Advances in the fluid management strategies of pediatric acute respiratory distress syndrome / 国际儿科学杂志

Pediatric acute respiratory distress syndrome(PARDS)is a pulmonary inflammation syndrome caused by a variety of proinflammatory factors induced by many causes, which is mainly characterized by noncardiogenic pulmonary edema.The main pathophysiological feature is the destruction of the integrity of the alveolar capillary membrane, and the loss of the alveolar epithelial-endothelial barrier function.In the PARDS′s clinical practice, the mainstay of the treatment is supportive.Although there is still no clear definition and general consensus or guidelines, appropriate liquid therapy is an important part of non-ventilatory treatment measures.Proper fluid management strategy is helpful to improve pulmonary edema, maintain normal circulatory perfusion, prevent functional failure of important organs and improve the prognosis of patients.According to volume status, implementing the goal-oriented and phased differentiated fluid management strategy is significant for the therapy of PARDS patients.However, the effects of fluid strategy management according to PARDS phenotypes remain to be evaluated.

Midday Napping, Nighttime Sleep, and Mortality: Prospective Cohort Evidence in China / 生物医学与环境科学（英文）

OBJECTIVE@#In developed countries, midday napping and nighttime sleep duration have been linked to long-term survival; however, little is known about such effects in less developed regions. Therefore, this study aimed to assess the associations of midday napping and nocturnal sleep with mortality in middle-aged and older Chinese adults.@*METHODS@#A nationwide cohort of 15,524 adults aged ≥ 45 years was enrolled from 28 provincial regions across mainland China and followed up from 2011 to 2018, using data from the Chinese Health and Retirement Longitudinal Study. Midday napping and nighttime sleep duration were assessed using standardized questionnaires. Cox proportional hazards models with random intercepts for the surveyed provinces were used to estimate hazard ratios ( HRs) of all-cause mortality, adjusting for sociodemographic characteristics, behavioral factors, and health status.@*RESULTS@#A total of 1,745 deaths occurred during a median follow-up of 7.1 years, and the mean (standard deviation) age was 59 (10.1) years at baseline. Compared with non-nappers, over 60 min nappers had a higher risk of all-cause mortality [ HR: 1.35, 95% confidence interval ( CI): 1.17-1.56], while no significant associations were observed among < 30 min nappers. Compared with sleep duration of 6-8 h/night, both short (< 6 h) and long (≥ 8 h) sleep duration were significantly associated with increased mortality, with corresponding HR (95% CI) estimates of 1.21 (1.05-1.38) and 1.26 (1.10-1.44), respectively. We observed significant patterns for greater risks associated with longer nap duration, with a P trend value < 0.001 for all-cause mortality. No significant evidence of an additive interaction was identified between midday napping and nighttime sleep.@*CONCLUSION@#Long midday napping and inappropriate nighttime sleep were independently associated with an increased risk of all-cause mortality in middle-aged and older Chinese populations. Biological studies are needed to validate our findings and clarify the mechanisms underlying this association.

Efficacy of 0.01% atropine in myopic children of different ages / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To valuate the efficacy of 0.01% atropine for controlling myopia in children of different ages.METHOD: A randomized, double-blind, placebo control and single-center study was conducted. A total of 295 myopic children, aged 6～13 years, with myopia of -0.5D～-6.00D and astigmatism ≤2.0D, who admitted to our hospital from May 2019 to May 2020 were randomly assigned to experimental group(197 cases)and control group(98 cases)in a 2:1 ratio. Two groups were further divided into three subgroups according to age, 6～8 years old group(40/26 cases), 9～10 years group(84/34 cases), and 11～13 years group(73/38 cases). 0.01% atropine was administrated in the experimental group and placebo was administrated in the control group once before sleep. The changes of parameters were compared before and at 2wk, 3, 6, 9 and 12mo after treatment. Intraocular pressure, accommodation amplitude, best corrected distance and near visual acuity, pupil diameter and tear film were tested at 2wk. Cycloplegic refraction was assessed before treatment, and at 6 and 12mo after treatment.RESULTS: The spherical equivalent and axial length progression at 12mo after administration was -0.37±0.69D and 0.29±0.24mm in the experimental group, and -0.59±0.65D and 0.37±0.23mm in the control group(P=0.008, 0.006). In 6～8 years group, spherical equivalent and axial length progression between experimental and control group were not statistically significant(t=0.054, P=0.957; t=-0.623, P=0.536). In 9～10 years group, spherical equivalent and axial length progression between groups were statistically significant(t=2.056, P=0.042; t=-2.057 P=0.042). In 11～13 years group, spherical equivalent and axial length progression between groups were statistically significant(t=2.33, P=0.022; t=-2.424, P=0.017). The pupil was slightly dilated and the accommodation amplitude was decreased in experimental group, and the mean pupil diameter of the two groups was 3.94±0.79 and 3.16±0.48 mm respectively at 12mo after treatment(P<0.001). Other parameters and adverse event noted between groups were not statistically significant.CONCLUSIONS: 0.01% atropine is helpful to control the progression of myopia in children, which is well tolerated by adolescents. However, the effect of 0.01% atropine on the control of myopia for children aged 6～8 years is not enough. The findings suggest that increased concentration of atropine can be tried for 6～8 years old.

Monte Carlo design and preliminary test of X-ray protective rubber / 中国辐射卫生

@#<b>Objective</b> To complete the Monte Carlo design and preliminary test of X-ray protective rubber. <b>Methods</b> According to the characteristics of X-ray energy spectrum for interventional therapy, the shielding effects of lead rubber, tungsten and bismuth composite rubber, and gadolinium and bismuth composite rubber samples were calculated by Monte Carlo simulation. The variation law of lead equivalent of lead-free rubber and lead rubber with X-ray peak tube voltage was obtained through actual measurement. <b>Results</b> Within the peak tube voltage range of 60-110 kV, lead-free rubber effectively replaced lead rubber. <b>Conclusion</b> The shielding and attenuation effect of the existing lead-free protective rubber on low-energy stray X-rays is better than that of lead rubber. Considering the inherent defects of lead rubber, flexible X-ray protective materials with thermoplastic elastomer as filler will have broad development prospects.

Diagnostic efficacy of serum NT-proBNP and D-dimer for cardiogenic cerebral embolism based on population in southern Sichuan / 中国医师杂志

Objective:To investigate the diagnostic efficacy of serum N-terminal B-type brain natriuretic peptide (NT-proBNP) and D-dimer for cardiogenic cerebral embolism (CE) based on population in southern Sichuan.Methods:We selected the clinical data of 313 patients with acute cerebral infarction (ACI) for the first time, 34 patients with simple atrial fibrillation (AF) and 30 healthy people who were admitted to the Affiliated Hospital of Southwest Medical University from June 2019 to April 2021. The patients with ACI were divided into four subgroups according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) typing: large artery atherosclerosis (LAA), CE, small artery occlusion (SAO), and indeterminate subtype (UT). The differences in clinical data in the groups were compared. At the same time, the differences of NT-proBNP and D-dimer in serum in CE group, AF group and healthy group were compared; The risk factors of CE were analyzed by binary logistic regression, and the diagnostic efficacy of serum NT-proBNP and D-dimer for CE was evaluated by receiver operating characteristic (ROC) curve.Results:The prevalence of hypertension, diabetes, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at admission, prothrombin time (PT), international normalized ratio (INR), fibrinogen (FIB), D-dimer, fibrinogen degradation products (FDP), National Institutes of Health Stroke Scale (NIHSS) score at admission, NT-proBNP and AF rate were significantly different among ACI subgroups (all P<0.05); There was no significant difference in PT and NIHSS score at admission between LAA group and CE group (all P>0.05). The prevalence of D-dimer, NT-proBNP and AF rate in CE group was significantly higher than those in other three groups (all P<0.05). The D-dimer, NT-proBNP, FDP and SBP level in CE group were significantly higher than those in AF group and healthy group (all P<0.05). Binary logistic regression analysis showed that D-dimer and NT-proBNP were independent risk factors for CE (both P<0.05). When the optimal cut-off value of serum D-dimer was 1.015 mg/L, the area under the ROC curve (AUC) was 0.896 (95% CI: 0.856-0.935, P<0.01); the sensitivity and specificity were 0.878 and 0.833, respectively; the positive predictive value and the negative predictive value were 0.705 and 0.953, respectively. When the best cut-off value of serum NT-proBNP was 657.145 ng/L, the AUC was 0.987 (95% CI: 0.977-0.998, P<0.01); the sensitivity and specificity were 0.959 and 0.963, respectively; the positive predictive value and the negative predictive value were 0.922 and 0.981, respectively. The accuracy of the combined detection of serum D-dimer and NT-proBNP in the diagnosis of CE was higher, and the AUC was 0.988 (95% CI: 0.978-0.998, P<0.01), sensitivity of 0.960, specificity of 0.977, positive predictive value of 0.950, negative predictive value of 0.982. Conclusions:The serum levels of NT-proBNP and D-dimer in CE patients increased significantly; NT-proBNP and D-dimer are important predictors of CE and have higher diagnostic efficacy for CE. The combination of them has a higher specificity for diagnosis.

One case of Creutzfeldt-Jakob disease with restless leg syndrome as the first symptom and literature analysis / 中国基层医药

Objective:To analyze the clinical features and auxiliary examination results of sporadic Creutzfeldt-Jakob disease (sCJD) with restless leg syndrome (RLS) as the first symptom.Methods:The clinical features and auxiliary examination results of one case of sCJD who received treatment in Sichuan Mianyang 404 Hospital were analyzed based on relevant literature.Results:A 59-year-old woman of Han nationality who had sCJD with restless leg-like manifestation of the left lower limb for 18 days was included in this study. The patient was first treated in orthopedic department, but her symptom did not improve after treatment. Twenty days later, she was transferred to neurology department for further treatment. Her daily life and activities were not affected. Head magnetic resonance imaging, electroencephalography, cerebrospinal fluid routine examination and biochemical test results were normal. Five days later, the patient had mild left-sided ataxia, which then progressed rapidly, followed by right-sided ataxia, left-leg spasticity and adduction, involuntary movement, myoclonia, cognitive decline, akinetic mutism, repeated hyperthermia, repeated complex partial seizures. Two weeks later, head magnetic resonance imaging examination revealed hyperintense signal of the cingulate gyrus, frontal cortex and right island cortex on DWI, with cerebellar atrophy and three-phase electroencephalography wave. Four weeks later, CSF14-3-3 protein was positive, and no related genetic mutation in the prion protein gene was found. The duration from onset to death was about 8 months.Conclusion:sCJD is a common subtype of prion protein disease, and the condition can be stabilized for more than 1 month after the onset of RLS. There is no specificity in early clinical and auxiliary examinations, and neither dobutazine treatment nor neurotrophic treatment is effective. The disease progresses rapidly after 1 month, head MRI and EEG reexamination can reveal clues, and CSF14-3-3 protein can assist clinical diagnosis.

Influence of ADOPT mode nursing intervention on airway self-care ability in patients after total laryngectomy / 中国实用护理杂志

Objective:To explore the effect of ADOPT mode nursing intervention on airway self-care ability in patients with total laryngectomy.Methods:50 patients who received total laryngectomy were randomly divided into control group (25 cases) and observation group (25 cases). The control group received routine nursing, while the observation group received ADOPT mode nursing intervention on the basis of routine nursing. The Exercise of Self-Care Agency Scale and self-made airway self-care knowledge questionnaire were used to evaluate the airway self-care ability and the incidence of airway related complications was also evaluated.Results:On discharge and 3 months after discharge, total scores about self-care knowledge of airway were 83.80 ± 5.06 and 89.40 ± 4.86 in the experimental group, which were significantly higher than those in the control group (68.75 ± 5.57, 72.50 ± 6.76), the differences were statistically significant ( t = -9.91, -10.09, both P<0.05). On discharge and 3 months after discharge, total scores in ESCA were 126.88 ± 9.77 and 133.60 ± 8.10 in the experimental group, which were significantly higher than those in the control group (113.29 ± 17.06 and 119.13 ± 15.30). The differences were significant ( t = -3.42, -4.12, both P<0.05). The incidence of airway complications was 41.67% (10/24) in the control group and 12.00%(3/25) in the observation group, which was statistically significant ( χ2 = 5.53, P<0.05). Conclusions:ADOPT mode nursing intervention can significantly improve the airway self-care ability of patients with total laryngectomy, reduce the incidence of airway complications, and is beneficial to patients′ physical and mental recovery.

Fluid overload in critically ill children and advances in its treatment / 国际儿科学杂志

Fluid overload(FO)is significantly associated with survival in critically ill children.Excessive fluid accumulation in the body causes tissue oedema, which may lead to heart failure, acute kidney injury(AKI)and acute pulmonary oedema, affecting length of hospital stay, readmission rates and prognosis.According to the cause of the FO, the main treatments are fluid restriction, diuretics, and ultrafiltration.Diuretics are often used clinically to treat patients with FO.International guidelines recommend ultrafiltration to remove excess water when diuretic therapy is not effective or when diuretic resistance occurs, or when life-threatening complications arise.However, there is no conclusion on the setting for the net ultrafiltration intensity in ultrafiltration, particularly in critically ill children.With the development of ultrafiltration technology, the application of ultrafiltration in the treatment of FO patients will be further carried out.This article provides a review of the FO and its treatment in critically ill children.

China guideline for the screening, early detection and early treatment of gastric cancer (2022, Beijing) / 中华肿瘤杂志

Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China's national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.

China guideline for the screening, early detection and early treatment of esophageal cancer (2022, Beijing) / 中华肿瘤杂志

Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demonstrated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China's national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.

Effects of salidroside on the secretion of inflammatory mediators induced by lipopolysaccharide in the co-culture of rat alveolar macrophages and type II alveolar epithelial cells / 生理学报

The aim of the present study was to investigate the effect of salidroside (Sal) on inflammatory activation induced by lipopolysaccharide (LPS) in the co-culture of rat alveolar macrophages (AM) NR 8383 and type II alveolar epithelial cells (AEC II) RLE-6TN. CCK-8 colorimetric method was used to detect cell proliferation percentage. The enzyme-linked immunosorbent assay (ELISA) was used to determine the content of tumor necrosis factor alpha (TNF-α), macrophage inflammatory protein-2 (MIP-2) and interleukin-10 (IL-10) in the supernatant. Western blot was used to examine the expression levels of phosphorylated AKT (p-AKT) and total AKT protein. The results showed that pretreatment of RLE-6TN cells or co-culture of RLE-6TN and NR 8383 cells with 32 and 128 µg/mL Sal for 1 h, followed by continuous culture for 24 h, significantly increased the cell proliferation (P < 0.05). Compared with control group, 32 and 128 µg/mL Sal pretreatment significantly increased the ratio of p-AKT/AKT in RLE-6TN cells (P < 0.05). Pretreatment of 32 µg/mL Sal not only inhibited the secretion of TNF-α and MIP-2 by NR 8383 cells induced by LPS (P < 0.05), but also enhanced the inhibitory effect of RLE-6TN and NR 8383 cells co-culture on the secretion of TNF-α and MIP-2 by NR 8383 cells induced by LPS (P < 0.05). In addition, 32 µg/mL Sal pretreatment promoted LPS-induced IL-10 secretion by NR 8383 cells (P < 0.05), and enhanced the promoting effect of co-culture of RLE-6TN and NR 8383 cells on the IL-10 secretion by LPS-induced NR 8383 cells (P < 0.05). In conclusion, Sal may directly inhibit LPS-induced inflammatory activation of AM (NR 8383), promote the proliferation of AEC II (RLE-6TN) through PI3K/AKT signaling pathway, and enhance the regulatory effect of AEC II on LPS-induced inflammatory activation of AM.

Physical and chemical characteristics of PM2.5 and its toxicity to human bronchial cells BEAS-2B in the winter and summer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

With the increasing occurrence of haze during the summer, the physicochemical characteristics and toxicity differences in PM2.5 in different seasons are of great concern. Hangzhou is located in an area that has a subtropical monsoon climate where the humidity is very high during both the summer and winter. However, there are limited studies on the seasonal differences in PM2.5 in these weather conditions. In this test, PM2.5 samples were collected in the winter and summer, the morphology and chemical composition of PM2.5 were analyzed, the toxicity of PM2.5 to human bronchial cells BEAS-2B was compared, and the correlation between PM2.5 toxicity and the chemical composition was discussed. The results showed that during both the winter and summer, the main compounds in the PM2.5 samples were water-soluble ions, particularly SO42-, NO3-, and NH4+, followed by organic components, while heavy metals were present at lower levels. The higher the mass concentration of PM2.5, the greater its impact on cell viability and ROS levels. However, when the mass concentration of PM2.5 was similar, the water extraction from the summer samples showed a greater impact on BEAS-2B than that from the winter samples. The cytotoxicity of PM2.5 was closely associated with heavy metals and organic pollutants but less related to water-soluble ions.

Severe Strongyloides stercoralis infection: a case report / 中国血吸虫病防治杂志

This paper reports a severe case of Strongyloides stercoralis infection during routine sputum smear examinations, due to cough and shortness of breath, so as to improve clinicians’ awareness of strongyloidiasis to avoid and reduce misdiagnosis and missed diagnosis.

A correlation study of necrotizing enterocolitis and encephalopathy of prematurity in premature infants with gestational age ＜ 32 weeks / 中国新生儿科杂志

Objective To study the correlation of necrotizing enterocolitis (NEC) and encephalopathy of prematurity (EOP) in premature infants with gestational age (GA) ＜ 32 weeks.Method From January 2009 to December 2014,clinical data of preterm infants (GA ＜ 32 weeks) admitted to department of neonatology of Children's Hospital of Fudan University and received brain magnetic resonance imaging (MRI) at corrected GA of full term or near full term were collected.NEC patients were assigned into the NEC group.At the same time,patients with similar GA and birth weight without NEC were assigned into the control group.The incidence and MRI characteristics of EOP were studied using Chi-square method.Result A total of312 preterm infants were included in our study,104 in the NEC group,and 208 in the control group.The incidence of EOP in the NEC group was higher than the control group (27.9％ vs.17.3％).The difference between the two groups were statistically significant (P =0.030).The incidence of non-cystic EOP in the NEC group was significantly higher than the control group (89.7％ vs.63.9％,P =0.017).Conclusion NEC and EOP may be correlated in preterm infants with GA ＜32 weeks.Most of EOP were non-cystic injury.

CT-guided percutaneous transthoracic needle biopsy for the diagnosis of non-small cell lung cancer: a retrospective analysis of its diagnostic accuracy / 介入放射学杂志

Objective To investigate the diagnostic accuracy of CT-guided percutaneous transthoracic needle biopsy (PTNB) for non - small cell lung cancer (NSCLC), and to discuss the factors affecting the diagnostic accuracy of puncture biopsy. Methods The clinical data of a total of 203 patients with pathologically-proved NSCLC, who received CT-guided PTNB during the period from January 1, 2010 to November 1, 2016, were retrospectively analyzed. CT - guided PTNB was performed in all patients before surgery, and tissue specimens were collected for pathological study. The diagnostic accuracy of needle biopsy was calculated, and the factors that might affect the diagnostic accuracy of needle biopsy were analyzed. Results (l)The coincidence rate of pathological results of CT-guided PTNB (small specimens) with surgical specimens (large specimens) was 92. 6％ (188/203). The squamous cell carcinoma and adenocarcinoma had the highest coincidence rates, which were 100％ and 97. 5％ respectively. The coincidence rate of large cell carcinoma type was 20％. No statistically significant differences in the coincidence rate of adenocarcinoma and squamous cell carcinoma existed between small specimens and large specimens (κ=0. 872, P=0. 250). (2)Chi square test showed that only the lesion size was an important factor that affected the diagnostic accuracy of needle biopsy (P=0. 008). Conclusion In diagnosing commonly seen NSCLC, CT - guided PTNB has high coincidence rate with surgical specimens, therefore, CT-guided PTNB is worth popularizing widely in clinical practice. The lesion size is an important factor that affected the diagnostic accuracy of needle biopsy. (J Intervent Radiol, 2018, 27:274-277)

The diagnostic value of ferritin, procalcitonin (PCT) and C-reactive protein (CRP) on infections disease / 中国医师杂志

Objective To evaluate the diagnostic value of ferritin,procalcitonin (PCT) and C-reactive protein (CRP) on infectious diseases.Methods A total of 190 patients with infectious diseases in our hospital from 2012 to 2017 were enrolled and analysed retrospectively.Among them,bacterial infection was found in 130 cases (bacterial infection group),and viral infection in 60 cases (viral infection group).Serum levels of erritin,CRP,PCT in 190 patients were deteceted for further statistical analysis.Results Among the 190 cases of infectious fever,serum levels of erritin,CRP,PCT in bacterial infection group were higher than that in the viral infection group,with significant difference.The receiver operating curve (ROC) curve analysis showed that area under curve (AUC) of CRP,PCT,ferritin were 0.797,0.803,0.883.Conclusions The present study identified ferritin,PCT and CRP that should be considered in the differential diagnosis of infectious diseases,providing useful information for future diagnosis.

Comparing invasive effects of five foodborne bacterial pathogens in human embryonic intestine 407 cells and human ileocecum HCT-8 cells

Objective To refine the infectious doses of enteric bacterial pathogens in animal assays and vaccine clinical trials by studying the invasion kinetics of five bacterial pathogens with human intestinal cells. Methods Utilizing in vitro cultured cell invasion assays with gentamicin-killing step, the invasive effects were analyzed in foodborne pathogens including Salmonella, Shigella, Yersinia, Escherichia coli (E. coli) O157 and opportunistic pathogens Citrobacter in human embryonic intestine 407 cells and ileocecum HCT-8 cells at multiplicities of infection (MOIs) of 0.04–4 000.00 E. coli HS served as a noninvasive control. Results The study results showed that the bacterial invasive efficiency and the average number of internalized bacteria per host cell changed with different starting MOIs. Higher starting MOIs did not always produce more bacterial internalization. The bacterial invasion effects varied with different bacterial strains and host cell lines. E. coli O157:H7 did invade human ileocecum HCT-8 cells. Conclusions This study shows that these bacteria possess different invasive patterns at various starting MOIs and also in different cell lines. The results could help to figure out the appropriate infectious doses of the bacteria in animal assays and in vaccine clinical trials. The bacterial invasion kinetics is also valuable in evaluating the safety and efficacy of live attenuated bacterial vaccines.

A case-control study of bone mineral density and its influencing factors in 2079 recruits / 军事医学

Objective To find out about the charateristics of bone mineral density(BMD)and its influencing factors among 2079 recruits.Methods Recruits of Armed Police Force in Tianjin were selected as subjects.Their BMD was measured with dual-energy X-ray absorptiometry(DXA).A normal group and low bone mineral density group were selected according to the results of bone mineral density and the methord of 1:1 case-control analysis.Questionnaires were used to investigate their dietary nutrition and lifestyles.One-way ANOVA,chi-square test and Logistic regression analysis were used to explore the influencing factors of BMD.Results In total,2079 military recruits underwent a DXA scan.Normal bone mineral density accounted for 44.78%,and T value was -0.36 ±0.62.Medium bone mineral density made up 50.51%, and T value was -1.57 ±0.38.Low bone mineral density accounted for 4.71%,and T value was -2.82 ±0.39.Single factor analysis suggested that body weight, BMI, movement time, sports venues, spending too much time online all had influences on bone mineral density.Multiariable Logistic regression analysis showed that high animal diet(OR=3.435), spending too much time online(OR=1.246)were the risk factors for bone density.Dairy consumption(OR=0.296)and movement time(OR=0.549)were positively associated with bone mineral density.Conclusion There is a low bone mass in the recruits.We suggest that scientific and standardized management,popularization of knowledge,healthy diet and living habits are necessary to promote good bone peaks.

Functional differentiation of dopaminergic neurons derived from human embryonic stem cells / 中国组织工程研究

BACKGROUND: The in vitro differentiation methods of stem cell-derived dopaminergic neurons that serve as a cell source for the replacement therapy of Parkinson's disease are continuously optimized and improved, as well as the subsequent identification methods and testing indicators. OBJECTIVE: To observe the morphological development and electrophysiological characteristics of dopaminergic neurons differentiated from human embryonic stem cells so as to identify whether these differentiated cells have mature morphology and function under the current differentiation program. METHODS: Monolayer adherent method combined with dual-SMAD signaling inhibition was used to induce the directional differentiation of human embryonic stem cells into dopaminergic neurons. Then the cells were identified by light microscopy, electron microscopy and immunofluorescence, and the electrophysiological properties of dopaminergic neurons were detected by patch clamp electrophysiological technique. Herein, we evaluated the electrophysiological functions of dopaminergic neurons differentiated in vitro, with reference to the evaluation standard of dopaminergic neuron in vivo. RESULTS AND CONCLUSION: In this study, we successfully obtained dopaminergic neurons with mature morphology and functions differentiated from human embryonic stem cells in vitro. Findings from the subsequent electrophysiological test confirmed that dopaminergic neurons we acquired had electrophysiological properties in accordance with the evaluation standards of dopaminergic neurons in vivo. To conclude, the monolayer adherent method combined with dual-SMAD signaling inhibition can successfully induce the directional differentiation of human embryonic stem cells into dopaminergic neurons with mature morphology and functions.

Analysis on associated factors of elderly patients' stay in emergency department of a hospital in Shanghai / 上海交通大学学报（医学版）

Objective·To investigate the effect of population aging on health condition of Emergency Department (ED) visitors, the disease constitution of ED, the pressure of emergency treatment and the emergency department length of stay (EDLOS). Methods·Patient data from ED of a tertiary hospital in Shanghai from Jan. 2014 to Dec. 2016 were collected and retrospectively analyzed, including gender, age, arrival time, diagnosis, EDLOS, outcome, chronic disease, infection or tumor, etc. Statistics was used to determine possible factors associated with prolonged EDLOS. Results·A total of 15429 cases were selected. The number of the elderly patients (≥65 years old) was 8480 (54.96%). The elderly patients' EDLOS was significantly longer than patients younger than 65 years (P=0.000). The incidence of chronic aging diseases was significantly higher in elderly patients (67%) than in who were below 65 years old (52%). Tumor and infection were independent risk factors for EDLOS (P=0.000). The proportion of elderly patients with acute onset and unknown diseases was only 14%. Conclusion·The increasing proportion of elderly patients in ED is the main reason leading to the pressure of emergency treatment. The elderly patients who had chronic diseases prolong the EDLOS and cost the most medical resources of emergency treatment. So the gerontology should be rapidly expanding. Meanwhile, the complex chronic aging diseases, acute onset of chronic disease and varying severity of disease in the elderly patients should be treated by the new stepping mode "Family- Hospitalization-Emergency".