Microbial detection and analysis of a foodborne disease caused by Staphylococcus aureus infection / 中国基层医药

Objective:To identify the cause of a suspected foodborne disease caused by bacterial food poisoning using multiple detection methods.Methods:At 9:35 a.m. on August 9, 2022, a suspected foodborne disease incident was handled by the Hefei Center for Disease Control and Prevention. The preliminary laboratory test results showed that the foodborne disease was caused by Staphylococcus aureus infection. Sixteen strains of Staphylococcus aureus were isolated, cultured, and identified using real-time fluorescent polymerase chain reaction. At the same time, the 16 strains of Staphylococcus aureus isolated from different sources were analyzed by pulsed-field gel electrophoresis to determine the correlation between strains. Results:The distribution of 16 strains of Staphylococcus aureus enterotoxins isolated was that the anal swab and chopping board (inner) smear samples from a salesperson surnamed Li showed SEB type, and the remaining 14 strains all carried type A, C, and E enterotoxin genes simultaneously. Pulsed-field gel electrophoresis typing results showed that there were two types of strains; except the anal swab and chopping board (inner) smear samples from the salesperson surnamed Li, the other 14 strains were all of the same type, with a similarity of 100%. The similarity between the anal swab and the chopping board (inner) smear samples from the salesperson surnamed Li was 80.65%, and the similarity with another type was 59.26%. This result was consistent with the detection results of Staphylococcus aureus enterotoxins. Conclusion:The foodborne disease in this case was caused by mixed contamination of two or three different sources of Staphylococcus aureus with enterotoxins.

Correlation between end-dialysis over-weight in initial stage of hemodialysis and long-term prognosis in hemodialysis patients / 中华肾脏病杂志

Objective:To explore the relationship between end-dialysis over-weight (edOW) in initial stage of hemodialysis and long-term prognosis in maintenance hemodialysis patients.Methods:The data of initial uremia patients receiving hemodialysis in the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017 were retrospectively analyzed. The end point of follow-up was death or until April 30, 2018. The general data including age, gender, body mass index, primary disease, complications and laboratory indicators of the patients and the related parameters of dialysis from four to twelve months were collected. Kaplan-Meier method was used to analyze survival rate. Cox multivariate regression was used to analyze the relationship between edOW and all-cause mortality and cardiovascular disease (CVD) mortality.Results:A total of 469 patients (300 males, 64.0%) were enrolled, with age of (56.9±17.1)years old. During the follow-up period of (4.1±2.4) years (1.0-10.3 years), 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.1% (45/102). The value of edOW was (0.28±0.02) kg. The patients were divided into edOW<0.28 kg group ( n=292) and edOW≥0.28 kg group ( n=177) according to the mean value of edOW. Kaplan-Meier survival analysis showed that the long-term survival rate in edOW<0.28 kg group was higher than that in edOW≥0.28 kg group (Log-rank χ2=4.134, P=0.043), and the CVD mortality in edOW≥0.28 kg group was significantly higher than that in edOW<0.28 kg group (Log-rank χ2=11.136, P=0.001). Cox multivariate regression analysis showed that high edOW was an independent influencing factor for all-cause death and CVD death in hemodialysis patients ( HR=1.541, 95% CI 1.057-2.249, P=0.025; HR=1.930, 95% CI 1.198-3.107, P=0.007). Conclusion:High edOW in early phase is an independent influencing factor of all-cause and CVD death in hemodialysis patients.

Analysis of intestinal flora in patients with chronic rhinosinusitis based on highthroughput sequencing / 南方医科大学学报

OBJECTIVE@#To investigate the changes in diversity, relative abundance and distribution of intestinal flora in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) using high-throughput sequencing technology identify the intestinal flora significantly related to pathogenesis and progression of CRSwNP.@*METHODS@#Ten patients with CRSwNP hospitalized in the Department of Otolaryngology-Head and Neck Surgery of Guangdong Provincial People's Hospital were selected as the case group with 10 healthy volunteers recruited in the same period as the control group. Fecal genomic DNA extraction kit was used to extract the DNA in the fecal samples, and the DNA fragment length was measured and quantified. The V3 and V4 highly variable regions of the 16S rDNA gene of prokaryotes were amplified followed by library construction, Illumina MiSeq sequencing, sequence alignment and species identification analysis. The relative abundance, diversity and distribution characteristics of the intestinal flora were analyzed, and the relevant metabolic pathways were predicted.@*RESULTS@#Compared with the control group, the patients with CRSwNP had significant changes in the overall structure of the intestinal flora, highlighted by increased abundance of Saccharopolyspora and decreased contents of , , and . Among the metabolic pathways predicted to be associated with CRSwNP, 9 showed significant changes in patients with CRSwNP as compared with the control group ( < 0.05).@*CONCLUSIONS@#Patients with CRSwNP have significant changes in the structural characteristics of intestinal flora related with multiple metabolic pathways, and these changes may play an important role in the development of chronic rhinosinusitis.

Analysis of early mortality and related risk factors in maintenance hemodialysis patients / 中华肾脏病杂志

Objective:To analyze the early mortality and related risk factors of new hemodialysis patients in Zhejiang province, and provide basis for reducing the death risk of hemodialysis patients.Methods:The early mortality and related factors of new hemodialysis patients from January 1, 2010 to June 30, 2018 were retrospectively analyzed using the database of Zhejiang province hemodialysis registration. The early mortality was defined as death within 90 days of dialysis. Cox regression model was used to analyze the related risk factors of the early mortality in hemodialysis patients.Results:The mortality was the highest in the first month after dialysis (46.40/100 person year), and gradually stabilized after three months. The early mortality was 25.33/100 person year. The mortality within 120 days and 360 days were 21.40/100 person year and 11.37/100 person year, respectively. The elderly (≥65 years old, HR=1.981, 95% CI 1.319-2.977, P<0.001), primary tumor ( HR=3.308, 95% CI 1.137-5.624, P=0.028), combined with tumors (not including the primary tumor, HR=2.327, 95% CI 1.200-4.513, P=0.012), temporary catheter (the initial dialysis pathway, HR=3.632, 95% CI 1.806-7.307, P<0.001), lower albumin (<30 g/L, HR=2.181, 95% CI 1.459-3.260, P<0.001), lower hemoglobin (every 0.01 g/L increase, HR=0.861, 95% CI 0.793-0.935, P=0.001), lower high density lipoprotein (<0.7 mmol/L, HR=1.796, 95% CI 1.068-3.019, P=0.027) and higher C reactive protein (≥40 mg/L, HR=1.889, 95% CI 1.185-3.012, P=0.008) were the risk factors of early death for hemodialysis patients. Conclusions:The early mortality of hemodialysis patients is high after dialysis, and gradually stable after 3 months. The elderly, primary tumor, combined with tumors, the initial dialysis pathway, lower albumin, lower hemoglobin, lower high density lipoprotein and higher C reactive protein are the risk factors of early death for hemodialysis patients.

Risk factors analysis of malignancy from gallbladder polyps / 中华消化外科杂志

Objective To investigate the risk factors of malignancy from gallbladder polyps (GBPs).Methods The retrospective case-control study was conducted.The clinicopathological data of 604 patients with GBPs who were admitted to the Chinese PLA General Hospital between January 2011 and October 2016 were collected.There were 255 males and 349 females,aged from 19 to 88 years,with an average age of 47 years.There were 565 of 604 patients with benign GBPs and 39 with malignant GBPs.Observation indicators:(1) risk factors analysis of malignancy from GBPs;(2) the predictive ability of polyp diameter for malignancy from GBPs.Measurement data with normal distribution were expressed as Mean ± SD,measurement data with skewed distribution were described as M (range),and the univariate analysis was done using the t test or rank-sum test.Count data were described by the absolute amount,and the univariate analysis was done using the chi-square test or Fisher exact probability.The indicators with P＜0.05 in the univariate analysis based on clinical application were used in the Logistic regression models for multivariate analysis.The receiver operating characteristic (ROC) curve was drawn.The Youden index was calculated to analyze the predictive ability of polyp diameter for malignancy from GBPs.Results (1) Risk factors analysis of malignancy from GBPs:results of univariate analysis showed that age,polyp diameter,polyp number,chronic cholecystitis and carcinoembryonic antigen (CEA) level were related factors affecting malignancy from GBPs (t=-5.50,Z=-9.65,x2=15.92,312.65,Z=-1.78,P＜0.05).The results of multivariate analysis showed that age,polyp diameter and polyp number were independent factors affecting malignancy from GBPs (odds ratio =1.088,45.190,9.655,95％ confidence interval:0.974-1.159,4.312-121.139,0.890-117.551,P＜0.05).(2) The predictive ability of polyp diameter for malignancy from GBPs.The sensitivity and specificity predicting malignancy from GBPs were 94.9％ and 81.2％ in patients with polyp diameter =10 mm and Youden index =0.761,89.7％ and 90.6％ in patients with polyp diameter =12 mm and Youden index =0.803,84.6％ and 92.6％ in patients with polyp diameter =13 mm and Youden index =0.772,respectively.Conclusions The age,polyp diameter and polyp number are the independant factors affecting malignancy from GBPs.The malignancy possibility from GBPs is higher in patients with the age ＞ 50 years,polyp diameter ＞ 12 mm,solitary polyp,and should undergo surgical therapy actively.

Investigation and analysis of clinical teaching satisfaction degree in residents standardized training in Zhejiang University / 中华医学教育探索杂志

Objective@#To investigate and analyze the clinical teaching of residents standardized training in Zhejiang University, so as to provide references to improve the quality of residents standardized training.@*Methods@#Questionnaires were designed and electronic surveys via WJX software were conducted among residents from six affiliated hospitals of Zhejiang University School of Medicine on management, clinical teaching and assessment of residents. SPSS 19.0 was used to perform the χ2 test of relevant data.@*Results@#A total of 799 residents, including 312 males and 487 females, took part in this survey. In terms of satisfaction degree, trained residents had a relatively high satisfaction degree on training base (73.46%), satisfaction degrees of residents from Grade one, two and three were 69.05%, 74.72% and 79.30%, respectively. Satisfaction degree of residents with different identities to training base was social men (85.71%) > staff working in units (74.08%) > professional postgraduates (56.7%). In terms of teaching, 64.45% residents thought that clinical teachers spent 20% more time on the clinical teaching than on the daily routine work, 39.42% residents thought that clinical teachers spent 30% more and 18.52% residents thought clinical teachers spent 40% more. In addition, 70.47% residents responded that their teachers revised and instructed the medical history writing more than twice a week; 78.84% trained residents admitted that all teachers made full preparations for clinical teaching rounds. Besides, the process evaluation of training base was well implemented. Implementation rate of after-department examination and annual examination were 99.37% and 98.50%, respectively.@*Conclusion@#Residents of Zhejiang University have a high satisfaction degree on training management and clinical teaching. Homogenized management of training base should be strengthened, and evaluation and feedback should be stressed.

Investigation and analysis of clinical teaching satisfaction degree in residents standardized training in Zhejiang University / 中华医学教育探索杂志

Objective To investigate and analyze the clinical teaching of residents standardized training in Zhejiang University, so as to provide references to improve the quality of residents standardized training. Methods Questionnaires were designed and electronic surveys via WJX software were conducted among residents from six affiliated hospitals of Zhejiang University School of Medicine on management, clinical teaching and assessment of residents. SPSS 19.0 was used to perform the χ2 test of relevant data. Results A total of 799 residents, including 312 males and 487 females, took part in this survey. In terms of satisfaction degree, trained residents had a relatively high satisfaction degree on training base (73.46％), satisfaction degrees of residents from Grade one, two and three were 69.05％, 74.72％and 79.30％, respectively. Satisfaction degree of residents with different identities to training base was social men (85.71％) > staff working in units (74.08％) > professional postgraduates (56.7％). In terms of teaching, 64.45％ residents thought that clinical teachers spent 20％ more time on the clinical teaching than on the daily routine work, 39.42％ residents thought that clinical teachers spent 30％ more and 18.52％ residents thought clinical teachers spent 40％more. In addition, 70.47％residents responded that their teachers revised and instructed the medical history writing more than twice a week; 78.84％ trained residents admitted that all teachers made full preparations for clinical teaching rounds. Besides, the process evaluation of training base was well implemented. Implementation rate of after-department examination and annual examination were 99.37％and 98.50％, respectively. Conclusion Residents of Zhejiang University have a high satisfaction degree on training management and clinical teaching . Homogenized management of training base should be strengthened, and evaluation and feedback should be stressed.

Effects of SNCG gene silencing on the cell cycle of endometrial carcinoma HEC-1A cells / 实用医学杂志

Objective To observe changes of cell cycle after stable silencing of SNCG gene in human endometrial carcinoma HEC-1A cells.Methods Flow cytometry was used to observe the changes of SNCG stable silencing HEC-1A cell growth cycle.The percentage of G2/M phase of HCE-1A cells after acridine orange staining was observed by laser scanning confocal microscopy.Results Flow cytometry results showed that the group of SNCG stable silencing in G1 and G2/M phase of the cells increased,but the percentage of cells in the S phase were decreased,the difference were both statistically significant (P ＜ 0.05).The results of cells after confocal microscopy observation of acridine orange staining,the group of SNCG stable silencing were observed in G2/M phase high percentage were statistically significant (P ＜ 0.05).Conclusion Two experimental methods commonly validated that the cell cycle of SNCG stable silencing on HEC-1A cells was arrested in G2/M phase,suggesting that SNCG gene is closely related to the cell growth cycle of endometrial carcinoma.

An evaluation of Mandard tumor regression grade system in patients with locally advanced rectal cancer treated with preoperative radiotherapy / 中华放射医学与防护杂志

Objective To explore the clinical and imaging factors influencing the patients' prognosis after preoperative radiotherapy for local advanced rectal cancer.Methods We retrospectively analyzed 106 locally advanced rectal cancer patients from June 2004 to September 2015 in our institution.All patients underwent preoperative radiotherapy.According to the Mandard score,patients were divided into 5 groups (TRG1-5).All patients were divided into two groups according to the TRG,which including good responder (TRG1 + 2) and poor responder (TRG3 + 4 + 5) groups.All of the tumor ADC values of post-RT were measured by Diffusion-weighted MRI technology,and the relationship between tumor ADC values of post-RT and TRG was analyzed.Results In univariate analysis,age,chemotherapy,pT,pN,differentiation degree,vascular invasion and TRG were significantly associated with overall survival (x2 =3.945-8.110,P ＜ 0.05).Multivariate analysis indicated that differentiation degree and TRG were the independent prognostic factors for OS (x2 =5.221,6.563,P ＜ 0.05).No significant difference was found between long-course and short-course radiotherapy group (P ＞ 0.05) in OS.The good responder group had a favorable survival in 5-year OS compared to the poor responder group (x2 =8.110,P ＜ 0.05).Preoperative radiotherapy,preoperative chemotherapy,pathological type,differentiation degree and gross type,vascular tumor thrombus and tumor ADC values of post-RT were significantly associated with TRG (x2 =4.189-18.139,P ＜ 0.05).The best critical point of tumor ADC values of post-RT was 1.7 x 10-3 mm2/s by using ROC curve.The accuracy of tumor ADC values of post-RT in predicting TRG1 + 2 was 70％.Conclusions The TRG can predict the efficacy of preoperative radiotherapy in patients with locally advanced rectal cancer based on the Mandard score.There was no significant difference in OS between long-course radiotherapy group and short-course radiotherapy group.The tumor ADC values of post-RT might become a potential factor to predict TRG in patients with locally advanced rectal cancer after preoperative radiotherapy.

Transportation and Absorption of Thermo-sensitive Gel Mediated 5-FU Multiple Emulsion in Caco-2 Cell Monolayer Model / 中国药师

Objective: To develop 5-FU multiple emulsion entrapped into thermo-sensitive gel (5-FU-DEG) and detect the ab-sorption and transportation in Caco-2 cell monolayer model. Methods:The 5-FU multiple emulsion was prepared by a two-step emulsif-ying method. Poloxamer 407 (P407) was used as the thermo-sensitive material and sodium alginate (SA) was used as the bioadhesive material for the preparation of 5-FU-DEG. Caco-2 cell monolayer model was used to investigate the transportation and absorption of 5-FU. Results:5-FU-DEG gelled at the ambient temperature and turned into liquid below 10℃ The apparent permeability coefficient (Papp) of 5-FU-DEG was 1.47 ±0.11 ×10 -5(cm·s-1), which was about 6 times higher than that of 5-FU water solution(2.39 ± 0.21 ×10 -6 cm·s-1)(P<0.01). The cellular uptake rate of 5-FU-DEG was (17.1 ±0.24) %, which was 3.9 times greater than that of 5-FU water solution (4. 41 ± 0. 23%)(P<0. 01). Conclusion:5-FU-DEG can efficiently enhance the transportation and ab-sorption of drug in rectal site by using micro-emulsion technology combined with thermo-sensitive technology, which can be an effective rectal delivery system for 5-FU to treat rectal cancer.

Quality study about the cooperation experiences of doctors and nurses from the Infectious Department / 中国基层医药

Objective To understand the cooperation experiences of doctors and nurses from the Infectious Department,that may be contributive to promote a harmonious relationship between doctors and nurses.Methods Sixteen nurses and nine doctors came from Infectious Department were interviewed.The data were collected through face-to-face in-depth semi-structured interviews.Thematic analysis based on Qualitative Research method,qualitative content analysis was used for data interpretation by analysis and management.Results Three themes were identified and described as the cooperation experiences between doctors and nurse,the cooperation troubles,suggestions about promoting a harmonious relationship between doctors and nurses.Conclusion Harmonious relationship is particularly important in the clinical work,but in fact,there are many factors affect the harmonious relationships,so it is recom-mended that hospital leaders should take measures to build a harmonious relationship between doctors and nurses.

Relationship between epithelial mesenchymal transition and tumor stem cells / 国际肿瘤学杂志

At present, more and more studies show that epithelial-mesenchymal transition (EMT) is closely associated with cancer stem cell formation and tumor cell invasion, migration and metastasis.EMT not only enhances the capacity of cancer cell invasion and metastasis, but also makes the cell obtain self regeneration and other stem cell characteristics and promotes the production of cancer stem cells.As a result, the investigation of the relationship between EMT and common stem cells can be served as a new approach for searching for effective ways to control tumor invasion and metastasis.It also can provide new targets for the treatment of tumor.

Determination method of related substances in risedronate sodium tablets / 药学实践杂志

Objective To establish a HPLC method for determination of related substances of risedronate sodium tab‐lets .Methods The C18 column ,5 μm ,150 mm × 4 .6 mm ,the buffer solution (3 .22 g tetrabutyl ammonium bromide was added to a buffer solution of 1 000 ml 0 .05 mol/L ammonium chloride ,then adjusted pH to 7 .8 ± 0 .05 by ammonia)‐methanol‐aceto‐nitrile =250:50:25 as mobile phase ,column temperature:room temperature ,flow rate:1 .0 ml/min ,detection length:254 nm . Results Determined by HPLC at high temperature ,acid ,alkali degradation ,the main peak and the impurity peaks were separa‐ted well ,and the peaks had a linear relationship ,Y=1 .28 × 107 X-1 .62 × 105 (r=0 .999 9) .Conclusion The method was rap‐id ,simple ,accurate and sensitive ,and suitable for determination of risedronate sodium tablets related substances .

Study on influential factors associated with the long-term effect of allergic rhinitis specific immunotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the influential factors associated with the long-term effect of allergic rhinitis (AR) specific immunotherapy (SIT).@*METHOD@#Retrospective analyzed the following visual analog scale(VAS) before and after the specific immunotherapy of 219 patients with allergic rhinitis. Logistic regression and pair t-test were used to explore the key factors influencing the prognosis.@*RESULT@#(1) The gender and the VAS before specific immunotherapy (P 0.05) were not associated with the long-term effect of specific immunotherapy; (2) Compared VAS of different endpoints with VAS before the treatment,there were significant differences. The primary endpoints were the time following no more than half a year (total effective rate: 50.0%), half a year to 1 year (total effective rate: 51.7%), 1 to 2 year (total effective rate: 47.1%), 2 to 3 year (total effective rate: 54.5%) and over 3 year (total effective rate: 40.7%).@*CONCLUSION@#Apart from the gender and the VAS before specific immunotherapy,genetic and other factors can not significant influence the long-term effect of specific immunotherapy. The effect of specific im- munotherapy seems to last for 3 years at least. Increasing stitches can not improve long-term effect of SIT,but it can consolidate the effect. The long-term effect of specific immunotherapy tends to drop off with fluctuations over time and the higher of VAS before SIT,the better effect of long-term SIT. Further more, the long-term effect of SIT of male is worse than female. In consequences, we speculate epigenetics related to the interaction between environmental factors and genetic factors plays an important role in the long-term effect of allergic rhinitis specific immunotherapy.

Stimuli phrases of adductor spasmodic dysphonia phonatory break in mandarin Chinese / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases.@*METHOD@#Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn".@*RESULT@#Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn".@*CONCLUSION@#Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.

Diagnosis and treatment of grade Ⅴ liver trauma combined with hilar bile duct transection injury / 中华消化外科杂志

According to the Organ Injury Scale Grading System of the American Association for the Surgery of Trauma (AAST-OIS),grade Ⅴ liver trauma is always complicated with retrohepatic inferior vena cava injury and less bile duct injury,and it is extremely severe and difficult to be treated.Timely and fast judgment,emergent exploration and effective repair of the injured bile duct are the key points for the treatment of bile duct injury.One patient with grade Ⅴ liver trauma combined with hilar bile duct transection injury was admitted to the Fuzhou General Hospital of Nanjing Military Command on August 30,2013.The rupture of left and right liver junction was detected by preoperative multidisciplinary consultation and emergency open surgery at admission hour 4.There was left and right hepatic duct bifurcation rupture at the first hepatic hilum.Non-functional liver tissues were excised.Breakage left and middle hepatic vein were sutured by polymer suture line.Liver traumatic bleeding and bile duct were sutured and ligatured individually.Left and right hepatic duct laceration was sutured by 6-0 PDS suture line.A hole in the stomach wall was opened fist,and then most part of the gastric contents was removed and the gastric wall was reparied by stapler.Patient received the postoperative symptomatic treatment with gradual recovery,and was discharged from hospital at admission day 26.The patient was readmitted to the hospital at 31 days of discharge due to outflow of purulent fluid from abdominal cavity drainage tube,and was treated by ceftriaxone sodium and tazobactam sodium according to the results of drug sensitive test and continuous peritoneal lavage.The abdominal cavity drainage tube and left and right hepatic duct drainage tube were removed at postoperative day 83.The patient was discharged from hospital at readmission day 28,and was followed up till December 2014 with good recovery and without complication.

The Effects of Voice Training Therapy on Dysphonia in Patients with Vocal Nodules / 听力学及言语疾病杂志

Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

Clinical application of serum thyroid hormone homemade quality control materials / 国际检验医学杂志

Objective To investigate the feasibility of self‐control materials serum thyroid hormone detected in the clinical labo‐ratory internal quality control in applications .Methods The serum thyroid hormone test results in patients with high‐value ,the ser‐um was mixed with a certain proportion of the healthy population ,dubbed serum control materials ,after aliquots -20 ℃ .Every o‐riginal supporting quality control and simultaneous detection of free thyroxine (FT4) ,three free triiodothyronine (FT3) ,thyroid stimulating hormone (TSH) ,thyroglobulin (TG) ,thyroid‐microglobulin antibody (TMA) ,thyroglobulin antibodies (TGA) and other thyroid hormone six items detected before the appearance of control samples was observed continuously detected six months to observe stability ;used EXCELL do J‐L maps ,statistical mean of each project within six months ,CV and uncontrolled number of observed values in the internal quality control applications .Results Within 6 months after the product was frozen homemade quali‐ty control serum soluble appearance clear and transparent ,no precipitation and turbidity ;1 ,3 ,6 ,10 ,15 ,30 ,45 ,60 ,90 ,120 day of the first magnitude and no significant changes in thyroid hormone ;compared with the original quality control materials ,low CV values . In the six months internal quality control applications ,the cumulative results of each project without 1 ,3 ,6‐month and six months significantly different ;project and six months mean cumulative comparison between the mean drift or change in trend did not ap‐pear ;items and cumulative CV were in control of the allowable range (CV <1/3 times within total variation );6 months of internal quality control work ,runaway alarm :13s ,2 times ,22s ,1 times ,R4s ,1 times .Conclusion Serum thyroid hormone homemade frozen control samples have better stability ,and can replace its import control materials ;internal quality control in their daily activities , through EXCELL test results for J‐L diagram precision can find instability timely corrective treatment to ensure that thyroid func‐tion test results are reliable ,worthy of clinical application .

Advance in targeted immunotherapy for hematological malignancies based on immunosuppressive receptors / 白血病·淋巴瘤

T cell immune deficiency results in inefficient anti-tumor immune response in most patients with hematological malignancies,thereby tumor cells escaping the attack of host immune system,that is the immune escape of tumor cells.Recently,new insights regard to the CD8+ T cell exhaustion which is one of the most important mechanisms of tumor immune suppression.The CD8 + T cell exhaustion is mediated by abnormal expression of T-cell immunosuppressive receptors such as PD-1 and CTLA-4.Blocking these molecules may restore the partial or all functions of T cells.This article reviewed the advances on the role of the PD-1 and CTLA-4 in hematological malignancies,including their functions on mediating T cell-immune tolerance and the progression of targeted immunotherapy,to provide the new strategy for hematological malignancies.

Expression of A20 in patients with systemic lupus erythematosus / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the expression and regulation of A20 in healthy individuals and the patients with systemic lupus erythematosus (SLE).METHODS:The expression levels of A20, NF-κB, MALT1, and MALT1V1 in peripheral blood mononuclear cells ( PBMC) of the patients with SLE ( including 2 cases with scleroderma, 1 case with rheumatoid arthritis, and 1 case with lymphoma) were analyzed by real-time PCR.RESULTS:A significantly lower A20 expression level was found in the PBMC from SLE group compared with the healthy controls, while the expression levels of MALT1 and NF-κB were also decreased.In addition, no significant correlation between A20 and NF-κB expression levels in healthy group was observed, but a positive correlation was found in SLE group ( P<0.05) .A significant positive corre-lation between MALT1 and NF-κB expression levels in healthy group ( P<0.05) was observed, and no significant correla-tion was found in SLE group.The expression level of MALT1V1 in SLE group was significantly lower than that in healthy control group, and there was a positive correlation between A20 and MALT1V1 in healthy volunteers (P<0.01), but that did not exist in SLE group.CONCLUSION: The characteristics of the expression pattern of MALT1-A20-NF-κB in the SLE patients were presented.Lower level of A20 expression was found in the SLE patients, in particular with other autoim-mune disease or lymphomas, indicating the lower immune tolerance in SLE.The positive correlation of A20 and NF-κB may relate to positive regulation of MALT1.