Organizing Pneumonia in A Patient Double-Positive for ANCA and Anti-GBM Antibodies: A Case Report / 中国医学科学杂志(英文版)

Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.

An Analysis of Self-reported Income Status and Related Determinants among Primary Care Providers in a County in Dali / 昆明医科大学学报

Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%～69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%～47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.

The Awareness,Treatment and Control of Hypertension and Its Determinants in the Elderly Hypertensive Patients of Dean Nationality:A Multilevel Model Analysis / 昆明医科大学学报

Objective To determine the awareness, treatment and control of hypertension and its determinants in the elderly hypertensive patients of Dean nationality so as to explore the associated determinants. Methods This was a cross-sectional, population-based survey. A total of 939 persons aged 60 years and older sampled by stratified sampling method from the elderly population of Dean nationality were examined from July to September 2016. Meanwhile, the data of medical history and examination were collected. Results There were 353 elderly patients with hypertension in the 939 subjects. The awareness, treatment and control of hypertension in the elderly hypertensive patients (EHP), which was 47.3％, 36.5％and 22.1％respectively, were higher than the results of previous national study and had the upward trends with the increasing age (<0.05) . In comparison with the reference group, EHP living in middle economic level area had the higher awareness, treatment and control of hypertension (<0.05) . The results of covariate-adjusted multilevel logistic regression model indicated that there was a cross-level interaction effect between middle economic level area and dyslipidemia on the awareness and treatment of hypertension respectively, and a cross-level interaction effect between middle economic level area and low fat diet on the control of hypertension ( <0.05) . The individual level covariates, age (OR=1.3412, 1.3144, 95％ CI 1.0217-1.7609, 1.0030-1.7225) and diabetes ( OR=2.6735, 2.3078, 95％ CI 1.0721-6.6672, 1.0240-5.2007), had the positive association with the awareness and treatment of hypertension;age (OR=1.4740, 95％CI 1.0034-2.1654), non-drinking (OR=3.2056, 95％CI 1.5554-6.6066) and low salt diet (OR=3.6969, 95％CI 1.7996-7.5946) had the positive association with the control of hypertension. Conclusion The awareness, treatment and control of hypertension in the EHP of Dean nationality were higher than those of the national level, and the dominant factors were economic level, age, dyslipidemia, diabetes, non-drinking, low fat diet and low salt diet, etc.

Study on establishing perioperative nursing prevention strategies for patients with deep venous thrombosis in department of orthopedics / 中华护理杂志

Objective To establish nursing prevention strategies for patients with deep venous thrombosis in department of orthopedics,so as to guide the specific context of clinical nursing practice,offer evidence-based evidence.Methods Clinical practice guidelines and original researches at home and abroad were retrieved using systematic review approach,and appraisal of literatures was conducted using Australia JBI based Quality Evaluation Center for health care evaluation methods and Johns Hopkins standard.The preliminary nursing prevention strategies for patients with deep venous thrombosis in department of orthopedics and Delphi mail questionnaire were developed.Using Delphi method,the operational feasibility of the final evidence strategies was improved for clinical evidence application through two rounds of consultation from clinical experts.Results A total of 111 articles were included in this study.Forty-nine prevention strategies were established under 3 dimensions including "risk assessment graded prevention" and "education and instruction" through systematic review and Delphi method.Conclusion Nursing prevention strategies in department of orthopedics for patients with deep venous thrombosis based on systematic review and Delphi method have scientific practicability and operability,and can provide objective reference and implementation strategies for nursing practice,assisting the implementation of effective preventive measures.

Middle and long-term results of total hip arthroplasties for secondary post-traumatic arthritis and femoral head necrosis after acetabular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate middle and long-term results of total hip arthroplasties (THA) for the treatment of secondary hip traumatic osteoarthritis and femoral head necrosis after acetabular fractures.</p><p><b>METHODS</b>From January 2000 to December 2005, 33 patients with secondary hip traumatic osteoarthritis and (or) femoral head necrosis after acetabular fractures were treated with THA. There were 21 males and 12 females, ranging in age from 27 to 69 years old, with an average of 52 years old. Twenty-three patients were performed with open reduction and internal fixation: 5 patients were treated with anterior approach; 12 patients, posterior approach; 6 patients, combined approaches; other 10 patients, conservative treatment in the early stage. All THA were performed with posterior-lateral approach. Bone union was achieved in the all acetabular fractures. Removal of all implants was necessary in 5 patients, and partial removal in 3 patients. Cemented cup was implanted in 6 patients and uncommented cup in 27 patients. Intraoperative and postoperative complications were observed, and Harris hip scores before surgery and 10 years after operation were compared. The prosthetic loosening, osteolysis or revision were used to evaluate 10 years survival rate of prosthesis.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 10 to 15 years, with a mean of 12 years. One patient died at the 10th year after operation. The Harris score at the 10th year was higher than the preoperative one. One and two patients were performed with revision total hip arthroplasty caused by aseptic loosening alone and aseptic loosening combined with osteolysis respectively. Osteolysis occurred in 1 patient; deep venous thrombosis in 4 patients; dislocation of prosthesis in 2 patients. One patient had infection of incision and one patient had infection around the prosthesis. Ten years survival rate of implant was 84.8% (28/133).</p><p><b>CONCLUSION</b>THA is an effective method to treat secondary hip traumatic osteoarthritis and (or) femoral head necrosis after acetabular fractures in improving hip joint functions with high implant survival rate and good middle and long-term results.</p>

acetylcholinesterase [AChE] inhibition analysis of medaka [Oryzias latipes] in the exposure of three insecticides

The continuous effects on Acetylcholinesterase [AChE] activity of medaka [Oryzias latipes] caused by dichlorvos, methomyl and deltamethrin in vivo were investigated, and the trends of AChE activity inhibition due to the influence of these insecticides were discussed. The LC[50]-24 h of dichlorvos, methomyl and deltamethrin on medaka were 2.3 mg/L, 0.2 mg/L, and 2.9×10[-3] mg/L respectively. The result suggested that at the beginning of the exposure, the AChE activity might increase, and the AChE activity in dead individuals was obviously lower than the live individuals. Though the de novo synthesis of AChE in medaka might help the AChE activity recover, the trends during the exposure in different treatments were downward, and it showed both exposure time and concentration dependent. Meanwhile, higher temperature might cause the AChE inhibition earlier due to the higher metabolic rate. Therefore, as a specific biomarker for organophosphate, carbamate pesticides and pyrethroids, the degree of the AChE inhibition with in vivo conditions is a good tool in continuous monitoring of insecticides, which may induce the nerve conduction disorders

Clinical research on corneal perforation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the clinical characteristics of corneal perforation ( CP) . METHODS:A retrospective analysis in July 1995 to July 2010 the First Affiliated Hospital of Fujian Medical University diagnosed CP 72 patients ( 72 eyes ) , clinical characteristics of all the patients were analyzed. RESULTS: The incidence of corneal ulcer perforation rised year by year, the morbidity of male and female was 17:7, the onset age focused on 48 years old. Of 23 industrial workers ( 32%) with clear history of trauma, pathogeny identification results:top two:fungal infection and Acanthamoeba keratitis. A using history of glucocorticoid was found in 10 cases. CONCLUSION:There are plenty of primary causes of CP such as traumas, fungal infection, Acanthamoeba keratitis, eroded keratitis, etc. CP happens in middle-aged males in Fujian province, most traumas are the causes, the main pathogenic bacteria is fungal infection.

Characteristics of mixed prolactin and adrenocorticotropin secreting pituitary adenomas and the differences in patients with merely prolactin-secreting adenomas

To evaluate the characteristics of pituitary adenomas that produce both prolactin and adrenocorticotropin. Between 2002 and 2011, we reviewed the data of 336 patients undergoing transsphenoidal surgery at Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. Patients were divided into 2 subgroups: patients with mixed prolactin and adrenocorticotropin secreting adenomas, and patients with merely prolactin-secreting adenomas. Clinical and endocrinological data, imaging, histopathological reports, and outcomes were reviewed. Differences between the 2 groups were statistically analyzed, and p<0.05 was considered statistically significant. Compared to patients with merely prolactin-secreting adenomas, patients with mixed prolactin and adrenocorticotropin secreting adenomas were younger [p<0.001], had higher incidences of headaches and dizziness [p=0.021], progressive obesity [p<0.001], menstrual disorders [p=0.006], polyuria and polydipsia [p<0.001], hypertension [p=0.001], diabetes mellitus [p=0.001], and had higher rates of postoperative hyponatremia [p<0.001]. Recurrence rates in patients with prolactin-secreting adenomas were 19.1% and patients with mixed prolactin and adrenocorticotropin secreting adenomas were 35.1% [p=0.023]. However, the endocrine normalization rate in mixed prolactin and adrenocorticotropin secreting adenomas was lower [p=0.004]. Careful long-term follow-up is needed for patients with mixed prolactin and adrenocorticotropin secreting adenomas

role of Ki-67 in women with a resistant prolactinoma: a retrospective analysis in 199 hospitalized patients over a period of 5 years

Proliferation-associated antigen Ki-67 is used for the histological evaluation of different tumors. Few studies have been conducted on women with a resistant prolactinoma

To better define the characteristics and to evaluate the differences between patients with different Ki-67 labeling index [LI], a retrospective study was designed to recruit 199 females with a resistant prolactinoma. The patients were divided into two groups, patients with Ki-67 LI>3% and patients with Ki-67 LI<3%. Tumors in the LI>3% group were also larger [p=0.043], had a higher rate of invasion (p=0.014), and were associated with more frequent polyuria and polydipsia [p=0.008] compared to the LI<3% group. The pre- and post-operative PRL levels in the LI>3% group remained significantly higher compared to patients with LI<3% [p<0.05]

The incidences of transient diabetes insipidus and hyponatremia in the LI>3% group were also significantly higher [p=0.037, p=0.041]

Additionally, the postoperative PRL normalization rate was lower in patients with LI>3?/o compared with patients with LI<3% [p=0.028]

The recurrence rate in the LI>3% and LI<3% groups were 27.27% and 8.47%, respectively. In conclusion, high Ki-67 LI is predictive sign of a poor prognosis in women with resistant prolactinoma

Application of interest teaching method in the teaching of human parasitology / 中华医学教育探索杂志

Interest teaching method aims to inspire students' initiative and inquiry in learning.In the teaching process,we used some teaching methods including class lead-in,relevant extracurricular books and websites,scene representation,lectures on special content and arrangements of the review writing.It is important to maintain students' motivate and interest in learning human parasitology,therefore,we should no longer make students passively accept but the initiatively make inquiry learning.

Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism.</p><p><b>METHODS</b>From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment.</p><p><b>RESULTS</b>All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05).</p><p><b>CONCLUSION</b>Bone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary</p>

Feasibility of proton magnetic resonance spectroscopy of the myocardium in vivo / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of proton magnetic resonance spectroscopy ((1)H-MRS) of the myocardium in vivo.</p><p><b>METHODS</b>A total of 100 volunteers were examined with 1H-MRS scan using a 1.5T MR scanner, and the magnetic resonance spectra were analyzed.</p><p><b>RESULTS</b>All the volunteers completed the examinations, and the spectral peaks were identified with the chemical shifts of water (4.7 ppm), choline (3.2 ppm), creatine (3.0 ppm), and triglyceride (0.9-1.6 ppm), whose presentation ratios were 100%, 86%, 90%, and 98%, respectively. In 86 cases the spectra showed all the chemical shifts. The myocardial metabolite contents were expressed as the ratio of metabolites to water (%), and the contents of choline, creatine, and triglyceride were 1.94%, 1.95%, and 9.41%, respectively.</p><p><b>CONCLUSION</b>(1)H-MRS can be used in detecting the metabolic products of myocardium in vivo.</p>

Exploration of opening the relevant medical microbiology elective course / 中华医学教育探索杂志

In order to stimulate students to interest in study,broaden their horizons,and strengthen their scientific literacy,the writers opeed the elective course of medical microbiology---《plague and the movie》.During this teaching process the writers explored the setting of the elective course,and summarized the experience and the existing problems of the process and prospect the teaching work of the future.