Investigation on patient safety culture in standardized training for resident doctors / 中华医学教育探索杂志

Objective To investigate the cognition on patient safety culture of resident doctors re-ceiving standardized training in two affiliated hospitals, analyze the effectiveness of publicity and education in patient safety culture and put forward suggestions for improvements. Methods A total of 913 resident doctors receiving standardized training in the two affiliated hospitals during 2014 to 2016 were enrolled. Their cognition on patient safety culture were investigated using questionnaire surveys from May to October in 2016, and the main factors influencing the cognition on patient safety culture in standardized training were put forward through expert interviews. All statistical analyses were performed with SPSS 17.0 software with Chi-square test. Results The response rate of the questionnaire was 87.62％ (800/913). Three factors were involved in the patient safety system, including the hospital security objectives, security feedbackchannels, and adverse event warning mechanism. The cognitiive level of A hospital (68.96％, 62.52％, 62.81％) was higher than that of B hospital (52.99％, 46.16％, 47.01％), and the difference was statistically significant (P<0.05). The publicity of pre-service training, education in the department, and encouragement from teachers (82.13％, 84.48％, 78.33％) was better in A hospital than in B hospital (68.38％, 71.8％, 62.39％) (P<0.05). The reporting rate of adverse events in A hospital was higher than that in B hospital (P <0.05). Conclusion It is necessary for hospitals to further intensify the publicity and education on patient safety culture. We can improve students' cognition on patient safety culture to reduce medical errors by cre-ating a favorable atmosphere, establishing standardized admission education and training system, improving teachers' teaching ability, and strengthening the training for clinical skills.

A retrospective analysis of clinical characteristics and outcomes of heart failure patients with different left ventricular ejection fractions / 中华内科杂志

Objective To compare the clinical characteristics,and outcomes of patients with heart failure with different left ventricular ejection fractions (LVEF).Methods A total of 1 182 hospitalized patients with heart failure (HF) were enrolled and retrospectively studied in the present study.The patients were stratified by LVEF as reduced (HFrEF,LVEF ＜ 40％,n =313),mid-range (HFmrEF,40％ ≤ LVEF ＜50％,n =287) and preserved (HFpEF,LVEF≥50％,n =582) ejection fraction groups.Among the 1 182 cases,941 of them (81.3％,84.9％,and 84.0％ inHFrEF,HFmrEF and HFpEF groups,respectively) were followed up for an median duration of 27.3 months.Results (1) Among the study patients,26.5％ were in HFrEF,24.3％ in HFmrEF,and 49.2％ in HFpEF groups.(2) Ischemic heart disease with HFmrEF was more frequent than that in patients with HFrEF.The average age,percentage of female subjects,systolic blood pressure,uric acid,N terminal B-type natriuretic peptide precursor (NT-proBNP),hemoglobin,and the incidence of hypertensive heart disease,anemia,atrial fibrillation in patients with HFmrEF were higher than those in patients with HFrEF,but lower than those in patients with HFpEF (all P ＜0.01).(3) The all-cause cumulative mortality was 10.8％ at 1 year,20.6％ at 2 years and 35.9％ at 5 years.No difference was observed in the all-cause cumulative mortality at 1 year,2 years,5 years among the three groups (all P ＞ 0.05).Conclusions The HFmrEF patients,as a new and distinct group,were with many intermediate characteristics compared with HFrEF and HFpEF subjects.However,the all-cause mortality was not significantly differeut among HF patients with different LVEF.

Correlation between family factors and social adaptability of clinical professional postgraduates / 中华医学教育探索杂志

Objective To explore the influence of family factors on the social adaptability of post-graduate students in clinical medicine, and to provide scientific basis for training medical personnel with high social adaptability. Methods From September to November 2016, using stratified random sampling method, a questionnaire survey was conducted to investigate the family environment and social adaptability of 210 clinical professional postgraduates from three grades of a medical college in Xinjiang, the question-naire included the basic situation, family factors and the revised diagnostic questionnaire of social adapt-ability of Professor Zheng Richang. T test, ANOVA and multiple linear regression were carried out by using SPSS 17.0 software package. Results 201 valid questionnaires were returned with an effective recovery rate of 95.71％. The average value of the social adaptability of 201 clinical postgraduates was (17.00±11.12), so social adaptation ability of them was general. There were significant differences in the social adaptation ability of clinical professional master's degree between different genders, grades and working experience (P<0.05). The student was in difference family sources, length of life and father/mother master's degree had statistical significance difference in social adaptation ability (P<0.05). The score of graduate students from rural areas [(19.59±11.77)] was higher than that of urban students [(15.34±10.78)] and and city students (15.14±10.92). The postgraduates who left their homes for more than 10 years scored higher than those whose departure time was less than 10 years. Multi factor analysis found that gender, grade, mother's educa-tion, family sources, the number of home years and whether the work had a major impact on the social adaptability of clinical professionals. Conclusion The family factors of postgraduates in clinical medicine have an influence on their social adjustment ability. From the perspective of family environment, we should carry out the characteristics of intervention education to the students with poor social adaptation ability, in order to constantly improve the level of social adaptability of medical students.

Efficacy and safety of bevacizumab combined with chemotherapy in treatment of EGFR wild type or EGFR-TKI resistant lung adenocarcinoma with brain metastases / 肿瘤

Objective: There is no standard chemotherapy regimen for patients with wild type epidermal growth factor receptor (EGFR) and EGFRtyrosine kinase inhibitor (TKI) resistant lung adenocarcinoma with brain metastases. This study aims to observe the efficacy and toxicity of chemotherapy combined with bevacizumab in wild-type EGFR and EGFR-TKI resistant lung adenocarcinoma patients with brain metastases. Methods: A total of 10 lung adenocarcinoma patients with brain metastases between January and December 2015 received bevacizumab and chemotherapy. The response was evaluated by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) every 2 cycles and the toxicity was evaluated by National Cancer Institute-Common Toxicity Criteria version 3.0 (NCI-CTC 3.0) every cycle. Results: Of the eight patients who could be evaluated for response, the overall response rate was 25% (2/8) and the disease control rate was 75% (6/8). And for intracranial lesions, the response rate was 12% (1/8) and the disease control rate was 87% (7/8). The most commonly adverse events induced by bevacizumab were hypertension, proteinuria and bleeding, which were mostly degrees I-II. Conclusion: Bevacizumab combined with chemotherapy is an effective and safe treatment method for EGFR wild type and EGFR-TKI resistant lung adenocarcinoma patients with brain metastases.

Relationship between FRAS1 protein and brain metastases of NSCLC / 中国病理生理杂志

[ ABSTRACT] AIM: To explore the relationship between FRAS 1 protein and brain metastases of non-small cell lung cancer (NSCLC).METHODS:The mRNA expression of FRAS1 in the brain metastatic tumor tissues and primary tumor tissues of NSCLC was detected by qPCR .The protein expression of FRAS 1 in the tumor tissues and normal tissues adjacent to tumor tissues of NSCLC was measured by SP method of immunohistochemistry .The protein expression of FRAS 1 in NSCLC primary tumor tissues with or without brain metastases was also determined .RESULTS:The mRNA expression of FRAS1 in the brain metastatic zone was nearly 10 times higher than that in the primary tumor tissues , and there was sig-nificant difference between the 2 groups (P<0.05).FRAS1 protein was expressed in the NSCLC primary tumor tissues , but was not found in the normal tissues adjacent to primary tumor tissues .The protein expression of FRAS 1 in the NSCLC with brain metastases was significantly higher than that without brain metastases ( P<0.01 ) .CONCLUSION: FRAS1 protein may be associated with the occurrence of NSCLC .The over-expression of FRAS1 protein may be related to brain metastases with NSCLC .

Alterated Serum Levels of Immunoglobulin E in Patients With Calcific Aortic Valve Disease / 中国循环杂志

Objective: To explore the relationship between serum levels of immunoglobulin E (IgE) and calciifc aortic valve disease (CAVD) in relevant patients. Methods: A total of 394 patients were enrolled in our study. Based on echocardiography presentation, the patients were divided into 2 groups: CAVD group,n=169 and Non-CAVD group,n=225. Serum levels of IgE were examined by chemiluminescence method. The IgE levels were compared between 2 groups and the relationship between serum IgE level and CAVD was analyzed. Results: Serum levels of IgE in CAVD group was significantly higher than Non-CAVD group 113.30 IU/ml vs 63.76 IU/ml (P Conclusion: Serum IgE level is obviously increased in CAVD patients. IgE is an independent biochemical indicator of CAVD, it may play the important role in CAVD pathogenesis.

Reflection on the Establishment of Disciplines Scientific Evaluation System for Key Disciplines / 中华医学科研管理杂志

Discipline evaluation is an effective and boosting mean of constructing high level key disciplines,but if there is something wrong or flaws with the means,indicators,process,ways,the effect may be just the opposite.Therefore,establishing scientific evaluation system is an important premise to construct key disciplines,promote discipline development and improve the level of academy construction.This article which is aimed at current situation of discipline evaluation system,puts forward some major principles to establish scientific evaluation for discipline,it is significant to play a right evaluation guide and promote the discipline construction.Carrying out discipline evaluation needs to have right guiding thought,establish and perfect indicator system of discipline evaluation,strengthen orderly management of evaluation work,offer scope to stimulate function of discipline evaluation.Only in these ways,can we construct a batch of characteristic and competitive key disciplines.

Mitogenic effects of growth and differentiation factors on rat liver stem cell WB-F344 in vitro / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the relationship between the proliferation, differentiation of rat hepatic stem like cell line WB-F344 and cytokines in vitro.</p><p><b>METHODS</b>(3)H thymidine labelling of new synthesized DNA was used to examine the mitogenic responsiveness of WB-F344 cells to cytokines, western blot was used to study the expression of cytokines receptors on hepatic stem cells, and apoptotic cells were detected by Flow cytometry.</p><p><b>RESULTS</b>WB-F344 cells showed a proliferative response to the cytokines of hepatocyte growth factor (HGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), Insulin at the dose of 80 ng/ml, and the relative cpm values are 982.95, 906.32, 863.98 and 968.67 respectively, while non response to interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) at the same dose, and an inhibition or apoptosis response to transforming growth factor-beta (TGF-beta) at 80 ng/ml with a 26.89% apoptotic rate. Western blot showed that there were HGF, EGF, FGF, TGF-beta receptors expressed on WB-F344 cells. When WB-F344 cells were cultured in the differential system (DMEM, 10% Fcs, HGF 10 to approximately 50 ng/ml, EGF 20 ng/ml, Insulin 1 microg/ml, Dex 1 micromol/L), the cells could differentiated into hepatocytes. In addition, HGF could scattered WB-F344 cells.</p><p><b>CONCLUSION</b>The proliferation and differentiation of liver stem cells are regulated by various cytokines which may play an important role when liver is damaged seriously.</p>

The role of the dephosphorylation of FOXO1 in the apoptosis and the chemotherapy sensitivity of Non-Hodgkin’s lymphoma cells / 中国免疫学杂志

Objective:Investigate the relation between the phosphorylation of FOXO1 and the apoptosis and the proliferation of lymphoma cells and to clarify its specific mechanism.Methods:The lymphoma cells Namalwa and Jurkat were treated with PI3K inhibitor wort mannin or etoposide or Wortmannin plus etoposide for different times-pan and at different concentration.The inhibition rates for cell growth of lymphoma cells were examined by XTT assay.Apoptosis were detected by flow cytometry.The expressions of p-Akt,p-FOXO1,FOXO1 and Bim were determined by Western blot analysis.Results:Wortmannin induced apoptosis of Jurkat cells and Namalwa cells and inhibited their survival effectively.The growth inhibition rate and the apoptosis rate of lymphoma cells induced by Wortmannin plus etoposide were higher than those induced by etoposide alone.After treated with Wortmannin,phosphorylation of FOXO1 remarkably reduced and bim markedly increased.Conclusion:The dephosphorylation of FOXO1 inhibits proliferation of Jurkat cells and Namalwa cells,promotes their apoptosis and enhanced the sensitivity of Non-Hodgkin lymphoma cells to etoposide.Bim activated by FOXO1 promotes cell apoptosis.