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OBJECTIVES@#Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vaso-specific inflammatory marker that exacerbates atherosclerotic through inflammatory responses. It can be used to predict the occurrence of adverse cardiovascular events and to assess the residual risk of cardiovascular diseases. This study aims to investigate the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men, and to provide evidence for preventing the cardiovascular diseases.@*METHODS@#Male subjects, who participated in health examination at the Health Management Center, Third Xiangya Hospital, Central South University from May 1, 2020 to April 30, 2021, were selected. The smoking status and other information were collected by the Self-test Scale of Physical Examination. According to the smoking status, they were divided into a never-smoking group, a current smoking group, a quit smoking group and a passive smoking group. According to the daily smoking amount, the current smoking subjects were divided into a <10 cigarettes group, a 10 to 20 cigarettes group, a 21 to 30 cigarettes group, and a >30 cigarettes group. According to the smoking years, the current smoking subjects were divided into a <5 years group, a 5 to 10 years group, a 11 to 20 years group, and a >20 years group.Serum Lp-PLA2 levels and other clinical indexes in different smoking groups were measured and compared, the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men was analyzed by logistic regression analysis.@*RESULTS@#Serum Lp-PLA2 levels were significantly different between the never-smoking group and the current smoking group (P<0.05). Logistic regression analysis showed that, before adjusting other influencing factors and in terms of smoking status, the current smoking group (OR=1.81, 95% CI 1.27 to 2.58, P<0.01) and the quit smoking group (OR=2.09, 95% CI 1.12 to 3.90, P<0.05) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the passive smoking group had no correlation with serum Lp-PLA2 levels (OR=1.27, 95% CI 0.59 to 2.73, P>0.05). In terms of daily smoking amount, the 10 to 20 cigarettes group (OR=2.09, 95% CI 1.40 to 3.12, P<0.001) and the 21 to 30 cigarettes group (OR=1.98, 95% CI 1.22 to 3.20, P<0.01) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the <10 cigarettes group (OR=1.45, 95% CI 0.81 to 2.60, P>0.05) and the >30 cigarettes group (OR=1.17, 95% CI 0.60 to 2.28, P>0.05) had no correlation with serum Lp-PLA2 levels. In terms of smoking years, the 5 to 10 years group (OR=1.94, 95% CI 1.07 to 3.53, P<0.05), the 11 to 20 years group (OR=2.06, 95% CI 1.33 to 3.18, P<0.01), and the >20 years group (OR=1.66, 95% CI 1.11 to 2.47, P<0.05) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the <5 years group had no correlation with serum Lp-PLA2 levels (OR=1.12, 95% CI 0.38 to 3.33, P>0.05). After adjusting for age and other indicators, the correlation between smoking years and serum Lp-PLA2 levels was the same as before adjustment among the above smoking groups, except that the correlation between the smoking 5 to 10 years group and serum Lp-PLA2 levels was not significant (OR=1.77, 95% CI 0.95 to 3.29, P>0.05).@*CONCLUSIONS@#Smoking is correlated with serum Lp-PLA2 levels in overweight and obese men.
Subject(s)
Humans , Male , 1-Alkyl-2-acetylglycerophosphocholine Esterase , Overweight , Cardiovascular Diseases , Tobacco Smoke Pollution , Biomarkers , Obesity , Smoking , Risk FactorsABSTRACT
Objective:To investigate the clinical and genetic characteristics, pathogenesis and treatment strategy of congenital nephrogenic diabetes insipidus(CNDI)combined with hyperuricemia.Methods:The clinical manifestations and laboratory data of an infant patient diagnosed as CNDI with hyperuricemia and his family members were collected and retrospectively analyzed. Whole exome sequencing(WES)was applied to detect the proband′s genome variation of each exon and suspected variants of AVPR2 and ABCG2 were verified by PCR-Sanger sequencing of members from his pedigree. Furthermore, we retrospectively collected the serum uric acid levels of patients(≤14-year-old) with CNDI in the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2022.Results:The proband was clinically diagnosed with CNDI and the rest of the family members had no symptoms of polydipsia or polyuria. In addition to the proband, his father was also suffered from hyperuricemia. WES showed that the proband carried a hemizygous AVPR2 gene variation(p.S331R)and a heterozygous ABCG2 gene variation(p.N308K). The former was X-linked recessive inheritance from his mother, and the latter was autosomal dominant inheritance from the father. Fraction excretion of uric acid(FEUA)of the proband and his father with hyperuricemia were 3.1% and 2.7%, respectively. Twelve children(≤14-year-old)were diagnosed with CNDI from the respective study. Among all the cases, 11 patients were male and 1 was female, ranging from 3-month to 14-year-old. Five patients were accompanied with hyperuricemia.Conclusion:Children with CNDI may be complicated with hyperuricemia, and the regimen of hydrochlorothiazide combined with benzbromarone is effective. The pathogenicity of the AVPR2 gene variation(p.S331R)and ABCG2 gene variation(p.N308K)in this pedigree needs to be further studied.
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Objective:To investigate the diagnostic value of prognostic nutritional index (PNI) and C-reactive protein to albumin ratio(CAR) in Crohn′s disease complicated with intra-abdominal infection (CD-IAI).Methods:From January 2016 to December 2021, the clinical data of 61 patients with Crohn′s disease (CD) and 61 patients with CD-IAI diagnosed at Nanfang Hospital, Southern Medical University were retrospectively analyzed. Crohn′s disease activity index (CDAI), Crohn′s disease endoscopic index of severity (CDEIS), laboratory parameters(white blood cell count, neutrophil ratio, platelet count, C-reactive protein (CRP), procalcitonin (PCT), D-dimer, prothrombin time (PT), fibrinogen, activated partial thromboplastin time (APTT)), PNI and CAR were compared between CD patients and CD-IAI patients. From January to May in 2022 another 30 patients with CD and 13 patients with CD-IAI diagnosed at Nanfang Hospital, Southern Medical University were selected to verify the accuracy of PNI and CAR in predicting CD-IAI. The optimal cut-off values of PNI and CAR in predicting CD-IAI, area under the curve (AUC), Youden index, sensitivity and specificity were calculated by receiver operating characteristic curve (ROC). Spearman correlation was used to analyze the correlation between PNI, CAR, CDAI, and CDEIS, and logistic regression was performed to analyze the influencing factors of CD-IAI. Independent sample t test and Mann-Whitney U test were used for statistical analysis. Results:CDAI and CDEIS were higher in CD-IAI patients than those of CD patients(256.68±8.50 vs.144.87±7.83; 3.80 (1.80, 5.40) vs. 1.20 (0.20, 2.80)), and the differences were statistically significant( t=-9.67, Z=-4.02, both P<0.001). The white blood cell count, neutrophil ratio, platelet count, CRP, PCT, D-dimer, PT, fibrinogen, and APTT of CD-IAI patients were all higher than those of CD patients (7.81×10 9/L (5.98×10 9/L, 11.39×10 9/L) vs. 5.94×10 9/L (4.86×10 9/L, 7.11×10 9/L); (73.43±10.67)% vs. (62.30±11.03)%; 360.00×10 9/L (266.50×10 9/L, 456.00×10 9/L) vs. 294.00×10 9/L (222.50×10 9/L, 356.00×10 9/L); 44.27 mg/L (16.82 mg/L, 82.65 mg/L) vs. 3.42 mg/L (0.59 mg/L, 18.33 mg/L); 0.07 μg/L (0.04 μg/L, 0.22 μg/L) vs. 0.04 μg/L (0.02 μg/L, 0.05 μg/L); 0.75 mg/L (0.32 mg/L, 2.00 mg/L) vs. 0.26 mg/L (0.15 mg/L, 0.46 mg/L); 11.90 s (11.40 s, 12.90 s) vs. 11.20 s (10.45 s, 11.70 s); 4.58 g/L (3.59 g/L, 5.59 g/L) vs. 2.99 g/L (2.17 g/L, 4.23 g/L); 30.40 s (28.30 s, 32.80 s) vs. 28.00 s (25.45 s, 31.10 s)), and the differences were statistically significant ( Z=-4.48; t=-5.66; Z=-2.71, -6.47, -3.78, -4.87, -4.87, -5.44 and -2.74; all P<0.01). The serum albumin level of CD-IAI patients was lower than that of CD patients (34.10 g/L (31.40 g/L, 36.90 g/L) vs. 39.00 g/L (35.10 g/L, 43.20 g/L)), and the difference was statistically significant( Z=-3.91, P<0.001). The PNI of CD-IAI patients was lower than that of CD patients (41.65, (38.58, 44.58) vs. 47.80 (40.45, 52.98)), while CAR was higher than that of CD patients (1.29 (0.48, 2.67) vs. 0.10 (0.01, 0.46)), and the differences were statistically significant ( Z=-3.83 and -6.44, both P<0.001). The results of Spearman correlation analysis showed that PNI was negatively correlated with CAR, CDAI, and CDEIS ( r=-0.64, -0.53 and -0.50, all P<0.001), and CAR was positively correlated with CDAI and CDEIS ( r=0.63 and 0.52, both P<0.001). The results of logistic regression analysis showed that high level of PNI was a protective factor for CD-IAI ( OR= 0.911, 95% confidence interval 0.864 to 0.961), and high level of CAR was a risk factor for CD-IAI ( OR=2.846, 95% confidence interval 1.745 to 4.644). The results of ROC indicated that the AUC value of combined PNI and CAR in the diagnosis of CD-IAI was 0.829 ( P<0.001), Youden index was 0.541, the sensitivity was 0.934, and the specificity was 0.607. The sensitivity and specificity of optimal cut-off value of the combination of PNI and CAR in predicting CD-IAI were 0.692 and 0.967. Conclusions:PNI and CAR have certain diagnostic value in CD-IAI. The risk of CD-IAI is high when PNI <45.550 and CAR >0.466.
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Objective:To examine the influencing factors of endothelial injury using the structural equation model (SEM).Methods:A total of 6 861 asymptomatic individuals free of cardiovascular disease underwent health examinations at the health management center of the third Xiangya hospital, Central South University from May 2015 to August 2020. And collected their questionnaire and checkup data. Spearman′s rank correlation coefficient was used to analyze metabolic factors and brachial artery flow-mediated dilatation (FMD). Exploratory factor analysis (3 430/6 861) and confirmatory factor analysis (3 431/6 861) were conducted on the diet items. An SEM was constructed using the diet pattern data, cardiovascular risk factors and FMD, and using multi-path regression analysis to determine the correlation between the indicators.Results:Based on the factor analysis, diet items were divided into three patterns: healthy food, meat, and supplementary food. The SEM indicated that age ( β=0.27) and blood pressure ( β=0.12) had obvious effects on low FMD. Triglyceride ( β=0.03), fasting blood glucose ( β=0.04), and body mass index ( β=0.08) were positively correlated with low FMD. On the upstream, healthy food was negatively correlated with blood pressure ( β=-0.04) and body mass index ( β=-0.04), meat was positively correlated with triglyceride ( β=0.33), blood pressure ( β=0.06), fasting blood glucose ( β=0.20), and body mass index ( β=0.16), and supplementary food was negatively correlated with fasting blood glucose ( β=-0.30). This was the only pattern that was directly correlated with FMD ( β=0.05). Conclusions:SEM is an effective method to analyze the influence of various risk factors on the population and the relationship between individual indicators. This study revealed direct and indirect correlations between age, diet pattern, cardiovascular-metabolic risk, and FMD impairment. Comprehensive control of dietary patterns and metabolic indicators could prevent and improve early cardiovascular injury.
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Objective@#To analyze the nursing methods and effects of early rehabilitation and health management for hypertensive patients with cerebral infarction and hemiplegia.@*Methods@#Totally 86 patients with hypertension and cerebral infarction with hemiplegia were randomized to a random number table, with 43 patients in each group. The control group received routine nursing, and the observation group underwent early rehabilitation health management care, and the recovery of the two groups was compared.@*Results@#After treatment, the patient medical research committee score (MRC) in the observation group was (50.25±3.37) points, higher than the control group (40.28±3.38) points, and the Fugl-Meyer score (upper limb) of the observation was (65.44 ± 1.08) points, which was higher than that of the control group (53.38 ±1.22) points, and the Fugl-Meyer score (lower limb) was (28.15±1.13) points, significantly higher than the control group (26.52±1.17) points, the living activity ability Barthel index (88.65±4.73) was significantly higher than the control group (80.27 ±4.69)( t values were 6.571-48.536, P < 0.01). After nursing, the scores of memory and thinking, emotion, communication, mobility, daily living ability, hand function, strength and participation in the quality of life in the observation group were (74.58 ±3.27) points, (75.87 ±4.06) points, (72.31 ±5.08) points, (72.13 ±5.06) points, (69.75 ±4.41) points, (78.56 ±5.13) points, (64.17±3.50) points and (68.95±5.03) points. The scores of the observation group were significantly higher than those of the control group, which were (69.27 ±3.66) points, (66.35 ±4.17) points, (63.59±5.41) points, (58.95±4.22) points, (59.67±4.30) points, (63.49±5.07) points, (59.74±3.15) points, (54.09±5.10) points (t values were 6.144-13.701, P < 0.05).@*Conclusion@#Early rehabilitation health management and nursing for hypertensive patients with cerebral infarction and hemiplegia is helpful to improve the limb motor function and life activity ability of patients, and can significantly improve the quality of life of patients, which is worthy of promotion.
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Objective:To analyze the status and influencing factors of long-term care demand of the community elderly in Taian and in order to provide a theoretical basis for the government to formulate policies to meet the needs of the elderly.Methods:A self-designed questionnaire was used to investigate 294 elderly aged 60 years in three areas in Tai'an using Convenient sampling.Results:The total average score of long-term care demand was (2.67±0.46). The top three demand are economic, chronic disease rehabilitation, and dignity demand. Multiple linear regression showed that age, living conditions, place of residence, and chronic disease were the influencing factors of long-term care needs ( P<0.05). Conclusions:The long-term care needs of the elderly in Tai'an community were at a medium level, Age, living conditions, place of residence and chronic diseases have different effects on long-term care demand. It is suggested that the government and medical staff should pay more attention to the economic, rehabilitation and dignity needs of the elderly in the community, and formulate and implement relevant policies to meet the needs of the elderly in order to improve the quality of life and happiness of the elderly.
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Objective:To analyze the nursing methods and effects of early rehabilitation and health management for hypertensive patients with cerebral infarction and hemiplegia.Methods:Totally 86 patients with hypertension and cerebral infarction with hemiplegia were randomized to a random number table, with 43 patients in each group. The control group received routine nursing, and the observation group underwent early rehabilitation health management care, and the recovery of the two groups was compared.Results:After treatment, the patient medical research committee score (MRC) in the observation group was (50.25±3.37) points, higher than the control group (40.28±3.38) points, and the Fugl-Meyer score (upper limb) of the observation was (65.44 ± 1.08) points, which was higher than that of the control group (53.38 ±1.22) points, and the Fugl-Meyer score (lower limb) was (28.15±1.13) points, significantly higher than the control group (26.52±1.17) points, the living activity ability Barthel index (88.65±4.73) was significantly higher than the control group (80.27 ±4.69)( t values were 6.571-48.536, P < 0.01). After nursing, the scores of memory and thinking, emotion, communication, mobility, daily living ability, hand function, strength and participation in the quality of life in the observation group were (74.58 ±3.27) points, (75.87 ±4.06) points, (72.31 ±5.08) points, (72.13 ±5.06) points, (69.75 ±4.41) points, (78.56 ±5.13) points, (64.17±3.50) points and (68.95±5.03) points. The scores of the observation group were significantly higher than those of the control group, which were (69.27 ±3.66) points, (66.35 ±4.17) points, (63.59±5.41) points, (58.95±4.22) points, (59.67±4.30) points, (63.49±5.07) points, (59.74±3.15) points, (54.09±5.10) points ( t values were 6.144-13.701, P < 0.05). Conclusion:Early rehabilitation health management and nursing for hypertensive patients with cerebral infarction and hemiplegia is helpful to improve the limb motor function and life activity ability of patients, and can significantly improve the quality of life of patients, which is worthy of promotion.
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This study selected the military English listening course that combined the production-oriented approach (POA) with small-scale online course, that is, it was guided by POA, combined advantages of online and offline hybrid learning, and completed with three stages of driving, promoting and evaluating. After a semester of experiment, the authors found that the curriculum research effectively integrated the language and subject content of military English. A multi-dimensional and multi-layered learning network was formed among students and their critical thinking ability was enhanced through cooperative learning. After studying students' reflection reports and teachers' reflection on action research, the researchers found the students' gains and problems in the course and gave advice on the practical application of the theory.
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Objective@#To explore the feasibility of bronchoscopic brushing liquid-based slide cytology combined with automatic immunocytochemistry (ICC) for pathological typing of lung cancer.@*Methods@#A liquid-based thin-prep was prepared from 171 bronchoscopic brushing specimens of patients with pulmonary lesions. ICC was detected by automatic immunohistochemistry instrument while cytomorphological diagnosis was made. The results were compared with those of histopathological diagnosis.@*Results@#Among 171 patients, 130 (76.0%) could be classified by cell morphology alone, including 31 squamous cell carcinomas, 44 adenocarcinomas and 55 small cell carcinomas; 162 (94.7%) could be classified by cell morphology combined with ICC, including 38 squamous cell carcinomas, 61 adenocarcinomas and 63 small cell carcinomas (P<0.001). According to the gold standard of histopathological diagnosis, the coincidence rate of cytomorphology combined with ICC was higher than that of cell morphology alone. The coincidence rate of squamous cell carcinoma was increased from 85.2% to 97.1% (P=0.093), adenocarcinoma from 92.5% to 98.0% (P<0.001), and small cell carcinoma from 96.1% to 98.3% (P=0.465).@*Conclusion@#The combination of liquid-based thin-prep cytology and automatic immunohistochemistry can effectively improve the accuracy of pathological typing of brushing specimens under fiberoptic bronchoscopy, and provide more objective diagnostic results for clinical treatment.
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Objective@#To evaluate the utility of the BRAFV600E mutation detection in different cytoloy categories and to determine if the VE1 antibody can serve as a screening tool for the detection of BRAFV600E mutation in thyroid fine needle aspiration (FNA) specimens.@*Methods@#A total of 273 FNA residual specimens were collected. BRAFV600E testing was performed on these liquid-based specimens. And also 78 specimens with enough residual cells were stained with VE1 antibody. Comparisons of molecular and immunocytochemistry results with clinicopathological outcomes were performed. SPSS 17.0 software was used to analyze the data.@*Results@#There were 70 indeterminated diagnoses in 273 cases with FNAs. Fifty-eight cases were proven to be papillary thyroid carcinoma (PTC) by histology, including 9 cases of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 3 cases of follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), and 46 cases of suspicious for malignancy (SM). BRAFV600E analysis detected PTC in 3 of 9 cases with AUS/FLUS, and in 31 (67.4%) of 46 cases with SM. The sensitivity of immunostaining with VE1 antibody was 62.8%(27/43) and the specificity was 91.4% (32/35). VE1 expression showed moderately concordance with the molecular mutation (κ=0.524, P<0.001).@*Conclusions@#Additional BRAFV600E detecting can improve the diagnostic efficacy for PTC in AUS/FLUS and SM. VE1 expression may be an alternative method for BRAFV600E detecting when molecular detecting is unavailable.
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This study selected the military English listening course that combined the production-oriented approach (POA) with small-scale online course, that is, it was guided by POA, combined advantages of online and offline hybrid learning, and completed with three stages of driving, promoting and evaluating. After a semester of experiment, the authors found that the curriculum research effectively integrated the language and subject content of military English. A multi-dimensional and multi-layered learning network was formed among students and their critical thinking ability was enhanced through cooperative learning. After studying students' reflection reports and teachers' reflection on action research, the researchers found the students' gains and problems in the course and gave advice on the practical application of the theory.
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Objective To evaluate and compare the consistency and repeatability of three-dimensional ultrasound (3D-US) virtual organ computer-aided analysis (VOCAL) technique and two-dimensional ultrasound (2D-US) in the measurement of thyroid volume.Methods The thyroid volume of 50 healthy female adults aged 18 to 68 years were measured by 2D-US and 3D-US.The 2D-US was used to measure the three diameter lines (L,H,W) of the largest thyroid section,and the thyroid volume was calculated by the classical ellipsoid formula V=0.523×L×H×W.The 3D-US VOCAL technique was used to acquire the thyroid three-dimensional data,and VOCAL software was used to measure the thyroid volume.The two methods of measurement were also compared and analyzed.Results The coefficient of variation in the intra-assay was 0.738％ and 1.59％ respectively for the 3D-US VOCAL technology and traditional 2D-US measurement of thyroid volume,and the 95％ limit of agreement in the intra-assay was (-0.26 cm3,0.22 cm3) and (-0.32 cm3,0.46 cm3).In addition,the correlation coefficient in the inter-assay were 0.970xx and 0.942xx,and the 95％ limit of agreement were (-0.36 cm3,0.37 cm3) and (-0.75 cm3,0.64 cm3).To compare the two methods of measuring thyroid volume,the 3D-US VOCAL had a lower variation coefficient in the intra-assay,a higher correlation coefficient in the inter-assay and a narrower 95％ limit of agreement,which showed that the repeatability of the 3D-US VOCAL technique measuring was better than the traditional 2D-US in measuring thyroid volume.Conclusions The 3D-US VOCAL technique shows a higher repeatability in measuring thyroid than traditional 2D-US.As a safe,simple and feasible precise measurement method,it provides a reliable and effective new method for clinical measurement of irregular organ volume.
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Objective@#To explore the feasibility of conventional smears and liquid-based cytologic slides of lymphatic metastasis specimens of lung adenocarcinoma acquired by fine needle aspiration cytology (FNAC) to detect the expression of anaplastic lymphoma kinase (ALK/D5F3) by immunocytochemistry (ICC) analysis.@*Methods@#The lymphatic metastasis specimens of 147 lung adenocarcinoma, including 100 liquid-based cytologic slides and 47 conventional smears, were collected in this study. ALK fusion protein was detected by Roche Ventana ICC technology, which was compared with the ALK fusion gene assessed by fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR).@*Results@#The positive rate of ALK (D5F3) fusion protein in advanced lung adenocarcinoma acquired by FNAC was 11.6% (17/147), and 10.6% (5/47) and 12.0% (12/100) were reached in conventional smears and liquid-based cytologic slides, respectively.Among 147 cases, 57 cases including 17 positive cases and 40 negative cases were verified by RT-PCR and FISH. The whole coincidence rate reached 96.5% (55/57). The sensitivity and specificity of ALK (D5F3) fusion protein detected in lung adenocarcinoma acquired by FNAC were 94.1% (16/17) and 97.5% (39/40), respectively. The sensitivity and specificity were both 100% (5/5 of sensitivity and 10/10 of specificity) in conventional smears, while 91.7% (11/12) and 96.7% (29/30) in liquid-based cytologic slides.@*Conclusion@#Conventional smears and liquid-based cytologic slides of FNAC samples can be used to perform ICC analysis of ALK (D5F3) expression in advanced lung adenocarcinoma, especially for patients who have no opportunity for surgery or whose resected samples are difficult to form cell block.
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Reflective capacity is a very important tool of assessment for health professionals. Re-flective writing (RW) curriculum, aiming at promoting reflective capacity, is proliferating within American medical education. This paper generalizes the training process of RW capacity, its contents and evaluation tool. It discusses the meaningfulness of RW curriculum in improving doctor-patient relationship and profes-sionalism and developing academic goals. For better practice, the paper makes suggestions that we should reform our traditional medical education, develop interdisciplinary teams of teachers and evaluation tool and incorporate RW curriculum into continuing medical education.
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How to improve medical English writing skill effectively is an urgent problem to be solved in medical English teaching.This study aimed to evaluate the effect of the Presentation-Assimilation-Discussion (PAD) Class Model combining the advantages of traditional teaching model and the current flip classroom teaching model in medical English writing course.The study of "abstract writing" was divided into three parts,i.e.Presentation,Assimilation and Discussion which respectively focused on teacher's presentation of the basic structure of abstract in class,students' assimilation of the files after class,students-teacher's discussion in class.The test results and questionnaire were analyzed at the end of the course.PAD class model can optimize the teaching efficiency of basic knowledge,increase students' ability to learn autonomously,and promote the transformation of teachers' role.However,higher requirements are placed on the assessment methods,curriculum design,and teaching procedures.
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Objective To investigate the correlation between DWI value of cervical cancer in stage Ib1-II A2 and its pelvic lymph node metastasis. Methods 103 patients with cervical cancer of stage Ib1 - IIa2 confimed by surgery and pathology in our hospital from January 2014 to July2016 were retro-spectively studied,78 cases of cervical squamous cell carcinoma group(lymph node metastasis of 22 cases,non- lymph node metastasis 56 cases);25 cases of Cervical adenocarcinoma group(9 cases with lymph node metastasis,16 cases of no lymph node metastasis). All patients with preoperative were performed MR routine scan and DWI examination. The ADC value(meanADC,minADC and maxADC)between the two groups and between the groups with and without metastasis were statistically analyzed. Results The value of ADC staging of cervical carcinoma had no correlation with clinical FIGO stage(Pmean = 0.847、Pmin = 0.393、Pmax = 0.219). The meanADC values、minADC value、maxADC value[(0.84 ± 0.09)× 10-3mm2/s、(0.78 ± 0.09)× 10-3mm2/s、(0.86 ± 0.07)× 10-3 mm2/s]of Squamous cell carcinomas was lower than that of adenocarcinoma[(0.98 ± 0.04)× 10-3mm2/s、(0.93 ± 0.09)×10-3mm2/s、(0.97 ± 0.23)× 10-3mm2/s]and the difference was statistically significant(P <0.05). The meanADC values and minADC value of cervical cancer within each group in lymph node metastasis group was lower than that of non- lymph node metastasis group,the difference was statistically significant(P <0.05). The maxADC value had no significant difference(P > 0.05). Conclusion The ADC value of cervical cancer has some correlation with lymph node metastasis,which can be helpful to predict the risk of lymph node metastasis.
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Objective To analyze the epidemiology and clinical characteristics of Brucella infection in Heilongjiang Province,and to provide experience and basis for clinical treatment and prevention of brucellosis.Methods Using retrospective analysis method,clinically diagnosed patients with brucellosis from December 2016 to December 2017 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms,laboratory examination results,diagnosis and treatment effect.Healthy subjects undergoing health check-up at the same period were randomly selected as control group for laboratory blood biochemical test.Results A total of 396 patients were included in the brucellosis group,including 298 males and 98 females,with an average age of (43.6 + 15.6) years old,ranged from 1 to 75 years old.The control group included 125 cases,including 83 males and 42 females,with an average age of (41.7 ±+ 18.0) years old,ranged from 7 to 71 years old.There were no significant differences in age and gender between the two groups (t =1.083,x2 =3.789,P ＞ 0.05).The patients of ＞ 14-64 years old of age had the highest incidence (90.15％,357/396).The patients were mainly rural residents (76.01％,301/396) and the majority of them were farms (50.51％,200/396).The onset time was mainly from March to June of the year (47.73％,189/396).Clinical symptoms were fever,joint or muscle pain and hyperhidrosis,which accounted for 91.16％ (361/396),76.26％ (302/396) and 44.19％ (175/396),respectively.The levels of C-reactive protein (CRP),seropropane alanine aminotransferase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptadase (γ-GT),alkaline phosphatase (ALP),α-hydroxybutyrate dehydrogenase (HBDH),and lactate dehydrogenase (LDH) in patients with brucellosis were significantly higher than those in the control group (t =4.956,2.746,4.019,3.272,7.008,3.728,3.409,P ＜ 0.01 or 0.05),while total protein (TP) and albumin (ALB) levels were reduced (t =-7.252,-8.601,P ＜ 0.01).After treatment,the test results of CRP,ALT,AST,γ-GT,TP,ALB,ALP,HBDH and LDH were compared with those before the treatment,and the differences were statistically significant (t =2.291,4.393,3.382,2.608,-7.516,-4.710,3.509,4.585,4.473,P ＜ 0.01 or 0.05).Conclusions The patients with brucellosis in Heilongjiang Province are mainly male farmers,and the onset time is mostly concentrated in March-June.The clinical manifestations of brucellosis are varied,clinicians should strengthen discrimination and prevent misdiagnosis.Medicines for brucellosis might be cautiously used in clinical trial,and changes in liver function and myocardial enzyme activity should be monitored.
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Objective To determine the electrical conductivity of cerebrum, liver, lung and muscle of rats at different postmortem intervals for investigating the relationship between EC and PMI. Methods Healthy Sprague-Dawley rats were sacrificed and kept at constant temperature of 25°C. Cerebrum, lung, liver and muscle were extracted at different PMIs of immediate (0d), 1d, 2d, 3d, 4d, 5d, 6d and 7d, and their extraction liquids were prepared with ultrapure water at the ratio of 1g:10mL. EC were separately determined for different tissues and organs. The relationships between EC of different tissues and organs and PMI were analyzed and their regression functions were established. The characteristics of EC values for four tissues and organs were compared and their decomposition processes were discussed. Results EC of brain and muscle showed no significant changes within 1d, and increased rapidly during 2~7d; but EC of liver and lung started to increase within 1d and increased rapidly during 2~7d.The relationship between EC of different tissues and organs and PMI were well fitted with cubic equations and liver gained the highest coefficient (R2=0.96). Additional, the EC of four organs presented various increasing laws in different periods of PMI. Conclusion The EC of cerebrum, lung, liver and muscle of rats were well fitted with PMI and the determination of EC of cadaver tissues can be expected to become an effective method for PMI estimation in forensic practice.
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Objective To study clinical and laboratory features of children with brucellosis and to provide a theoretical basis for clinical diagnosis and treatment.Methods Using the retrospective analysis method,the clinical diagnosed information of child patients with brucellosis from January 2013 to January 2016 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms and laboratory examination results.At the same time,follow the case control method,dadult brucellosis laboratory results were selected,and the laboratory examination results were compared between child and adult patients.Results The children of ＞ 12-15 years of age had the highest incidence in 65 cases of brucellosis,and the rate was 47.7％ (31/65).Clinical symptoms were fever and joint pain,which accounted for 83.1％ (54/65) and 84.6％ (55/65),respectively.The mean values of γ-glutamyl transpeptadase (γ-GT),α-hydroxybutyric dehydrogenase (HBDH),creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) were compared between child brucellosis and adult brucellosis,and the differences were statistically significant [(30.66 ± 27.05) vs (82.80 ± 36.34) U/L,(287.40 ± 35.02) vs (180.08 ± 40.90)U/L,(20.88 ± 13.01) vs (11.70 ± 4.13)U/L,(328.69 ± 37.86) vs (217.88 ± 45.67)U/L,t =-4.243,3.396,3.756,3.135,all P ＜ 0.05].After treatment,the test results of children with aspartate transaminase (AST),alanine aminotransferase (ALT),γ-GT,total protein (TP),albumin (ALB),HBDH,CK-MB and LDH were compared with those of before the treatment,the differences were statistically significant [(56.95 ± 29.50) vs (23.00 ± 12.26) U/L,(57.60 ± 35.65) vs (23.94 ± 13.38) U/L,(30.66 ± 27.05) vs (18.45 ± 12.62) U/L,(63.77 ± 5.51) vs (67.42 ± 3.50) g/L,(39.15 ± 3.89) vs (43.06 ± 3.11) g/L,(287.40 ± 35.02) vs (139.23 ± 51.70) U/L,(20.88 ± 13.01) vs (11.61 ± 10.26) U/L,(328.69 ± 37.86) vs (187.77 ± 42.32) U/L,t =4.848,2.717,2.182,-5.442,-13.752,6.989,4.749,5.993,all P ＜ 0.05].Conclusions Liver and heart of children with brucellosis are injured.By monitoring the changes of myocardial enzymes,medicines for children might be cautiously used in clinical trial,and myocardial damages of children with brucellosis can be protected and prevented.
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Objective T o analyze the relationship am ong electrical conductivity (E C ), total volatile basic nitrogen (T V B-N ), w hich is an index of decom position rate for m eat production, and postm ortem inter-val (PM I). T o explore the feasibility of E C as an index of cadaveric skeletal m uscle decom position rate and lay the foundation for PM I estim ation. Methods H ealthy Sprague-D aw ley rats w ere sacrificed by cervical vertebrae dislocation and kept at 28℃. M uscle of rear lim bs w as rem oved at different PM I, ho-m ogenized in deionized w ater and then skeletal extraction liquid of m ass concentration 0.1 g/m L w as prepared. E C and T V B-N of extraction liquid w ere separately determ ined. T he correlation betw een E C (x1) and T V B-N (x2) w as analyzed, and their regression function w as established. T he relationship be-tw een PM I (y) and these tw o param eters w ere studied, and their regression functions w ere separately established. Results T he change trends of E C and T V B-N of skeletal extraction liquid at different PM I w ere alm ost the sam e, and there w as a linear positive correlation betw een them . T he regression equation w as x2=0.14 x1-164.91 (R2=0.982). E C and T V B-N of skeletal m uscle changed significantly w ith PM I, and the regression functions w ere y=19.38 x13-370.68 x12+2526.03 x1-717.06 (R2=0.994), and y=2.56 x23-48.39 x22+330.60 x2-255.04 (R2=0.997), respectively. Conclusion E C and T V B-N of rat postm ortem skeletal m uscle show sim ilar change trends, w hich can be used as an index for decom position rate of cadaveric skeletal m uscle and provide a m ethod for further study of late PM I estim ation.