Cytotoxicity of 4 Wild Mushrooms in a Case of Yunnan Sudden Unexplained Death / 法医学杂志

OBJECTIVES@#To explore the cytotoxicity of four wild mushrooms involved in a case of Yunnan sudden unexplained death (YNSUD), to provide the experimental basis for prevention and treatment of YNSUD.@*METHODS@#Four kinds of wild mushrooms that were eaten by family members in this YNSUD incident were collected and identified by expert identification and gene sequencing. Raw extracts from four wild mushrooms were extracted by ultrasonic extraction to intervene HEK293 cells, and the mushrooms with obvious cytotoxicity were screened by Cell Counting Kit-8 (CCK-8). The selected wild mushrooms were prepared into three kinds of extracts, which were raw, boiled, and boiled followed by enzymolysis. HEK293 cells were intervened with these three extracts at different concentrations. The cytotoxicity was detected by CCK-8 combined with lactate dehydrogenase (LDH) Assay Kit, and the morphological changes of HEK293 cells were observed under an inverted phase contrast microscope.@*RESULTS@#Species identification indicated that the four wild mushrooms were Butyriboletus roseoflavus, Boletus edulis, Russula virescens and Amanita manginiana. Cytotoxicity was found only in Amanita manginiana. The raw extracts showed cytotoxicity at the mass concentration of 0.1 mg/mL, while the boiled extracts and the boiled followed by enzymolysis extracts showed obvious cytotoxicity at the mass concentration of 0.4 mg/mL and 0.7 mg/mL, respectively. In addition to the obvious decrease in the number of HEK293 cells, the number of synapses increased and the refraction of HEK293 cells was poor after the intervention of Amanita manginiana extracts.@*CONCLUSIONS@#The extracts of Amanita manginiana involved in this YNSUD case has obvious cytotoxicity, and some of its toxicity can be reduced by boiled and enzymolysis, but cannot be completely detoxicated. Therefore, the consumption of Amanita manginiana is potentially dangerous, and it may be one of the causes of the YNSUD.

Risk factors analysis and risk prediction model construction and validation of cognitive dysfunction after brain trauma / 中华行为医学与脑科学杂志

Objective:To analyze the independent risk factors for the occurrence of post-traumatic cognitive dysfunction, construct a prediction model for the risk factors of post-traumatic cognitive dysfunction, and verify the effectiveness of the risk prediction model, so as to provide a clinical tool for early prediction of the risk of post-traumatic cognitive impairment.Methods:Part I: patients with brain trauma (training set with 556 subjects) who were hospitalized in 21 tertiary and secondary hospitals from Tangshan, Cangzhou and Chengde cities of Hebei province were retrospectively collected from February to May 2021 for Montreal cognitive assessment, and 33 influencing factors (general data, symptoms and signs, laboratory and imaging parameters) were obtained obtained through literature research.The patients were divided into case group and control group according to whether they had cognitive impairment or not, and univariate and multivariate analysis were used to screen independent risk factors.Part Ⅱ: a binary Logistic regression equation was used to construct a cognitive impairment prediction model, the visualization model of line graph is presented.Part Ⅲ: brain trauma patients (260 subjects of the validation set) hospitalized in the aforementioned 21 hospitals from August to October 2021 were collected as a prospective validation population for the prediction model of cognitive impairment, and the grouping basis of case group and control group was the same as before.And the risk factors between the two groups were compared.The receiver operating characteristic curve(ROC), calibration curve and clinical applicability of the model were drawn to evaluate the effectiveness of the model for internal and external verification of the model.Results:Binary Logistic regression analysis showed that the risk factors for post-traumatic cognitive dysfunction were basal ganglia injury, severe injury, amnesia experience after injury, frequent headache after injury, upper limb dysfunction after injury, age ≥ 60 years, and education level of elementary school or below.Visual nomograms showed that the experience of amnesia after injury, frequent headache after injury, upper limb dysfunction, and degree of injury among the symptom factors were the factors that contributed greatly to the risk of traumatic brain injury cognitive impairment in this model.Predictive model discrimination using area under curve(AUC) values of the area under the ROC curve showed that internal validation and external validation were 0.868 and 0.885 for R language analysis and 0.868 and 0.901 for SPSS analysis, respectively.The curve after model calibration almost coincided with the reference line, Hosmer-Lemeshow test P>0.05.The two decision curve analysis (DCA) curves drawn by the clinical applicability of the model were higher than the two extreme curves, predicting that traumatic brain injury patients with cognitive impairment could benefit from the predictive model, and there was a net benefit rate in the range of Pt about 0.1-0.8, when Pt reached about 0.1 until the approximate 1.0 composite evaluation model. Conclusion:Risk factors such as experience of amnesia after injury, frequent headache after injury, upper limb dysfunction, and degree of injury are predicting factors contributed to the risk of cognitive impairment in traumatic brain injury, and their prediction models have good predictive effect, high predictive accuracy and good clinical applicability, which can be applied in clinical diagnosis.

The correlation between mild cognitive impairment in the elderly and impaired fasting glucose tolerance and low fasting blood glucose / 中华老年医学杂志

Objective:To investigate the correlation between mild cognitive impairment(MCI)and abnormal glucose metabolism and thus to provide a basis for MCI prevention.Methods:A total of 1 074 elderly outpatients with normal cognitive function and without confirmed diabetes mellitus, hyperlipoidemia or gout were enrolled.During a five-year follow-up period, 121 subjects were diagnosed with MCI based on the mini mental state examination(MMSE)and the Montreal cognitive assessment(MoCA). Furthermore, annual blood glucose and glycated hemoglobin monitoring was carried out to examine the long-term effects of abnormal glucose metabolism on MCI risk.Results:According to cognitive function, 1 074 subjects were divided into the MCI group and the non-MCI group.Compared with the non-MCI group, the mean values of fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), triglycerides(TG)and total cholesterol(TC)in the MCI group were elevated( P<0.05). The receiver operating characteristic(ROC)curve showed that the cut-off value of FBG was 6.2 mmol/L for the hyperglycemia group(sensitivity: 84.1%, specificity: 90.9%, area under curve: 0.875, P<0.001)and 4.5mmol/L for the hypoglycemic group(sensitivity: 77.4%, specificity: 87.3%, area under curve: 0.823, P<0.001); the cut-off value of HbA1c was 5.5%(sensitivity: 76.0%, specificity: 87.0%, area under curve: 0.815, P<0.001). Multiple Logistic regression analysis showed that increased risk of MCI was associated with the mean values of fasting blood glucose <4.5 mmol/L( RR: 1.69, 95% CI: 1.11-2.59)or ≥6.2 mmol/L( RR: 1.81, 95% CI: 1.15-2.86)and of glycosylated hemoglobin ≥ 5.5%( RR: 2.13, 95% CI: 1.51-2.99). Conclusions:Impaired fasting glucose tolerance and low fasting blood glucose are independent risk factors for MCI in the elderly.

Pneumonia, Multiple Pulmonary Infarction and Abscess Caused by a Bamboo Stick Accidentally Piercing into Chest: a Case Misdiagnosed as Pulmonary Tuberculosis / 中国医学科学杂志(英文版)

Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body, some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough, chest pain, fever, hemoptysis, and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital, although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years, but no improvement of his symptoms was observed. Until one month before his death, the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia, pulmonary infarction, and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case, aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.

Cardiac Disease Associated Genetic Variants in Yi Nationality in Regions with High Incidence of Yunnan Sudden Unexplained Death / 法医学杂志

Objective To explore the association of cardiac disease associated genetic variants and the high incidence of Yunnan sudden unexplained death （YNSUD） in Yi nationality. Methods The genomic DNA was extracted from peripheral blood samples collected from 205 Yi villagers from YNSUD aggregative villages （inpatient group） and 197 healthy Yi villagers from neighboring villages （control group）. Fifty-two single nucleotide variants （SNVs） of 25 cardiac disease associated genes were genotyped using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF-MS）. The SPSS 17.0 was used to analyze data. The pathogenicities of variants with differences between the two groups that have statistical significance were predicted by protein function prediction software PolyPhen-2 and SIFT. All villagers from inpatient group were given electrocardiogram （ECG） examination using a 12-lead electrocardiograph. Results The allele frequency and the genotype frequency of missense mutation DSG2 （rs2278792, c.2318G>A, p.R773K） of pathogenic genes of arrhythmogenic right ventricular cardiomyopathy （ARVC） in inpatient group was higher than that in control group （P<0.05）. Abnormal ECG changes were detected in 71 individuals （34.6%） in the inpatient group, among which 54 individuals carried R773K mutation, including clockwise （counterclockwise） rotation, left （right） axis deviation, ST segment and T wave alteration and heart-blocking. Conclusion Definite pathogenic mutations have not been found in the 52 cardiac disease genes associated SNVs detected in Yi nationality in regions with high incidence of YNSUD. The cause of high incidence of YNSUD in Yi nationality needs further study.

Clinical observation and study of hormone replacement therapy on postoperative cervical squamous cell carcinoma / 中国综合临床

Objective:To observe the clinical effect of hormone replacement therapy(HRT) on patients with cervical squamous cell carcinoma after operation and its effect on sex hormone, blood fat, bone content and tumor markers, and to evaluate the clinical significance of HRT therapy.Methods:From January 2016 to January 2019, a total of 100 patients with cervical squamous cell carcinoma admitted to Zhuhai Maternal and Child Health Hospital were analyzed retrospectively.After surgical treatment, 50 patients were willing to receive hormone replacement therapy as the experimental group and 50 patients received routine treatment as the control group, Kupperma score was used to evaluate the severity of perimenopausal symptoms, and the serum levels of sex hormones, blood fat, bone content and tumor markers in the two groups before and after treatment were detected and the occurrence of adverse reactions were evaluated.Results:Before treatment, there was no significant difference in kupperma score, estradiol, follicle-stimulating hormone, luteinizing hormone level, lipid level, bone content and tumor marker level between the two groups(all P>0.05). After HRT treatment, kupperma score in the experimental group was significantly lower than that before treatment((11.47±5.12) vs.(20.46±7.52), t=7.262). In the detection of sex hormones, the levels of estradiol in the experimental group was significantly increased((39.26±7.43) ng/L vs.(13.78±7.52) ng/L, t=12.345), and the levels of follicle stimulating hormone((34.25±7.61) U/L vs.(62.18±19.12) U/L, t=8.245)and luteinizing hormone((20.31±6.25) U/L vs.(35.08±6.27) U/L, t=5.452, P=0.004) in the experimental group were significantly decreased.In the detection of blood lipid level, bone content and tumor markers, high-density lipoprotein((1.62±0.33) mmol/L vs(1.34±0.26) mmol/L, t=4.592, P=0.008) and alkaline phosphatase levels((66.21±25.75) U/L vs.(46.88±9.06) U/L, t=5.912, P=0.001)was significantly increased, the low density lipoprotein((2.78±0.43) mmol/L vs.(2.87±0.78) mmol/L, t=4.265, P=0.012)and total cholestenone((4.02±0.45) mmol/L vs.(4.23±0.91) mmol/L, t=5.761, P=0.002) levels were significantly decreased in the experimental group, with statistically significant differences(all P<0.05). There was no significant difference in the level of serum SCC antigen between the experimental group and the control group before and after treatment ( P> 0.05); there was no significant difference in the above indicators between the experimental group and the control group before and after treatment ( P> 0.05); there was no significant increase in adverse reactions such as breast swelling and pain (3 cases), body mass increase (2 cases), bleeding (1 case), body pain (4 cases), vomiting (4 cases), etc. between the experimental group and the control group (2, 1, 2, 3, 1 case) There was no statistical significance ( P> 0.05). Conclusion:HRT treatment of cervical squamous cell carcinoma patients after surgery can significantly improve the peri menstrual syndrome caused by low estrogen level, and did not significantly increase the risk of recurrence of cervical cancer patients and adverse reactions.

Clinical efficacy and safety of the anti-fungus treatment in advanced elderly patients with fungemia admitted into geriatric ICU / 中华老年医学杂志

Objective@#To observe the species distribution, clinical features, efficacy and safety of anti-fungus therapy in advanced elderly patients with fungemia.@*Methods@#Clinical data of patients aged 70 years and over with fungemia admitted into geriatric intensive care unit (GICU) of our hospital from Nov. 2012 to Nov. 2017 were retrospectively analyzed. The specie distribution, liver toxicity, differences in biochemical liver and renal functions before and after 28 days of treatment between the caspofungin group and the azole group (fluconazole plus voriconazole), and 28-d survival rate and its risk factors for death were analyzed.@*Results@#A total of 72 patients were enrolled, with a median age of 85.5 years (83, 90), a median score of Acute Physiology and Chronic Health Enquiry (APACHE-Ⅱ) of 25.5 (20.3, 31.5), a median score of Sequential Organ Failure Assessment (SOFA) 7 (4.0, 9.8). There were 33 patients (45.8%) with diabetes, 2 patients (2.8%) with hematological diseases, 44 patients (61.1%) with solid tumors and 18 patients (25.0%) with renal insufficiency. Thirty patients (41.7%) needed mechanical ventilation. The detection rate of Candida parapsilosis was 73.6% (53 cases), Candida famata 9.7% (7 cases), Candida tropicalis 5.6% (4 cases), Candida albicans 2.8% (2 cases), Candida glabrata 2.8% (2 cases) and others 5.6% (4 cases). The incidence rate of total liver toxicity was 23.6% after anti-fungus treatment. After 28 days of treatment, 29 patients survived in the caspofungin group (n=42) and 16 patients survived in the azole group (n=30). There were no significant differences in liver and renal function between the two groups before and after treatment. Logistic regression analysis showed that solid tumors (OR: 19.904, 95%CI: 1.944-203.808) and the median APACHE Ⅱ score were the independent risk factors for 28-day death in advanced patients with fungemia.@*Conclusions@#Fungemia is becoming more and more prominent in the GICU, which requires clinician’s constant attention in order to provide more basis for the treatment of fungemia in elderly patients.

Clinical efficacy and safety of the anti-fungus treatment in advanced elderly patients with fungemia admitted into geriatric ICU / 中华老年医学杂志

Objective To observe the species distribution,clinical features,efficacy and safety of anti-fungus therapy in advanced elderly patients with fungemia.Methods Clinical data of patients aged 70 years and over with fungemia admitted into geriatric intensive care unit (GICU) of our hospital from Nov.2012 to Nov.2017 were retrospectively analyzed.The specie distribution,liver toxicity,differences in biochemical liver and renal functions before and after 28 days of treatment between the easpofungin group and the azole group (fluconazole plus voriconazole),and 28-d survival rate and its risk factors for death were analyzed.Results A total of 72 patients were enrolled,with a median age of 85.5 years (83,90),a median score of Acute Physiology and Chronic Health Enquiry (APACHE-Ⅱ) of 25.5 (20.3,31.5),a median score of Sequential Organ Failure Assessment (SOFA) 7 (4.0,9.8).There were 33 patients (45.8％) with diabetes,2 patients (2.8％) with hematological diseases,44 patients (61.1％) with solid tumors and 18 patients (25.0％) with renal insufficiency.Thirty patients (41.7％) needed mechanical ventilation.The detection rate of Candida para psilosis was 73.6％ (53 cases),Candida famata 9.7％ (7 cases),Candida tropicalis 5.6％ (4 cases),Candida albicans 2.8％ (2 cases),Candida glabrata 2.8％ (2 cases) and others 5.6％ (4 cases).The incidence rate of total liver toxicity was 23.6％ after anti-fungus treatment.After 28 days of treatment,29 patients survived in the caspofungin group (n=42) and 16 patients survived in the azole group (n=30).There were no significant differences in liver and renal function between the two groups before and after treatment.Logistic regression analysis showed that solid tumors (OR:19.904,95％CI:1.944-203.808) and the median APACHE Ⅱ score were the independent risk factors for 28-day death in advanced patients with fungemia.Conclusions Fungemia is becoming more and more prominent in the GICU,which requires clinician's constant attention in order to provide more basis for the treatment of fungemia in elderly patients.

Dynamic observation of pulmonary function by plethysmography in preterm infants with bronchopulmonary dysplasia / 中国当代儿科杂志

OBJECTIVE@#To study the effect of bronchopulmonary dysplasia (BPD) on lung function in preterm infants.@*METHODS@#According to the presence/absence or the severity of BPD, 72 preterm infants were divided into non-BPD group (n=44), mild BPD group (n=15) and moderate BPD group (n=13). Lung function was assessed by plethysmography on days 7, 14 and 28 after birth.@*RESULTS@#The preterm infants in the three groups had gradual increases in tidal volume per kilogram (TV/kg), functional residual capacity (FRC), ratio of time to peak tidal expiratory flow to total expiratory time (%T-PF) and ratio of volume to peak tidal expiratory flow to total expiratory volume (%V-PF) on days 7, 14 and 28 after birth, while there were gradual reductions in effective airway resistance per kilogram (Reff/kg) and respiratory rate (RR) (P<0.05). Compared with the non-BPD group on days 7, 14 and 28 after birth, the mild and moderate BPD groups had significantly lower TV/kg, FRC, %T-PF, and %V-PF and significantly higher Reff/kg and RR (P<0.05). On day 7 after birth, the moderate BPD group had significantly higher airway resistance, Reff/kg and FRC/kg than the mild BPD group (P<0.05).@*CONCLUSIONS@#There is a certain degree of pulmonary function impairment in preterm infants with BPD. Dynamic monitoring of lung function by plethysmography is useful for assessing lung development in the neonatal period in these infants.

Effect of red blood cell storage duration on the clinical effect of exchange transfusion and internal environment in neonates with hyperbilirubinemia / 中国当代儿科杂志

OBJECTIVE@#To study the effect of red blood cell (RBC) storage duration on the clinical effect of exchange transfusion (ET) and internal environment in neonates with hyperbilirubinemia.@*METHODS@#A retrospective analysis was performed for the clinical data of 135 neonates with hyperbilirubinemia who received ET between January 2015 and August 2018. According to RBC storage duration, the neonates were divided into short-term storage group (RBCs were stored for ≤7 days) with 56 neonates and long-term storage group (RBCs were stored for >7 days) with 79 neonates. The two groups were compared in terms of serum total bilirubin (TBIL) level and the rate of TBIL reduction at 0 and 12 hours after ET, as well as the duration of continued phototherapy and rate of repeated ET. Routine blood test parameters, electrolytes, blood glucose, and blood gas parameters were measured before ET and at 0 hour after ET.@*RESULTS@#At 0 hour after ET, there were no significant differences in the TBIL level and the rate of TBIL reduction between the two groups (P>0.05). At 12 hours after ET, the long-term storage group had a significantly higher TBIL level and a significantly lower rate of TBIL reduction than the short-term storage group (P7 days in ET for neonates with hyperbilirubinemia does not affect the immediate effect of ET, but these neonates tend to have a poor outcome after continued phototherapy and high risk of hyponatremia, hyperkalemia, and metabolic acidosis.

Forensic Pathology Analysis of 363 Sudden Death Cases in Yunnan Province / 法医学杂志

OBJECTIVES@#To study the epidemiological and pathological features of sudden death （SD） in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death.@*METHODS@#Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed.@*RESULTS@#The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death （SUD）, cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death.@*CONCLUSIONS@#The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.

Analysis of 124 Suicide Cases in Wuhua District in Kunming / 法医学杂志

OBJECTIVES@#To analyze the relationship between the suicide method and the sex, age, education background and cause of suicide to provide reference for the forensic identification of suicide.@*METHODS@#After scene investigation, external body examination, autopsy and case investigation, 124 identified suicide cases which happened in recent three years in Wuhua district in Kunming were collected. Analytical methods as chi-square test and descriptive statistics were performed by SPSS 22.0.@*RESULTS@#In all the suicide cases, male to female ratio was 1.53∶1. The suicide methods were mainly fatal fall, hanging and drowning. The ratio of local to non-native residents was 1∶1. The suicide rate in the people with primary school or junior middle school education level was highest. The group of >10-50 years tended to choose fatal fall suicide and people over 60 years were more likely to choose hanging. People with different academic background tended to choose fatal fall suicide. The suicide methods as fatal fall and hanging were chosen because of mental and physical diseases and economic problems, while the suicides with emotional problems were more likely to choose fatal fall and poisoning.@*CONCLUSIONS@#Suicide belongs to a kind of complex cases. For the cases of suspected suicide, complete exploration and overall consideration should be done to determine the nature of cases based on comprehensive analysis of all the influence factors.

Genetic and epigenetic predispositions underlying cardiovascular outcomes among patients treated with clopidogrel and aspirin / 中国药理学与毒理学杂志

Coronary artery disease (CAD)is a major cause of death and disability worldwide, and consumes a considerable amount of medical resources every year.Clopidogrel is a first-line antiplate-let therapy for CHD, butit is associated with substantial variability in PK and pharmacodynamics re-sponse. To date, gene variants explain only a smallproportion of the variability.The study aimed to identify new genetic loci-modifying antiplatelet response to clopidogrel in Chinese patients with CAD by a systematic analysis combining antiplatelet effects and PK, and further to investigate the PON1 gene promoter DNA methylation and genetic variations possibly influencing clinical outcomes in pa-tients undergoing PCI. We identified novel variants in two transporter genes (SLC14A2rs12456693, ATP-binding cassette [ABC]A1 rs2487032) and in N6AMT1 (rs2254638) associated with P2Y12 reac-tion unit (PRU) and plasma active metabolite (H4) concentration. These new variants dramatically im-proved the predictability of PRU variability to 37.7％. The associations between these loci and PK pa-rameters of clopidogrel and H4 were observed in additional patients, and its function on the activation of clopidogrel was validated in liver S9 fractions (P<0.05). Rs2254638 was further identified to exert a marginal risk effect formajor adverse cardiac events in an independent cohort.Multivariate logistic regression analysis indicated that PON1methylation level at CpG site-161 (OR=0.95; 95％ CI=0.92–0.98;P<0.01)and the use of angiotensin converting enzyme inhibitors(OR=0.48;95％ CI=0.26–0.89;P<0.01) were associated with decreased risk of bleeding events. In conclusion, new genetic variants were systematically identified as risk factors for the reduced efficacy of clopidogrel treatment.The ab-normal expression of DNA methylation-regulating key genes in the pharmacokinetic and pharmacody-namics pathways of clopidogrel and aspirin may modify clinical outcomes in dual antiplatelet-treated pa-tients undergoing PCI.

Expression differences and significance of periostin in eyelid basal cell carcinoma associated fibroblasts and-normal fibroblasts / 眼科新进展

Objective To investigate the expression differences and significance of periostin (PN) in eyelid basal cell carcinoma associated fibroblasts (BCAFs) andnormal fibroblasts (NFs) after separation,culture,purification and identification.Methods The third generation of purified BCAFs and NFs was selected,and the concentrations of cell suspensions were modulated to 20 × 106 L-1 by trypsin,and then the cell suspension were seeded and cultured in 6-well plate by 2 mL per well.The cell culture supernatants were collected when BCAFs and NFs were cultured by serum-free medium for 48 h,then the content of PN in cell culture supernatants from BCAFs and NFs was detected by enzyme-linked immunosorbent assay (ELISA).The glass coverslips were placed at the bottom of the 6-well plate to make cell slides,and then the expression of PN in BCAFs and NFs cells were tested by immunofluorescence staining.Results ELISA showed that the content of PN in cell culture supernatants from BCAFs and NFs was (9.26 ± 2.35) μg · L-1 and (2.57 ± 0.41) μg · L-1.And the expression level of PN in BCAFs tested by immunofluorescence staining technology was higher than that in NFs cells,and the differences were statistically significant (all P ＜ 0.05).Conclusion The expression and secretion of PN in the eyelid BCAFs were highly enhanced when compared with NFs,suggesting that periostein may promote or inhibit the occurrence and development of the eyelid basal cell carcinoma in the microenvironment of the eyelid basal cell carcinoma.

A follow-up study about parenting sense of competence and rumination in mothers of premature infants / 中国实用护理杂志

Objective To explore the change trend of parenting sense of competence and rumination in mothers of premature infants and their relationship. Methods Qualified participants were selected from the First Affiliated Hospital of Xi′an Jiaotong University between April and August 2016 by convenience sampling. Chinese version of Parenting Sense of Competence Scale and Chinese version of Nolen-Hoeksema Ruminative Responses Scale were used to collect data in 1 month,3 months,6 months and 12 months after premature leaving hospital. Results The parenting sense of competence scores were 62.20 ± 11.94, 67.32 ± 12.28, 68.13 ± 12.33 and 72.56 ± 13.39 respectively, which had significant differences(F=9.457,P<0.01).The rumination scores were 50.52±11.26,46.18±10.12,44.36±9.85 and 42.64 ± 9.13 respectively, which had significant differences (F=9.187,P<0.01). There were significant negative relationships between the parenting sense of competence and rumination,symptoms of rumination and forced thinking (r=-0.722--0.332, P<0.01). Rumination, income and marital status were the associated factors of parenting sense of competence after multiple linear regression analysis (t=-5.871, 2.782, 2.048, P<0.01 or 0.05). Conclusion Medical workers should pay attention to mobilize social support system and alleviate negative emotions of preterm mothers, teach them parenting skills and positive pressure coping style,in order to improve their parenting sense of competence.

The Influence of Case Teaching of Forensic Pathology Based on Network Platform on Critical Thinking Skills among Forensic Students / 昆明医科大学学报

Objective The paper aimed to discuss the influence of case teaching of forensic pathology based on network platform on the critical thinking ability of forensic students.Methods Students majoring in forensic were randomly divided into the experimental group and the control group with 20 students per group. According to heterogeneity classification, the experimental group was divided into 4 subgroups. The subgroups participated in network cases learning whereas the control group received traditional case teaching. Participants were required to fill in California Critical Thinking Disposition Inventory-Chinese Version (CCTDI-CV) before and after learning. CCTDI-CV scores, the scores of final exam and the number of students who had improved in CCTDI-CV scores were compared between the two groups. Results For the experimental group, the total score of CCTDI-CVand the scores of items including looking for the truth, systematized ability, self-confidence, thirst for knowledge were significantly improved after learning. The performance of the experimental group was better than that of the control group at the end of teaching (P＜0.05) . The scores of final exam were higher in the experimental group compared to the control group (P＜0.05) .Conclusion Forensic pathology cases teaching based on network platform is an effective way to stimulate students'critical thinking ability and to improve the study ability.

Effect of timing for removing the vein detaining catheter on prognosis in elderly patients with catheter-related bloodstream infection / 中华老年医学杂志

Objective To explore the effect of timing for removing the catheter on prognosis in elderly patients with catheter-related bloodstream infection(CRBSI)and on the death-relevant risk factors.Methods 166 elderly patients with vein detaining catheter and a suspected CRBSI in General Hospital of Tianjin Medical University from 2010 to 2015 were retrospectively analyzed.The patients were divided into a group(n=80)of removing the catheter immediately and a group(n=86)of temporarily not removing the catheter.Mortality rate within 30 days was compared between two groups and mortality-related factors were analyzed.Results In patients with CRBSI,pathogen culture results showed that the detection rate of gram-positive bacteria(G+)was 40.4％ (n=67),the rate of gram-negative bacteria(G)was 40.4％(n=67),and the rate of fungi infection were 19.3％ (n =32).The mortality rate within 30 days was 17.5 ％ in group of removing the catheter immediately,and 31.4％ in group of temporarily not removing catheter.The incidence rate of CRBSI in elder patients was also lower in group of removing the catheter immediately versus not immediately(x2 =4.303,P =0.038).Multiple Logistic regression analysis showed that tumor and diabetes were independent risk factors for death in elder patients with CRBSI (OR =2.805,2.502;P =0.017,0.019).Tumor was a relative risk factor for patients who died after removal of catheter immediately (x2=4.033,P =0.045).Conclusions Removing the vein detaining catheter immediately is an urgent need when the suspected CRBSI symptoms such as chill and hyperpyrexia appear in elderly patients with vein detaining catheter.Nephrotic syndrome,hypoalbuminemia,tumor,diabetes and antibiotic usage＞7 days are risk factors for mortality in CRBSI patients.

Studies on the degradation impurity of linezolid tablets by UFLC-MS/MS / 药学学报

A method of ultra flow liquid chromatography-tandem mass spectrometry (UFLC-MS/MS) was developed to elucidate the impurity of linezolid tablets. Linezolid was subjected to forced degradation under hydrolytic (acid, base and neutral), oxidative, photolytic and thermal. The structure identification of the degra­dation products and the fragmentation patterns for the related impurities were analyzed. A total of four degra­dation impurities were characterized, impurity 1 is (S)-1-amino-3-((3-fluoro-4-morpholinophenyl)amino)propan-2-ol, impurity 2 is (S)-4-(4-(5-(acetamidomethyl)-2-oxo-oxazolidin-3-yl)-2-fluorophenyl)morpholine 4-oxide, impurity 3 is (S)-5-(aminomethyl)-3-(3-fluoro-4-morpholinophenyl)oxazolidin-2-one, impurity 4 is (R)-N-(3-((3-fluoro-4-morpholinophenyl)amino)-2-hydroxypropyl)acetamide. Acid degradation induced impurity 3 and impurity 4, base degradation induced impurity 1 and impurity 4, oxidation degradation induced impurity 2, hydrolysis degradation induced impurity 4. The study also determined calibration factor using impurity references, and the calibration factors were found to be 1.3, 1.4, 0.9 and 1.1, respectively. The toxicity of the degradation impurities was predicted by web-based prediction system. The results from this study provide an important reference in quality control and evaluation of linezolid.

Association between Helicobacter pylori infection and creatinine clearance rate in elderly hypertensive patients / 中华老年医学杂志

Objectives To reveal the association between Helicobacter pylori infection and creatinine clearance rate in elderly patients with hypertension.Methods A total of 600 elderly hypertensive patients with different degrees of renal impairment and helicobacter pylori(HP)infection were randomly selected from Department of Health Care,General Hospital of Tianjin Medical University from 2010 to 2015.Serum creatinine concentration detection was conducted and creatinine clearance rate was calculated.Patients were divided into HP infection group(n =254)and non-HP-infection group (n =346).The multiple logistic regression analysis showed the correlation between Helicobacter pylori infection and decreased creatinine clearance rate.Results Creatinine clearance rate was significantly lower in HP-infection group[(61.1 ± 12.7)ml/min] than in non-HP-infection group[(78.5 ± 11.9) ml/min,P =0.014].Multifactorial logistic analysis revealed that Helieobacter pylori infection was significantly associated with decreased creatinine clearance rate(OR=3.5 18,95 ％ CI:1.105～4.918,P =0.011).Conclusions Helicobacter pylori infection is significantly related with decreased creatinine clearance rate in elderly patients with hypertension.