定性研究

背景开展全科医学继续教育(简称全科继教)是加快全科医生队伍建设的重要途径,而全科医学师资是全科继教不可或缺的参与方。了解全科医学师资对全科继教现状的看法有助于发现当前我国全科继教存在的主要问题,并可为现存问题的解决提供一个新视角。目的从全科医学师资角度出发,了解我国全科继教现状及全科医学师资对现状的看法,探索全科继教师资的内涵,旨在为改善和提高全科继教的质量提供借鉴。方法2020年11月至2021年2月,采用滚雪球式抽样、目的性抽样法选取符合全科医学师资标准且具有丰富全科继教培训经验的全科医学师资作为研究对象,通过线上视频对其进行一对一的半结构化深度访谈。应用NVivo 12软件对访谈内容进行编码、归类;采用主题框架分析法对资料进行整理、分析,并提炼访谈主题。结果共纳入10例全科医学师资,其中,男6例,女4例;年龄29~49岁,平均年龄(38.7±5.8)岁;8例学历为硕士研究生及以上;9例在三级医疗机构从事全科医疗工作;从事全科继教培训工作的年限为4~12年,平均年限(7.8±2.8)年。通过对访谈资料进行分析,提炼出5个主题:全科医生方因素影响全科继教培训效果;全科继教师资队伍建设和管理存在不足;教学理论对于全科继教教学较为重要,但全科医学师资培训中缺少相关内容;立足基层需求、改进教学方式,以提升全科继教培训效果;全科继教培训受外部因素的影响。结论我国全科继教面临师资管理水平较低、培训质量参差不齐等诸多困难和挑战。明确全科继教师资内涵,并完善全科继教师资培训体系和考核标准,对于探索有效的全科继教培训模式和提升全科继教质量具有重要意义。

社区医疗机构向个人开放电子健康档案的意义与挑战

电子健康档案是社区卫生发展的重要信息化手段之一。2018-06-20,国家卫生健康委员会(原国家卫生和计划生育委员会)相关文件要求社区应逐步推行电子健康档案向个人开放。为探索其可能的影响和意义,本文回顾国内外社区电子健康档案的历史与发展情况,了解关于推行电子健康档案向个人开放的相关研究,发现当前我国电子健康档案利用率低、维护率低,尚未发挥应有的价值。推行电子档案向个人开放,其未来发展的方向包括健康提醒、医患沟通、自我管理等,意义在于改善医疗结局、以患者为中心、提升患者满意度等,但推行电子档案向个人开放仍然需要解决诸多问题,如国家政策支持、技术和资金支持、人员配备及信息安全隐患等。