The effect of neutrophil/lymphocyte ratio on the early-stage condition judgment and prognosis of intracercbral hemorrhage / 中国医师进修杂志

Objective:To investigate the relationship of neutrophil/lymphocyte ratio (NLR) and early hematoma enlargement (HE) of intracerebral hemorrhage (ICH).Methods:Retrospectively analyzed the clinical data of 360 patients with ICH who were diagnosed and admitted to the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2017.Among them, 198 patients were selected for this study. According to the 24 h checked CT, they were divided into the hematoma expansion (HE) group (87 patients) and the non-HE group (111 patients). The clinical data of the two groups and the changes of hematology and imaging were compared.Results:Univariate analysis showed statistically significant differences of two groups in systolic blood pressure, diastolic blood pressure, Glasgow coma scale (GCS) score, hematoma volume at admission: (180.45 ± 25.90) mmHg(1 mmHg = 0.133 kpa) vs. (171.81 ± 25.87) mmHg, (103.29 ± 14.26) mmHg vs. (97.98 ± 14.81) mmHg, (11.05 ± 2.02) scores vs. (13.04 ± 1.58) scores, (25.14 ± 14.88) ml vs. (13.57 ± 11.98) ml; and GCS score, NLR , hematoma volume at 24 h after admission: (7.54 ± 2.04) scores vs. (11.04 ± 2.12) scores, 12.79 ± 7.24 vs. 5.59 ± 3.59, (17.07 ± 8.95) ml vs. (7.97 ± 3.56) ml, there were significant differences ( P<0.05). Logistic regression analysis showed that NLR, GCS, hematoma volumeat 24 h after admission and number of island sign were independent correlated factors of HE ( P<0.05). Receiver operation characteristic(ROC) curve analysis showed that when the NLR at 24 h after admission cut off value was 7.65, the sensitivity of predicting HE in patients with ICH was 78.16%, the specificity was 81.98%, and the area under the ROC curve was 0.852 (95% CI 0.798-0.907, P<0.001). Conclusions:HE have association with NLR, hematoma volume change.

Awareness of ionizing radiation safety and protection knowledge among clinical healthcare professionals / 中国辐射卫生

@#<b>Objective</b> To investigate the awareness of ionizing radiation safety and protection knowledge among clinical healthcare professionals. <b>Methods</b> A cross-sectional study was performed among 270 nurses using a self-designed questionnaire. The questionnaire included participants’ socio-demographic features, and knowledge of radiation physics and biology, principle of radiation use, radiation protection, and guideline for safe use of ionizing radiation. The questionnaire results were analyzed using the descriptive epidemiological method. <b>Results</b> A total of 270 questionnaires were assigned, and 252 valid questionnaires were recovered, with an effective response rate of 93.33%. Among the 252 respondents, 99.21% were female, 80.16% at the age of 25 to < 55, 31.35% with work seniority of 20 years and longer, 66.67% with an education level of bachelor degree, and 75.00% with a history of receiving medical radiation knowledge training and education. The awareness rates of the following problems were all more than 90%: “knowing the protocols concerning radiation workers who are pregnant”, “trying best to promote agreed safety protocols concerning radiation dose and radiation usage in my daily work and actions”, “being aware of the radiation safety arrangements at my work”, “understanding the meaning of radiation safety culture”, “understanding the warning signs concerning radiation while working in the control area”, “knowing the meaning of warning signs regarding radiation safety”, “knowing how to report abnormal events in radiation use”, “knowing how to properly use personal radiation protection equipment”, “understanding the principle of dose limitation in radiation protection”, “knowing how ionizing radiation is produced”, “know how the harmful effects of medical radiation are caused”, and “knowing how to document all the essential information concerning the use of radiation”; however, the awareness rates of “knowing how to account for differences between adult and child/adolescent patients in radiological examinations” and “understanding the meaning of the inverse square law in radiation protection” were very low. <b>Conclusion</b> The overall awareness of ionizing radiation safety and protection knowledge remains unsatisfactory among clinical healthcare professionals. The training on ionizing radiation safety and protection knowledge requires to be improved, and the radiation protection skills are recommended to be increased.

Development and validation of a preoperative model in differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To develop and validate a preoperative prediction model based on laboratory parameters in differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC).Methods:Data from 833 patients with primary liver cancers treated at the First Affiliated Hospital of Nanjing Medical University between January 2016 and May 2020 were retrospectively analyzed. There were 652 males and 181 females, aged (59.0±11.1) years, with 649 patients diagnosed to have HCC and 184 patients ICC. Based on the different admission time, they were divided into a development cohort ( n=577) and a validation cohort ( n=256). Logistic regression analysis was used to identify independent differential factors which were then included in the nomogram. The discrimination and calibration ability of the nomogram were evaluated by using concordance indexes (C-index) and calibration curves. Results:Female ( OR=4.989, 95% CI: 2.547-9.772), hepatitis B surface antigen positivity ( OR=0.144, 95% CI: 0.074-0.279), α-fetoprotein (21-399 ng/ml, OR=0.142, 95% CI: 0.072-0.283; ≥400 ng/ml, OR=0.023, 95% CI: 0.006-0.095), carcinoembryonic antigen (>4.7 ng/ml, OR=2.667, 95% CI: 1.352-5.261) and carbohydrate antigen 199 >39 ng/ml ( OR=11.019, 95% CI: 5.739-21.159) were independent differential factors for ICC. A nomogram was established by incorporating these 5 factors. The C-indexes were 0.942 (95% CI: 0.919-0.965) and 0.949 (95% CI: 0.914-0.985) in the development and validation cohorts, respectively. Calibration curves showed good agreement between the predicted risk by the nomogram and real outcomes. Conclusion:In this study, a preoperative nomogram for differential diagnosis between ICC and HCC was established. The model could aid clinicians in clinical treatment decision making.

Correlation between changes of brain microbleed and worsening of chronic kidney disease in patients with lacunar infarction / 中国医师进修杂志

Objective To investigate the correlation between the progression of cerebral microbleed (CMB) and their distribution patterns in patients with lacunar infarction (LI) and the worsening of chronic kidney disease (CKD).Methods A prospective cohort study was used.Two hundred and fourteen patients with LI from June 2014 to June 2016 in Siyang People's Hospital of Jiangsu Province were consecutively selected.The clinical,laboratory and imaging-related data of patients were recorded in detail.The chronic kidney disease epidemiology collaboration (CKD-EPI) formula was used to estimate the estimation glomerular filtration rate (eGFR).After admission and 1-year'follow-up,head MRI (including gradient echo sequences) was performed,and the CMB distribution pattern was evaluated using the microbleed anatomical rating scale (MARS).Results Among the 214 patients with LI,90 patients were in CMB-positive group,of which simple lobe of brain CMB was in 16 cases,and deep/subtentorial CMB was in 74 cases,and 124 patients were in CMB-negative group.The baseline eGFR and eGFR classifications in CMB-negative group were significantly better than those in CMB-positive group,and there were statistical differences (P＜0.01 or ＜0.05).After 1 year'follow-up,worsening of CMB was in 45 cases,and worsening of CKD was in 22 cases.Multivariate Logistic regression analysis result showed that age and stroke history were independent risk factors for worsening of CMB in LI patients with simple lobe of brain CMB (OR =1.14 and 2.91,95％ CI 1.06 to 1.23 and 1.14 to 7.42,P＜0.01 or ＜0.05),and baseline eGFR and worsening of CKD were independent risk factors for worsening of CMB in LI patients with deep/subtentorial CMB (OR =0.90 and 4.11,95％ CI 0.87 to 0.94 and 1.04 to 16.21,P＜0.01 or ＜0.05).Conclusions Renal function in LI patients with CMB negative is significantly better than that in LI patients with CMB positive.In LI patients with deep/subtentorial CMB,the worsening of CMB is associated with worsening of CKD;in LI patients with simple lobe of brain CMB,the worsening of CMB is not associated with worsening of CKD.

Occupational exposure investigation and protective measures in a tertiary infectious disease hospital / 中华劳动卫生职业病杂志

Objective@#To investigate the cause of occupational exposure among 136 nurses in a tertiary infectious disease hospital, and puts forward the prevention strategy.@*Methods@#A total of 136 nurses exposed to occupational exposure between 2014 and 2016 were included in the study. Analysis was conducted from the years of work of nurses, exposure routes, and the pathogens.@*Results@#The nurses suffer from the highest risk of occupational exposures (73.91%) .Nurses working for less than 5 years and interns are most likely to suffer occupational exposure (45.59% and 35.29% respectively) . Occupational exposure was mainly caused by needle injuries, in which infusion was the main route of occupational exposure (36.76%) . The improper treatment of needle pulling after infusion is the main link of needle puncture (36.76%) . Occupational exposure pathogens were mainly HBV (63.24%) .@*Conclusion@#Nursing staff is the high-risk group of occupational exposure. Irregular operation, lack of awareness of protection, improper disposal after the needle withdrawal and poor safety assessment of the operating environment are the main causes of occupational exposure. It is suggested to strengthen the training of occupational safety and protection, enhance clinical nurses occupational safety protection consciousness, standardize medical operation, so as to prevent the occurrence of occupational exposure.

Selection and identification of aptamers for mesenchymal stem cells from different species / 军事医学

Objective To screen an ssDNA aptamer for rabbit mesenchymal stem cells (MSCs) and to identify the ability of the aptamer to recognize MSCs of a variety of species origin.Methods MSCs were isolated from the thigh bone of immature rabbits and identified by induced osteogenic and adipogenic differentiation,respectively.Aptamers were screened by cell SELEX (systematic evolution of ligands by exponential enrichment) technique targeting to isolated MSCs.Enrichment of the 5th pool was evaluated through binding assay of FAM modified pool to MSCs by confocal microscopy.The enriched 5th pool was then cloned into pGE-T vector and the cloned sequences were determined randomly.The candidates were chosen based on primary sequence conservation and predicted secondary structure by RNA structure and MEME online analysis.Flow cytometry analysis was used to identify the aptamers binding to MSCs of rabbit, rat, and human origin.Results The isolated MSCs had the potential of osteogenic differentiation and adipogenic differentiation under certain conditions.Aptamer 5-1-12 from 5th enriched pool was characterized as MSCs recognizing aptamer binding to MSCs of rabbit, rat and human origin.Conclusion Aptamer 5-1-12 that recognizes MSCs of different species origin is obtained through live cell-SELEX.

Calreticulin-mediated upregulation of anti-apoptotic Bcl-XL and Mcl-1 promotes survival of fibroblast-like synoviocytes in rheumatoid arthritis / 中华风湿病学杂志

Objective Fibroblast-like synoviocytes (FLS) play important roles in the pathogenesis of rheumatoid arthritis (RA).The present study was undertaken to investigate the mechanism of calreticulin (CRT) to promote FLS survival in RA.Methods FLS were isolated by enzymatic digestion of synovial tissue specimens obtained from RA and osteoarthritis (OA) patients and cultured in vitro.The expression of Bcl-XL and Mcl-1 in FLS at mRNA and protein level was detected by quantitative-polymerase chain reaction (q-PCR),Western blotting and immunofluorescence respectively.RA and OA FLS were cultured with different concentrations of recombinant human CRT for 48-72 h,the expression of Bcl-XL and Mcl-1 was detected by q-PCR and Western blotting.The proliferation of RA FLS following CRT stimulation was determined by MTT assay.Results ① Compared with FLS from OA patients (1.00±0.39;1.00±0.46),the anti-apoptotic Bcl-XL and Mcl-l mRNA expression (14.51 ±2.20;12.82±1.80) was significantly higher in the FLS from RA patients (t=10.47,1 1.02;P＜0.01);Western blotting analysis also showed increased protein levels of Bcl-XL and Mcl-1 in RA FLS;Immunofluorescence results showed higher expression of Bcl-XL and Mcl-1 in RA at the single FLS level;② CRT up-regulated the expression of Bcl-XL and Mcl-1 in RA FLS:compared with the control group (0 ng/ml),CRT stimulation at 10 ng/ml and 50 ng/ml increased the levels of Bcl-XL mRNA (1.70±0.28 vs 1.00±0.20,q=4.58,P＜0.05;1.87±0.35 vs 1.00±0.20,q=5.69,P＜O.05) and Mcl-1 mRNA (1.85±0.36 vs 1.00±0.20,q=5.63,P＜0.05;1.72±0.26 vs 1.00±0.20,q=4.77,P＜0.05) in RA FLS,while no significant effects of CRT on Bcl-XL and Mcl-1 mRNA expression were observed in OA FLS (F=1.49,1.60;P＞0.05);Western blotting results showed elevated protein levels of both Bcl-XL and Mcl-1 in RA FLS after CRT treatment at a concentration dependent manner.However,neither Bcl-XL nor Mcl-1 expression was significantly changed in OA FLS.③ MTT assay showed that CRT had no significant effect on the proliferation of RA FLS (F=2.88,P＞ 0.05).Conclusion Our results indicate that CRT-mediated up-regulation of anti-apoptotic Bcl-XL and Mcl-1 may inhibit apoptosis and promote the survival of FLS from RA patients.

The expression of P16,Ki-67 in cervical squamous epithelial lesions and the significance of their detection combined with HPV / 国际检验医学杂志

Objective To study the expression of P16 ,Ki‐67 in cervical squamous epithelial lesions and the significance of their detection combined with human papillomavirus(HPV) .Methods 188 cases of cervical tissues from surgical excision were collected , including 48 cases of cervical cancer ,100 cases of cervical intraepithelial neoplasia(CIN) ,and 40 cases of chronic cervicitis ,which were set as cervical cancer group ,CIN group and cervicitis group ,respectively .Expression of P16 ,Ki‐67 in cervical tissue were de‐tected by using immunohistochemistry ,and the HPV infection were detected by using PCR technology .Results The positive ex‐pression rates of P16 and Ki‐67 in cervical cancer ,CIN group was significantly higher than those in cervicitis group(P0 .05) .With the increase of CIN level ,the positive expression rates of P16 and Ki‐67 increased ,among the three CIN groups there were significant difference(P<0 .05) .In cervical cancer group and CINⅢ group ,the expression rates of P16 and Ki‐67 were both significantly high‐er than the other 3 groups(P<0 .05) .In CINⅠ - Ⅲ groups ,the over expression rates of P16 and Ki‐67 were statistically different (P<0 .05) .The expression of P16 positively correlated with the positive rates of HPV infection (rs =0 .706 ,P=0 .011);the ex‐pression of Ki‐67 positively correlated with the positive rates of HPV infection(rs=0 .695 ,P=0 .021) .Conclusion CIN and cervi‐cal cancer of early stage could be diagnosed and the pathological progress of CIN could be predicted by using the combined detection of P16 ,Ki‐67 and HPV .

Increased expression of calreticulin promotes angiogenesis involved in the pathogenesis of rheumatoid arthritis / 天津医药

Objective Calreticulin (CRT)is a multifunctional protein of endoplasmic reticulum implicated in the pathogenesis of rheumatoid arthritis(RA). The present study was undertaken to determine whether CRT was involved in an?giogenesis events in RA. Methods Serum CRT levels were measured by enzyme-linked immnuosorbent assay(ELISA)in 106 patients with established RA, 75 osteoarthritis(OA)and 80 healthy controls(HC). CRT levels in synovial fluid were al?so measured in 25 RA and 22 OA patients. The expression of CRT in synovial tissue was examined by immunohistology. In order to investigate the role of CRT on angiogenesis, human umbilical vein endothelial cells(HUVECs)were isolated and cultured for in vitro experiments. The proliferation, migration and tube formation of HUVECs following CRT stimulation were examined in vitro by MTT assay, scratch wound healing assay and tube formation assay. Results Our results showed a sig?nificantly higher concentration of CRT in serum [(6.4±3.1) μg/L] of RA patients compared to that of OA [(3.7±0.9) μg/L, P<0.01] and HC [(3.4±1.0) μg/L, P<0.01];and significantly higher CRT in synovial fluid [(6.9±3.4) μg/L] of RA vs OA [(3.9± 0.7) μg/L, P<0.01]. Increased CRT expression predominantly localized to vascular endothelial cells, inflammatory cells and perivascular areas in both the lining and sublining layers of RA synovial tissue. Furthermore, CRT significantly promoted the proliferation, migration and tube formation of HUVECs, as showed by MTT assay, scratch wound healing assay and tube for?mation assay. Conclusion These findings suggested that CRT may be involved in synovitis and pannus formation events via promoting angiogenesis in RA.

Selection and identification of ssDNA aptamers specific to clinical isolates of Streptococcus mutans strains with different cariogenicity / 南方医科大学学报

<p><b>OBJECTIVE</b>To select and identify ssDNA aptamers specific to Streptococcus mutans strains with different cariogenicity isolated from clinical specimens.</p><p><b>METHODS</b>Subtractive SELEX technology targeting the whole intact cells was used to screen for ssDNA aptamers specific to the clinical isolates Streptococcus mutans strains with different cariogenicity. Radioactive isotope, flow cytometry, gene cloning and sequencing, MEME online software and RNA structure analysis software were employed to analyze the first and secondary structures of the aptamers and identify the screened aptamers.</p><p><b>RESULTS</b>Detection by radioactive isotope showed sufficient pool enrichment after 9 rounds of subtractive SELEX. Flow cytometry showed that the selected aptamers H1, H16, H4, L1, L10 and H19 were capable of binding specifically with highly cariogenic Streptococcus mutans strains but not with strains with a low cariogenicity. The aptamer H19 had the strongest binding capacity to highly cariogenic Streptococcus mutans strains, with a dissociation constant of 69.45∓38.53 nmol/L.</p><p><b>CONCLUSION</b>We have obtained the ssDNA aptamers specific to the clinical isolates of highly cariogenic Streptococcus mutans strains.</p>

Preliminary screen of high cariogenicity Streptococcus mutans strains isolated from clinical specimens / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To screen of high cariogenicity Streptococcus mutans (S. mutans) strains isolated from clinical specimens preliminary.</p><p><b>METHODS</b>Acidogenicity, aciduricity, extracellular polysaccharide production and adhesion of 41 strains of S. mutans isolated from clinical specimens were investigated to screen high cariogenicity S. mutans strains.</p><p><b>RESULTS</b>There were different cariogenicity among 41 strains of S. mutans, in which 3 strains of S. mutans had all high ability to produce extracellular polysaccharide, adhere to the saliva-coated hydroxyapatite, produce acid and tolerate acid, indicated there were 3 strains with high cariogenicity S. mutans strains isolated from clinical specimens. Another 3 strains of S. mutans with all low ability to produce extracellular polysaccharide, adhere to the saliva-coated hydroxyapatite, produce acid and tolerate acid indicated they were low cariogenicity S. mutans strains isolated from clinical specimens.</p><p><b>CONCLUSION</b>We may have obtained high cariogenicity S. mutans strains isolated from clinical specimens.</p>

The expression of cylindromatosis in oxygen and glucose deprivation and reperfusion induced primary cortical neuron necroptosis / 中华行为医学与脑科学杂志

Objective To investigate the location of CYLD in the neurons and explore the expression of CYLD in OGD/reperfusion-induced neuronal necroptosis.Methods Primary cortical neurons were cultured for 6days and neuronal purity was observed by double staining immunofluorescence of β3-tubulin and DAPI.The location of CYLD was identified by double staining immunofluorescence of NeuN,DAPI and CYLD using primary cortical neurons cultured for 14 days.Then,primary cortical neurons were divided into 8 groups:Control,EBSS,DMSO,OGD/reperfusion(0 h,2 h,6 h,8 h,12 h).Neurons were pretreated with zVAD-fmk for 30 min,OGD for 2 h and the levels of CYLD were evaluated after reoxygenation at different time points.The peak value(8 h) was chosen as reoxygenation time point.Neurons were divided into two groups as Control and OGD.The levels of CYLD were determined in both cytoplasm and nucleus after OGD 2 h and reoxygenation 8 h.Results The double staining immunofluorescence showed that neuronal cultured purity was about 70％ and the CYLD strongly expressed in nucleus but weakly in cytoplasm.The levels of CYLD increased gradually with different reoxygenation time and arrived at peak value after reoxygenation for 8 h (P ＜ 0.05),which was in accordance with the change of LDH (P ＜0.05) (Control (1.00±0.00),EBSS (1.07 ±0.03),DMSO (1.09 ±0.03),0h (1.40±0.12),2 h (1.74±0.08),6 h (2.25 ± 0.12),8 h (2.97 ± 0.15),12 h (3.01 ± 0.08)).The level of cytoplasm CYLD increased significantly in the OGD group (reoxygenation for 8 h)than that in control group (P＜0.05).But the level of nucleus CYLD had no difference between OGD and control group (P ＞ 0.05),which was in accordance with the results of immunofluorescence.Conclusion The CYLD in neurons cytoplasm is involved in necroptosis induced by OGD/deprivation and downregulating of CYLD has a protective effect on the brain injury resulted from ischemia/ reperfusion.

The establishment of a new method to detect food allergen specific IgE and its clinical application for detecting allergic diseases / 中华检验医学杂志

Objective To prepare a detective membrane strip for detection of food allergen-specific IgE in serum samples and estimate its clinical application value in allergic diseases. Methods The crude extracts of the food allergens were prepared. Nitrocellulose membrane as the solid support was selected and the coating and the detecting conditions were optimized. The membrane strips were used to detect serum samples in 210 patients with allergic diseases and the results were compared with German Allergy Screentesting system. Results The optima] experimental conditions were as follows: The NC membrane was adopted as the solid support. After being spotted, the food allergens were incubated for 2 hours at room temperature, followed by 2% PVA blocking for 1 hour. After serum samples were diluted (1: 10) and incubated for 2 hours at room temperature, the concentration of anti-human IgE was 2 μg/mL Compared with the German Allergy Screen-testing system, their positive detectical coincidence was 63.6%, and negative detectical coincidence was 94. 6%. The two methods had no difference in detecting the majority of food allergens such as egg white, milk, peanut, soybean, crab and shrimp (X2 2.53, 2.40, 2.08, 2.38, 0.17,1.13, P>0.05). Conclusions The advantages of our method for detecting allergic diseases are little serum needed, multiple detective allergens, simple manipulation and low cost. This method has obvious clinical application value, which should be a new detective method for the allergic diseases with broad perspectives.

Purification and identification of recombiant human IGF-Ⅰ / 军事医学科学院院刊

Objective:To obtain highly purified recombinant human IGF-Ⅰ(rhIGF-Ⅰ) and identify it.Methods:rhIGF-Ⅰ Was purified through ion-exchange chromatography and gel filtration chromatography after the inclusion bodies of rhIGF-Ⅰ were extracted from Escherichia coli. The recombinant protein was characterized through molecular weight assay, Western-blot, and fluorescent chromatography. The renaturation and biological assay of rhIGF-Ⅰ were investigated. Results and Conclusions: The purity of rhIGF-Ⅰ was higher than 99%. The analysis of molecular weight, Western-blot, fluorescent chromatography and sequences of NH2-terminal 15 amino acids were same as those anticipated. 3-10 mg/ml was the concentration of renatured rhIGF-Ⅰ to support half-maximal stimulation of cell proliferation with BALB/c 3T3 cells.