Effectiveness of early warning management of nosocomial infection based on neural network model and decision tree model / 公共卫生与预防医学

Objective To predict the effectiveness of nosocomial infection management and effectively control the risk of nosocomial infection. Methods In this study, with the population of ICU patients in a Grade A hospital , 345 ICU patients seen from June 2020 to June 2021 were included in the analysis to collect the infection data in the hospital. Based on the use of the decision tree model to analyze the influencing factors of nosocomial infection, the neural network model was also used to predict the risk of developing nosocomial infection. Results The decision tree model showed that advanced age (age> 80 years) influenced the root node. Type 2 diabetes, gender by male, and BMI level were child nodes, which had different synergistic effects on the occurrence of nosocomial infection. At the same time, random forest (RF), support vector machine (SVM), logical regression (LR) and K nearest neighbor (KNN) algorithms were used to construct a neural network prediction model of nosocomial infection risk, suggesting that the condition, sex and body size of basic diseases are related to the occurrence of nosocomial infection. The combined use of the above model in parallel can effectively increase the specificity and reduce the missed diagnosis. Conclusion The neural network model joint decision tree model in parallel and joint early warning of nosocomial infection risk have excellent effect, and can effectively provide information support for the prevention, management and disposal of nosocomial infection.

The effect of postoperative intravenous drip oftranexamic acid on perioperative blood loss in patients undergoing total knee arthroplasty / 中国医师进修杂志

Objective:To explore the effect of postoperative intravenous drip of tranexamic acid on perioperative blood loss, coagulation function and knee joint function in patients undergoing total knee arthroplasty.Methods:A total of 100 patients who underwent unilateral total knee arthroplasty for the first time from August 2018 to August 2020 in Dingzhou People′s Hospital were selected and divided into the tranexamic acid group and the control group according to registration order, with 50 cases in each group. The tranexamic acid group was given intravenous infusion of tranexamic acid immediately after the operation, and the control group was given intravenous infusion with the same dose of normal saline after the operation. The postoperative drainage volume was evaluated at 12 h after the treatment, and the total blood loss and occult blood loss were calculated. The change value of hemoglobin, related indexes of the coagulation function at 24 h after the operation, the knee joint range of motion before and after the operation, and Hospital for Special Surgery knee score (HSS score) were recorded. The proportion of blood transfusion, the rate of deep vein thrombosis and the incidence of pulmonary embolism were compared.Results:The postoperative drainage, total blood loss and occult blood loss in the tranexamic acid group were significantly lower than those in the control group ( P<0.05). The change value of hemoglobin in the tranexamic acid group was significantly lower than that in the control group: (33.32 ± 8.87) g/L vs. (47.37 ± 9.26) g/L, t = 7.75, P<0.05. There was no statistically significant difference in related indexes of coagulation function in the two group at 24 h after the operation ( P>0.05). The range of motion of the knee joint and the HSS scores in the tranexamic acid group were significantly greater than those in the control group: (98.57 ± 7.28)° vs. (87.20 ± 8.05)°, (87.25 ± 8.30) points vs. (78.37 ± 10.20) points, t =7.41, 4.78, P<0.05. The proportion of postoperative blood transfusion, the rate of deep vein thrombosis and the incidence of pulmonary embolism in the tranexamic acid group were significantly lower than those in the control group: 14.0%(7/50) vs. 32.0%(16/50), 6.0%(3/50) vs. 20.0%(10/50), 4.0%(2/50) vs. 16.0%(8/50), χ2 = 4.57, 4.33, 4.00, P<0.05. Conclusions:Tranexamic acid can reduce perioperative bleeding in patients undergoing total knee arthroplasty, reduce the proportion of patients undergoing blood transfusion, without increasing the risk of thrombosis and pulmonary embolism complications. Besides, it doesnot affect the coagulation function, and can accelerate the recovery of knee joint function.

The therapeutic effects of tranexamic acid in total knee arthroplasty during perioperative period / 药学实践杂志

Objective To evaluate the application value of tranexamic acid in total knee arthroplasty. Methods 120 elderly patients with knee osteoarthritis admitted to Department of Joint Surgery in our hospital from December 2018 to March 2020 were selected as study subjects. They were divided into the control group and the observation group by random number table method, with 60 patients in each group. The control group was treated with total knee arthroplasty. The observation group received one tranexamic acid injection during and after total knee arthroplasty. Both groups were followed up for 6 months after the operation. The operation-related indexes in two groups, preoperative and postoperative coagulation function 48 h after operation, preoperative and postoperative knee joint function 6 months after operation were compared. The incidence of complications during hospitalization in the two groups was counted. Results The intraoperative blood loss, hidden blood loss and postoperative drainage volume of the observation group were lower than those in the control group (P<0.05). The postoperative drainage time, drying time and wound healing time in the observation group were all shorter than those in the control group (P<0.05). There was no significant difference in prothrombin time (PT), partial thromboplastin time (APTT) and whole blood fibrinogen (FIB) between two groups before the surgery and 48 h after operation (P>0.05). No statistically significant difference was observed between the two groups (P>0.05). Compared with those before operation, the pain, walking stability, walking distance, walking assistance, flexor extension and muscle strength scores of the subjects in the two groups increased 6 months after the operation. The index scores in the observation group were higher than those in the control group (P<0.05). During the treatment, the total complication rate was 8.33% in the observation group and 13.33% in the control group, with no statistically significant difference between the two groups (P>0.05). Conclusion Tranexamic acid can effectively reduce blood loss, postoperative drainage volume, and postoperative drainage time in total knee arthroplasty for elderly patients with knee osteoarthritis. It promotes wound healing, improves knee joint function, and has little effect on coagulation function and less postoperative complications.

The analysis on perioperative blood loss factors and effect of tranexamic acid on the amount of occult bleeding in total knee arthroplasty / 中国医师进修杂志

Objective:To explore the factors of perioperative blood loss during total knee arthroplasty (TKA), and to analyze the influence of tranexamic acid on the amount of occult bleeding.Methods:A total of 100 patients who underwent TKA surgery in the knee surgery department of Dingzhou People′s Hospital from August 2018 to August 2020 were selected as the research subjects. According to whether tranexamic acid was used or not, they were divided into tranexamic acid group (68 cases) and non-tranexamic acid group (32 cases). The influence of the age, presence or absence of comorbidities, tourniquet use time, body mass index (BMI), platelet count (PLT) levels, and tranexamic acid use on TKA perioperative occult blood loss were analyzed.Results:Univariate analysis showed that factors such as age, presence or absence of comorbidities, tourniquet use time, BMI and PLT levels had a significant effect on occult blood loss, and the difference between different groups was statistically significant ( P<0.05), while gender and disease type, operation side, operation time and blood transfusion type had no significant effect on occult blood loss ( P>0.05); The latent blood loss in the tranexamic acid group was significantly lower than that in the non-tranexamic acid group: (662.47 ± 65.82) ml vs. (733.86 ± 59.86) ml, P<0.05. The proportion of allogeneic blood transfusion in the tranexamic acid group was significantly lower than that in the non-tranexamic acid group: 45.49%(31/68) vs. 68.75% (22/32), P<0.05. Postoperative drainage volume and perioperative total blood loss in the tranexamic acid group were significantly lower than those in the non-tranexamic acid group: (211.54 ± 85.63) ml vs. (427.61 ± 103.08) ml, (995.38 ± 187.11) ml vs. (1 276.42 ± 236.84) ml, P<0.05. Multivariate analysis showed that age, comorbidities, and tourniquet use time, and BMI were independent risk factors affecting the increase of perioperative occult blood loss ( P<0.05), and tranexamic acid was a protective factor ( P<0.05). Conclusions:Old age, comorbidities, excessive use time of tourniquets, and obesity can all cause the increase of perioperative occult blood loss during TKA. The use of tranexamic acid can effectively reduce the occult blood loss.

Changes of serum transient receptor potential channel 1 in peripheral blood of patients with vascular depression / 中华行为医学与脑科学杂志

Objective@#To understand the changes of serum transient receptor potential channel 1(TRPC1) in patients with vascular depression.@*Methods@#58 patients with vascular depression, 49 patients with major depressive disorder and 38 healthy controls were recruited.The TRPC1 of all subjects were detected by ELISA.Patients with vascular depression and patients with primary depression were scaled by HAMD-17.The level of TRPC1 was contrasted in different ages groups and in different nosogenesis (cerebral infarction, ischemic cerebrovascular disease, old cerebral hemorrhage, cerebral microbleeds, vascular risk factors, etc.) of vascular depression.The relationship between TRPC1 level and severity of depressive symptoms was further analyzed.@*Results@#(1)The level of TRPC1 of serum((643.76±118.43)pg/ml) was decreased in patients with vascular depression compared with that in healthy controls ((712.48± 98.75) pg/ml). The level of TRPC1 in patients with vascular depression over 60 years ((601.43±113.55)pg/ml)was lower than that in patients with major depressive disorder over 60 years ((626.32±125.46)pg/ml) and healthy controls over 60 years((721.84± 99.62)pg/ml) .(2) Among the various causes of vascular depression, the level of TRPC1 in patients with cerebral infarction, ischemic cerebrovascular disease and cerebral microbleeds was significantly lower (P<0.05). (3) The levels of TRPC1 in the patients with vascular depression (r=-0.962, P<0.05) and patients with major depressive disorder (r=-0.674, P<0.05) were negatively correlated with HAMD-17 score.@*Conclusion@#The level of TRPC1 is lower in patients with vascular depression, which is more obvious in patients with cerebral infarction, ischemic cerebrovascular disease, and cerebral microhaemorrhage.The lower the level of TRPC1, the more severe the depression.The neuroprotective effect of TRPC1 is reduced in patients with vascular depression.The TRPC1 can be used as a biomarker for vascular depression.

Meta-analysis of the effects between endotracheal intubation and laryngeal mask airway for patients with out-of-hospital cardiac arrest / 中华危重病急救医学

Objective To comprehensively evaluate the resuscitation effect of endotracheal intubation (ETI) ventilation and laryngeal mask airway (LMA) for out-of-hospital cardiac arrest (OHCA). Methods Databases such as Cochrane Library, PubMed, Embase, Ebsco, Elsevier, OVID, Springer, Proquest, and China biomedical literature database (CBMdisc), CNKI, Wanfang database, Chinese Science and Technology Journal Full-text Database, VIP Chinese biomedical journal database were searched from the establishment of literature database to December 2017 to study the difference of effects between ETI and LMA for patients with OHCA. The effect determination indexes included the return of spontaneous circulation (ROSC) rate, 1-month survival and 1-month neurological recovery. After evaluation of the quality of included studies and extraction of the data, the software of RevMan 5.3 was used to analyze those outcomes. Results A total of 9 articles, including 7 English, 2 Chinese;5 prospective studies and 4 retrospective studies were included. All of the literatures had high quality, and the Newcastle Ottawa scale (NOS) scored 7-9 points. The Meta-analysis showed that ETI was significantly more beneficial than LMA in improving the rate of ROSC [odds ratio (OR) = 1.51, 95% confidence interval (95%CI) = 1.42-1.62, Z = 12.35, 1 < 0.01], and 1-month survival (OR = 1.16, 95%CI = 1.06-1.26, Z = 3.41, 1 < 0.01), and there was no significant difference in 1-month neurological recovery (OR = 1.13, 95%CI = 0.96-1.32, Z = 1.49, 1 = 0.14). Conclusion ETI has higher recovery success rate and survival rate than LMA for the rescue of OHCA adult patients, but the improvement of the nervous system is unclear.

Improving effect and mechanism of Chinese arborvitae glycosides on the behavior of rat model of Alzheimer’s disease / 中国比较医学杂志

Objective To study the influence of semen platycladi saponins on oxidative stress response of hippocampus of rat model of Alzheimer’s disease (AD), and to explore the neuroprotective mechanism of semen platycladi saponins (SPS) on AD model rats. Methods Sixty SPF 24-week old female Wistar rats were divided into three groups:the normal control group, AD model group, and SPS intervention group. The rats of AD model group and SPS group were injected with Aβ1-42in bilateral hippocampi to produce AD animal models. After the successful establishment of AD model, the AD model group and the normal control group received 5 mL saline sodium with carboxymethyl cellulose (500 mg/kg) orally, daily for 30 days. The SPS group received orally 5 mL normal saline with 300 mg/kg SPS daily for 30 days. The learning and memory function of the rats were assessed by Morris water maze test, and the levels of MAD, SOD and GSH in the hippocampal tissues of model rats were detected with biochemistry. The expressions of Bcl-2, survivin, Fas, Bax, caspase-3 proteins and mRNA in the hippocampi of AD model rats were detected by western blotting. Results Compared with the control group and SPS group, the rats in AD model group displayed a longer search time and shorter percentage of search distance (P＜ 0. 01). There was a longer search time and lower percentage of search distance of the SPS groups than the control group (P＜ 0. 01). The positioning experiment showed that rats in the control group learned to find the platform within 2. 1 days, indicating that the latency was rapidly decreased. MDA in the SPS intervention group was significantly decreased than in the AD model group (P＜ 0. 01), but increased than the normal control group (P＜0. 01). The expressions of SOD and GSH were significantly increased in the SPS group than the model group (P＜ 0. 01). The expressions of Bcl-2 and survivin were significantly increased in the SPS group than the model group (P＜ 0. 01), but lower than the normal control group (P＜ 0. 05). The expressions of Fas, Bax and caspase-3 were decreased in the SPS intervention group (P ＜ 0. 01 ), but increased than the normal control group (P ＜ 0. 05 ). Conclusions Semen platycladi saponins can protect the neurons and improve the cognition function of AD model rats by inhibiting oxidative stress response and enhancing the antioxidant mechanism in the hypocampus.

The value of IVIM-DWI and DTI in the diagnosis of invasive breast carcinoma of no special type / 实用放射学杂志

Objective To evaluate the value of IVIM-DWI and DTI parameters in quantitative analysis and differential diagnosis of invasive breast carcinoma of no special type(NST).Methods We retrospectively analyzed 60 patients (63 lesions)who underwent MR examination in our hospital and all lesions were verified by pathologic results.MR protocol included DCE-MRI,IVIM-DWI using 14b values and DTI.The ADC,ADCslow,ADCfast,f,λ1of lesions were measured and compared by two independent samples t test between the benign lesions and NST.Logistic regression analysis was made using ADC,ADCslow,f,λ1as predictors in detecting and differentiating the NST,ROC analysis was performed to compare diagnostic performance based on the area under the curve(AUC).Results The ADC,ADCslow,ADCfast,f andλ1of NST were (1.49±0.63)×10-3mm2/s,(1.32±0.49)×10-3mm2/s,(25.98±21.84)×10-3mm2/s,0.20±0.13 and (4.98±0.47)×10-3mm2/s,these values of benign lesions were (2.31±0.66)×10-3mm2/s,(2.24±0.65)×10-3mm2/s,(18.71± 12.26)×10-3mm2/s,0.33±0.15 and(5.59±0.59)×10-3mm2/s.All parameters except ADCfast(P=0.271)had significantly statistical differences (P<0.000 1)between NST and benign lesions.The regression model showed that ADCslowwas an independent predictor in NST’s detection.Conclusion The ADC,ADCslow,f andλ1is helpful for differentiation between NST and benign lesions.The regression model is most valuable in NST detection and ADCslowis the preferred index.

Investigation on the detection of transient ischemic attack in cerebrovascular disease surveillance in Hunan Province / 中华健康管理学杂志

Objective To determine the incidence and prevalence of transient ischemic attack (TIA) and to evaluate its epidemiological situation in Hunan province.Methods Seven monitoring points were randomly selected from the province,a total of 8 311 subjects aged≥50 years were then chosen by stratified sampling.The cases counted in prevalence was defined as patients diagnosed before 24:00 o'clock August 31st,2013,and the new diagnosis for incident counting was defined as those diagnosed between 00:00 September 1st,2012 and 24:00 August 31st,2013.Results Among all 8 311 screened subjects,the number of TIA patients was 24 (288.8 per 100 000 people),the incidence of TIA was 7 (85.2 per 100 000 people).Standardized prevalence and incidence were 283.2 and 82.4 per 100 000 respectively using 2010 China census population.Among them,the standardized incidence rate of female was higher than that of male (114.8 per 100 000 person-years vs.48.8 per 100 000 person-years),and the prevalence rate of males was higher than that of female (288.2 per 100 000 people vs.273.2 per 100 000 people).Hypertension is the most important risk factor for TIA (55.2％).Conclusion The incidence and prevalence of TIA in Hunan province are higher than the national average.Hypertension is the main risk factor.

The inhibitory effects of suberoylanilide hydroxamic acid on the malignant phenotypes of ovarian carcinoma cells / 天津医药

Objective To explore the effects and molecular mechanisms of suberoylanilide hydroxamic acid (SAHA) on ovarian carcinoma. Methods (1)Two groups of ovarian carcinoma cell lines (SKOV3 and SKOV3/DDP, HO8910 and HO8910-PM) were exposed to SAHA (1, 3, 5 and 7μmol/L SAHA,group 1-group 4). CCK-8 method was employed to eval-uate the inhibitory effects of SAHA.(2)Ovarian cancer cell lines treated with SAHA (2 or 5μmol/L SAHA) were used as 1 and 2 groups. Flow cytometry was performed following staining with Annexin V-FITC and PI for cell cycle and apoptosis.(3) Reverse transcription polymerase chain reaction (RT-PCR) and Western blot assay were used to assess the mRNA and pro-tein expression levels of phenotypic correlation factor. Results (1)After 48 h of SAHA treatment,the OD value of SKOV3, SKOV3/DDP,and HO8910 showed a trend of gradually reduce (P<0.05).(2)The apoptotic rates were significantly higher in SAHA 1 and SAHA 2 groups than those of control group (P<0.05). Compared with control group, after 48 h of SAHA treat-ment,S phase and G2/M phase of SKOV3 and SKOV3/DDP cells increased;G0/G1 phase of HO8910 and HO8910-PM cells increased in SAHA 1 and 2 groups (P<0.05).(3)The expression levels of CyclinB1 and Cdc2 (p34) mRNA were significant-ly lower in SAHA 1 and 2 groups than those of control group,while the expression levels of Caspase-3,p21 and p53 mRNA expression were significantly higher in SAHA 1 and 2 groups than those of control group. Furthermore,the expression of Ac-Histone H3,Ac-Histone H4,p53 protein were markedly improved,and CyclinB1,Cdc2(p34) protein decreased in SAHA 1-4 groups. Conclusion SAHA may suppress cell growth, induce apoptosis and cause cycle arrest in ovarian carcinoma cells by promoting histone acetylation or modulating their phenotype-related proteins of Caspase-3, p53, CyclinB1 and Cdc2(p34).

Establishment, monitoring and improvement of indicators of specimen quality in clinical laboratories / 中华检验医学杂志

The pre-examination process is the first key step in the total testing process of clinical laboratories.Specimen acceptability is an important indicator to measure the quality of pre-examination.In order to identify the risks and the root causes in the process , establishment and monitoring of quality indicators about specimen will effectively control the risks , enhance the acceptability of specimens , promote the improvement of pre-examination quality and finally get the aim of assuring patients′safety.

Application of hierarchical management for psychiatric nursing in psychiatric ward / 中国实用护理杂志

Objective To know the effects of using hierarchical management for psychiatric nursing in psychiatric ward,and then to offer some rationales and theoretical support for hospital management.Methods The fine hierarchical management was implemented from Janurary 2012 in Xi'an Mental Health Center and the metal hygiene clinics of Xi'an Jiaotong University.Before and after the hierarchical management carried out,the nursing care quality was assessed among the family members of hospitalized patients by using satisfaction survey questionnaires,flight rate of patients was evaluated,and at the same time,nursing care quality and the nurse comprehensive ability was inspected.And then,the EPIDATE 3.0 and SPSS16.0 software was used to analyze and compare the satisfaction scores.The nurse comprehensive ability,and nursing care quality scores before and after implementation.Results The nurse comprehensive ability were improved.The satisfaction scores of family members of hospitalized patients was higher than that before implementation after the fine management implementation,which had statistical difference,P＜ 0.05.The satisfaction rate of patients' family member was 96.77％(2 543/2 628) after the fine management implementation,which was significant higher than that of before implementation,91.19％(2 382/2 612),x2=107.66,P＜0.05.Flight rate of patients was reduced after the hierarchical management,which was significantly lower than that of in before,P＜0.05.Nursing care quality scores were higher than those of in before,which has a statistical difference respectively,P＜0.05.Conclusions The hierarchical management could improve the satisfaction of family numbers,reduce the flight rate of patients,enhance nursing care quality and improve the nurse comprehensive ability.It would reduce the incidence of medical malpractice.The fine hierarchical management is worth to be applied and generalized in nursing care of psychiatric nursing in psychiatric ward.

Risk factors of gas-related complications in peroral endoscopic myotomy for achalasia / 中华消化内镜杂志

Objective To investigate the risk factors and incidence of gas-related complications in peroral endoscopic myotomy for easophageal achalasia.Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected.Potential risk factors for gas-related complications were analyzed by univariate and multivariate analysis.Results The incidence of gas-related complications was 10.2％ (22/216).Univariate analysis showed risk factors for complications were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,tunnel width ≤3 cm,degree of myotomy,and operation time (P ＜ 0.05),while multivariate analysis showed the risk factors were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,and tunnel width ≤3 cm(P ＜ 0.05).Conclusion Simple longitudinal incision for tunnel entry,tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas-related complications in POEM,while myotomy depth is not.

Clinical Observation Laparoscopy Combined with Dienogest and TCM in the Treatment of Endometriosis / 中国药房

OBJECTIVE:To compare therapeutic efficacy and safety of laparoscopy combined with dienogest and laparoscopy combined with dienogest and TCM in the treatment of endometriosis. METHODS:126 endometriosis patients were selected and divid-ed into control group and observation group,with 63 cases in each group. Control group received combined with dienogest(25 mg/time,qd);observation group was additionally given TCM on the basis of control group. Therapeutic efficacy,recovery time of ovula-tion,menstrual recovery time and ADR were compared between 2 groups,and recurrence and pregnancy of them were followed up for 2 years. RESULTS:The total effective rate of observation group (93.65%) was significantly higher than that of control group (80.96%),with statistical significance (P<0.05). The menstrual recovery time and recovery time of ovulation in observation group were significantly shorter than control group,with statistical significance (P<0.05). The incidence of ADR in observation group (9.52%)was significantly lower than control group(26.98%),with statistical significance(P<0.05);the recurrence rate of observa-tion group (4.76%) was significantly lower than that of control group (17.46%),with statistical significance (P<0.05). In 2-year follow-up,there were 23 pregnancy patients in observation group,which was significantly higher than that of control group (9 cas-es),with statistical significance (P<0.05). CONCLUSIONS:Laparoscopy combined with dienogest and TCM in the treatment of endometriosis have better clinical effect,higher safety and lower recurrence rate. The patients are easily pregnant.

Epigenomic analysis reveals 23 breast cancer pathogenic genes induced by aberrant DNA methylation / 实用肿瘤学杂志

Objective To identify and analyze the DNA methylation induced pathogenic genes in breast cancer.Methods Using genomic data provided by the international cancer genome,we carried out systematic a-nalysis of the abnormal gene expression in breast cancer and epigenetic regulation mechanism by bioinformatics methods.Results We identified 428 genes with abnormal expressions in breast cancer by t test.Functional enrich-ment analysis revealed genes up-regulation in breast cancer were closely related to the cell cycle,and those down-regulated were significantly enriched in the hormone response function.Study on DNA methylation revealed that breast cancer showed an unique DNA methylation pattern.Further analysis reveals 23 breast cancer genes induced by abnormal DNA methylation.Conclusion DNA methylation can mediate the abnormal expression of breast canc-er genes,and is an important biological marker for early diagnosis and prognosis of breast cancer.

Risk factors of airway mucous plug caused byMycoplasma pneumoniae pneumonia in children / 临床儿科杂志

Objective To analyze the risk factors of mucous plug caused byMycoplasma pneumoniae pneumonia (MPP) in children and guide clinical therapy to decrease the incidence of sequela caused by airway inlfammatory obstruc-tion.Methods We conducted a retrospective study of the clinical data of 116 children with MPP who received ifber broncho-scope from January 2012 to January 2014 admitted to the respiratory department of the Children's Hospital of Hebei provience. Based on the airway mucosal lesions seen through the bronchoscope, the subjects were divided into the mucous plug group (n=67) and the control group (n=49). Gender, age of onset, febrile course, pleural effusion, white blood cell counts, neutrophil ratio, C reactive protein (CRP), serum lactate dehydrogenase level (LDH), initial time of received macrolides and ifber bronchoscope were compared between the two groups. If the Results of single factor analysis showedP<0.05, the indicators were analyzed by the logistic regression analysis. The receiver operator characteristic (ROC) curve was drawn to evaluate the predictability of logistic regression model.Results The Results of single factor analysis showed that age of onset, febrile course, CRP, serum LDH, pleural effusion cases in the mucous plug group were higher than those in control group (P<0.05). The Results of the logis-tic regression analysis showed that older than three years (OR=7.45), febrile course more than 10 days (OR=4.01), the level of CRP and LDH higher than 40 mg/L (OR=5.41) and 350 U/L (OR=3.63) were respectively the risk factors of mucous plug caused by MPP in children. The area under the ROC curve is 0.846 (95%CI: 0.773-0.919,P=0.000).Conclusions MPP children with age older than three years, or with febrile course more than 10 days, or with the level of CRP and LDH higher than 40 mg/L and 350 U/L has the possibility of forming a mucous plug.

Association between tumor necrosis factor superfamily member 4 gene polymorphism and risk of asymptomatic carotid vulnerable plaque in a Chinese population / 中华流行病学杂志

Objective Vulnerable plaque of carotid artery is one of the risk factors of atherosclerotic cerebral infarction.Detection and treatment of vulnerable atherosclerotic plaque of carotid artery before symptoms of cerebral infarction is an effective way to prevent atherosclerotic cerebral infarction.Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis,a common risk factor for both myocardial and cerebral infarctions.Studies have indicated that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction and SNP rs3861950 in TNFSF4 is associated with higher risk of atherosclerosis cerebral infarction (ACI),but little is known about the association between TNFSF4 variations and vulnerable plaque of carotid artery.Methods A case-control study involving 510 patients with asymptomatic vulnerable plaque of carotid artery and 485 age and sex matched healthy subjects without vulnerable plaque of carotid artery was conducted in Hunan province.Asymptomatic vulnerable plaque of carotid artery means vulnerable plaque of carotid artery without cerebral infarction.Two SNPs of TNFSF4,rs3850641 and rs3861950,were genotyped by the TaqMan SNP genotyping method,and verified partly by Genomic DNA Sequencing.Results The results revealed a significant allelic association between rs3861950 and asymptomatic vulnerable plaque of carotid artery in case group (x2=9.13,P=0.003;OR=1.41,95％ CI:1.12-1.76).Compared with control subjects,the difference in genotype was significant in case group (x2=25.28,P＜ 0.000 1).However,there was no significant association between rs3850641 and asymptomatic vulnerable plaque of carotid artery(OR=1.16,95％CI:0.92-1.46;x2＝ 1.47,P=0.225).Conclusion TNFSF4 gene polymorphism rs3861950 was associated with the risk of vulnerable plaques of carotid artery in a Chinese population,which might be middle phenotype indicating higher risk of cerebral infarction.

Research on Constant-current Characteristics of Howland Current Source Used in Bioelectrical Impedance Detection / 生物医学工程学杂志

This study aims to analyze and improve Howland current source circuit and to study the constant current source of alternating current with high output impedance and high stability. A simulation study was carried out on the constant-current characteristics of Howland current source from two aspects of resistance match value and the selection of Op amp parameters, and then the output impedance was analyzed. The simulation experiment showed that when it was with the best matched resistance, the constant-current characteristics of Howland current source was better. Op amp parameters could affect the constant-current characteristics of Howland current source. In Howland current source circuit, the current source after parameter optimization had better output impedance and load capacity. The results showed that there was the best matched resistance in the selection by Howland current source. The Op amp with large broadband, high slew rate and open loop gain, and wide range of power supply voltage is more suitable for the bioelectrical impedance detection circuit.

Construction and identification of HSV-1 vector vaccine carrying HIV-1 antigen / 生物工程学报

To construct an HSV-1 vector vaccine carrying HIV-1 antigens, HIV-1 gp160, gag, protease and the expression elements were chained together, and then inserted into the internal inverted repeat sequence region of HSV-1 by bacterial artificial chromosome technology. Firstly, HIV-1 gp160 (including type B and C), gag and protease genes were cloned into pcDNA3 in series to generate the pcDNA/gBgp and pcDNA/gCgp, then the recombinant plasmids were transfected into 293FT cells, and HIV-1 antigen was detected from transfected cells by Western blotting. Then the expression cassettes from pcDNA/gBgp and pcDNA/gCgp, comprising HIV-1 antigen genes and expression elements, were cloned into pKO5/BN to generate the shuttle plasmids pKO5/BN/gBgp and pKO5/BN/gCgp. The shuttle plasmids were electroporated into E. coli cells that harbor an HSV-BAC, the recombinant bacteria were screened, and the recombinant DNA was extracted and transfected into Vero cells. The recombinant virus was purified through picking plaques, the virus' DNAs were identified by Southern blotting; HIV-1 antigen was detected from the recombinant HSV-1 infected cells by Western blotting, and the virus' replication competent was analyzed. As the results, gp160 and gag proteins were detected from 293FT cells transfected with pcDNA/gBgp and pcDNA/gCgp by Western blotting. The recombinant bacteria were generated from the E. coli electroporated with pKO5/BN/gBgp or pKO5/BN/gCgp. The recombinant HSV was purified from the Vero cells transfected with the recombinant DNA, the unique DNA fragment was detected from the genome of recombination HSV by Southern blotting; gp120 and gp41 were detected from the infected cells by Western blotting, and the recombinant HSV retained replication competent in mammalian cells. The results indicate that the recombinant HSV carrying HIV-1 gp160, gag and protease genes was generated, the virus retains replication competent in mammalian cells, and could be used as a replicated viral vector vaccine.

Value of MRI in differential diagnosis of primary architectural distortion detected by mammography / 中华放射学杂志

Objective The aim was to evaluate the diagnostic value of MRI in lesions with architectural distortion manifested in mammography. Methods A retrospective analysis of MRI was performed in 60 patients with 61 lesions manifested as architectural distortion in full?field digital mammography (FFDM) and subsequently confirmed by pathology or two year's follow?up, 30 were malignant and 31 were benign. All the patients underwent MRI within 2 weeks of mammography. MRI protocol included conventional MR, DWI and dynamic contrast?enhanced MRI. The breast imaging reporting and data system (BI?RADS) was used as the reference standard. BI?RADS categories 1 to 3 were considered as negative for malignancy and BI?RADS categories 4 to 5 were considered as positive for malignancy. ADCs of suspicious lesion of interest and glandular tissue were calculated. nADC was then calculated using the following formula:nADC=ADC(lesion)/ADC(glandular tissue). ADC and nADC were compared by using t test. ROC analysis was carried out to define the most effective threshold ADC and nADC value to differentiate malignant from benign lesion in the breast. Diagnostic performance of the FFDM, DCE?MRI and DCE?MRI combined nADC were calculated. Results ADC value of malignant and benign lesions was (1.35±0.31)×10?3 mm2/s and (1.07±0.40)×10?3 mm2/s, respectively . nADC values were 0.83±0.17 and 0.59± 0.25, respectively (t values were 2.82 and 4.54, P<0.01). Area under the curve of ADC and nADC were 0.829 and 0.753 respectively. When threshold of ADC was set at 1.19×10?3mm2/s, sensitivity and specificity were 71.0%and 86.7%, respectively. For a nADC value threshold of 0.589, sensitivity and specificity were 93.5%and 76.7%, respectively. Sensitivity, specificity and accuracy with FFDM were 80.0%(24/30), 9.7%(3/31) and 44.3%(27/61), Sensitivity, specificity and accuracy with DCE?MRI were 90.0%(27/30), 41.9%(13/31) and 65.6%(40/61), Sensitivity, specificity and accuracy with DCE?MRI combined nADC were 93.3%(28/30), 77.4%(24/31) and 85.2%(52/61), respectively. Conclusion Sensitivity and specificity with DCE?MRI combined nADC is higher, and DCE?MRI combined nADC values is helpful to differentiate malignant from benign lesions with architectural distortion manifested in FFDM.