Application of body surface markers localization in totally implantable venous access port implantation via internal jugular vein approach / 国际外科学杂志

Objective:To investigate the feasibility of using body surface marker localization method to determine the correct position of catheter tip (lower 1/3 of the superior vena cava or the junction of superior vena cava and right atrium) in totally implantable venous access port (TIVAP) implantation via internal jugular vein approach.Methods:The clinical data of 220 patients who underwent TIVAP implantation in Beijing Tongren Hospital, Capital Medical University from June 2019 to June 2021 were retrospectively analyzed. Among them, 168 patients used the internal jugular vein approach. According to the method implemented for determining the length of central venous catheter (CVC) during the operation, the patients were divided into two groups: 136 patients using the body surface marker localization method were defined as the study group; and the remaining 32 cases treated by the intraoperative X-ray fluoroscopic localization method were defined as the control group. The difference in the excellent or good rate of CVC tip position immediately after implantation and the time of implantation was compared between the two groups. In addition, the correlation between the length of CVC indwelling, height, age, and the distance between the catheter tip and tracheal carina was analyzed for the patients with right and left internal jugular vein catheterization. Kolmogorov-Smirnov test was used for statistical distribution of measurement data. Normal distribution of measurement data was expressed as mean ± standard deviation ( ± s), independent sample t-test was used for comparison between groups. Chi-square test was used for comparison between counting data. With TIVAP catheter indenture length as dependent variable and height as independent variable, Pearson correlation analysis was performed, the relationship equation between ideal catheter indenture length and patient height was analyzed by unitary linear regression. Results:When the CVC tip was located at the second intercostal space, the third sternocostal joint and the third intercostal space, the corresponding probability of being in the correct position was 34.8%, 83.3% and 95.0% respectively. The third sternocostal joint or the third intercostal space had a higher probability of correct CVC tip location than the second intercostal space, and the difference were statistically significant ( P<0.001). Furthermore, there was no significant difference in the possibility of the CVC tip located in the correct position between the third sternocostal joint and the third intercostal space ( P=0.149). Compared with the control group (before adjusting catheter position), the proportion of excellent or good CVC position in the study group was significantly improved (94.1% vs 46.9%), and the difference was statistically significant ( χ2=41.99, P<0.001); while the total operation time was significantly shortened [(33.04±6.69) min vs (42.50±5.54) min], and the difference was statistically significant ( P<0.05). There was a linear correlation between the length of CVC insertion and height. Indwelling catheter length via right internal jugular vein approach (cm) =0.159× height (cm)-1.284 ( r=0.597, r2=0.356, P<0.001); length of catheter indwelling through the left approach (cm) =0.097× height (cm) + 12.139 ( r=0.322, r2=0.104, P=0.020). Conclusions:The third sternocostal joint or the third intercostal space would be the corresponding correct surface landmark of the CVC tip when the body surface marker localization method was adopted during the TIVAP implantation via the internal jugular vein approach. Compared with the intraoperative X-ray fluoroscopy localization, the operation time is significantly shortened with the application of the body surface marker localization method. This technique is simple and easy to master and has high reliability in determining the length of catheter and the position of CVC tip.

Leonurine inhibits ferroptosis in renal tubular epithelial cells by activating p62/Nrf2/HO-1 signaling pathway / 中国中药杂志

To investigate the protective effect and the potential mechanism of leonurine(Leo) against erastin-induced ferroptosis in human renal tubular epithelial cells(HK-2 cells), an in vitro erastin-induced ferroptosis model was constructed to detect the cell viability as well as the expressions of ferroptosis-related indexes and signaling pathway-related proteins. HK-2 cells were cultured in vitro, and the effects of Leo on the viability of HK-2 cells at 10, 20, 40, 60, 80 and 100 μmol·L~(-1) were examined by CCK-8 assay to determine the safe dose range of Leo administration. A ferroptosis cell model was induced by erastin, a common ferroptosis inducer, and the appropriate concentrations were screened. CCK-8 assay was used to detect the effects of Leo(20, 40, 80 μmol·L~(-1)) and positive drug ferrostatin-1(Fer-1, 1, 2 μmol·L~(-1)) on the viability of ferroptosis model cells, and the changes of cell morphology were observed by phase contrast microscopy. Then, the optimal concentration of Leo was obtained by Western blot for nuclear factor erythroid 2-related factor 2(Nrf2) activation, and transmission electron microscope was further used to detect the characteristic microscopic morphological changes during ferroptosis. Flow cytometry was performed to detect reactive oxygen species(ROS), and the level of glutathione(GSH) was measured using a GSH assay kit. The expressions of glutathione peroxidase 4(GPX4), p62, and heme oxygenase 1(HO-1) in each group were quantified by Western blot. RESULTS:: showed that Leo had no side effects on the viability of normal HK-2 cells in the concentration range of 10-100 μmol·L~(-1). The viability of HK-2 cells decreased as the concentration of erastin increased, and 5 μmol·L~(-1) erastin significantly induced ferroptosis in the cells. Compared with the model group, Leo dose-dependently increased cell via-bility and improved cell morphology, and 80 μmol·L~(-1) Leo promoted the translocation of Nrf2 from the cytoplasm to the nucleus. Further studies revealed that Leo remarkably alleviated the characteristic microstructural damage of ferroptosis cells caused by erastin, inhibited the release of intracellular ROS, elevated GSH and GPX4, promoted the nuclear translocation of Nrf2, and significantly upregulated the expression of p62 and HO-1 proteins. In conclusion, Leo exerted a protective effect on erastin-induced ferroptosis in HK-2 cells, which might be associated with its anti-oxidative stress by activating p62/Nrf2/HO-1 signaling pathway.

Surgical management of nipple areola complex in central breast cancer / 中华肿瘤杂志

Objective: To explore the surgical strategy of nipple areola complex (NAC) management in central breast cancer. Methods: A retrospective analysis was conducted on 164 cases of central breast cancer who underwent surgery treatment from December 2017 to December 2020 in the Breast Center of Beijing Tongren Hospital, Capital Medical University. Prior to the surgery, the tumor-nipple distance (TND) and the maximum diameter of the tumor were measured by magnetic resonance imaging (MRI). The presence of nipple invagination, nipple discharge, and nipple ulceration (including nipple Paget's disease) were recorded accordingly. NAC was preserved in patients with TND≥0.5 cm, no signs of NAC invasion (nipple invagination, nipple ulceration) and negative intraoperative frozen pathological margin. All patients with signs of NAC involvement, TND<0.5 cm or positive NAC basal resection margin confirmed by intraoperative frozen pathology underwent NAC removal. χ(2) test or Fisher exact test was used to analyze the influencing factors. Results: Of the 164 cases of central breast cancer, 73 cases underwent breast-conserving surgery, 43 cases underwent nipple-areola complex sparing mastectomy (NSM), 34 cases underwent total mastectomy, and the remaining 14 cases underwent skin sparing mastectomy (SSM). Among the 58 cases of NAC resection (including 34 cases of total mastectomy, 14 cases of SSM, and 10 cases of breast-conserving surgery), 25 cases were confirmed tumor involving NAC (total mastectomy in 12 cases, SSM in 9 cases, and breast-conserving surgery in 4 cases). The related factors of NAC involvement included TND (P=0.040) and nipple invagination (P=0.031). There were no correlations between tumor size (P=0.519), lymph node metastasis (P=0.847), bloody nipple discharge (P=0.742) and NAC involvement. During the follow-up period of 12 to 48 months, there was 1 case of local recurrence and 3 cases of distant metastasis. Conclusions: For central breast cancer, data suggest that patients with TND≥0.5cm, no signs of NAC invasion (nipple invagination, nipple ulceration) and negative NAC margin in intraoperative frozen pathology should be treated with NAC preservation surgery, whereas for those with TND<0.5 cm or accompanied by signs of NAC invasion, NAC should be removed. In addition, nipple reconstruction can be selected to further improve the postoperative appearance of patients with central breast cancer.

Analysis of clinical phenotype and genotype of Chinese children with disorders of sex development / 中华儿科杂志

Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.

Efficacy and safety of programmed death-1/programmed death-ligand 1 inhibitors in treatment of hepatitis B virus-associated hepatocellular carcinoma / 临床肝胆病杂志

Combined immunotherapy for hepatocellular carcinoma (HCC) based on immune checkpoint inhibitors (ICIs), especially programmed death receptor-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors, has achieved a remarkable clinical effect in clinical research and practice. Hepatitis B virus (HBV) infection is considered a major risk factor in the process of HCC. Studies are being conducted to investigate the efficacy and safety of PD-1/PD-L1 ICIs used alone or in combination in the treatment of patients with HBV-associated HCC, and some studies have shown that the patients with HBV-associated HCC receiving PD-1/PD-L1 inhibitors have achieved a similar treatment outcome to those without HBV infection; however, no consensus has been reached on the safety issues related to HBV activation. This article reviews the clinical trials of PD-1/PD-L1 blockade immunotherapy for HCC, so as to clarify the safety and efficacy of this new treatment regimen in the particular circumstances of HBV infection.

Role of connexin 43 in odontoblastic differentiation and structural maintenance in pulp damage repair / 国际口腔科学杂志·英文版

Dental pulp can initiate its damage repair after an injury of the pulp-dentin complex by rearrangement of odontoblasts and formation of newly differentiated odontoblast-like cells. Connexin 43 (Cx43) is one of the gap junction proteins that participates in multiple tissue repair processes. However, the role of Cx43 in the repair of the dental pulp remains unclear. This study aimed to determine the function of Cx43 in the odontoblast arrangement patterns and odontoblastic differentiation. Human teeth for in vitro experiments were acquired, and a pulp injury model in Sprague-Dawley rats was used for in vivo analysis. The odontoblast arrangement pattern and the expression of Cx43 and dentin sialophosphoprotein (DSPP) were assessed. To investigate the function of Cx43 in odontoblastic differentiation, we overexpressed or inhibited Cx43. The results indicated that polarized odontoblasts were arranged along the pulp-dentin interface and had high levels of Cx43 expression in the healthy teeth; however, the odontoblast arrangement pattern was slightly changed concomitant to an increase in the Cx43 expression in the carious teeth. Regularly arranged odontoblast-like cells had high levels of the Cx43 expression during the formation of mature dentin, but the odontoblast-like cells were not regularly arranged beneath immature osteodentin in the pulp injury models. Subsequent in vitro experiments demonstrated that Cx43 is upregulated during odontoblastic differentiation of the dental pulp cells, and inhibition or overexpression of Cx43 influence the odontoblastic differentiation. Thus, Cx43 may be involved in the maintenance of odontoblast arrangement patterns, and influence the pulp repair outcomes by the regulation of odontoblastic differentiation.

Efficacy and safety of human chorionic gonadotropin combined with human menopausal gonadotropin and a gonadotropin-releasing hormone pump for male adolescents with congenital hypogonadotropic hypogonadism / 中华医学杂志(英文版)

BACKGROUND@#Compared to adult studies, studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism (CHH) are limited and no universal treatment regimen is available. The aim of this study was to evaluate the feasibility of human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) therapy for treating male adolescents with CHH.@*METHODS@#Male adolescent CHH patients were treated with hCG/hMG (n = 20) or a gonadotropin-releasing hormone (GnRH) pump (n = 21). The treatment was divided into a study phase (0-3 months) and a follow-up phase (3-12 months). The testicular volume (TV), penile length (PL), penis diameter (PD), and sex hormone levels were compared between the two groups. The TV and other indicators between the groups were analyzed using a t-test (equal variance) or a rank sum test (unequal variance).@*RESULTS@#Before treatment, there was no statistical difference between the two groups in terms of the biochemistry, hormones, and other demographic indicators. After 3 months of treatment, the TV of the hCG/hMG and GnRH groups increased to 5.1 ± 2.3 mL and 4.1 ± 1.8 mL, respectively; however, the difference was not statistically significant (P > 0.05, t = 1.394). The PL reached 6.9 ± 1.8 cm and 5.1 ± 1.6 cm (P  0.05, t = 0.314). After 9 to 12 months of treatment, the T level was higher in the hCG/hMG group. Other parameters did not exhibit a statistical difference.@*CONCLUSIONS@#The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH. The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy. Furthermore, results from the extended time-period showed positive outcomes at the 1-year mark; however, the long-term effectiveness, strengths, and weaknesses of the hCG/hMG regimen require further research.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT02880280; https://clinicaltrials.gov/ct2/show/NCT02880280.

Screening results and genetic features of glucose-6-phosphate dehydrogenase deficiency in 54 025 preterm infants in Chengdu, China / 中国当代儿科杂志

OBJECTIVE@#To analyze the screening results of glucose-6-phosphate dehydrogenase (G6PD) deficiency and gene mutation distribution of G6PD deficiency in preterm infants in Chengdu, China, in order to provide a basis for the improvement of G6PD screening process in preterm infants.@*METHODS@#Fluorescent spot test for G6PD deficiency using dried blood spots was used for G6PD screening of 54 025 preterm infants born from January 1, 2015 to December 31, 2019 in Chengdu, and G6PD enzymology and gene detection were used for the diagnosis of 213 infants with positive screening results.@*RESULTS@#Among the 54 025 preterm infants, 192 were diagnosed with G6PD deficiency, with an incidence rate of 3.55‰. The incidence rate of G6PD deficiency in preterm infants was higher than that in full-term infants in the same period of time and tended to increase year by year. Birth in summer, gestational age T mutation tend to have mild conditions.

Virological response to direct-acting antiviral therapy and changes in liver fibrosis indices in chronic hepatitis C patients with different alanine aminotransferase and aspartate aminotransferase levels in a real-world setting / 临床肝胆病杂志

ObjectiveTo investigate the virologic response to direct-acting antiviral (DAA) therapy and the changes in liver stiffness measurement (LSM), fibrosis-4 (FIB-4), and aspartate aminotransferase-to-platelet ratio index (APRI) after treatment in chronic hepatitis C (CHC) patients with different alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at baseline in a real-world setting. MethodsCHC patients who attended the outpatient service of Department of Infectious Diseases, Peking University First Hospital, from December 2017 to May 2020 were enrolled, and virologic response rate was calculated. The Wilcoxon rank-sum test was used to compare LSM, FIB-4, and APRI between groups at baseline and at 12 weeks after treatment, and the chi-square test was used for comparison of categorical data between groups. ResultsA total of 48 CHC patients were enrolled, among whom 33.3% had abnormal ALT or AST at baseline. Among these patients, the virologic response rate was 85.4% at week 4 of treatment and 100% at the end of treatment and at 12, 24, and 48 weeks after treatment, and there were significant changes from baseline to 12 weeks after treatment in LSM ［6.1 (51-12.4) kPa vs 8.6 (5.7-16.9) kPa, Z=-1.676, P=0.043］ and APRI ［0.24(0.19-0.48) vs 0.42(0.23-1.17), Z=-2.050, P=0027］. From baseline to 12 weeks after treatment, the patients with abnormal ALT or AST at baseline had significant changes in LSM ［89(5.6-13.1) kPa vs 14.4(8.0-28.2) kPa, Z=-1.679, P=0.047］ and APRI ［0.44(0.25-0.50) vs 1.29(0.99-2.09), Z=-3.427, P=0.001］. ConclusionCHC patients achieve a high sustained virologic response rate after DAA therapy, and the patients with abnormal ALT or AST at baseline tend to have more significant improvements in LSM and APRI than those without such abnormality.

Features of liver injury in adolescents and adults with infectious mononucleosis: A single-center retrospective clinical study of 274 cases / 临床肝胆病杂志

ObjectiveTo investigate the features of liver injury and related influencing factors in adolescents and adults with infectious mononucleosis (IM). MethodsA retrospective analysis was performed to investigate the features of liver injury in adolescents and adults with IM who were hospitalized in Peking University First Hospital from January 2005 to December 31 2018, and the patients were divided into subgroups based on age, Epstein-Barr virus (EBV) DNA level, and presence or absence of jaundice or infection with cytomegalovirus or hepatitis E virus (HEV). The t-test was used for comparison of continuous data meeting analytical conditions between two groups, and the Mann-Whitney U test was used for comparison of continuous data which did not meet analytical conditions between two groups; the chi-square test was used for comparison of categorical data between two groups, and the Fisher’s exact test was used for comparison of categorical data which did not meet the analytical conditions of the chi-square test. A logistic regression analysis was used for multivariate analysis. ResultsA total of 274 patients were enrolled, with 154 male patients (56.2%) and 120 female patients (43.8%), and the mean age of onset was 22.3±67 years. The incidence rate of liver injury ［defined as alanine aminotransferase (ALT) ＞50 U/L and/or aspartate aminotransferase (AST)＞40 U/L］ was 97.4% (267/274), and that of jaundice was 27.6% (74/268). The patients, aged ≥20 years, tended to have a higher level of gamma-glutamyl transpeptidase (GGT) (Z=2.070, P=0.038). Serum EBV DNA was measured for 167 patients, among whom 90 had positive results and 77 had negative results. The positive serum EBV DNA group had significantly higher levels of GGT (Z=3.005, P=0.003) and lactate dehydrogenase (Z=2.162, P=0.031) than the negative serum EBV DNA group. The patients with cytomegalovirus infection tended to have a higher level of alkaline phosphatase (Z=2.351, P=0.019), and the patients with HEV infection presented with a higher level of GGT (Z=1.988, P=0.047). AST (odds ratio ［OR］=1.006, 95% confidence interval ［CI］: 1.002-1.010, P=0.005) and ALP (OR=1.012, 95%CI: 1.005-1.020, P=0.001) were independent risk factors for jaundice. ConclusionThere is a high incidence rate of liver injury in adolescents and adults with IM, and the patients with an older age or positive serum EBV DNA tend to have more severe liver injury.

Interleukin-1β is a potential therapeutic target for periodontitis: a narrative review / 国际口腔科学杂志·英文版

Interleukin(IL)-1β, a pro-inflammatory cytokine, was elevated and participates in periodontitis. Not only the link between IL-1β and periodontitis was proved by clinical evidence, but also the increased IL-1β triggers a series of inflammatory reactions and promotes bone resorption. Currently, IL-1β blockage has been therapeutic strategies for autoimmune and autoinflammatory diseases such as rheumatoid arthritis, cryopyrin-associated periodic syndromes, gout and type II diabetes mellitus. It is speculated that IL-1β be a potential therapeutic target for periodontitis. The review focuses on the production, mechanism, present treatments and future potential strategies for IL-1β in periodontitis.

Efficacy and metabolic safety of long-term treatment with ethinyl oestradiol/cyproterone and desogestrel/ethinyl oestradiol tablets in women with polycystic ovary syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy and metabolic safety of long-term treatment with ethinyl oestradiol/cyproteroneand desogestrel/ethinyl oestradiol tablets in women with polycystic ovary syndrome (PCOS).</p><p><b>METHODS</b>Women with PCOSfrom West China Second Hospital of Sichuan University enrolled between September, 2011 and August, 2013 were randomlyallocated to receive either ethinyl oestradiol/cyproterone tablets (Group A, =355) or desogestrel/ethinyl oestradiol tablets(Group B, =357) for a prospective observation period of 6 months. Women with insulin resistance also received metformin. Atbaseline, 3 months, and 6 months, the patients were evaluated for menstruation, acne score, body mass index (BMI), waist-tohip ratio (WHR), plasma levels of sex hormones, fasting blood glucose (FPG), HOMA-insulin resistance index (HOMA-IR), serum lipid, ovarian volume, and the number of ovarian follicles.</p><p><b>RESULTS</b>All the patients had a regular menstrual cycle aftertreatments. Testosterone level, acne score, LH/FSH, ovarian volume, and the number of follicles decreased significantly afterthe treatments without significant differences between the two groups. Significant increases were noted in TG, TCh, LDL, HDL, and AIP, and HDL level in group A as compared with group B ( < 0.001). FPG decreased in both groups, and wassignificantly lower in group B at 6 months ( < 0.05). BMI and WHR decreased in all the patients with insulin resistance aftercombination treatment with metformin ( < 0.05), but increased significantly in patients without insulin resistance ( < 0.05). Ingroup A, HOMA- IR significantly increased in patientswithout insulin resistance at 3 months ( < 0.05), whereas asignificant increase was not observed until 6 months ingroup B ( < 0.05).</p><p><b>CONCLUSIONS</b>Both ethinyl oestradiol/cyproterone tablets and desogestrel/ethinyl oestradioltablets can relieve the symptoms of PCOS, but it isadvisable to assess the risk of cardiovascular diseasebefore the treatments.</p>

Bladder symptoms and its impact on quality of life in type 2 diabetes mellitus / 中国实用护理杂志

Objective To estimate the bladder symptoms, and explore its impact on patients′ quality of life in type 2 diabetes mellitus. Methods Overactive bladder symptom score (OABSS) was used to evaluate patients′ bladder symptoms, and Medical Outcome Study 12-Item Short Form Health Survey Scale (SF-12), Overactive Bladder Questionnaire Short Form(OABq-SF)were conducted to test the effect of bladder symptoms on general and disease-specific quality of life. Results Among the four bladder symptoms, nocturia was the most prevalent symptom (46.7%,479/1025 ), followed by urinary frequency (14.9%,153/1025 ),urinary urgency (14.2%,146/1025 ), urge urinary incontinence (7.9%, 81/1025). Nocturia and urge urinary incontinence significantly increased symptom bother (nocturia B=0.337,P<0.01;urge urinary incontinence B=0.437,P<0.01) and decreased disease-specific quality of life (nocturia B=-0.364,P<0.01;urge urinary incontinence B=-0.346, P<0.01) in these patients. Meanwhile, urge urinary incontinence was negatively associated with general mental health (B=-0.255, P=0.011). Conclusions The prevalence of bladder symptoms in type 2 diabetes patients was high, and was found to be associated with patients′general and disease-specific quality of life. Health care providers should be aware of the high prevalence of bladder symptoms and its impact on QOL to facilitate early diagnosis and treatment of bladder symptoms during diabetic care.

Clinical significance of combined detection of serum brain natriuretic peptide, homocysteine and blood lipids in patients with heart failure / 重庆医学

Objective To explore the clinical application value of combined detection of serum brain natriuretic peptide (BNP),homocysteine(HCY) and blood lipids in the patients with heart failure.Methods The levels of serum BNP,HCY,TC,TG,HDL-C,LDL-C,ApoA,ApoB and Lpa were detected in 100 patients with heart failure (observation group) and contemporaneous 100 persons (control group) undergoing healthy physical examination.Then the comparative analysis was performed.Results Compared with the control group,the BNP and HCY levels in the observation group were significantly increased(P＜0.05);among 7 indicators of the blood lipid,the Lpa level in the observation group was increased compared with the control group,while the TC,HDL-C and LDL-C levels were significantly decreased(P＜0.05),and the TG,ApoA and ApoB levels had no statistical differences between the two groups(P＞0.05).Conclusion Serum BNP,HCY,TC,HDL-C,LDL-C and Lpa levels have close correlation with heart failure,especially the combined detection of BNP,HCY and Lpa,which has predictive and diagnostic value in heart failure and is worthy of clinical popularization and application.

Application of early warning model based on decision tree for medical equipment quantity and quality / 医疗卫生装备

Objective To propose a decision tree-based early warning model so as to predict the medical equipment quantity and quality under special conditions to quantize maintenance and detection staffs allocation,components supply,emergency planning and etc.Methods A data set was established based on the verification report,data on performance parameters detection and daily management log,and then underwent pretreatment.A decision tree came into being with the algorithms of ID3,CHAID and etc.The data rule corresponding to the decision tree was transformed into a series of early warning information.The model was verified by applying it to medical equipment usage management.Results The decision tree developed was applied to analyzing a vehicle-mounted water purifying device maintenance and usage records in some logistics support vehicle,and it's found the main factors contributing to the failures included migration distance along non-paved road,ambient temperature and service time.Conclusion The decision tree-based early warning model for medical equipment quantity and quality gains high feasibility and practical values.

Clinical value of serum (1-3 )-β-d-glucan detection on diagnosis of deep fungal infection / 国际检验医学杂志

Objective To investigate the clinical value of serum (1-3)-β-D-glucan(BG) detection (G test) in early diagnosis of deep fungal infection .Methods 132 patients with suspected deep fungal infection in the Chongqing Emergency Medical Center from October 2015 to April 2016 were selected as the research subjects .Among them ,38 cases definitely diagnosed and suspected diagnosed deep fungal infection served as the positive group and other 94 cases were taken as the negative group .Serum BG level was measured by Jinshanchuan MB-80 microbial dynamic detection system ,and the results were compared with the fungal culture results by the body fluid fungal culture .Results The serum BG level of the positive group was (150 .8 ± 133 .2)pg/mL ,and which of the negative group was (25 .7 ± 20 .1)pg/mL ,the difference was statistically significant (t=5 .76 ,P＜0 ,05) .The sensitivity ,specificity ,positive predictive value and negative predictive value of G test were 78 .9% ,85 .1% ,68 .1% and 91 .0% respectively ;the sensitivity ,specificity ,positive predictive value and negative predictive value of fungal culture were 57 .9% ,80 .9% ,52 .3% and 82 .6%respectively .Conclusion The serum BG detection is fast ,accurate ,simple and convenient ,and has clinical application value in the early diagnosis of deep fungal infection and clinical rational medication guidance .

Help-seeking behavior among individuals with overactive bladder in type 2 diabetes mellitus and its influencing factors / 中国实用护理杂志

Objective To estimate help-seeking behavior among individual with overactive bladder (OAB) in type 2 diabetes mellitus and its influencing factors.Methods This was a cross-sectional survey with a representative sample of 133 patients with OAB in type 2 diabetes mellitus responded the questionnaires,including a self-designed Demographic Data Questionnaire,12-item Short-Form health survey questionnaire,Overactive Bladder Symptom Score,Patient Perception of Bladder Condition,Help-seeking Behavior Questionnaire.Results Among cases,21.8％(29/133) had seen a doctor for voiding problems.In the Logistic model,educational status,Charlson comorbidity index,glycosylated hemoglobin,and OAB symptom bother were found to be associated with help-seeking behavior,OR value(95％ confidence interval) were 3.158(1.511-6.599),2.537(1.327-4.849),0.631(0.430-0.926),1.655(1.126-2.434),P ＜0.01 or 0.05.Conclusions The help-seeking rate of OAB individuals in type 2 diabetes mellitus patients is low.Health care providers should understand the predictors of help-seeking behavior and take actions to improve patient's health care utilization and quality of life.

Discussing the unqualified rate and analysing the upper limit of ALT donated by volunteers in Chongqing city / 国际检验医学杂志

Objective To investigate the upper limit of plasma′s alanine aminotransferase (ALT ) donated by volunteers in Chongqing city ,utmost avoid blood discarding due to ALT unqualified and provide a scientific basis for the improvement measures . Methods Checking 115 530 blood donors′ALT by rate method ,the activity of ALT value was normal distribution ,deem x ± 1 .96s as the upper limit of ALT of blood donors ,the upper limit of ALT and the unqualified rate was analyzed according tomonth ,age , gender .Results 95% upper limit of blood donors′ ALT reference range to less than 47 .88 U/L .From June to September ,ALT value unqualified rate compared with other months of the year have significant difference (P0 .05) .There was obvious difference about unqualified rate and upper limit between different sex group ,there was statistical significance (P<0 .05) .Conclusion The quantitative blood agen‐cies should increase propagandist strength ,optimize ALT screening strategy ,gender‐specific blood donors screening measures should be taken ,re‐establish a more scientific ALT Elimination standard ,the maximum reduct blood ALT′s failure rate .To ensure the safety and clinical local blood supply at the same time ,the maximum to avoid waste of blood .

The analysis ofβ-lactam antibiotics interference in fructosamine testing / 国际检验医学杂志

Objective To evaluate the interference of 13 kinds of β‐lactam antibiotics in fructosamine detection .Methods A se‐ries of solution of antimicrobial drugs were formulated with water for injection ,and added into the mixture fresh serum volume by 5% .Interfere with antimicrobial drugs on the test results of fructosamine were evaluated .Results When the blood concentrations of cefathiamidine and ticarcillin sodium/clavulanate potassium were up to 37 .5 mg/L and 247 .5 μg/mL respectively ,they began to produce positive interference on fructosamine detection .However ,the degree of interference was not correlated to the serum concen‐tration of fructosamine .Conclusion Cephathiamidine and ticarcillin sodium/clavulanate potassium have positive interference on fructosamine detection .

A survey on test results of HBsAg,ALT and anti-HIV,anti-HCV,anti-TP antibodies among voluntary blood donors in Chongqing from 2008 to 2012 / 国际检验医学杂志

Objective To analyze the test results of hepatitis B virus surface antigen(HBsAg) ,alanine aminotransferase(ALT) and anti-hepatitis C virus (HCV) ,anti-human immunodeficiency virus (HIV) ,anti-treponema pallidum (TP) antibodies among voluntary blood donors ,and to provide basis for recruiting low-risk voluntary blood donors and reducing blood abandonment . Methods 551 133 blood samples derived from voluntary blood donors which had accepted enzyme-linked immunosorbent assay (ELISA) screening in Chongqing Blood Center from 2008 to 2012 were collected and were subject to HBsAg ,ALT and anti-HIV , anti-HCV ,anti-TP antibodies detection .Laboratory information management system ITSWELL was employed to read ,save and gather the test results ,and whether the samples were qualified was determined .Results Total of 37 534(6 .81% ) substandard blood samples were detected .Among them ,the substandard rates of HBsAg ,ALT and anti-HCV ,anti-HIV ,anti-TP antibodies were 1 .10% ,3 .79% ,0 .51% ,0 .33% and 1 .08% ,respectively .Conclusion Strengthening the screen of blood detection reagents and building the team of voluntary blood donors will contribute to the safety of clinical blood transfusion .