Expression Level and Target Gene Prediction of miR-181b in Patients with Chronic Lymphocytic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression level of miR-181b in CD19+ B lymphocytes of patients with chronic lymphocytic leukemia (CLL), to analyze the relationship between its expression and the prognosis of CLL patients, and to predict the potential target gene of miR-181b in CLL by using bioinformatics.@*METHODS@#Eight-four patients with CLL treated in People's Hospital of Xinjiang Uygur Autonomous Region from June 2013 to June 2018 were selected. and 20 healthy people were selected as control group. RNA was extracted from CD19+B lymphocytes of peripheral blood by magnetic bead sorting, the expression level of miR-181b was detected, and it's expression differences in different IPI groups were analyzed. The correlation between the expression level of miR-181b and PFS of CLL patients also was analyzed. miR-181b target genes were predicted by online database and literatures, and gene annotation analysis and relevant signal pathway analysis were performed for candidate target genes.@*RESULTS@#The expression level of miR-181b in CLL patients was significantly lower than that in control group (P＜0.01); The expression level of miR-181b in the low-risk group was higher than that in high-risk group and extremely high-risk group (P＜0.05), but there was no statistical difference between low-risk group and medium-risk group (P=1.00). The expression level of miR-181b in medium-risk group was higher than that in high-risk group and extremely high-risk group (P＜0.05), but there was no difference between high-risk group and extremely high-risk group (P=1.00). ROC curve results showed that the area under the curve (AUC) was 0.792 (P＜0.01).When the expression level of miR-181b was at the threshold value of 0.279, it showed a better sensitivity (62.9%) and specificity (91.8%). Survival analysis results suggested that compared with the high expression group, the miR-181b low expression group had poor PFS (log rank: P=0.047). Prediction of miR-181b by using the starBase, targetscan and picTar database and its combination with literature reports indicated that CARD11, ZFP36L1, RUNX1, NR4A3, ATP1B1, PUM1 and PLAG1 related with blood diseases, and up-regulated CARD11 and ZFP36L1 participated in lymphoid tumor formation by promoting cell proliferation and inhibiting cell aging.@*CONCLUSION@#The expression level of miR-181b in CLL group are significantly lower than that in the controls group, and the low expression of miR-181b relates with poor prognosis of CLL patients. Through bioinformatics prediction and combined with literature reports, it is speculated that CARD11 and ZFP36L1 as target genes of miR-181b may be participated in the occurrence and development of CLL. Further experiments are needed to verify this result.

A randomized controlled study of bedside electrocardiograph-guided tip location technique & the traditional chest radiography tip location technique for peripherally inserted central venous catheter in cancer patients

Background & objectives: The peripherally inserted central catheter (PICC) has the advantages of higher safety, lower infection rate and longer retention time than peripherally inserted catheter. This study was aimed to evaluate the accuracy and safety of bedside electrocardiograph (ECG)-guided tip location technique in PICC in cancer patients, and compared with traditional chest radiography tip location technique. Methods: Patients were randomly assigned into two groups: The ECG test group patients underwent PICC insertion with ECG-guided tip location, while the control group patients had PICC insertion by the conventional method. The precision of tip location was verified by chest radiography in both groups. The groups were compared with regard to the accuracy of tip placement, anxiety levels before and after the procedure; medical cost and incidence of complications at one week, three months and six months after PICC insertion. Results: Accurate tip location was achieved in 99.30 per cent in the ECG test group vs 92.30 per cent in the control group (P<0.001). At 24 h after the procedure, the anxiety level was significantly lower in the ECG test group. The presence of thrombogenesis was significantly lower in the ECG test group at both three months and six months after the procedure (P=0.04 and P=0.03, respectively). Interpretation & conclusions: The ECG-guided PICC tip location technique was accurate and caused fewer procedure-related complications and less anxiety in patients compared to chest radiography tip location technique. Radiographic confirmation of PICC tip position may not be needed when ECG guidance is used and thus it can help avoid radiation exposure.

Molecular typing and drug resistance of Methicillin-resistant Staphylococcus aureus isolated from hospital environment / 上海预防医学

[Objective] To investigate the prevalence, drug resistance and molecular characteristics of MRSA in hospital environment, so as to provide basis for prevention and control of nosocomial MRSA infection. [Methods]Specimens from Dec 2014 to May 2015 were collected from a tertiary hospital in Jing'an District of Shanghai and MRSA strains isolated from hospital environment and characterized by antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE). [Results]From 316 specimens were detected 46 MRSA strains with contamination rate being 14.6％ (46/316). And 22 (7.0％) were detected to be carriers of MRSA on the surfaces of ICU environment. MRSA had higher resistant rate to cefuroxime, levofloxacin, ciprofloxacin, Ampicillin/sulbactam, erythrocin, gentamycin than MSSA, and the difference was statistically significant (P<0.01). A total of 8 PFGE patterns were identified among the 14 MRSA isolates, which were mostly similar from one clone. [Conclusion] MRSA strains isolated from ICU in this hospital are multi-resistant to β-lactam antibiotics, quinolones and macrolides. There is clonal pollution in the environment. It is necessary to decrease the contamination rates between patients and environment, health care workers and environment, also it is worthwhile to increase the disinfection rate of environment.

Feasibility of Detection Three Kinds of Sexually Transmitted Pathogenby MGX Automatic Nucleic Acid Extraction Workstation / 现代检验医学杂志

Objective To verify the feasibility of Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG),Ureaplasma urealyticum(UU)detection by automatic nucleic acid extraction workstation(MagX).Methods The test samples of CT (159),NG(128)and UU(144)were collected.The samples were extracted of nucleic acid two methods:manual extraction, which entailed manually preparing PCR reaction system and MagX automatic nucleic acid extraction workstation,which au-tomatically prepared the reaction system.The two parts of nucleic acids proceeded to the Simultaneous Amplification and Testing(SAT).The result of manual extraction was set as the golden standard and the Kappa consistency analysis was con-ducted.Meanwhile,the sensitivity,specificity,accuracy and carry pollution experiments of MagX were verified.Results The sensitivity of MagX automatic nucleic acids extraction workstation were 92.59%(CT),100.00%(NG)and 93.33%(UU).The specificity were 98.48%(CT),98.18%(NG)and 95.24%(UU).The accuracy were 97.48%(CT),98.44%(NG)and 94.44%(UU).The results of kappa consistency analysis were greater than 0.8(CT:Kappa=0.910 6,NG:Kap-pa=0.938 3,UU:Kappa=0.885 6).MagX detected the precision of CT,NG and UU:Coefficient of Variation(CV)<5%. There was no pollution phenomenon.Conclusion MagX automatic nucleic acids extraction workstation could be used to test three kinds of sexually transmitted pathogen in clinical settings.

Continuous blood purification treatment for endotoxin-induced acute respiratory distress syndrome

This study aimed to explore the effects of continuous blood purification (CBP) treatment in pigs affected with acute respiratory distress syndrome (ARDS). A total of 12 healthy male pigs, weighing 12±1.8 kg, were randomly and equally assigned to the control and experimental groups. The ARDS pig model was prepared by intravenous injections of endotoxin (20 µg/kg). The control group was given conventional supportive therapy, while the experimental group was given continuous veno-venous hemofiltration therapy. During the treatment process, the variations in dynamic lung compliance, oxygenation index, hemodynamics, and urine volume per hour at different times (Baseline, 0, 2, 4, and 6 h) were recorded. The levels of tumor necrosis factor (TNF-α), interleukin 6 (IL-6), and IL-10 in serum and bronchoalveolar lavage fluid (BALF) were measured using the enzyme-linked immunosorbent assay. The histomorphological changes of the lung, heart, and kidney were visualized using a light microscope. The nuclear factor κB p65 protein content of the heart, lung, and kidney tissues was also detected using western blot. The experimental group outperformed the control group in both respiratory and hemodynamic events. CBP treatment cleared TNF-α, IL-6, and IL-10 partially from serum and BALF. The pathological examination of the heart, lung, and kidney tissues revealed that the injury was less severe in the experimental group. CBP treatment can improve the organ functions of pigs affected with endotoxin-induced ARDS and protect these organs to some extent.

Operative versus nonoperative treatment for displaced midshaft clavicle fractures: a meta-analysis based on current evidence

Literature searches of the Cochrane Library, PubMed, EMBASE, Web of Science, LILACS, China National Knowledge Infrastructure, and Wanfang Data databases were performed from 1966 to September 2014. Only randomized and quasi-randomized controlled clinical trials comparing operative and nonoperative treatments for displaced midshaft clavicle fractures were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Thirteen studies were considered in the meta-analysis. Constant scores and the Disabilities of the Arm, Shoulder and Hand scores were improved in the operative fixation group at a follow up of one year or more. The nonunion and symptomatic malunion rates were significantly lower in the operative group. Additionally, the nonoperative group had a higher likelihood of neurological symptoms compared with the operative group. A significantly higher risk of complications was found in patients treated conservatively than in those who underwent operative fixation. However, when patients with nonunion and symptomatic malunion were excluded from the analysis, no significant differences in the complication rate were found. We concluded that based on the current clinical reports, operative treatment is superior to nonoperative treatment in the management of displaced midshaft clavicle fractures. However, we do not support the routine use of primary operative fixation for all displaced midshaft clavicle fractures in adults.

A meta-analysis for the efficacy and safety of tourniquet in total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of tourniquet in total knee arthroplasty.</p><p><b>METHOD</b>Studies on comparison between with and without tourniquet in total knee arthroplasty were identified from Medline, PubMed, EMASE, Cochrane Library, CBM, Highwire, CNKI, VIP, Articles Digital Periodicals.All the randomized controlled trials were included for meta-analysis with RevMan 4.2.2 software.</p><p><b>RESULTS</b>Nineteen studies involving 15 in foreign languages, 4 in Chinese were identified. There were 1159 cases of knee replacement patients. The results of meta-analysis indicated that there were statistical difference between two groups on intraoperative blood loss (P = 0.000), the number of deep venous thrombosis (P = 0.020), thigh pain (P = 0.000), knee hematoma (P = 0.030), wound infection (P = 0.040), skin ecchymosis area (P = 0.000), and the increasing rate of knee circumference of 3 days after the operation (P = 0.000), while there were no statistical differences with respect to the total blood loss (P = 0.100), the number of blood transfusions (P = 0.150), operation time (P = 0.120), length of hospital stay (P = 0.350), the number of pulmonary embolism (P = 0.310), and skin blisters (P = 0.170).</p><p><b>CONCLUSIONS</b>The tourniquet for total knee arthroplasty can reduce intraoperative blood loss, but can not reduce total blood loss and the number of blood transfusions transfusion, can not improve operative efficiency, can not shorten the hospitalization time and promote the knee joint functional recovery. Furthermore the tourniquet increases the probability of occurrence on deep vein thrombosis, wound infection, hematoma and ecchymosis knee, it also causes knee swelling and thigh pain. It suggests minimize to use tourniquet in total knee arthroplasty.</p>

The Analysis of Health Related Behavior after Using Health Information on the Internet / 예방의학회지

OBJECTIVES: This study investigated the health information such as the general health information, the health product information, and the hospital information, and we wanted to identify the association between internet health information and the health related behavior by analyzing the process after people search the Internet. METHODS: A telephone survey with structured questionnaire was performed by trained surveyors. The respondents were sampled proportionate to the Korean demographic distribution with considering the city size and the populations' ages and gender. The survey was conducted from October 2006 to November 2006. RESULTS: Out of 3,758 successfully connected persons of age 20 or more, 871(23.2%) respondents had used Internet health information during the last year. The purposes of searching the Internet for health was, 1) to get general health information (717 cases, 81.0%), 2) shopping for health product (109 cases, 12.3%) and 3) seeking information about hospital selection (59 cases, 6.7%). Our research showed that the process after searching the Internet for health information depends on the purpose of the search. 68.8% of the searchers for general health information, 67% of the searchers for health product shopping and 64.4% of the searchers seeking information to guide hospital selection were satisfied with their Internet search. However one third of the respondents reported not being satisfied with the result of the search. CONCLUSIONS: Unsatisfied consumers with internet health information tended to ask lay referrals from others or they gave up seeking health information. The health information system should be improved to increase the accessibility and to provide reliable and effective information. Also, a more user-centric community is needed in order to strengthen the effective role of lay referrals among the internet users.

The Factors Influencing Korean Health Behavior / 간호학회지

PURPOSE: This study was performed to investigate the factors influencing health behavior. METHOD: Data used in this study was drawn from a 2001 National Health survey done by Korea Institute for Health and Social Affairs. Number of samples were 5,085 people between age 20 years and 69 years in whole country. In this study, we modified Green and Kreuter's Precede-Proceed model to analyse influence of factors in health behavior. Hierarchical regression were used in the analysis. RESULT: 1) Factors that had statistically significant positive relation with overall health behavior were age, educational level, income level, disease in the family, medical examination, subjective weight, and concern about health, 2) Factors that had statistically significant negative relation with overall health behavior were sex, subjective health, stress, and degree of physical activity. CONCLUSION: 1) It would be necessary to set the target group for the health promotion in advance. 2) It was very important to adopt easy and efficient methods to change the health behavior of target group, for example, ability to control stress.