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Objective To improve the early diagnosis of congenital heart disease (CHD), investigate the awareness, screening knowledge and screening ability of CHD among health care providers in the rural areas of Yunnan province and discover an effective way to improve the related knowledge and skills of CHD screening. Methods From 2015 September to 2017 April, we set up charity mobile schools and chose eight areas as the investigating and training sites. We designed two questionnaires, and adopted the theoretical training as the main method combined with the training of clinical skills. We investigated and trained a total of 1022 medical staff. The training content include the awareness of CHD,the knowledge and skills of CHD screening. We also evaluated the outcomes of the training. Results A total of 2044 questionnaires were collected. After training, the number of objects which would screen CHD in future increased, and the cognition of the incidence and common clinical manifestations of CHD, Eisenmanger's syndrome,cardiac auscultation, pulse oximetry and the related knowledge of CHD were also improved; 563 took the test on practical skills of CHD detection. The correct rate of auscultation, period of murmurs and characteristics of murmurs was 98.22%(553),30.55%(172) and 28.60%(161). The correct rate of murmurs in ventricular septal defect,atrial septal defect and patent ductus arteriosus was 45.47%(256), 39.79 (224) and 50.80%(286) respectively. Online training was advised by 244 trainees. Increasing investment in congenital heart disease screening was suggested by 652 trainees. Conclusions The awareness of CHD screening in grassroots medical workers of Yunnan province is insufficient. It is an effective way to establish charity mobile school and to train the grassroots medical staff with the theory and practical knowledge to improve the awareness,screening knowledge and screening skills of CHD. The next step suggests that we can improve the early diagnosis of congenital heart disease (CHD).
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<p><b>OBJECTIVE</b>To investigate the effect of daunorubicin on the number and procoagulant activity of Microparticles derived from acute promyelocytic leukemia(APL) cells.</p><p><b>METHODS</b>APL cells were isolated from bone Marrow of 5 newly diagnosed APL patients, the bone marrow mononuclear cells were collected from 5 patients with iron deficiency anemia as control.APL cells were treated with different concentration of daunorubicin(0.1,0.5,1.0 and 2.0µmol/L) for 24 h. Microparticles were extracted from the cell culture medium for qualitative anaysis of the extracted microparticles.The morphologic features of the microparticles were observed by transmission electron microscopy.The number of microparticles was detected by flow cytometry.The procoagulant activity of microparticles was measured by recalcification time assays.</p><p><b>RESULTS</b>Under a transmission electron microscope, theextracted microparticles took a round or oval morphology with a transparent center,and their diameters were arund 100nm, consistent with the morphological characteristics of microparticles. Compared with bone marrow mononuclear cells-derived microparticles,the counts of the bone marrow APL cells-derived microparticles significantly increased(P<0.05).Daunorubicin increased the shedding of microparticles in a dose-dependent manner(r=0.73,P<0.01).Compared with normal bone marrow mononuclear cells-derived microparticles,bone marrow APL cells-derived microparticles showed higher procoagulant activity(P<0.05).Daunorubicin treatment enhanced the prccoagulant activity of APL cells-derived microparticles which paralleled the increasing drug concentrations(r=-0.78,P<0.01).</p><p><b>CONCLUSION</b>Daunorubicin can promote the release of APL cells-derived microparticles and enhance their related procoagulan activity.</p>
Subject(s)
Humans , Bone Marrow , Cell-Derived Microparticles , Daunorubicin , Flow Cytometry , Leukemia, Promyelocytic, AcuteABSTRACT
<p><b>OBJECTIVE</b>To evaluate the deformation of ProTaper rotary instruments using in root canals of different curvature in vitro.</p><p><b>METHODS</b>Extracted first mandibular molars were divided into two experimental groups according to the curvature of mesial buccal canals: group A with moderate curvature and group B with severe curvature. Only the mesial buccal canals of all these teeth were prepared with 6 sets of new ProTaper rotary instruments individually. Additionally, the control group was established with a set of new ProTaper rotary instruments. After finishing each canal preparation, the instruments accompanied by control were examined under the stereomicroscope by an inspector without knowing the group. If distortion, unwinding, abrasion or fracture occurred within one set of instruments, then the whole set was disposed. The sets without problems were in use until 30 times. After 5, 10, 20 times canal preparation, S1, F1 files without deformation under stereomicroscope were examined under scanning electron microscope (SEM).</p><p><b>RESULTS</b>Deformation of ProTaper rotary instruments happened after 12 times in group A and after 7 times in group B. In these two experimental groups, microcracks were found increasing with the times of use under SEM in the instruments without deformation under stereomicroscope. The microcracks on tip of instruments were deep in the early use and became smoother after 10 times. Similar changes happened on knife-edge of instruments, and the microcracks extended over the edge after 20 times use.</p><p><b>CONCLUSION</b>Root canals with severe curvature tend to damage ProTaper rotary instruments more frequently than moderately curved canals. ProTaper rotary instruments are appropriate to treat less than 7 root canals with severe curvature or 12 root canals with moderate curvature. Stereomicroscope is recommended to detect early damages on Ni-Ti rotary instruments, for preventing instruments fracture in clinic.</p>