Clinical report of two dose fractionation modes using carbon ion beam therapy in the lymph node drainage area for lung cancer / 中华放射肿瘤学杂志

Objective:To compare the adverse reactions, efficacy and survival rate of carbon ion beam irradiation in the elective lymph node (ENI) drainage area of locally advanced non-small cell lung cancer (LA-NSCLC) with relative biological effect (RBE) dose of 48 Gy using 16 and 12 fractions.Methods:A total of 72 patients with pathologically confirmed LA-NSCLC admitted to Wuwei Heavy Ion Center of Gansu Wuwei Tumor Hospital from June 2020 to December 2021 were enrolled and simple randomly divided into groups A and B, with 36 patients in each group. Patients in groups A and B were treated with carbon ion beam irradiation to the lymph node drainage area with 48 Gy (RBE) using 16 and 12 fractions. The acute and chronic adverse reactions, efficacy and survival rate were observed. The survival curve was drawn by Kaplan-Meier method. Difference test was conducted by log-rank test.Results:The median follow-up time was 13.9 (8.8-15.7) months in group A and 14.6 (6.3-15.9) months in group B. Sixteen (44.4%) patients were effectively treated in group A and 9 (25%) patients in group B. Thirty-four (94.4%) cases achieved disease control in group A and 30 (83.3%) cases in group B. Statistical analysis showed that the overall survival rate in group B was similar to that in group A ( χ2=1.192, P=0.275). Comparison of planning parameters between two groups showed CTV volume, D mean, V 5 Gy(RBE), V 20 Gy(RBE) and V 30 Gy(RBE) of the affected lung, cardiac V 20 Gy(RBE), V 30 Gy(RBE) and D mean, esophageal V 30 Gy(RBE), V 50 Gy(RBE), D max and D mean, D max of the trachea and spinal cord had no significant difference (all P>0.05). No grade 3 or 4 adverse reactions occurred in the enrolled patients during treatment and follow-up. No statistical differences were observed in the acute radiation skin reaction ( χ2=5.134, P=0.077), radiation esophagitis ( χ2=1.984, P=0.371), and advanced radiation pneumonia ( χ2=6.185, P=0.103) between two groups. Conclusions:The two dose fractionation modes of carbon ion therapy system are equally safe in the mediastinal lymphatic drainage area of LA-NSCLC, and the adverse reactions are controllable. The long-term efficacy still needs further observation.

The exploration of online typical case module practice in the dental standardized residency training / 中华医学教育探索杂志

Based on the in-depth analysis of the defects of the existing traditional chair-side teaching and simulation examination for the oral residency training students, this paper designs an online typical case teaching module for teaching practice. After the teaching, the examination results reveal that the use of online teaching tool can improve the clinical thinking and decision-making ability, and strengthen the clinical thinking process. The questionnaire results show that most residents are satisfied with the online teaching. All in all, the online teaching mode in this study is conducive to increasing the breadth and depth of case teaching, facilitating the process and visualization of clinical thinking, and improving the clinical decision-making ability of the typical cases of the residency training students, so as to achieve the goal of training residents with great post competences.

Epidemiological characteristics of measles in Baoshan District of Shanghai in 2005‒2021 / 上海预防医学

ObjectiveTo determine the epidemiological characteristics and distributions of measles in Baoshan District， Shanghai. MethodsThis study used the measles surveillance information and reporting system to collect reported cases of measles in Baoshan District in 2005‒2021 and then conducted descriptive epidemiological methods to determine the temporality using the concentration method. ResultsIn 2005‒2021， a total of 525 measles cases were reported in Baoshan District with an average annual reported incidence rate of 1.75/105， showing an overall fluctuating downward trend and obvious seasonality. The cases concentrated in 30‒39 years of age （31.24%）， 20‒29 years （28.57%）， and under 5 years （16.57%）. Majority of them were workers （18.10%）， preschool children （16.19%）， and unemployed persons （12.76%）. The incidence was significantly higher in the central region than in the other two regions for workers， preschool children， and unemployed persons （χ2=54.515， P<0.001）. Spatially， the incidence was significantly higher in the north-central sub-districts than in the south （χ2=88.103， P<0.001）. Moreover， 33.14% of measles cases did not receive measles-containing vaccine （MCV）， while 53.90% of the cases remained unknown. Additionally， uptake rate of MCV in non-local residents was significantly lower than in local residents （χ2=14.422， P<0.001）. ConclusionThe measles incidence remains remarkably low in Baoshan District of Shanghai. Young and middle-aged populations in the north-central region are susceptible to measles. It is recommended to further strengthen measles surveillance， maintain high coverage of MCV among school-age children combined with catch-up immunization for at-risk populations， and improve health education.

Propensity score matching study of outcomes of elderly patients over 80 years of age with preoperative combined type 2 diabetes mellitus following laparoscopic colorectal cancer resection / 国际外科学杂志

Objective:To investigate the outcome after laparoscopic radical surgery for colorectal cancer in patients over 80 years of age with preoperative combined type 2 diabetes (T2DM).Methods:Clinical data of 919 patients who underwent colorectal cancer laparoscopic resection surgery in Shaanxi Provincial People′s Hospital from January 2015 to January 2019 were retrospectively analyzed. The propensity score matching (PSM) method was used for 1∶1 matching of gender, ASA score, preoperative serum albumin level, body mass index(BMI), preoperative haemoglobin level, clinical tumour pathology TNM staging, tumour location, other medical comorbidities and history of abdominal surgery and finally group of 104 elderly diabetic patients aged ≥80 years with combined T2DM were successfully matched with another 104 non-elderly non-diabetic patients <80 years without combined diabetes group. (1) To compare the differences in operating time, intraoperative bleeding, number of intraoperative blood transfusions, number of lymph nodes dissected, number of ICU treatments, postoperative time to exhaustion and postoperative hospital stay, and postoperative adjuvant chemotherapy between the two groups after matching. (2)To observe the difference in major postoperative complications between the two groups. (3) Patients in both groups were observed for three years post-operative survival rate during the follow-up period. SPSS 25.0 statistical software was used for data analysis. The survival analysis was carried aut by the Kaplan-Meier curve method in parallel and the Log-Rank test.Results:Both groups were balanced in terms of baseline variable after PSM ( P>0.05). There was no difference between the two groups in terms of operative time, intraoperative bleeding, number of intraoperative blood transfusions, number of lymph nodes dissected, or time to postoperative evacuation ( P>0.05). There was a statistically significant difference between two groups in the number of people admitted to the ICU for treatment ( χ2=4.04, P=0.042), and ≥80 years diabetic group was higher. The difference in the incidence of postoperative complications between the two groups was not statistically significant [34.6% (36/104) vs 25.0% (26/104), χ2=2.30, P=0.130]; according to the Clavien-Dindo classification of postoperative complications, the incidence of Clavien-Dindo grade Ⅲ complications in the group ≥80 years with diabetes mellitus were was higher than that in the group <80 years without diabetes [12.5% (13/104) vs 4.8% (5/104), χ2=3.89, P=0.049]. For local surgical complications, the incidence of postoperative anastomotic leak was significantly higher in the ≥80 years diabetic group than in the <80 years non-diabetic group ( χ2=4.70, P=0.030), and the incidence of postoperative wound infection was no statistical significance in the two group. For non-surgical local complications, there was a statistically significant difference in pulmonary infection in the ≥80 years diabetic group compared to the <80 non-diabetic group ( χ2=4.68, P=0.031) and in acute coronary syndrome ( χ2=4.02, P=0.045). Compared with the <80 years non-diabetic group, patients in the ≥80 years diabetic group had significantly longer postoperative hospital stay [(13.3±4.4)d vs (9.2±3.2) d, t=3.41, P=0.019]. The difference in adjuvant chemotherapy after surgery between the two groups was not statistically significant (67.3% vs 76.0%, χ2=1.92, P=0.166). The survival rate at 3 years after surgery was not statistically significant in both groups [68.9% vs 74.2%, χ2=4.34, P=0.085]. Conclusions:The short-term and long-term outcomes of colorectal cancer in advanced age with type 2 diabetes are satisfactory. Adequate preoperative assessment of the patient's physical condition should be carried out, close intraoperative control of blood glucose, and close postoperative monitoring and regulation of blood glucose should be performed, except for patients with severe comorbidities and coexisting diseases that cannot tolerate surgery and advanced tumours that have lost their surgical significance.

Correlation between triglyceride-glucose index and high on-treatment platelet reactivity during clopidogrel treatment in patients with ischemic stroke / 国际脑血管病杂志

Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.

Risk factors of early postoperative complications after intersphincteric resection for low rectal cancer and construction of a nomogram prediction model / 中华普通外科杂志

Objective:To identify the risk factors for postoperative early complications of low rectal cancer treated with intersphincteric resection (ISR).Methods:The perioperative data of 82 patients with low rectal cancer undergoing ISR at the General Surgery Department of Shaanxi Provincial People's Hospital between Jan 2017 to Dec 2021 were retrospectively analyzed. Univariate, Logistic regression and multivariate analysis were used to analyze the risk factors for early complications after ISR, and a nomogram prediction model was drawn. Predictive models are validated.Results:There were 22 patients (27%) with complications. Univariate analysis showed that early complications were related to diabetes (0.021), serum albumin (<0.001), nutritional prognosis index (0.003), neoadjuvant chemoradiotherapy (<0.001), and operation time (<0.001). By multivariate analysis, diabetes ( OR=4.853, 95% CI: 1.059-22.241, P=0.042), low serum albumin ( OR=0.672, 95% CI: 0.468-0.966, P=0.032), neoadjuvant chemoradiotherapy ( OR=4.482, 95% CI: 1.117-17.979, P=0.034) and longer operation time ( OR=1.015, 95% CI: 1.001-1.029, P=0.037) were independent risk factors A nomogram prediction model was thus constructed, and the area under the curve of the nomogram prediction model was 0.888 (95% CI: 0.812-0.965). Conclusion:Diabetes mellitus, low serum albumin, neoadjuvant chemoradiotherapy, and longer operation time are independent risk factors of early postoperative complications for low rectal cancer undergoing ISR.

Preliminary efficacy observation of carbon ion radiotherapy in the treatment of muscle-invasive bladder cancer in phase Ⅰ/Ⅱ clinical trials / 中华放射医学与防护杂志

Objective:To evaluate the feasibility and safety of carbon ion radiotherapy (CIRT) in the treatment of muscle-invasive bladder cancer in phase Ⅰ/Ⅱ clinical trials.Methods:Clinical stage T 2-3 patients with muscle-invasive bladder cancer (without distant metastasis) were studied. A three-fraction treatment was applied, including the local irradiation with the dose from 12 Gy to 24 Gy and 11 fractions of whole-bladder irradiation with a dose of 44 Gy. The carbon ion irradiation dose is determined with relative biological effectiveness (RBE) of 3.0. The total dose for bladder tumor was 56-68 Gy in 14 fractions. The primary endpoints included tumor treatment-related side effects, dose-limiting toxicity (DLT) responses, and local control (LC) rate, and the secondary endpoints included progression-free survival (PFS). Results:Nine patients received CIRT of various doses in the clinical trials, with the dose gradually increasing to 68 Gy. The patients did not suffer from DLT response, acute adverse effects of radiation therapy of grade ≥3, and late radiation adverse reactions during follow-up. When the dose to the tumor reached 68 Gy, there were 2 cases of grade 2 acute urogenital tract reaction and 1 case of acute lower gastrointestinal tract symptom. For the group with a dose above 62 Gy, three cases of grade 1 late radiation bladder reaction were observed and their symptoms included urinary frequency and microscopic hematuria. At the end of treatment, hematuria disappeared, dysuria was relieved, and urine red blood cell value significantly decreased for all the patients. Three months and six months after treatment, the LC rates were 100% and 88.9%, respectively, and the objective response rates were both 88.9%. One patient developed local recurrence and was treated with salvage surgery six months after treatment.Conclusions:The preliminary efficacy observation of CIRT in the treatment of muscle-invasive bladder cancer showed significant short-term efficacy, obvious symptom relief, and good tolerability for patients, without DLT. Therefore, CIRT is safe and feasible.

A visualized nucleic acid test of 2019-nCoV based on helicase isothermal amplification / 中华检验医学杂志

Objective:To develop a novel method for detection of genomic RNA of 2019-nCoV with reverse-transcription thermophilic helicase-dependent amplification (tHDA) and lateral flow dipsticks.Methods:This study included 143 PCR-negative nucleic acid specimens and 20 PCR- positive nucleic acid specimens collected from patients from January to April 2020 at Institute of Clinical Laboratory, Jinling Hospital. 5 pairs of primers were designed for conserved sequence of both gene N and E of 2019-nCoV, and the amplicons were analyzed by gel electrophoresis to screen out the most efficient primers. High level (5×10 5 copies/ml) and low level (5×10 2 copies/ml) templates were amplified, and lateral flow dipsticks (LFD) were used to detect amplification products. The amplification time and visualization time were optimized to visualize the results, and the optimal tHDA-LFD reaction system was established. Simulated specimens with low, medium, and high concentrations were detected for 15 times, and precision was assessed. The limit of detection was evaluated using tenfold serial dilutions of 2019-nCoV in contrived samples. To evaluate the cross-reactivity, six samples of respiratory viruses, including influenza A virus, influenza B virus, human adenovirus, human respiratory syncytial virus, human parainfluenza virus and coronavirus 229E were tested using this assay. The tHDA-LFD assay was performed to detect 2019-nCoV in 163 clinical specimens stored in our laboratory. The clinical diagnostic efficacy was determined. Results:The established RT-tHDA one-step method combined with LFD was adopted, which could be conducted within 60 min and was reproducible with good precision, showing 100% positive concordance rate. The assay showed no cross reaction with other six human respiratory pathogens. The limit of detection of the RT-tHDA assay was 5×10 2 copies/ml for both N and E genes detected by LFD. The diagnostic efficacy evaluation showed that the sensitivity of the method was 95.00%(19/20), and the specificity was 100.00%(143/143). The positive predicted value of the method was 100.00% (19/19)and the negative predicted value was 99.31%(143/144). Compared with real-time RT-qPCR assay, it showed Kappa value of 0.971 ( P<0.0001). Conclusion:The proposed tHDA-LFD assay is a rapid and visualized method to detect 2019-nCoV.

A comparative study on two liver suspension methods in laparoscopic radical gastrectomy / 中华普通外科杂志

Objective:To compare liver adhesive suspension method and V-shaped liver suspension of anterior abdominal wall in laparoscopic radical gastrectomy.Methods:This study retrospectively evaluated 115 patients who underwent laparoscopic radical gastrectomy from Jan 2018 to Dec 2019 at Shanxi Provincial People′s Hospital, 59 cases were under liver adhesive suspension (study group) and 56 cases under V-shaped liver suspension of anterior abdominal wall (control group). Intraoperative and postoperative conditions were observed and compared between the two groups.Results:All the 115 cases successfully completed surgery. The liver suspension time in study group was (2.4±0.5)min, which was significantly shorter than that of the control group((12.5±2.6) min)( t=-28.100, P<0.01). The total operation time in was (284±69) min and (307±78) min, respectively, ( t=-1.656, P=0.10). There were no statistically significant differences between the two groups in preoperative ALT, AST, total bilirubin, intraoperative incidence of hepatic lacerations and subcapsular hematoma, postoperative total bilirubin level, AST on the day 7 postoperatively, tumor location, TNM staging, surgical method, postoperative duration of hospital stay, and VAS score ( P>0.05). Conclusions:Both methods of liver suspension are safe and feasible in laparoscopic surgery for gastric cancer.Compared with V-shaped liver suspension of anterior abdominal wall, liver adhesive suspension has the advantages of less invasive, safe, and time-saving.

Essential palatal tremor: a case report and literature review / 中华神经科杂志

Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.

Study on the effects of periodontal subgingival scaling under the mode of standardized residency training of stomatology general medicine / 中华医学教育探索杂志

Objective:To observe the effects of the periodontal subgingival scaling in different stages of standardized residency training of stomatology general medicine.Methods:Thirty residents in Affiliated Stomatology Hospital of Zhejiang University School of Medicine were recruited by stratified randomization and divided into three groups, including 1-month group, 3-month group and 6-month group. The residual ratio of clinical calculus was compared after periodontal subgingival scaling among groups. SPSS 23.0 was conducted for Kruskal-Wallis H test. Results:The mean residual ratio of clinical calculus in 3-month group and 6-month group were significantly lower than that in the 1-month group. In the 3-month group, the scaling could only achieve the effective results at the shallow pockets and anterior tooth area. Compared with the 1-month group, the 6-month group significantly decreased the residual ratio of clinical calculus for the sites with pocket depth of 4-6 mm, but there were still insufficiency to deal with the posterior tooth area.Conclusion:The 3-6 months residency training of periodontology could improve the effectiveness of the periodontal subgingival scaling. We should establish reasonable assessment and evaluation system according to different stages of residents, and the subgingival scaling training in the posterior areas and the distal interproximal sites should be reinforced in order to more effectively improve the quality of the standardized residency training.

Effect of thoraco-laparoscopic esophagectomy on postoperative immune function of patients with esophageal carcinoma / 南方医科大学学报

OBJECTIVE@#To investigate the effect of thoraco-laparoscopic esophagectomy on postoperative immune function of patients with esophageal carcinoma.@*METHODS@#Eighty-one patients undergoing radical esophagectomy in our hospital between January, 2017 and December, 2019 were enrolled in this study.According to the surgical approach, the patients were divided into endoscopic group (41 cases) and open surgery (3 incisions) group (40 cases).The immunological indicators (CD3@*RESULTS@#No death occurred in either of the group after the operation.On days 4 and 7 after the operation, CD3@*CONCLUSIONS@#Thoraco-laparoscopic resection of esophageal cancer can reduce postoperative secretion of proinflammatory factors, alleviate inflammatory responses, and promote the recovery of immune functions to accelerate postoperative recovery of the patients.

Effect of captopril pretreatment on the dentin bonding durability of self-etch adhesive / 浙江大学学报·医学版

To investigate the effect of captopril on the dentin bonding durability of self-etch adhesive. Different concentrations of captopril ethanol solutions or captopril ethanol/water solutions were prepared to pretreat dentin as primer for the self-etch adhesives. The surface morphology of the dentin was observed with scanning electron microscopy (SEM). Based on the morphology analysis, the pretreatment condition was selected and two self-etch adhesives were employed to evaluate the improvement effect of the captopril pretreatment on the dentin bonding durability. : SEM showed that the pretreatment of captopril ethanol solutions and captopril ethanol/water solutions were able to remove the smear lay and partially expose collagen matrix. According to the SEM results, the pretreating condition of captopril ethanol/water solution with the pretreating time of was selected for further dentin bonding study. For Clearfil SEBOND system, the immediate bonding strength increased from to  (0.05]. For Clearfil S BOND system, there was no significant difference in the immediate bonding strength between the experimental group [(4.07) MPa] and the control group[(4.11) MPa]. But after one-year aging, the bonding strength of the experimental group was higher than that of the control group <0.05]. : The pretreatment with captopril ethanol/water solution increases the dentin bonding strength of the self-etch adhesive systems and also improves the bonding durability.

Innovation and practice of hospital population diversion management strategy under the state of normalized COVID-19 prevention and control / 中华医院管理杂志

Hospital is a crowded place, and the population health management is very important. In the context of the normalized control of COVID-19, it is crucial to establish a set of insensitive, intelligent and effective crowd diversion management strategies. By deeply integrating information technologies such as big data processing, movement tracking and face recognition, Hangzhou Ninth People′s Hospital built a set of crowd health management and population diversion work mechanism, which included temperature monitoring, health code inspection and epidemiological history investigation. The mechanism could effectively promote the efficiency and accuracy of hospital population health screening under the situation of normalized epidemic prevention and control.

Clinical significance of complement in precision medicine of glomerular diseases / 中华检验医学杂志

Abnormal activation of complement system is one of glomerular dysfunction pathogenesis, including abnormal complement activity, anti-complement antibody and genetic mutation of complement related genes. At present, the examination of complement components and activities is an important assistant diagnostic index for glomerular diseases, which is helpful for the diagnosis, differential diagnosis and classification of glomerular diseases. This paper summarizes the abnormal activation of complement in glomerular diseases, the methods of complement testing and their significance in the diagnosis and treatment of glomerular diseases, so as to provide the basis for precision medicine of glomerular diseases.

Exploratory research on detection of influenza viruses by reverse transcriptase-recombinase polymerase amplification / 中华实验和临床病毒学杂志

Objective@#To establish and hevaluate a detection method for influenza virus using reverse transcriptase-recombinase polymerase amplification (RT-RPA).@*Methods@#RT-RPA was developed for detection of influenza viruses (type A and B) and subtyping of H1 and H3 using the primers targeted matrix and hemagglutinin (HA) genes of influenza A virus, and non-structural (NS) protein gene of influenza B virus. The specificity and sensitivity of RT-RPA were determined.@*Results@#The RT-RPA for the detection of influenza viruses showed specific amplification products of corresponding target gene, but no amplification products for other respiratory viruses, indicating that the method had good specificity. The detection limits of RT-RPA were 100 copies/μl. RT-RPA combined with SYBR Green I was used for the detection of influenza B virus with the detection limit of 100 copies/μl.@*Conclusions@#The feasibility of detecting influenza virus by RT-RPA was preliminarily confirmed.

Beginning of modern stomatology education of China in later Qing dynasty / 中华口腔医学杂志

In the 19th century, modern stomatology education were introduced into China with the impact of the west medicine and education. The apprenticeship of modern stomatology education were carried out by missionaries firstly, and then changed to dental schools established by the missionaries or foreigners, which was replaced partly by local Chinese dentists later and improved the development of modern Chinese stomatology education preliminarily.

Value of haemoglobin A1c as the cut-off point for diabetes diagnosis based on the population in the department of endocrinology / 中国医师进修杂志

Objective@#To investigate the value of haemogobin A1c(HbA1c) for diagnosing various hyperglycemias in the Second Affiliated Hospital of Harbin Medical University.@*Methods@#This study is based on the data randomly selected from patients without clinical intervention in the endocrinology department and admission office in the Second Affiliated Hospital of Harbin Medical University from January 1st of 2010 to December 31th of 2012. In this study, 2 853 patients aged 16-85 year were selected, who performed OGTT and HbA1c on the same day. Their data of HbA1c and OGTT were collected. Selection criteria: the OGTT and HbA1c were performed simultaneously unless the patients had acidosis, and patients with past history of diabetes and oral hypoglycemic drugs or insulin treatment, or other basic combined diseases were included in this study. People in pregnancy were ruled out. Area under the receiver operating characteristics curve (ROC), sensitivity, and specificity were adopted to evaluate the diagnosis effect of HbA1c using FPG and OGTT as golden standard for diabetes and pre-diabetes.@*Results@#The area under the ROC were 0.902 (95% confidence interval 0.890-0.914) for HbA1c alone and 0.915 (0.906-0.925) for FPG alone. The HbA1c threshold of 6.5% showed the highest Youden index of 64.4% and significantly higher sensitivity 81.1% compared with FPG ≥ 7.0 mmol/L (69.8%, P < 0.01) in detecting diabetes. The optimal HbA1c thresholds for diagnosing pre-diabetes was 5.6% (the area under the ROC: 0.725; sensitivity: 74.1%; specificity: 60.3%).@*Conclusions@#These findings suggest that HbA1c 6.5% and 5.6% can be used as the diagnosing criterions for diabetes and pre-diabetes among the population who visit department of endocrinology.

Value of haemoglobin A1c as the cut-off point for diabetes diagnosis based on the population in the department of endocrinology / 中国医师进修杂志

investigate the value of haemogobin A1c(HbA1c) for diagnosing various hyperglycemias in the Second Affiliated Hospital of Harbin Medical University. Methods This study is based on the data randomly selected from patients without clinical intervention in the endocrinology department and admission office in the Second Affiliated Hospital of Harbin Medical University from January 1st of 2010 to December 31th of 2012. In this study, 2 853 patients aged 16-85 year were selected, who performed OGTT and HbA1c on the same day. Their data of HbA1c and OGTT were collected. Selection criteria: the OGTT and HbA1c were performed simultaneously unless the patients had acidosis, and patients with past history of diabetes and oral hypoglycemic drugs or insulin treatment, or other basic combined diseases were included in this study. People in pregnancy were ruled out. Area under the receiver operating characteristics curve (ROC), sensitivity, and specificity were adopted to evaluate the diagnosis effect of HbA1c using FPG and OGTT as golden standard for diabetes and pre-diabetes. Results The area under the ROC were 0.902 (95% confidence interval 0.890- 0.914) for HbA1c alone and 0.915 (0.906-0.925) for FPG alone. The HbA1c threshold of 6.5% showed the highest Youden index of 64.4% and significantly higher sensitivity 81.1% compared with FPG ≥ 7.0 mmol/L (69.8%, P<0.01) in detecting diabetes. The optimal HbA1c thresholds for diagnosing pre-diabetes was 5.6% (the area under the ROC: 0.725; sensitivity: 74.1% ; specificity: 60.3% ). Conclusions These findings suggest that HbA1c 6.5% and 5.6% can be used as the diagnosing criterions for diabetes and pre-diabetes among the population who visit department of endocrinology.

Effect of lentivirus vector-mediated RNA interference dbpA gene silencing on the biological behavior of colorectal cancer cells / 中华普通外科杂志

Objective To investigate the effects of lentivirus-mediated RNA interference (RNAi) targeting DNA binding protein A (dbpA) on the proliferation and the biological behavior of colorectal cancer cell line SW620.Methods The experiment was divided into 3 groups:KD group (siRNA-dbpA,lentivirus interference group),CON group (non-specific sequence group) and NC group (blank control group).The lentiviral vector siRNA-dbpA was constructed and verified by PCR and DNA sequencing.SW620 cells were transfected with siRNA-dbpA plasmid,nontargeting siRNA plasmid,or empty plasmid.After 48 h the transfection,the cells were examined for dbpA expression using Western blot.After 72 hrs transfection,flow cytometry was used to detect the cell apoptosis and cell cycle changes.The cell growth inhibition rate was detected by MTT (4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide) assay,and then clone formation was detected,and the ability of SW620 cells to form tumors in vivo after dbpA was silenced was studied in nude mice.Results PCR analysis and DNA sequencing demonstrated that the RNAi sequence targeting dbpA gene was successfully inserted into the lentiviral vector.siRNA-dbpA transfection resulted in reduced expression of dbpA in SW620 cells.After transfection,the apoptosis rate of siRNA-dbpA-transfected cells increased to 26.60％ ± 0.38％,significantly higher than that in cells transfected with the nontargeting plasmid or the empty plasmid 12.54％ ± 0.25％ and 4.46％ ± 0.19％,respectively (F =28.159,P ＜0.01).The growth inhibition test indicate that the OD value of the fifth day in siRNA-dbpA group was 0.194 ±0.037,significantly lower than that in the other two groups 0.814 ±0.043 and 1.625 ±0.061,respectively(F =23.214,P ＜ 0.01).The colony formation number is 37 ± 3,64 ± 5and 175 ± 10 respectively,siRNA-dbpA is significantly higher than that in the other two groups(F =40.254,P ＜ 0.01).After the completion of nude mouse transplantation tumor model,through the detection of tumor volume,KD group (group siRNA-dbpA) tumor volume after 14 d and CON and NC group had obvious difference (F =38.256,P ＜ 0.05),and after 21d is more significant difference in tumor size (F =40.241,P ＜ 0.01),can be clearly observed after 35 d KD group (group siRNA-dbpA) growing tumors had differences with the control group (F =30.257,P ＜ 0.05).Conclusion Lentivirus-mediated RNAi targeting dbpA can effectively suppress the expression of dbpA in colorectal tumor in nude mice,it is proved that dbpA silencing has a significant inhibitory effect on the growth of living tumor cells and decrease the proliferation of the colorectal cells.