Progress in TN staging of rectal cancer based on multimodal magnetic resonance imaging / 国际生物医学工程杂志

Rectal cancer is one of the most common gastrointestinal malignancies in China. Accurate and reasonable assessment of the preoperative staging of rectal cancer can significantly enhance treatment outcomes and improve patient prognosis. Magnetic resonance imaging is the technique of choice for local staging of rectal cancer and has significant advantages in the diagnosis of rectal primary tumors (T) and peri-intestinal lymph nodes (N). In this review paper, the research ideas and progress of traditional radiomics and deep learning methods for preoperative TN staging prediction of rectal cancer were reviewed around multimodal magnetic resonance images, with the aim of providing new ideas for realizing fully automated TN staging algorithms for rectal cancer.

Gene expression and immunolocalization of chitin deacetylase BmCDA2 in silkworm / 生物工程学报

Deacetylation of chitin is closely related to insect development and metamorphosis. Chitin deacetylase (CDA) is a key enzyme in the process. However, to date, the CDAs of Bombyx mori (BmCDAs), which is a model Lepidopteran insect, were not well studied. In order to better understand the role of BmCDAs in the metamorphosis and development of silkworm, the BmCDA2 which is highly expressed in epidermis was selected to study by bioinformatics methods, protein expression purification and immunofluorescence localization. The results showed that the two mRNA splicing forms of BmCDA2, namely BmCDA2a and BmCDA2b, were highly expressed in the larval and pupal epidermis, respectively. Both genes had chitin deacetylase catalytic domain, chitin binding domain and low density lipoprotein receptor domain. Western blot showed that the BmCDA2 protein was mainly expressed in the epidermis. Moreover, fluorescence immunolocalization showed that BmCDA2 protein gradually increased and accumulated with the formation of larval new epidermis, suggesting that BmCDA2 may be involved in the formation or assembly of larval new epidermis. The results increased our understandings to the biological functions of BmCDAs, and may facilitate the CDA study of other insects.

Adverse psychological state and its influencing factors in patients with dysphagia after cerebral stroke / 中华健康管理学杂志

Objective:To analyze the adverse psychological state and its influencing factors in patients with dysphagia after cerebral stroke.Methods:In this cross-sectional survey, 120 patients with dysphagia after cerebral stroke in the Department of Neurology, Stroke Center in Henan Provincial People′s Hospital from January 2021 to March 2022 were selected with convenience sampling method for questionnaire survey. The depression anxiety stress scale-21 (DASS-21), family adaption partnership growth affection resolve index (APGAR) and social support rating scale (SSRS) were used to evaluate the adverse psychological state, family care degree and social support in those patients. And general data of the patients were collected too. A total of 120 questionnaires were sent out and reclaimed, among them 116 were valid. One patient withdrew from the study on his own. Finally, 115 patients were included as research objects. Analysis of variance and LSD-t test were used to compare the adverse psychological state of patients with different characteristics, Pearson correlation analysis was used to analyze the correlation between adverse psychological state and family care and social support. The multivariate linear regression analysis was used to analyze the influencing factors of adverse psychological state in patients with dysphagia after cerebral stroke. Results:The total DASS-21 score in the 115 patients with dysphagia after stroke was (43.32±6.58) points, of which, it was (16.02±3.45) points in the depression dimension, (14.55±3.27) points in anxiety dimension, (12.75±4.01) points in stress dimension; the total score of APGAR was (5.15±0.87) points, the total score of SSRS was (28.75±5.16) points. Family care and social support were both negatively correlated with adverse psychological state in those patients ( r=-0.514, -0.433, both P<0.05). Marital status, per capita monthly income, number of complications, family care and social support were the influencing factors of adverse psychological state in patients with dysphagia after cerebral stroke (β′=0.501, -0.365, 0.234, -0.269, -0.372, all P<0.05). Conclusions:Patients with dysphagia after cerebral stroke have a higher degree of adverse psychological state. Marital status, per capita monthly income, complications, family care and social support can affect the mental health in those patients.

Effects of empathy nursing on negative emotion, sleep quality and health literacy of home treatment patients with pulmonary tuberculosis / 中国实用护理杂志

Objective:To explore the effect of empathy nursing intervention on negative emotion, sleep quality and health literacy of patients with pulmonary tuberculosis.Methods:A total of 77 patients in Department of Infectious Diseases of People′s Hospital of Leshan from June 2019 to September 2020 were divided into intervention group ( n=39) and control group ( n=38) by random digits table method. The patients in the control group were given routine nursing, and the patients in the intervention group were given empathy nursing intervention on the basis of routine nursing. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI) and Health Literacy Management Scale (HeLMS) were used before and 12 weeks after intervention to evaluate the effects. Results:There was no significant difference in the total scores of HAMD, HAMA, PSQI and HeLMS between the two groups before intervention ( P>0.05), but after intervention, the scores of HAMD and HAMA in the intervention group were 10.64 ± 1.86, 12.64 ± 2.12, lower than those in the control group (14.63 ± 2.19, 15.11 ± 2.71). The differences were statistically significant ( t=-8.63, -4.46, P<0.05). The total score of PSQI and the scores of daytime dysfunction, use of hypnotic drugs, time of falling asleep, time of sleep, sleep quality, sleep disorder and sleep efficiency in the intervention group were 10.26 ± 1.65, 1.22 ± 0.22, 1.48 ± 0.23, 1.51 ± 0.27, 1.45 ± 0.26, 1.57 ± 0.22, 1.54 ± 0.21,1.49 ± 0.24, lower than those in the control group (13.07 ± 2.14, 1.92 ± 0.31, 1.75 ± 0.34, 1.95 ± 0.29, 2.02 ± 0.33, 1.84 ± 0.31, 1.72 ± 0.27, 1.87 ± 0.29). The differences were statistically significant ( t values were -11.45--3.27, all P<0.05). The total score of HeLMS and the scores of information acquisition, communication and interaction, and health improvement intention in the intervention group were 96.12 ± 14.71, 37.87 ± 5.83, 35.91 ± 5.13, 16.21 ± 2.53, higher than those in the control group (86.35 ± 14.12, 33.17 ± 5.27, 32.87 ± 5.42, 14.16 ± 2.19). The differences were statistically significant ( t values were 2.53-3.80, all P<0.05). Conclusions:Empathy nursing intervention can effectively alleviate the negative emotions of pulmonary tuberculosis patients, improve their sleep quality, and improve their health literacy level.

Establishment and effect evaluation of risk prediction model for lung infection after kidney transplantation / 器官移植

Objective To establish and evaluate the predictive value of the risk prediction model for lung infection within postoperative 1 year in kidney transplant recipients. Methods Clinical data of 197 kidney transplant recipients were retrospectively analyzed. All recipients were divided into the infection group (n=42) and non-infection group (n=155) according to the incidence of lung infection within postoperative 1 year. The incidence and risk factors of lung infection after kidney transplantation were analyzed. Risk prediction model was established by multiple logistic regression analysis. Forty-five kidney transplant recipients who met the inclusion criteria, including 8 cases in the infection group and 37 cases in the non-infection group, were selected to verify the predictive effect of the established model. Results The incidence of lung infection within 1 year after kidney transplantation was 21.3% (n=42), including 38 cases (90%) of pneumonia severity index (PSI) class Ⅰ, 1 case (2%) of PSI class Ⅲ and 3 cases (8%) of PSI class Ⅴ. Lung infection occurred within 1 month after operation in 13 cases, within postoperative 2-6 months in 22 cases and after postoperative 6 months in 7 cases. Nineteen recipients were diagnosed with bacterial infection, 7 cases of fungal infection, 10 cases of viral infection and 6 cases of mixed infection. Smoking history, diabetes mellitus history, pulmonary disease history and albumin level of < 35 g/L were the independent risk factors for lung infection after kidney transplantation (all P < 0.05). The equation of risk prediction model for postoperative lung infection in kidney transplant recipients was logit (lung infection within postoperative 1 year in kidney transplant recipients)=-1.891+1.063×smoking history (yes=1, no=0)+1.398×diabetes mellitus history (yes=1, no=0)+1.732×pulmonary disease history (yes=1, no=0)+1.269×albumin level (< 35 g/L=1, ≥35 g/L=0). The area under the curve (AUC) of receiver operating characteristic (ROC) was 0.788, the sensitivity was 0.786, the specificity was 0.645, and the Youden index was 0.431, respectively. Hosmer-Lemeshow goodness-of-fit test demonstrated that the predicted value of this model yielded relatively high consistency with the observed value. The AUC in the verification group was 0.834. Hosmer-Lemeshow goodness-of-fit test validated high degree of calibration of this model. Conclusions The risk prediction model, consisting of smoking history, diabetes mellitus history, pulmonary disease history and albumin level as predictors, may effectively predict the incidence of lung infection within postoperative 1 year in kidney transplant recipients.

Gene therapy for recessive dystrophic epidermolysis bullosa / 中华皮肤科杂志

Recessive dystrophic epidermolysis bullosa (RDEB) is caused by loss-of-function mutations in the COL7A1 gene encoding the α-1 chain of type Ⅶ collagen, leading to reduced or absent expression of basement membrane type Ⅶ collagen (C7) . Currently, there is no effective treatment for this rare disease, and the management is mainly palliative and supportive. Gene therapy is expected to be an effective treatment of RDEB. This review summarizes current strategies of gene therapy in clinical trials for RDEB, as well as their progress, pros and cons, and prospects.

A study on multiparametric MRI-based radiomics approach to preoperatively estimating tumor-stroma ratio in rectal cancer / 中华放射学杂志

Objective:To develop and validate a radiomics biomarker for the preoperative estimation of the tumor-stroma ratio (TSR) in rectal cancer.Methods:From January 2016 to March 2019, totally 149 patients with rectal cancer were enrolled retrospectively at Fudan University Shanghai Cancer Center. The patients were divided into two cohorts using a random number table, 119 in the training and 30 in validation cohorts. The patients were classified into the TSR-high group (TSR>50%) and TSR-low group (TSR≤50%) according to the content of tumor stroma in pathology. All patients underwent T 2WI, enhanced T 1WI and DWI. The lesions on the T 2WI, enhanced T 1WI, DWI and ADC images were delineated and radiomics features were extracted. A radiomics signature (rad-score) was generated by using the least absolute shrinkage and selection operator (LASSO) algorithm. The Spearman correlation coefficients were used to determine the association between rad-score and TSR. The area under the ROC curve (AUC) was used to assess the diagnostic performance of the rad-score. The reliability of the rad-score was quantified by calculating the sensitivity, specificity and accuracy of TSR. Results:With LASSO, a rad-score with 13 radiomics parameters was successfully constructed and was positively correlated with TSR score in the training ( r=0.72, P<0.001) and validation cohorts ( r=0.46, P=0.011). In the training cohort, the AUC of the rad-score was 0.940, with the sensitivity, specificity, accuracy of 100%, 87.3%, 92.4%. In the validation cohort, the AUC was 0.796, with the sensitivity, specificity, accuracy of 83.3%, 67.7%, 73.3%. Conclusions:The rad-score is of promising value for TSR estimation in rectal cancer. It is a promising supplement for patient stratification and may inform decision-making.

Application value of wide detector CT target scanning technique in the preoperative evaluation of pancreatic cancer / 中华胰腺病杂志

Objective:To explore the application value of wide detector multi-slice spiral CT target scanning technique in the preoperative evaluation of pancreatic cancer.Methods:The clinical data of 22 patients with pancreatic cancer who underwent pancreatic arterial contrast enhanced CT scanning and were diagnosed by pathology in the First Affiliated Hospital of Naval Medical University from September 2019 to October 2019 were analyzed retrospectively. The CT phantom experiment was carried out on the international standard phantom CATPHON500. By changing the scanning radiation dose, scanning mode and scanning field of view, the spatial resolution and density resolution of the image were compared and analyzed. The target scan technical parameters obtained from the experiment were applied to the late arterial phase of MDCT enhanced scan in 22 patients with pancreatic cancer. Executive current, volume scanning mode and small scanning field were used for scanning. The attenuation value (CT value) and noise value (SD value) of pancreatic cancer tissue and normal pancreatic tissue were measured at different phases, the attenuation difference and contrast signal-to-noise ratio (CNR) of the two tissues were calculated, the contrast difference between the two tissues was evaluated, and the CT values of celiac trunk, renal artery and vein, superior mesenteric artery and vein, splenic vein and portal vein were measured, and the display of tumor tissue and peripancreatic important vessels was evaluated.Results:In the phantom experiment, under the condition of the same radiation dose, the image quality of the volume scan mode was better than that of the spiral scan mode (1%@4 mm versus 1%@9 mm at 5 mGy and 1%@2 mm versus 1%@6 mm at 25 mGy). In comparison between pancreatic tumor and pancreatic tissue, the enhancement process of pancreatic tumor tissue was increased at first and then decreased, while that of pancreatic tumor tissue was slightly enhanced. The attenuation difference between pancreatic tissue and tumor tissue and CNR also increased at first and then decreased, reaching the maximum at the late arterial stage [(91.96±29.29)HU, 8.60±5.71]. The differences between each phase were statistically significant ( F values were 47.20 and 19.80 respectively, all P values <0.05). The evaluation of vascular variation and invasion showed that a better arterial phase image could be obtained on the late arterial target scan images, while taking into account the display of splenic vein, mesenteric vein and portal vein. Conclusions:The wide detector MDCT target scanning technique can improve the spatial resolution and density resolution of the image, greatly improve the contrast between tumor tissue and peripancreatic tissue and blood vessels, and provide more accurate tumor staging and resectability evaluation information for preoperative evaluation of pancreatic cancer.

Research progress in mechanisms of idiosyncratic drug-induced liver injury mediated by inflammatory stress / 药学学报

Idiosyncratic drug-induced liver injury (IDILI) is an unpredictable serious adverse drug reaction, which only occurs in a minority of special susceptible individuals. Although the mechanism of IDILI has not been fully understood, several hypotheses have been proposed to explain the action mode and specific mechanism of IDILI. Of these hypotheses, inflammatory stress hypothesis is one of the most important theories. Under the condition of inflammatory stress, drugs interact with inflammation and mediate the occurrence of IDILI through a variety of mechanisms, which can induce the production of inflammatory cytokines, activate coagulation system, affect the activity of metabolites, induce cholestasis, affect mitochondrial damage, and others. This review will summarize the main mechanisms and influencing factors of IDILI mediated by inflammatory stress, in order to provide a reference for preclinical drug development and basic research on drug-induced liver injury.

Imaging features of 3 cases with pancreatic schwannoma and literature review / 中华胰腺病杂志

Objective:To improve the current understanding on the imaging features of pancreatic schwannoma.Methods:Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.Results:A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T 1WI, and in partially low signal and partially high signal at T 2WI, and completely opposite signal characteristics of T 2WI area after T 1 enhancement, referring to the finding that low T 2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal. Conclusions:Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.

Imaging features of 3 cases with pancreatic schwannoma and literature review / 中华胰腺病杂志

Objective@#To improve the current understanding on the imaging features of pancreatic schwannoma.@*Methods@#Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.@*Results@#A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T1WI, and in partially low signal and partially high signal at T2WI, and completely opposite signal characteristics of T2WI area after T1 enhancement, referring to the finding that low T2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal.@*Conclusions@#Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.

Effect of endoplasmic reticulum stress and autophagy on hepatocyte apoptosis / 临床肝胆病杂志

Endoplasmic reticulum stress and autophagy are two two-edged swords. On the one hand, in case of intracellular environment disturbance, unfolded protein response reduces protein synthesis, promotes protein degradation, and increases protein folding to restore intracellular homeostasis through three signaling pathways, while excessive stress activates a series of signaling molecules to induce apoptosis; on the other hand, autophagy is a protective pathway for self-degradation in human body and can absorb and decompose damaged or harmful macromolecular substances in cells through autophagic vacuole-lysosome complex and promote cell metabolism, while excessive autophagy also causes apoptosis. Endoplasmic reticulum stress and autophagy play important roles in the process of hepatocyte apoptosis. Therefore, these two molecular mechanisms may serve as targets for future drug research and provide therapeutic and diagnostic strategies for hepatocellular diseases.

Prognostic significance of combined TERT and IDH gene mutation analysis in diffusely infiltrating gliomas / 中华病理学杂志

Objective@#To investigate the status and prognostic significance of TERT and IDH1/2 genes mutations in diffusely infiltrating gliomas.@*Methods@#Hot spot mutations of TERT and IDH1/2 genes were detected by DNA sequencing in 236 cases of gliomas at West China Hospital from 2012 to 2016, including pilocytic astrocytoma (WHO grade Ⅰ, 16 cases), diffuse astrocytoma and oligodendroglioma (WHO grade Ⅱ, 89 cases), anaplastic astrocytoma and oligodendroglioma (WHO grade Ⅲ, 72 cases) and glioblastoma (WHO grade Ⅳ, 59 cases). The prognostic significance of TERT and IDH1/2 hot spot mutations was evaluated.@*Results@#No IDH or TERT mutations were detected in pilocytic gliomas. TERT promoter mutation frequency was higher in patients aged ≥40 years(60.8%, 93/153) than in patients aged <40 years (32.8%, 22/67; P<0.01). TERT promoter mutation rate was also significantly higher in oligodendroglioma (87.5% , 56/64) than that in astrocytoma(37.8%, 59/156; P<0.01). Young age (<40 years), oligodendroglioma and IDH1 mutation were favorable prognostic factors for diffusely infiltrating astrocytic and oligodendroglial tumors. TERT mutation alone was not of prognostic significance. Diffusely infiltrating astrocytic and oligodendroglial tumors were divided into four molecular subtypes according to TERT and IDH1 mutation status: IDH(+ )/TERT(+ ), IDH(+ )/TERT(-), IDH(-)/TERT(-) and IDH(-)/TERT(+ ). There was significant prognostic difference among the 4 subtypes.@*Conclusions@#Combined IDH and TERT gene mutation analysis may be useful for prognostic subgrouping. Notably, IDH1 wild-type cases can be further subdivided into TERT(+ ) or (-) subgroups with significant prognostic difference.

Effect of food exchange regulation by hand measurement on patients with type 2 diabetes mellitus / 预防医学

Objective To explore the effect of food hand measurement exchange on patients with type 2 diabetes in communities. Methods A stratified random sampling method was used to divide the community into five groups according to the geographical location. Forty patients were randomly selected from each group and randomly divided into intervention group and control group. The control group was administered according to the requirements of the management of diabetes mellitus in the national basic public health service project. The intervention group conducted the dietary instruction for 12 months on the basis of the management of the national basic public health service project. Two groups were investigated before and after the intervention,and physical examination were conducted and biochemical indicators were detected. Results Before and after the intervention,there was no significant difference between the two groups in behavior and physical examination (P>0.05) . In the intervention group, the proportion of drug treatment decreased from 96.00% to 92.00% after 12 months of intervention. The proportion of people controlling diet increased from 90% to 99%, and the proportion of control weight increased from 75.00% to 91.00% . The proportion of patients who were monitored blood sugar was from 71% to 98%.Compared with the control group, the behavioral habits of the intervention group in drug use, diet control, weight control and blood glucose monitoring were higher than those in the control group(Wald x2=10.644, 4.324, 5.957, 12.229, P<0.05) . In the intervention group, the compliance rate of blood pressure and HDLC compliance rate increased from 16.00% and 56.00% to 64.00% and 76.00% respectively after 12 months intervention. Compared with the control group, the increase of blood pressure, FPG and HDL-C in the intervention group was higher than that in the control group(Wald x2=16.642, 10.128, 6.457, P<0.05) . Conclusion Food hand measurement exchange method on patients with type 2 diabetes in communities was a simple calorie intake measurement tool,and could greatly improve the patient's control diet compliance, and could promote drug treatment and monitor of blood sugar and other behavior improvement, thus ultimately improve the blood pressure, blood sugar and blood lipids.

A study on the construction of evaluation indicator system of family doctor's contract service / 中国卫生政策研究

Objective:The objective of this study is to construct the evaluation indicator system of family doc-tors contracted service,to evaluate the main current family doctor contracted service in China from different aspects of health services. Methods:literature research method,field survey method and expert consultation method were used for the preliminary screening of the evaluation indicator; after consultation with Delphi experts to conduct a primary health care service management,using statistical analysis was used to build a family doctor evaluation indicator sys-tem. Results:The results show that the evaluation indicator system of family doctors contracted service was deter-mined,and consists of three first-level indicators,which were respectively preparatory,procedural and outcome eval-uation indicators;eight secondary indicators,which mainly include human resources input,basic medical treatment, basic public health,service efficiency and satisfaction and so on;and thirty-nine tertiary indicators,such as the num-ber of doctors per 10,000 population,the rate of first diagnosis,the rate of medical malpractice and the incidence of medical disputes of contracted residents,etc. Conclusions:The indicator system constructed in this study is sensitive and feasible,and it can comprehensively evaluate the work of family doctor contract,and provides a reference for the management,assessment and evaluation of family doctor contract service.

Design of image diagnostic module for tent-form field medical system / 医疗卫生装备

Object To develop an easy-assembled and-disassembled image diagnostic module to solve the problems of the tent-form field medical system in size, weight, mobility, accessories, protection and etc, which is of high references for combination and integration scheme of large-scale digital imaging equipment by adopting box instrumentation.Methods The module had its design executed with system modeling, structure simulation and CAD after its service requirements were analyzed. The design fell into the ones for overall framework, combination mode, packaging and buffer vibration isolation, ergonomics, box instrumentation, radiography accessories for vertical and horizontal positions, protection device and etc.Results The module was gifted with radiodiagnosis-related performances such as digital radiography, digital diagnosis,diagnosis reporting, compatibility to vertical- and horizontal- position radiography, and radiation protection during war conditions.Conclusion The module developed gains advantages in power, continuous radiography, assembling and disassembling, accessories and protection, and thus meets the requirements of the tent-form field medical system in mass casualties imaging diagnosis.

Design and application of field tent hospital system / 医疗卫生装备

Objective To develop a set of field tent hospital system to further enhance campaign-level medical support service. Methods The system had its service orientation, functional requirements, component unit and modular elements determined with system analysis. The technical architecture was realized with tent combined with boxes, and the system modules were designed with the method of integrated box and instruments.Results The system had its design executed from the aspects of layout,composition of grid tent,medical functional units,support unit and packaging unit,which was applied in a series of military medical support operations in foreign countries and China as well as in the construction of national medical emergency rescue forces. Conclusion The system gains advantages in modularity, integration, completing, informatization and standardization,and thus greatly enhances the military medical support ability and national emergency medical rescue ability in China.[Chinese Medical Equipment Journal,2018,39(5):1-6,16]

Effects and mechanism of hypoxia exposure on related genes in brown fat tissue of obese mice based on mRNA expression profile microarray / 中国应用生理学杂志

OBJECTIVE@#This study intended to screen differentially expressed genes and pathways in Brown Adipose Tissue (BAT) of obese mice after the intervention of hypoxia by mRNA expression profile microarray, exploring the mechanism of hypoxia activated BAT.@*METHODS@#Thirty C57BL/6J male mice were divided into the normal diet control group (N, =8), high-fat diet control group (OB, =8) and high-fat diet hypoxia group (H, =8). Group H was intervened by hypoxia exposure in the oxygen concentration of 11.2% of the normal oxygen and hypoxia for 8 h/d, 6 d/w of 4 weeks. Blood lipid and blood glucose were detected after intervention; RNA microarray scan and bioinformation analysis were done of BAT from scapula. Genes significantly ( ≤ 0.05) regulated more than 1.5 fold were chosen to do Gene Ontology and enrichment analysis by KOBAS 2.0, and confirmation of genes participating in key biological process (BP) and pathway was done by real time qPCR.@*RESULTS@#After intervention, the body weight and blood lipid and glucose levels in group H were significantly lower than those of group OB. Comparing with group N, 802 genes were significantly up-regulated and 1 175genes were down-regulated. The BP of these genes mainly concerned with glucose and lipid metabolic process and inflammatory reaction. Comparing with group OB, 297 genes were significantly up-regulated and 228 genes were down-regulated. These genes participated in glucose and lipid metabolic process, lipid transport, muscle system process and cardiovascular system development. The pathways of regulating BAT by hypoxia exposure mainly concentrated on the HIF-1, PI3K-AKT, FoxO and ErbB signaling pathways.@*CONCLUSIONS@#A series of genes and pathways in BAT could be adjusted by hypoxia exposure, so that hypoxia could improve the activity of BAT, promoting obese organism to lose weight.

Ryan index for detection of laryngopharyngeal reflux diseases / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the utility of pharyngeal pH monitoring which positive standard is Ryan index in diagnosis of laryngopharyngeal reflux disease.@*Methods@#In a retrospective study, clinical data of 590 patients who had symptoms laryngopharyngeal reflux disease from February 2016 to March 2017 were analyzed. All patients were received electronic laryngoscopy, assessment of reflux symptom index(RSI) and reflux finding score(RFS), and pharyngeal pH monitoring. SPSS 19.0 software was used to analyze the date.@*Results@#There were 94 patients whose Ryan index were positive(15.93%). Among the 94 patients, 70 were positive during upright, 12 during supine and 12 during both upright and supine. There were 40 patients(6.78%)with pH decline events related to symptoms, while those Ryan index were normal. There were 536(90.85%), 417(70.68%), 233(39.49%) and 117(19.83%) patients with pH<6.5, pH<6.0, pH<5.5 and pH<5.0 events respectively. The positive rate of RSI, RFS, RSI and RFS, RSI or RFS were 44.24%, 16.78%, 7.12%, 53.90% respectively. The RFS score in Ryan index positive group was higher than that in Ryan index negative group[(8.2±2.4) vs (4.0±2.9), u=5.424, P<0.05], while the RSI score in Ryan index positive group was not statistically different from that in Ryan index negative group[(11.3±6.2) vs (12.7±5.8), t=1.247, P=0.167].@*Conclusions@#Pharyngeal pH monitoring is an objective and non-invasive method which can reflect laryngopharyngeal reflux directly. However, with the Ryan index as a criterion for the diagnosis of laryngopharyngeal reflux disease, partial patients may be missed. Further studies are needed to obtain more accurate and objective laryngopharyngeal pH statistical index for diagnosis of laryngopharyngeal reflux disease.

Evidence-based practice of standardized gastric lavage for acute organophosphorus pesticide poisoning / 中华护理杂志

Objective To formulate standardized program of gastric lavage for acute organophosphorus pesticide poisoning(AOPP) and evaluate the effects.Methods Evidence was obtained via evidence-based approach,and recommendations were formed.The standardized program of gastric lavage for AOPP was formulated and then applied to clinical practice.The effects were evaluated by examining indicators of success rate of catheterization,the first time of gastric lavage,the time of atropinization and total usage of atropine,ChE recovery time,hospital stay,rebound rate,adverse event rate.Results After implementation,the first time of gastric lavage,the time of atropinization,total usage of atropine,ChE recovery time,and hospital stay were significantly lower than the control group (P＜0.05).Conclusion Evidence-based practice of gastric lavage for AOPP can improve therapeutic effects,reduce adverse reactions,improve quality of nursing,and promote safety of medical care.