Diagnosis, treatment and management status of COPD in county-level hospitals of China / 中华健康管理学杂志

Objective:To understand the current management status of chronic obstructive pulmonary disease (COPD) in county-level hospitals in China from 2020 to 2021.Methods:This survey was led by the China Association of County Hospital President. In 2021, a questionnaire survey was conducted on 633 secondary and tertiary hospitals from 24 provinces, and the questionnaire was filled out according to the actual situation of the hospital in 2020, including diagnosis, treatment, rehabilitation and comprehensive management of COPD. The nature of the hospital was divided into public or private. The type of hospital was divided into general or specialist. The economic zones was divided into eastern, central or western. Through the content of the questionnaire, the influencing factors of the diagnosis, treatment and management capabilities of COPD in county-level hospitals were explored.Results:A total of 633 questionnaires were collected in this survey, and 26 were removed due to the incorrect information or information loss. Thus, a total of 607 questionnaires were finally included in this survey, including 425 secondary hospitals and 182 tertiary hospitals; 591 public hospitals and 16 private hospitals. For the capabilities of diagnosis and treatment, the tertiary hospital was significantly better than the secondary hospital on the availability of respiratory outpatient clinics, COPD outpatient clinics, outpatient comprehensive clinics, respiratory ward and intensive care unit (ICU) (94.5% and 78.4%, 51.1% and 32.7%, 79.7% and 67.3 %, 84.6% and 59.8%, 78.6% and 61.9%, respectively) (all P<0.01). In terms of lung function test and bronchodilation test, tertiary hospitals performed significantly better than secondary hospitals ( P<0.05). There was no difference in availability of inhaled bronchodilators and expectorant drugs among different hospital levels, nature, type, and economic zones ( P>0.05). However, the proportion of hospitals with available triple inhalation drugs was lower in secondary hospitals than tertiary hospitals. For the non-drug treatment, the proportion of general hospitals carrying out vaccination was significantly higher than that of specialized hospitals (52.7% and 28.1%, P=0.010). The tertiary hospitals performed significantly better than secondary hospitals in smoking cessation guidance (98.4% and 94.4%, P=0.031). In terms of rehabilitation, tertiary hospitals also performed significantly better than secondary hospitals (79.7% and 61.9%, P<0.001). The proportion of hospitals carrying out long-term management of COPD in tertiary hospitals was significantly higher than secondary hospitals, and the proportion in public hospitals was significantly higher than private hospitals (80.2% and 61.2%, 68.2% and 18.8%, both P<0.001). Conclusions:County hospitals in China have a good overall performance in the diagnosis and drug treatment of COPD, but need to be further improved in non-drug treatment, rehabilitation, and comprehensive management. The hospital level is the main factor affecting the management ability of COPD. The nature and type of hospital mainly affect the construction of departments and comprehensive management of COPD.

The effect of peer assisted learning method in infectious disease surgical nursing students in evaluation / 中国实用护理杂志

Objective To improve the effectiveness of internship nursing students in infectious diseases by implementing peer teaching method. Methods The nursing students were divided into two groups according to the order of student number. The control group was given the teaching method of the general outline. On the basis of the outline teaching, the experimental group gave counseling and counseling to the students in their professional and psychological aspects. Results There were significant differences between the two groups in terms of the results of the three tests and the theoretical evaluation, and the results of the test group were better than those of the control group (P<0.05). Conclusion Peer- to- peer learning method can improve the practical effect of surgical nursing students in infectious diseases, and can be popularized in a certain extent.

Efficacy and its related factors of phenobarbital treatment for epilepsy management in rural China / 中华全科医师杂志

Objective To analyze efficacy and its influencing factors of phenobarbital treatment for epilepsy management in rural China.Methods Total 3 315 patients with convulsive epilepsy from rural areas of 24 counties were enrolled in this joint epilepsy management program.All patients received phenobarbital monotherapy for 1 year during November 2011 to November 2013.The efficacy and potential influencing factors including sex,age,duration of epilepsy,number of seizures in the 12 months before management(≥2),previous treatment,daily dose of phenobarbital,taking other antiepileptic drugs and compliance of patients were studied with multivariate analysis.Results Among 3 315 patients,38.9％ were seizure-free during the entire management period.The rates of seizure-free in 15 to 39 y age group (35.2％,495/1 405)and in patients receiving irregular treatment previously (34.6％,625/1 808)were lower.The rates of seizure-free were higher in patients taking phenobarbital 60-90 mg everyday (49.4％,988/2 000) and those with good compliance(42.3％,1 160/2 744).Patients taking other antiepileptic drugs in 12 months had lower seizure-free rate (31.0％,45/145).Univariate analysis showed that gender of patients was not related to seizure-free rate (P ＞ 0.1).Multivariate analysis showed that the longer duration of epilepsy(OR =0.015,95％ CI:1.008-1.021,P ＜ 0.001),more seizures in the 12 months (OR =0.005,95％ CI:1.002-1.007,P =0.002) and the irregular treatment before management were the risk factors for low seizure-free rate (P ＜ 0.05).Patients received formal treatment or untreated had a lower risk of seizure compare with the irregular treatment (OR =0.737,95％ CI:0.611-0.889,P =0.001;OR =0.566,95％ CI:0.469-0.683,P ＜0.001).Patients with good compliance and with a daily dose of 60-89 mg phenobarbital(OR =0.107,95％ CI:0.013-0.905,P =0.040) were associated with high seizurefree rate;in contrast the poor compliance was a risk factor for not being seizure-free(OR =2.038,95％ CI:1.634-2.541,P ＜ 0.001).Conclusion Regular medication of phenobarbital with good compliance is effective for convulsive epilepsy management in rural China.

Breast cancer patient compliance with endocrine therapy / 中华内分泌外科杂志

Objective To investigate the compliance with endocrine therapy(ET) and assess the factors associated with treatment accuracy for breast cancer.Methods 379 patients with hormone receptor-positive breast cancer undergoing complete treatment from Jun.2006 to Jun.2008 in Jiangsu Cancer Hospital were followed up.Factors related to compliance were analyzed.Results Among the 322 (85.0％) patients successfully interviewed,15 (4.7％) patients did not receive ET,43 (13.4％) patients stopped taking drugs after discharge,14 (4.3％)patients had intermittent ET,and the rest 250 patients obeyed 5-year oral ET regularly.The treatment accuracy was 77.6％ (250/332).We found that majority of withdraw occurred within 2 months and within 2 years,accounting for 39.5％ and 48.8％,respectively.Job and education status were relevant to these patients.Moreover,too much concern of adverse drug effects and difficulty of long-term medication were the main reasons to noncompliance.Conclusions ET is effective in hormone receptor-positive breast cancer patients and has been used as a conventional therapy.However,due to the long therapeutic period and lack of medical supervision after discharge,its treatment accuracy and compliances are becoming low,resulting in decreased efficiency.It is therefore necessary to investigate such patients' management to improve the compliance and treatment accuracy of ET.

The role of microRNAs in breast cancer stem cells / 国际肿瘤学杂志

Cancer stem cells are a kind of cancer cell group with the ability of self-renewal and various diferentiation potentials.Recent studies have implicated that they play a significant role in tumor formation,metastasis,resistance to anticancer therapies and cancer recurrenee.Many studies show that microRNAs are involved in the maintenance,growth and behavior of breast cancer stem cells (BCSCs),paving a new way for diagnosis,prognosis and therapy of breast cancer.

Expressions of MiR-342-3p in different molecule subtypes and cell lines of breast cancer / 医学研究生学报

Objective The individualized treatment of breast cancer have attracted more and more attention .Different mo-lecular subtypes of breast cancer have different kinds of prognosis and therapeutic regimen .Studies have found that miR-342-3p is asso-ciated with breast cancer of hormone receptor and endocrine therapy resistance , as well as tumor cell apoptosis .This study was to fur-ther investigate the expressions of miR-342-3p in different breast cancer molecular subtypes and breast cancer cell lines to reveal the importance of miR-342-3p in individualized treatment of breast cancer . Methods A total of 90 tissue samples from patients with breast cancer surgery were collected .Three types of breast cancer cell line were cultured , including MCF-7, SKBr3 and MDA-MB-231.Real-time fluorescent quantitative PCR was applied to detect the expression of miR-342-3p in breast cancer tissue . Results Expression of the miR-342-3p increased the most in Lumina B type breast cancer tissue (1.594 ±0.465), followed by Lumina A type (1.386 ±0.443), Her-2 high expression type (1.165 ±0.337), and the lowest in the tripe negative breast cancer tissue (0.837 ± 0.351), representing significant difference (P0.05).As to the expression of miR-342-3p in three types of breast cancer cell line , taking SKBr3 as the reference, the relative ratio was 126(118-134) and MDA-MB-231 was 0.017(0.014-0.018). Conclusion The expressions of miR-342-3p are different in different molecular subtypes and cell lines of breast cancer , which are relevant to different molecular subtypes of breast cancer , making it possible reference index for breast cancer typing and relevant to good prognosis .

Polymorphism of methylenetetrahydrofolate reductase gene is associated with response to fluorouracil-based chemotherapy in Chinese patients with gastric cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The importance of polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene for the prediction of the response to fluorouracil-based adjuvant chemotherapy in gastric cancer patients remains unclear. The aim of this study is to assess the predictive value of several polymorphisms of the MTHFR gene for clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population.</p><p><b>METHODS</b>Three hundred and sixty-two Chinese patients with gastric cancer were treated with fluorouracil-based adjuvant chemotherapy. DNA samples were isolated from peripheral blood collected before treatment. The three single nucleotide polymorphisms (SNPs) (rs1801131, rs1801133, rs2274976) genotypes of the MTHFR gene were determined by matrixassisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).</p><p><b>RESULTS</b>The average response rate for chemotherapy was 46.7%. Homozygous genotypes rs2274976G/G (χ(2) = 22.7, P < 0.01) and rs1801131A/A (χ(2) = 14.3, P = 0.008) were over-represented in responsive patients. Carriers of the rs2274976A allele genotypes (G/A and A/A) and of the rs1801131C allele genotypes (A/C and C/C) were prevalent in nonresponsive patients. In the haplotype association analysis, there was a significant difference in global haplotype distribution between the groups (χ(2) = 20.69, P = 0.000 124).</p><p><b>CONCLUSIONS</b>These results suggest that polymorphisms of the MTHFR gene may be used as predictors of the response to fluorouracil-based chemotherapy for gastric cancer patients in Chinese population. Well-designed, comprehensive, and prospective studies on determining these polymorphisms of MTHFR gene as clinical markers for predicting the response to fluorouracil-based therapy in gastric cancer patients is warranted.</p>

Effect of miR-342-3p on chemotherapy sensitivity in triple-negative breast cancer / 中南大学学报(医学版)

OBJECTIVE@#To study the effect of miR-342-3p on the chemotherapy sensitivity in triple-negative breast cancer (TNBC).@*METHODS@#Tissue samples were collected from January 2011 to August 2013 samples in Jiangsu Cancer Hospital from a total of 32 triple-negative breast cancer patients with preoperative chemotherapy, with 5 cases of complete response (CR) and 27 cases of partial response (PR). We detected miR-342-3p expression of TNBC with RT-PCR. We transfected has-miR-342-3p mimic and inhibitor into breast cancer cell lines MDA-MB-231 by lipofection transfection and set up negative control mim-NC and inhi-NC. Group of mimic, mim-NC, inhibitor and inhi-NC were cultivated with 2 μmol /L paclitaxel, cisplatin or 4 μmol/L doxorubicin for 48 h. The cell growth rates were measured by CCK8 reagent kit, and the cell apoptosis rate by flow cytometry.@*RESULTS@#The expressions of miRNA-342-3p in TNBC tissue of CR were higher than those of PR. The cell growth rates of mimic were lower and cell apoptosis rates were higher than those of min- NC after cultivating with paclitaxel or cisplatin for 48 h, with significant difference (P0.05).@*CONCLUSION@#TNBC with high expression of miR-342-3p are more sensitive to chemotherapy. miRNA-342-3p may regulate the sensitivity of breast cancer cell line MDA-MB-231 to chemotherapy drugs paclitaxel and cisplatin, but can not affect the chemotherapy sensitivity of doxorubicin.

Expression of β2 microglobin and vascular endothelial growth factors in diffuse large B-cell lymphoma and its clinical significance / 肿瘤研究与临床

Objective To investigate the expression and clinical significance of β2 microglobin (β2-MG)protien and vascular endothelial growth factor (VEGF) protien in diffuse large B-cell lymphoma (DLBCL).Methods The expressions of VEGF protien and β2-MG protien were evaluated in 49 DLBCL patients which started the initial treatment by luminex suspension array.Results Among 49 DLBCL patients,expression of β2-MG protein was high in 37 cases and the expression of VEGF protein was high in 23 cases.The expression of VEGF protien and β2-MG protien were not related with gender,age,B symptoms,clinical stage and lactic acid (LDH).There was positive correlation between the high expression of β2-MG protien and chemotherapy (P =0.037).There was relevant trend between the higher expression of VEGF protien (P =0.067).Conclusion The expressions of VEGF protien and β2-MG protien are detected in DLBCL,both proteins may be the potencial markers of DLBCL and therapeutic targets for DLBCL.

Pregnane X receptor and tumor multidrug resistance / 国际肿瘤学杂志

The overexpression of P-glycoprotein(P-gp)and its coding gene mdrl is regarded as the classic mechanism of muhidrug resistance(MDR).Recent studies find that pregnane X receptor(PXR)can mediate the expression of P-gp.It is confirmed that PXR can also inhibit apoptosis of tumor cells.Therefore,preventing the activation of PXR specifically may be a new method to prevent MDR.

Efficacy assessment of sodium valproate in treating 607 patients with epilepsy in rural China / 中华神经科杂志

Objective To observe the efficacy and the side-effects of sodium valproate (VPA) in patients with epilepsy in rural China. Methods Epilepsy patients were selected from rural areas of Tianmen in Hubei province and Tiandong county in Guangxi province according to the inclusion and exclusion criteria.Efficacy evaluation standard depending on the change of seizure frequency compared with the situation prior to entering the treatment group. Among the treated patients, no seizures, seizure reduced ＞ 75%, seizure reduced 50%-75% sums for the total effective rate. Results All 607 patients with epilepsy were treated and followed up, the male were 395 (65. 1% ) female 212 (34. 9% ), and 579 patients were treated for 12 months. Patients with generalized tonic-clonic seizures were 517 (85.2%), absence seizures 20 (3. 3% )and the other types of seizures 70 (11.5% ) including simple partial seizures, tonic, clonic, myoclonic or atonic seizures etc. The completed control of seizures ( without any seizures) during the period after taking 3 months, 6 months, 12 months were 270 (45.5%), 249 (42. 3% ) and 238 (41.1%) respectively. The total effective rates in the three periods were 65.2% , 75.4% and 85.5% respectively. The 58 patients in the total group showed side-effects during the follow-up period, mainly including drowsiness, lethargy,fatigue, dizziness, headache and tremor. Nineteen patients (3. 1% ) quitted the treatment group.Conclusions The VPA is an effective antiepileptic drug and no more severe side-effects. It is the same as Phenobarbital and suitable to be used in rural areas of China.

Global Campaign Against Epilepsy: An update on the China Demonstration Project and Crest Study

Global Campaign Against Epilepsy conducted the Demonstration Project to improve epilepsy care in rural China from 2000 to 2004. The project involved 5 provinces and 2,455 patients with convulsive epilepsy using phenobarbital monotherapy. Forty percent of the patients were seizure free in one year and another 30% had their seizures decreased by over half. With the support of the central government, the project has currently been extended to cover 12 provinces with 11,000 patients. The long-term plan is to integrate epilepsy management into the existing primary health delivery system of China.

Genetic polymorphisms in methylenetetrahydrofolate reductase and clinical response to chemotherapy in non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Methylenetetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. In vitro, many studies have demonstrated that abnormal methylation of some genes may affect the sensitivity of tumor cells to cytotoxic drugs and agents interfering with DNA synthesis. The aim of this study is to investigate the relationship between genetic polymorphisms of MTHFR C677T or A1298C and the response to platinum-based chemotherapy in non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 97 patients with NSCLC were analyzed. MTHFR genotypes were detected in all the patients by PCR-RFLP method. All the patients were treated with platinum-based chemotherapy.</p><p><b>RESULTS</b>(1) Out of all the cases, the frequencies of MTHFR C677T C/C, C/T and T/T genotypes were 34.0%, 50.5% and 15.5%, respectively, while the frequencies of MTHFR A1298C A/A, A/C and C/C genotypes were 64.6%, 29.2% and 6.3%, respectively. The overall response rate (complete and partial response) to platinum-based chemotherapy was 39.2%. (2) No significant difference in response rate to chemotherapy was observed according to the MTHFR C677T or A1298C genotypes. However, MTHFR C677T and A1298C polymorphisms showed a synergic effect on chemotherapeutic efficacy, the response rate of patients with MTHFR C677T T allele and A1298C A/A genotype (51.1%) was significantly higher than those with MTHFR C677T C/T and A1298C C allele (12.5%)(P=0.007, OR=7.30, 95% CI: 1.34-52.47).</p><p><b>CONCLUSIONS</b>The results suggest that the synergic effect between MTHFR C677T and A1298C polymorphisms is associated with clinical response to platinum-based chemotherapy. Detection of MTHFR genotypes may indicate the sensitivity of NSCLC patients to platinum-based chemotherapy.</p>

An initial prevalence investigation of convulsive epilepsy in rural areas of Tibet Autonomous Region / 中华神经科杂志

Objective To find out the prevalence rate of epilepsy,its treatment gap and quality of life of epilepsy patients in rural areas of Tibet Autonomous Region (TAR).Methods Cluster sampling was adopted to conduct a door-to-door epidemiological survey among 14 822 rural population in Gangka town, Zhaxigang and Quzika village located in Medrogongka and Markham counties of TAR.The quality of life was measured by the 31-item quality of life in epilepsy inventory (QOLIE-31).Results Thirty-seven epilepsy patients were diagnosed as convulsive epileptic patients,and the prevalence was 0.25%.Thirty-five patients (94.59%) were diagnosed as active epilepsy,with a prevalence rate of 0.24%.Only one patient took standard Western Medicine within a week before the survey,and the treatment gap of the active epilepsy was 97.1%.The average QOLIE-31 total score was 42.15?17.63,and the lowest subcomponent score was 22.59?20.31 for seizure worry with the highest subcomponent score 85.83?18.59 for medication effects. Age,occupation,education,economic status,age at epilepsy onset and seizure frequency were significantly correlated with low QOLIE-31 scores (P

Polymorphisms of methylenetetrahydrofolate reductase C677T and the risk of stomach cancer / 中华流行病学杂志

<p><b>OBJECTIVE</b>In order to study the relation between polymorphisms of methylenetetrahydrofolate reductase C677T (MTHFR) and susceptibility of stomach cancer (SC).</p><p><b>METHODS</b>We conducted a case-control study with 107 cases of SC and 200 population-based controls in Huaian city of Jiangsu province, China. The epidemiological data were collected, and DNA of peripheral blood leukocytes was obtained from all of the subjects. MTHFR genotypes were detected by PCR-RFLP method.</p><p><b>RESULTS</b>(1) The frequency of MTHFR variant genotypes (C/T + T/T) among the cases (79.4%) was significantly higher than the controls (68.5%) (P = 0.041 6); the crude OR for SC was 1.78 (95% CI: 0.99 - 3.22). After adjustment for sex and age, the OR for SC was 1.89 (95% CI: 1.08 - 3.32). (2) Subjects who had MTHFR variant genotypes and having smoking habit were at a significantly higher risk of developing SC (OR = 7.72, 95% CI: 2.23 - 26.79) compared with those who had wild-type homozygotes (C/C) genotype and no smoking habit. Individuals who had variant genotypes and who had habit of frequent alcohol drinking were at an increased risk of developing SC (OR = 3.08, 95% CI: 1.30 - 7.23) compared with those with C/C genotype and low consumption of alcohol. As compared with subjects with C/C genotype and low consumption of alcohol and no smoking habit, individuals who had variant genotypes and who had habits of frequent alcohol drinking and smoking had 12.96 (95% CI: 2.76 - 70.46) folds risk developing SC.</p><p><b>CONCLUSIONS</b>These results in the present study suggested that the polymorphisms of MTHFR C677T was associated with risk of developing SC, and there was a coordinated effect between MTHFR genotypes and habits of smoking and alcohol drinking in the development of SC.</p>

Changes of nitric oxide synthase in lung of rats after ischemic reperfusion of hind limbs / 中国病理生理杂志

AIM: To study the distribution of nitric oxide synthase (NOS) in normal lung of rats, and the changes in distribution and activity of NOS in lung of rats suffering from limb ischemia reperfusion (LIR). METHODS: Using tourniquet, the model rats undergoing ischemia reperfusion were made. Using ?-ANDPH-d histochemical method, computer analysis of image and spectrophotography, the distribution of NOS in normal lungs of rats, and the changes in distributon and activity of NOS in lung of rats suffering from limb ischemia reperfusion (LIR) were observed. RESULTS: Histochemically, in normal rats, the NOS positive staining was found in epithelial cells of respiratory duct including bronchi, alveolar duct as well as in endothelium of pulmonary vessels, and the negative staining was found in pneumonocytes. In LIR rats, the above NOS staining were significantly stronger than that in normal one, and positive staining was also found in vascular smooth muscle and pneumonocytes. Biochemically, the results showed that the values of lung NOS, NO in LIR group increased significantly compared with the normal control. CONCLUSION: NO may play an important role not only in physiology of lung but also in pathophysiology of acute lung injury following LIR. [

Effects of guava polysaccharides on blood glucose level and antioxidant activity in diabetic mice / 中成药

AIM: To study the effects of guava polysaccharides on blood glucose level and antioxidant activity in alloxan-induced diabetic mice. METHODS: The animal model of diabetes was established by injecting alloxan into mice abdominal cavity.The mice were divided into five groups: normal control group,diabetic model group,guava polysaccharides group I,guava polysaccharides group II,glybenclamide group.Blood glucose level was determined with blood glucose monitor 3 d and 10 d after being given polysaccharides.The mice were anaesthetized and killed on the tenth day.Activity of SOD and concentration of MDA in blood serum and liver were determined. RESULTS: Compared with diabetic model group,the blood glucose level of guava polysaccharides group I and guava polysaccharides group II significantly decreased.Activity of T-SOD in blood serum and liver significantly increased,while concentration of MDA in blood serum and liver significantly decreased. CONCLUSION: Guava polysaccharides can significantly decrease blood glucose level and improve the antioxidant activity of diabetic mice.lt is a potential hypoglycemic agent.