Path analysis on relationship among tested hearing thresholds, conscious hearing, and negative emotions in noise-exposed workers / 环境与职业医学

Background The correlation between noise exposure and negative emotions of noise-exposed workers has received increasing attention and related studies have been reported. However, there is a lack of research on the path and effect analysis of the relationship between noise exposure and negative emotions, which will contribute to a more comprehensive understanding of the health damage characteristics of noise in addition to hearing loss. Objective To explore the path and effects of cumulative noise exposure, tested hearing thresholds, and conscious hearing level of noise-exposed workers on negative emotions. Methods Using stratified random sampling, 312 noise-exposed workers from a machinery and equipment manufacturing enterprise were selected. Occupational history, negative emotions (including the feelings of stress, anxiety, and depression), and conscious hearing level of the workers were investigated using the Depression-Anxiety-Stress Scale (DASS-21) and a self-made questionnaire. The hearing threshold of the workers was measured by pure tone air conduction audiometry. Sound level meter was used to measure noise equivalent sound level at selected work sites. Individual cumulative noise exposure was estimated based on work site noise level and personal noise exposure history. Path analysis was used to analyze potential mediating effects of workers' hearing thresholds and conscious hearing levels on the relationship between noise exposure and negative emotions (including stress, anxiety, and depression). Results The positive rates of negative emotions among the 312 noise-exposed workers were 18.27% (57/312) for stress, 46.79% (146/312) for anxiety, and 28.53% (89/312) for depression; the cumulative noise exposure ranged from 101.0 to 136.1 dB(A)·d, with an average of 125.69 dB(A)·d. The distributions of tested hearing thresholds and conscious hearing levels among the workers exposed to noise were significantly inconsistent (P<0.001), with both unweighted and weighted Kappa values less than 0.4. The percentage of workers with conscious hearing levels higher than their hearing threshold levels was 16.0%, and the percentage of workers with conscious hearing levels lower than conscious hearing levels was 38.7%. The path analysis results showed that tested hearing thresholds had no mediating effect on the relationship between cumulative noise exposure and negative emotions. There was a partial mediating effect of conscious hearing level on the relationship between cumulative noise exposure and negative emotions, with a mediating effect value of 0.06 (95%CI: 0.03, 0.11) and a mediating effect ratio of 28.57%. Conclusion Conscious hearing plays a partial mediating role in the relationship between cumulative noise exposure and negative emotions of noise-exposed workers, while tested hearing thresholds do not.

Transcranial sonography image characteristics of substantia nigra in different Parkinson′s disease subtypes and their correlation with iron metabolism / 中华超声影像学杂志

Objective:To explore the pathological mechanism of SN hyperechogenicity by investigating the characteristics of substantia nigra (SN) hyperechogenicity on transcranial sonography (TCS) and serum iron metabolism parameters in the postural instability gait difficulty and tremor dominant subtypes of Parkinson′s disease (PD), and the correlation between them.Methods:A total of 155 PD patients recruited in Parkinson′s Disease Specialty in the Second Affiliated Hospital of Soochow University from January 2019 to December 2021 were divided into postural instability gait difficulty group( n=95) and tremor dominant group( n=60). Meanwhile, 49 healthy gender- and age-matched healthy individuals who sought for physical examination during the same period were included as the control group. All subjects underwent TCS and blood test, and the echo of SN between the postural instability gait difficulty group and tremor dominant group, serum iron metabolism parameters among the three groups were compared. The postural instability gait difficulty group and tremor dominant group were subdivided into with SN hyperechogenicity (SN+ )subgroup and without SN hyperechogenicity (SN-) subgroup respectively according to TCS results, and the differences in serum iron metabolism parameters between the subgroups were further compared. The association between SN hyperechogenicity and serum iron metabolism parameters of the postural instability gait difficulty group and tremor dominant group were further analyzed. Results:The total area of bilateral SN+ , the area of SN+ on the larger side, and the ratio of the total area of SN+ to the midbrain area (S/M) in postural instability gait difficulty group were larger than those in tremor dominant group (all P<0.001). The value of serum ceruloplasmin and transferrin in both postural instability gait difficulty group and tremor dominant group were lower than those in control group (all P<0.001), and compared with tremor dominant group and control group, the postural instability gait difficulty group had lower serum ferritin(all P<0.01). In both postural instability gait difficulty group and tremor dominant group, serum ceruloplasmin in SN+ subgroup was lower than that in SN-subgroup ( P=0.001, 0.032). Moreover, there was a negative correlation between serum transferrin and the area of SN hyperechogenicity in two subgroups(postural instability gait difficulty group: rs=-0.454, P<0.001; tremor dominant group: rs=-0.494, P<0.001). Conclusions:Compared with the tremor dominant patients, the postural instability gait difficulty patients have larger area of SN hyperechogenicity and lower serum ferritin level. The area of SN hyperechogenicity is significantly negatively correlated with serum transferrin level, indicating that the production of this imaging characteristics is related to iron metabolism.

Research progress of patients′decision self-efficacy in treatment decision-making / 中国实用护理杂志

Patients′ decision self-efficacy in treatment decision-making refers to the patient′s level of confidence in their ability to make medical decisions, which can affect the patient′s confidence and readiness to participate in their treatment or care decision-making, and it is a key facilitator for patients as collaborators working with health care providers to make high-quality treatment and care decisions. In order to comprehensively understand the research progress of patients′ self-efficacy of treatmentdecision-making, this paper reviews the connotation, assessment tools, status quo, influencing factors and intervention strategies of patients′ decision self-efficacy of treatment decision-making, providing the basis for objectively evaluating patients′ decision self-efficacy of treatment decisions in the future and the development of related research.

Clinical characteristics and risk factors of severe and critical influenza in children / 中华传染病杂志

Objective:To explore the clinical characteristics and risk factors of severe and critical influenza in children.Methods:The clinical data of 214 inpatient children with severe and critical influenza hospitalized in the Second Affiliated Hospital & Yuying Children′s Hospital of Wenzhou Medical University from January 1, 2016 to December 31, 2019 were retrospectively collected. The clinical characteristics including age, gender, symptoms, signs, underlying diseases, C-reactive protein (CRP), treatment and outcome of children with severe and critical influenza were compared. Chi-Square test was used for statistical analysis. A binary logistic regression model was constructed to analyze the risk factors for critically ill influenza.Results:Of the 214 children, 153 were male (71.5%), 177(82.7%) were under 5 years old. There were 52 children with underlying diseases. Fever occurred in 207 cases. Among the 54 cases that had convulsion during the course of the disease, three developed acute necrotizing encephalopathy. The influenza subtype was mainly type A, accounting for 190(88.79%). A total of 42(19.6%) children were critically ill. The incidence of critical influenza in children with underlying diseases (61.9%, 26/42) was higher than that in severe influenza children (15.1%, 26/172), and the difference was statistically significant ( χ2=40.175, P<0.01). The incidence of critical influenza in children with CRP≥40 mg/L was higher than that of severe influenza in children with CRP ≥40 mg/L (33.3%(14/42) vs 9.3%(16/172)), and the difference was statistically significant ( χ2=16.173, P<0.01). Multivariate logistic regression showed that underlying diseases (odds ratio ( OR)=8.794, 95% confidence interval ( CI) 3.845-20.111) and CRP ≥40 mg/L ( OR=5.050, 95% CI 1.966-12.970) were risk factors for critical influenza. All severe cases were improved and discharged.Among the 42 critically ill children, seven children died. Conclusions:Among the severe and critical influenza in children, the majority of children are under five years old.Underlying diseases and CRP ≥40 mg/L are risk factors for critical influenza.

Evaluation on monitoring effect of the electronic vaccine vial monitor label / 生物医学工程学杂志

The cold chain safety of vaccines is a global issue. The electronic vaccine vial monitor (eVVM) label can monitor the temperature of vaccines in real time and provide "early warning" prompts. In order to comprehensively evaluate the monitoring efficiency of eVVM, this study selected 75 eVVM labels and distributed them with a total of 600 vaccine vial monitor (VVM) labels of four different types in different experimental environment (2-8℃, -20℃ and 40℃), and used a temperature recorder as "gold standard". The results showed that the accuracy of the eVVM labels and VVM labels in high temperature environment was as same as that of the temperature recorder (

The role of TXNIP/NLRP3 pathway in migration and invasion of placental trophoblasts in gestational diabetes mellitus / 中华内分泌外科杂志

Objective:To investigate the expressions of thioredoxin-interacting protein (TXNIP) /NLR family pyrin domain containing 3 (NLRP3) pathway in placental tissues of gestational diabetes mellitus (GDM) patients and its role in the migration and invasion of placental trophoblast cells.Methods:The placenta tissues of 25 GDM pregnant women (GDM group) and 25 normal glucose tolerance pregnant women (normal group) were collected. The cultured human chorionic trophoblast cells were divided into control group (untransfected) , siNC group (negative control) , siTXNIP group (siRNA-TXNIP) , siTXNIP+pcDNA group (co transfected with siRNA-TXNIP and pcDNA3.1 empty vector plasmids) and siTXNIP + NLRP3 group (co transfected with siRNA-TXNIP and pcDNA3.1-Flag-NLRP3 over expression plasmids) . The expressions of TXNIP and NLRP3 mRNAs were detected by real-time fluorescence quantitative PCR, and the expressions of TXNIP and NLRP3 proteins were detected by Western blot. Cell viability was measured by thiazole blue method. Cell migration ability was detected by scratch test, and cell invasion was detected by Transwell’s cell experiment.Results:Compared with those in the normal group, mRNA and protein expression levels of TXNIP and NLRP3 in the placenta of patients in GDM group were significantly higher ( P<0.05) . Compared with those in the control group or siNC group, mRNA and protein expression levels of TXNIP in siTXNIP group were significantly lower, however, the cell viability and migration rate were significantly higher, and the number of transmembrane cells was significantly higher ( P<0.05) ; but there was no significant difference in the above indexes between siNC group and the control group ( P>0.05) . Compared with those in siTXNIP group or siTXNIP + pcDNA group, mRNA and protein expression levels of NLRP3 in siTXNIP + NLRP3 group were significantly higher, however, the cell viability and migration rate were significantly lower, and the number of transmembrane cells was significantly lower ( P<0.05) ; but there was no significant difference in the above indexes between siTXNIP + pcDNA group and siTXNIP group ( P>0.05) . Conclusions:TXNIP/NLRP3 pathway is closely related to the occurrence and development of GDM. TXNIP can inhibit the migration and invasion of placental trophoblast cells by activating NLRP3.

Clinical features of different isoforms of PML鄄RARα fusion gene in patients with acute promyelocytic leukemia / 白血病·淋巴瘤

Objective To explore the clinical features and prognosis of different PML_RARα fusion gene isoforms in acute promyelocytic leukemia (APL). Methods The clinical data of 78 patients initially diagnosed with APL in Fujian Medical University Union Hospital from February 2013 to July 2016 were collected. The clinical features and prognosis of different PML_RARα fusion gene isoforms were analyzed. Results There were 32 females (41%) and 46 males (59%) in 78 patients, with a median age of 40 years old (13-68 years old). The most common PML_RARα fusion gene was L type (48.7%, 38/78), followed by S type (46.2%, 36/78) and V type (5.1%, 4/78). The patients with white blood cell count more than 10×109/L (high_risk) occurred mostly in S type (61.1%, 22/36), compared with V type and L type, and there were statistically different (χ 2 ＝ 7.683, P < 0.05). A total of 78 patients included 8 cases (10.2%) of combined CD34 positive, 17 cases (21.8%) of combined FLT3_ITD mutation, 12 cases (15.4%) of combined DNMT3A mutation and 9 cases (11.5%) of additional chromosomal abnormalities. There were no significant differences in CD34 positive, FLT3_ITD, DNMT3A, and the incidence of additional chromosomal abnormalities among the three different isoforms (P＞0.05). The most common occurrence of retinoic acid syndrome (RAS) during treatment was S type (21/36), while rare for L type and V type (χ2＝ 7.633, P< 0.05). There were no statistical differences in the complete remission (CR) rate and disease_free survival rate among the patients with different PML_RARα isoforms (P＞0.05). Conclusions The clinical characteristics of different PML_RARα fusion gene isoforms are different, including most_common L type, more_common V type and S type in high risk groups; complicated RAS is commonly found in S type during the treatment. And different isoforms have no effect on the CR and DFS rate.

Changes in EGFR, FOXA2 and MUC5AC expression in respiratory syncytial virus-infected human bronchial epithelium cells and effects of rosiglitazone intervention / 中华微生物学和免疫学杂志

Objective To investigate the mechanism of epidermal growth factor receptor-forkhead transcription factor A2 (EGFR-FOXA2) pathway-involved high secretion of mucus in human bronchial epitheli-um (HBE) cells after respiratory syncytial virus (RSV) infection and to evaluate the effects of intervention using agonist ( rosiglitazone ) and antagonist ( GW9662 ) of peroxidase proliferation activated receptor γ( PPARγ) and EGFR inhibitor ( AG1478 ) . Methods HBE cells were randomly divided into six groups: A group ( AG1478+RSV) , B group ( rosiglitazone+RSV) , C group ( GW9662+RSV) , D group ( RSV) , E group (0. 1％ dimethyl sulfoxide DMSO) and F group (HBE cell control group). Two hours before RSV infection, A, B and C groups were respectively treated with 10 μmol/L of AG1478, rosiglitazone and GW9662. Expression of EGFR, PPARγ and FOXA2 at mRNA level in each group was detected by real-time fluorescence quantitative RT-PCR 12 h, 24 h and 48 h after HBE cells were infected with or without RSV. Expression of phosphorylated-EGFR ( p-EGFR) and EGFR at protein level was detected by Western blot. ELISA was performed to measure the expression of mucin-5AC (MUC5AC). Results Compared with F group, EGFR expression at mRNA lev-el, p-EGFR/EGFR protein ratio and MUC5AC expression at protein level were increased in a time-dependent manner in A, B, C and D groups at 12 h, 24 h and 48 h. Compared with group F, the expression of PPARγat mRNA level in A, B, and D groups increased at each time point. Moreover, PPARγ expression gradually in-creased over time in A and B groups, reaching the peaks at 48 h, but was in decline in D group. Expression of FOXA2 at mRNA level in RSV-infected HBE cells was declined at each time point compared with that in group F, especially in D group. Compared with group D, A and B groups showed significantly decreased EGFR ex-pression at mRNA level, p-EGFR/EGFR protein ratio and MUC5AC expression at protein level, but markedly increased FOXA2 expression at mRNA level. Conclusions RSV infection increased the expression of MUC5AC at protein level in HBE cells. PPARγand EGFR-FOXA2 signaling pathways were involved in the hypersecretion of airway mucus during RSV infection.

Clinical characteristics and correlative risk factors of interstitial pneumonia in systemic lupus erythematosus / 重庆医学

Objective To study the clinical characteristics and analyze the correlative risk factors of interstitial pneumonia in systemic lupus erythematosus (SLE-IP).Methods 80 SLE patients in department of rheumatology of Nanfang hospital form January 2013 to January 2016 were retrospectively analyzed.SLE patients with interstitial pneumonia (n=40) were divided into case group.40 cases of SLE with interstitial pneumonia were selected and matched with age and sex.Patients with mild SLE without interstitial pneumonia were treated as controls.The clinical manifestations,routine examination,biochemical examination and immunological examination were performed to compare the risk factors of SLE-related interstitial pneumonia.Results In this study,non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP) were common in SLE-IP patients.the ground-glass opacities were more common in NSIP type,while Grid shadows and honeycomb shadows were more common in UIP type.The dry cough,chest tightness / shortness of breath,Raynaud's phenomenon,wet rales,triglyceride increased,anti-Sm antibody positive rate,anti-U1-nRNP positive rate between two groups were statistically significant (P＜0.05).Logistic regression analysis showed that the risk factors of SLE-IP were dry cough,chest tightness / shortness of breath,Raynaud's phenomenon,wet rales,triglyceride increased,anti-Sm antibody positive and anti-U1-nRNP positive.Conclusion The presence of dry cough,chest tightness / shortness of breath,Raynaud's phenomenon,wet rales,triglyceride increased,anti-Sm antibody positive and anti-U1-nRNP positive all suggest the probability of interstitial pneumonia in SLE patients.HRCT plays an important role in the diagnosis of interstitial pneumonia in lupus,which is valuable to improve the prognosis.

Transcranial sonographic features of Parkinson's disease patients with musculoskeletal pain / 中华神经科杂志

Objective To investigate the substantia nigra (SN) and brainstem raphe (BR) echogenic features of Parkinson's disease (PD) patients with musculoskeletal pain.Methods A total of 115 PD patients recruited in the Second Affiliated Hospital of Soochow University from October 2014 to May 2016 were assessed with the following rating scales:Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn and Yahr Staging Scale (H/Y),Hamilton Rating Scale for Depression (HRSD),Beck Depression Inventory Ⅱ (BDI-Ⅱ) and Visual Analogue Scale (VAS).All the subjects underwent transcranial sonography during the clinical evaluation.And the patients were divided into PD with musculoskeletal pain (n =54) and PD without musculoskeletal pain (n =61) groups,or PD with depression(n =74) and PD without depression(n =41) groups.Results Compared with PD patients without pain,PD patients with musculoskeletal pain had higher scores of UPDRS-Ⅱ,-Ⅲ,HRSD,BDI,NMSQ and H/Y (UPDRS-Ⅱ score:12.56 ±6.01 vs 8.79 ±4.38,t =-3.801,P ＜0.01;UPDRS-Ⅲ score:24.43 ± 12.43 vs 20.07 ± 11.12,t=-1.986,P=0.049;HRSD score:11.65-±6.94 vs 8.38-±5.36,t=-2.844,P=0.005;BDI score:14.09 ±6.20 vs 9.74 ±6.00,t =-3.826,P ＜0.01;NMSQ score:8.57 ± 4.06 vs 5.60 ± 3.38,t=4.193,P＜0.01;H/Y:2.0(1.5,2.6) vs 1.5(1.0,2.0),Z=-3.011,P=0.003).Positive BR was more frequent in depressed than in non-depressed PD patients without pain (63.6％ vs 14.3％;x2 =15.25,P ＜0.01).Positive BR was positively associated with sex(r =0.228,P =0.014),age(r =0.184,P =0.049),disease duration (r =0.196,P =0.035),and depression (r =0.396,P ＜ 0.01).However,positive BR did not correlate with musculoskeletal pain.No correlation was found between positive SN and clinical characteristics of PD patients.Conclusions PD patients with musculoskeletal pain have worse activity of daily living,more severe motor symptoms,more non-motor symptoms,and are more depressed.SN and BR echogenecity do not correlate with musculoskeletal pain,however,hypoechogenic or interrupted BR is associated with depression in PD patients.

The values of anteroposterior diameter in fetal renal pelvis separation and its value of predicting the prognosis / 中华医学超声杂志（电子版）

Objective To analyze the values of anteroposterior diameter (APD) in fetal renal pelvis separation during different gestational weeks and in predicting the prognosis.Methods Totally 182 cases of fetal renal pelvis separation in the Second Affiliated Hospital of Soochow University were enrolled in this study between January 2013 and October 2015.All of them were followed up to 12 months after birth.The detecting gestational weeks of non-reversible renal hydronephrosis and values of fetal renal pelvis APD were analyzed.Results Among the 182 cases of fetal renal separation,46 cases were detected in the second trimester,136 cases were detected in the third trimester (bilateral renal pelvis separation occurred in 92 cases).During the follow-up,114 cases recovered in the fetal period and 52 cases recovered within 12 months after birth,finally,16 cases (8.8％,16/182) of them progressed to non-reversible renal hydronephrosis.Among the 16 fetus of non-reversible renal hydronephrosis,10 cases (62.5％,10/16) were detected in the second trimester,their values of APD were 7.4-11.5 mm and the average was (8.0± 1.5) mm;6 cases (37.5％,6/16) were detected in the third trimester,their values of APD were 13.6-14.8 mm and the average was (12.8±2.0) rmm.The values of APD in fetus who were detected in the second trimester were smaller than those in the fetus who detected in the third trimester and the prognosis in the fetus who were detected in the second trimester was worse than those in the fetus who were detected in the third trimester,the fetus (21.7％,10/46) who progressed to non-reversible renal hydronephrosis in the second trimester were more than the fetus (4.4％,6/136) who were detected in the third trimester.Conclusion Clinical following-up combined with the detecting gestational weeks of fetal renal pelvis separation and values of fetal renal plevis APD by prenatal ultrasound may be helpful in predicting their prognosis.

Preliminary study on the role of voltage-gated sodium channel subtype Nav1.5 in lymph node metastasis of oral squamous cell carcinoma / 中华口腔医学杂志

Objective@#To investigate the relationship between the expression of voltage-gated sodium channel subtype Nav1.5 in oral squamous cell carcinoma (OSCC) and the occurrence and lymph node metastasis of OSCC.@*Methods@#Totally 10 samples of normal oral mucosa tissue as control group, 26 samples of OSCC as the experimental group was divided into non-metastatic group (n=16) and metastatic group (n=10) according to the presence or absence of lymph node metastasis. Quantitative real-time PCR (qPCR), Western blotting, immunohistochemistry, and enzyme-linked immunosorbent assay (ELISA) were used to detect the expression of Nav1.5 in control group and experimental groups at mRNA and protein levels. The data were analyzed by one-way analysis.@*Results@#The expression of Nav1.5 mRNA in the experimental group (non-metastatic group: 2.311±0.134, metastatic group: 4.462±0.362) was higher than those in the control group (1.054±0.162) (P=0.037; P=0.029), and the metastasis group was significantly higher than the non-metastasis group (P=0.031). Western blotting showed the expression of Nav1.5 in experimental groups (non-metastatic: 0.143±0.005, metastatic: 0.253±0.015) was up-regulated significantly compared with control group (0.080±0.010) (P=0.034, P=0.026), and the metastasis group was significantly higher than the non-metastasis group (P=0.033). The immunohistochemistry show the positive expression rates of Nav1.5 in normal and OSCC tissues were 1/10 and 92% (24/26). The differences were statistically significant (P=0.016), and the metastasis group was significantly higher than the non-metastasis group (P=0.028). The ELISA results revealed that the level of Nav1.5 in control was control group (0.834±0.103) μg/L, in non-metastasis group was (1.578±0.167) μg/L, in metastasis group was (3.882±0.422) μg/L (P=0.041; P=0.032), and the metastasis group was significantly higher than the non-metastasis group (P=0.030).@*Conclusions@#Nav1.5 was highly expressed in poorly differentiated OSCC and the expression was significantly different with or without lymph node metastasis. Nav1.5 may be involved in the occurrence and metastasis of OSCC.

Analysis of etiology and clinical manifestations of 90 patients with suspected pertussis under 2 years old / 中华传染病杂志

Objective To investigate the etiology and clinical manifestations of patients with suspected pertussis under 2 years old.Methods A total of 90 patients under 2 years old with suspected pertussis were collected prospectively from July 2015 to June 2016.Nasopharyngeal secretions and clinical data were obtained.Bordetella pertussis was detected by polymerase chain reaction (PCR).Patients were classified into pertussis group if the PCR was positive,or pertussis syndrome group if negative.Other 13 respiratory viruses and atypical pathogens were also detected,and bacterial culture was performed.Pathogens and clinical manifestations were compared between groups.For normal distributed data,continuous variables between groups were compared using two-sample t-test,while categorical variables between groups were compared using chi-square test.Results A total of 90 suspected cases were included,including 46 males and 44 females.Age ranged from 33 days to 18 months,and the median age was 3 months.Thirty-five cases (38.9％) were positive for Bordetella pertussis PCR (the pertussis group),the age ranged from 34 days to 13 months,the median age was 2 months.Fifty-five cases (61.1 ％) were negative (the pertussis syndrome group),with the age ranging from 33 days to 18 months,and the median age was 4 months.In pertussis group,there was a higher percentage of hospitalization history in 1 month before onset than that of the pertussis syndrome group,and the difference was statistically significant (x2=4.496,P＜0.05).Patients in pertussis group were more likely to have cyanosis and cough at night (x2=4.234 and 10.960,both P＜0.05),and the course of pertussis was longer than that in pertussis syndrome (t=3.402,P＜0.05).The length of hospital stay before pertussis onset in pertussis group was longer than that in the pertussis syndrome group (P＜0.05).The mean white blood count in pertussis group was (22.00±9.42) × 109/L,and that in pertussis syndrome group was (16.31±8.10) × 109/L,and the difference between the two groups was statistically significant (t=3.049,P＜0.05).In pertussis group and pertussis syndrome group,influenza virus A was detected in 22 and 44 cases,respectively;rhinovirus in 16 and 25 cases,respectively;parainfluenza virus in 5 and 12 cases,respectively;respiratory syncytial viruses in 3 and 6 cases,respectively.Conclusions Patient who presents with cyanosis,cough at night and high white blood cell count is more likely to have pertussis.Influenza viruses A,humanrhinovirus and human parainfluenza viruses are common pathogens to be found in patients with suspected pertussis under 2 years of age.

Image and pathological features of Ewing's sarcoma in the oral and maxillofacial region / 中南大学学报(医学版)

OBJECTIVE@#To systematically evaluate the image and pathological features of Ewing's sarcoma (ES) in the oral and maxillofacial region.
@*METHODS@#Eight patients with ES in the oral and maxillofacial region were enrolled for this study. The X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) of ES and the pathological data were systematically evaluated.
@*RESULTS@#X-ray image showed a diffuse radiolucency with cystic component and ill-defined borders for bone lesion. CT showed that there was osteolytic mass with extensive bone destruction and soft tissue infiltration, but no periosteal reactions were observed. MRI demonstrated that ES showed an inhomogeneous structure and blurred borders with invasion to adjacent soft tissue for bone lesion. Similar manifestation also showed in MRI images for patients with soft tissues. Histologically, ES composed of small round cells, and expressed CD99, neuron specific enolase (NSE) and vimentin (Vim) in all patients. Desmin (Des), CD34, epithelial membrane antigen (EMA), chromogranin A (ChgA), etc, were negatively expressed in ES cells.
@*CONCLUSION@#X-ray, CT, and MRI are helpful to determine the property, extent and the relationship of ES with the surrounding tissues. Immunohistochemical stain of CD99, NSE, and Vim are helpful to confirm the pathological diagnosis of ES.

Induced pluripotent stem cells and cardiovascular disease / 中国组织工程研究

BACKGROUND:Induced pluripotent stem cel s have great prospects in tissue repair, due to the characteristic of self-renewal, multi-directional differentiation, no immunological rejection and ethics controversy. OBJECTIVE:To summarize the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and their applications in the cardiovascular diseases. METHODS:The first author performed a data retrieval of PubMed and CNKI databases from 2000 to 2015 to search articles addressing the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and reviewed the literatures systematical y. Final y, 78 articles were chosen for further analysis. RESULTS AND CONCLUSION:Induced pluripotent stem cel s can differentiate into cardiovascular cel s through a variety of methods. Factors such as cyclosporin A and ascorbic acid C may improve myocardial differentiation of induced pluripotent stem cel s, while vascular endothelial growth factor and basic fibroblast growth factor may improve the endothelial differentiation of induced pluripotent stem cel s. Cardiovascular cel s derived from induced pluripotent stem cel s can be applied to build disease models in vitro, transplantation in vivo and drug screening.

Influence of mindfulness on anxiety and depression of gynecological oncology patients / 中国基层医药

Objective To investigate the effect of mindfulness on anxiety and depression of gynecological oncology patients.Methods Using objective methods,80 patients with gynecological oncology were divided to the usual care group and mindfulness training group according to random number table,40 cases in each group.The self -rated anxiety scale and self -rated depression scale were used to compare the effects at three times.Results There were 3 patients lost and 77 patients were analyzed finally.The ANOVA showed that there were significant differences on anxiety and depression scores of SAS (F =4.614,P =0.035) and SDS (F =4.070,P =0.044) between the two groups,and the scores of SAS (F =15.115,P <0.001) and SDS (F =7.034,P =0.002) had interaction effects. Conclusion Mindfulness can adjust the psychology state of gynecological oncology patients and decreased the level of anxiety and depression.

Epidemiologic characteristics and the relationship with disease severity of respiratory syncytial virus genotypes from children with lower respiratory tract infection in the southern Zhejiang province / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) subtypes and genotypes in southern Zhejiang province, and to determine whether RSV genotypes are correlated with the disease severity of lower respiratory tract infection (LRTI).</p><p><b>METHOD</b>Nasopharyngeal secretions (NPS) from children under 5 years of age who were hospitalized with LRTI during 5 consecutive seasons from July 1, 2009 to June 30, 2014 were collected. RSV antigen was determined using direct immunofluorescence (DIF). Two hundred strains of RSV were randomly selected from each epidemic season. RNA was extracted and identified as subtype A or B by using reverse transcription-polymerase chain reaction (RT-PCR), and randomly selected strains of the full length attachment (G) genes of both subtype A and subtype B were amplified by PCR and sequencing. Clinical data were collected, and the disease severity between different genotypes were compared simultaneously.</p><p><b>RESULT</b>Of the total 1 000 randomly selected RSV positive samples, 462 (46.2%) and 538 (53.8%) samples were identified as subtype A and B, respectively. It was found that subtype B predominated in the 2009-2010 and 2012-2014 epidemic seasons and subtype A in 2010-2012 epidemic seasons. A total of 112 strains of complete sequences of G genes were obtained, including four subtype A genotypes NA1, NA4, GA2 and ON1, and six subtype B genotypes BA8-10, BA-C, CB1, and GB2. Phylogenetic analysis revealed that 39/52 (75.0%) subtype A strains were classified as NA1 genotype, followed by ON1 genotype (10/52,19.2%) and 44/60 (73.3%) subtype B strains were classified as BA9 genotype, followed by BA8 genotype (6/60,10.0%). BA9 was the predominant genotype among subtype B except 2010-2011 epidemic season, while NA1 was the predominant genotype among subtype A except 2013-2014 epidemic season. Only ON1 and BA9 genotypes were checked out during 2013-2014 epidemic season. There was statistically significant difference in the average severity score of illness in 39 cases infected with NA1 genotype (4.154) and 44 cases of BA9 genotype (3.341) (U=642.500, P<0.05). Furthermore, in the rate of oxygen uptake, the percentage of those infected with NA1 genotype (33.3%) was higher than those infected with BA9 genotype (13.6%) (χ2=4.544, P<0.05). However, there were no significant difference in the age, clinical symptoms, the percentage of intensive care unit admission, length of hospitalization and the outcome of the disease between NA1 and BA9 infection.</p><p><b>CONCLUSION</b>The shift of predominant RSV subtype from 2009 to 2014 were B-A-A-B-B in the southern areas of Zhejiang province. Multiple genotypes co-circulated during five RSV epidemic seasons. NA1 and BA9 genotypes were the predominant genotypes of subtype A and B, respectively. Compared with infection with BA9 genotype, NA1 genotype infection was associated with more severe disease and proportion of patients needed oxygen therapy was higher.</p>

Comparison of clinical efficacy between vaginal tightening surgeries of buried lead needle suture and vaginal posterior wall mucosa excision for treatment of vaginal relaxation / 中华医学美学美容杂志

Objective To compare the clinical effects of needle buried suture and the posterior wall of vagina mucosa excision vaginal tightening surgery for the treatment of mild to moderate vaginal relaxation.Methods A total of 71 patients with mild to moderate vaginal relaxation were randomly divided into observation group (39 cases) and control group (32 cases).The patients in the observation group were given buried lead needle suture,and the control group were treated with posterior wall of vagina mucosa resection.Analysis of two groups was conducted in patients with operation time,intraoperative bleeding,vaginal secretion color,postoperative wound healing and complications;sexual satisfaction was evaluated after 6,12 and 24 months in two groups of patients.Results There was no significant difference between two groups in operation time and vaginal secretion color (P＞ 0.05).Intraoperative blood loss was much more in the observation group than those in the control group,with statistically significant differences between the two groups [(6.23±2.43) ml vs (15.79 ± 7.31) ml,P＜0.05)].The follow-up for a number of months showed that sexual satisfaction had significant difference between the two groups (P＜0.05).None of the patients had rectal or urethral injury,no fistula,incision infection or other complications occurred,and the incision healed in stage Ⅰ.Conclusions For patients with mild to moderate vaginal relaxation,buried lead needle suture vaginal tightening surgery does not damage the vaginal mucosa,no scar,and fewer complications,which is a more simple and effective method to improve the quality of life in patients with vaginal relaxation.

Sun's procedure for patients with acute type A aortic dissection / 中华胸心血管外科杂志

Objective To analyze the early outcomes of the Sun' s procedure,which is an approach integrating total arch replacement using a 4-branched graft with implantation of a special stented graft in the descending aorta,and observe the mortality,morbidity and mid-term clinical results of postoperative in patients with acute type A aortic dissection (AAAD).Methods Clinical data of 61 consecutive AAAD patients undergoing the Sun' s procedure were analyzed.There were 53 male and 8 female,aged (54 ± 12) years.61 patients had postoperative follow-up and the clinical effect of Sun' s procedure were retrospectively analyzed.Results Cardiopulmonary bypass time was (229 ± 46) min,aortic clamping time was (147 ± 37) min and unilateral selective cerebral perfusion time was (35 ± 9) min.Reoperation for excessive bleeding in 5 cases (8.2％),acute renal failure in 3(4.9％),tracheotomy patients for pulmonary infection in 3(4.9％),and spinal cord injury in 2 (3.3％),delayed thoracic incision healing in 1 (1.6％),and osteofascial compartment syndrome of the right lower limb in 1 (1.6％).The 30 day mortality is 8.2％,and the leading causes was low cardiac output syndrome in 2(3.3％),multi-organ failure in 1 (1.6％),pulmonary infection in 1 (1.6％) and ruptured of abdominal aortic dissection in 1 (1.6％).The average follow-up time is(5.1 ± 0.7) years.Postoperative 1 year survival rate was 91.8％,5 year survival rate was 83.6％.Conclusion The Sun' s procedure has generated a relatively lower mortality rate in 61 patients with AAAD.Postoperative survival rate is high,and the reoperation rate is low.