Study on the construction status and countermeasures of Shandong Provincial Clinical Research Center / 中华医学科研管理杂志

Objective:By analyzing the development purpose and goals, status quo and achievements, characteristics, and problems identified of Shandong Provincial Clinical Research Center, tailored measurements and suggestions are put forward in this paper, to serve for better development of Shandong Provincial Clinical Research Center, and construct a more efficient clinical research transformation platform.Methods:Carrying out statistical analysis of the annual reports of the first two batches of 12 Shandong Provincial Clinical Research Centers to identify similarities and uniqueness; Benchmarking with the construction goals of Shandong Provincial Clinical Research Centers to figure out achievements and space for improvement; SWOT analysis was conducted to analyze opportunities and challenges, and experiences were summarized.Results:After two years’ construction, the centers have remarkable achievement by facilitating resources, establishing research platforms, and setting up collaborative research networks. However, common problems are still existed, such as: weak innovation foundation, insufficient attention from supporting institutions, lacking of compound talents in clinical research, peak discipline should be developed at provincial centers to promote the capacity building, and the ability to promote innovation at local level also needs to be improved.Conclusions:The construction of Shandong Provincial Clinical Research Center is facing a great deal of opportunities and challenges. By boosting attention of the supporting institution, enhancing continuing investment, implementing annual evaluation system, guiding the outstanding provincial centers to apply for national centers, and strengthening the achievement transfer and promotion, the construction of the provincial centers will be improved, and further enhance the clinical research capacity at provincial level.

Analysis of current situation and countermeasures for the development of hospital scientific and technological innovation in Shandong Province / 中华医学科研管理杂志

Objective:To analyze the overall situation and existing problems of the scientific and technological innovation capacity of hospitals in Shandong Province, propose strategies for the construction of first-class medical disciplines in hospitals, promote the transformation of medical science and technology achievements into clinical application, and provide a reference basis for building a highland of health scientific and technological innovation.Methods:Science and Technology Evaluation Metrics (STEM) data of hospitals in Shandong Province in 2020 were obtained by network research method, and the scientific and technological innovation capacity and sustainability of hospitals and disciplines were analyzed by statistical description method, assignment method, and NetDraw visualization tool.Results:The number of national top 100 hospitals and disciplines in Shandong Province ranks seventh and sixth in China, respectively. Only three hospitals in Shandong Province are among the national top 50, covering 80.6% of provincial top-ranked disciplines, while 41.6% of the national top 100 disciplines in Shandong Province are ranked after the top 50 in their respective discipline lists. The hospital scientific and technological innovation capacity of Shandong Province is at the middle-upper level with few and uneven distributions of first-class hospitals and disciplines, leading to a relatively weak overall science and technology impact.Conclusions:Given the current situation in Shandong Province, it is suggested that hospitals should take STEM as a guide to strengthen the construction of scientific research environments, vigorously develop clinical research, continuous strengthen discipline construction, and emphasize scientific innovative talent training and research integrity education, providing a science and technology strategic support for the acceleration of the medical scientific and technologic innovation and the promotion of high-level innovative province construction.

LncRNA XIST promotes carboplatin resistance of ovarian cancer through activating autophagy via targeting miR-506-3p/FOXP1 axis / 부인종양

Objective@#Resistance to chemotherapy drugs makes ovarian cancer (OC) difficult to treat and ultimately kills patients. Long non-coding RNAs are closely related to carboplatin resistance in OC. In present study, we explored the role of lncRNA X-inactive specific transcript (XIST) on carboplatin resistance in OC. @*Methods@#Cell viability, proliferation, and apoptosis were assessed through 2,5-diphenyl-2H-tetrazolium bromide, colony formation, and flow cytometry assays, respectively. Microtubule-associated protein 1A/1B-light chain 3 expression was evaluated by immunofluorescence assay to analyze the cell autophagy. The interaction of XIST/miR-506-3p or miR-506-3p/forkhead box protein P1 (FOXP1) was analyzed using RNA immunoprecipitation (RIP) and dual-luciferases reporter assays. The function of XIST/miR-506-3p/FOXP1 axis in vivo was further confirmed by tumor xenograft study and immunohistochemistry. @*Results@#The expression of XIST and FOXP1 increased while miR-506-3p decreased in OC and carboplatin resistance cells. XIST silencing repressed the proliferative and autophagic capacities of carboplatin resistance cells while promoted the apoptosis. XIST overexpression led to the opposite results. XIST targeted miR-506-3p and downregulated its expression. MiR-506-3p inhibition facilitated the proliferative and autophagic capacities while suppressed the apoptosis of cells, XIST knockdown reversed these effects. MiR-506-3p bound to FOXP1. XIST knockdown or miR-506-3p overexpression reversed the increase of cell proliferative and autophagic abilities and the decrease of apoptosis rate induced by FOXP1 overexpression. XIST affected autophagy and carboplatin resistance in vivo via regulating the miR-506-3p/FOXP1 axis. @*Conclusion@#XIST knockdown inhibited autophagy and carboplatin resistance of OC through FOXP1/protein kinase B (AKT)/mammalian target of rapamycin pathway by targeting miR-506-3p.

Survey on the first-aid capability of primary general practitioners in southern Zhejiang province / 中华全科医师杂志

Objective:To survey the first-aid ability of general practitioners (GPs) and the emergency service capacity of primary health institutions in southern Zhejiang province.Methods:The questionnaire of first-aid ability of GPs in primary care institution was developed on the basis of the Delphi method during August to October 2018. The questionnaire was employed in a survey on the first-aid ability among 480 GPs from 169 community health service centers of three regions in southern Zhejiang province. The survey covered basic information and first-aid skills and emergency response ability of GPs, and the emergency facilities of primary health institutions.Results:A total of 480 questionnaires were distributed and 447 were retrieved with an recovery rate of 93. 1%(447/480). Among the 447 responders, 55.9% (250/447) were males, 70.9% (317/447) had bachelor′s degree or above, and 60.2% (269/447) had middle and senior professional titles. There were 99.6% (445/447), 86.6% (387/447), 76.1% (340/447) and 69.8% (312/447) responders considered cardiopulmonary resuscitation(CPR), electrical defibrillation, respiratory balloon and endotracheal intubation as important first-aid skills, and corresponding mastery rates were 84.3% (377/447), 32.0% (143/447), 55.2% (247/447) and 12.9% (58/447), respectively. The 92.4% (413/447) responders thought that the rescue ability of common emergency and critical illness was the most important, while only 32.4% (145/447) responders mastered it. Least responders [41.4%(185/447)] thought that ability of using bedside ultrasound was important, and the corresponding mastery rate was only 3.8%(17/447); 77.4%(346/447) of general practitioners believed that CPR machines was important, while the available rate of CPR machines in primary health care institutions was only 16.0%(27/169).Conclusion:The GPs in southern Zhejiang province have a good grasp of cardiopulmonary resuscitation skills, but have a low mastery rate of first-aid skills such as electrical defibrillation, tracheal intubation, and emergency rescue capabilities, which are quite different from their perceived importance evaluation.

The value of contrast enhanced MRI radiomics in predicting the IDH 1 genotype in high-grade gliomas / 中华放射学杂志

Objective:To explore the predictive value of a radiomics model based on preoperative contrast enhanced MRI in the assessment of the isocitrate dedydrogenase 1 (IDH 1) genotype in high-grade glioma.Methods:A retrospective analysis was performed on a dataset including 182 patients with high-grade glioma confirmed by surgical pathology between December 2012 and January 2018 in the Affiliated Hospital of Qingdao University. There were 79 patients with IDH1-mutant glioma (45 cases with WHO grade Ⅲ, 34 with WHO grade Ⅳ) and 103 with IDH 1 wild-type glioma (33 cases with WHO grade Ⅲ, 70 cases with WHO grade Ⅳ). All patients had complete preoperative brain contrast enhanced MRI.The cases were divided into a training dataset and a validation dataset at a ratio of 7∶3 using stratified random sampling. Radiomic features were initially extracted using A.K (Analysis Kit, GE healthcare) software, and were selected and excluded using Kruskal-Wallis and Spearman analyses. Using R softwear " GLM" function, the Lasso-logistic model was finally conducted to obtain the optimized subset of the feature to build the radiomics model, and the model was then tested with cross-validation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of the model in differentiating IDH1-mutant type and wild-type gliomas.Results:The radiomics model showed good performance in IDH genotype differentiation in both the training dataset (AUC 0.870, 95% CI: 0.754 to 0.855, accuracy rate 79.8%, sensitivity 85.5%, specificity 75.4%, positive predictive value 0.734, negative predictive value 0.867) and the validation dataset (AUC 0.860, 95% CI: 0.690 to 0.913, accuracy rate 78.9%, sensitivity 91.3%, specificity 69.0%, positive predictive value 0.700, negative predictive value 0.909).Conclusion:The radiomics model based on the preoperative enhanced MR can provide a way to predict the IDH1 genotype in high-grade gliomas.

Effect of Jiawei-Danshen Yin on anti-myocardial fibrosis and Notch signaling pathway in rats with myocardial fibrosis / 国际中医中药杂志

Objective@#To study the effect of Jiawei-Danshen Yin on anti-myocardial fibrosis and Notch signaling pathway in rats with myocardial fibrosis.@*Methods@#The rats were randomly divided into normal group (10 rats), model group (5 rats), latopril group (5 rats), low dose group (5 rats) and high dose group (5 rats). In addition to the normal group, the other groups of rats prepared myocardial fibrosis model. One hour after model establishment, the rats in high and low dosage groups were given 1.5 mg/ml and 3.0 mg/ml of modified salvia miltiorrhiza drink respectively, the rats in captopril group were given 1 mg/ml of captopril, the rats in model group and normal group were given saline of equal volume for 1 day/time for one week. The collagen volume fraction (CVF) was measured by pathological observation. The left ventricular mass index (LVMI), heart mass index (HWI), heart rate (HR), left ventricular systolic pre-existing (LVSP) left ventricular end diastolic pressure (LVEDP) and left ventricular systolic pressure were measured. Western blot was used to detect the expression of Notch1, NICD, Notch3 and α-SMA.@*Results@#Compared with the model group, the levels of LVMI (2.26 ± 0.01 mg/g, 1.48 ± 0.03 mg/g vs. 2.86 ± 0.06 mg/g), CVF (3.44% ± 1.45%, 2.62% ± 1.43% vs. 7.82% ± 1.95%), HWI (4.05 ± 0.02 mg/g, 3.11 ± 0.02 mg/g vs. 4.58 ± 1.05 mg/g) in the low and high dose groups of Jiawei-Danshen Yin significantly decreased respectively(P<0.05). The levels of LVEDP (10.16 ± 2.35 kPa, 6.25 ± 1.23 kPa vs. 13.15 ± 3.06 kPa) significantly decreased, HR (375.22 ± 20.36 time/min, 450.32 ± 22.13 time/min vs. 329.36 ± 22.01 time/min), LVSP (90.12 ± 6.32 kPa, 110.45 ± 10.71 kPa vs. 80.54 ± 10.35 kPa) significantly increased (P<0.05) respectively. The expression of Notch1 (0.83 ± 0.05, 1.11 ± 0.04 vs. 0.51 ± 0.06), NICD (0.72 ± 0.01, 1.06 ± 0.03 vs. 0.35 ± 0.05), Notch3 (0.62 ± 0.03, 1.20 ± 0.06 vs. 0.39 ± 0.05) in myocardial tissue significantly increased, and the expression of α-SMA (1.12 ± 0.08, 0.92 ± 0.05 vs. 1.43 ± 0.07) significantly decreased (P<0.05).@*Conclusions@#The Jiawei-Danshen Yin has a significant effect on myocardial fibrosis model rats. It can improve the anti-myocardial fibrosis ability by activating Notch signaling pathway.

Effect of Jiawei-Danshen Yin on anti-myocardial fibrosis and Notch signaling pathway in rats with myocardial fibrosis / 国际中医中药杂志

Objective To study the effect of Jiawei-Danshen Yin on anti-myocardial fibrosis and Notch signaling pathway in rats with myocardial fibrosis. Methods The rats were randomly divided into normal group (10 rats), model group (5 rats), latopril group (5 rats), low dose group (5 rats) and high dose group (5 rats). In addition to the normal group, the other groups of rats prepared myocardial fibrosis model. One hour after model establishment, the rats in high and low dosage groups were given 1.5 mg/ml and 3.0 mg/ml of modified salvia miltiorrhiza drink respectively, the rats in captopril group were given 1 mg/ml of captopril, the rats in model group and normal group were given saline of equal volume for 1 day/time for one week. The collagen volume fraction (CVF) was measured by pathological observation. The left ventricular mass index (LVMI), heart mass index (HWI), heart rate (HR), left ventricular systolic pre-existing (LVSP) left ventricular end diastolic pressure (LVEDP) and left ventricular systolic pressure were measured. Western blot was used to detect the expression of Notch1, NICD, Notch3 and α-SMA. Results Compared with the model group, the levels of LVMI (2.26 ± 0.01 mg/g, 1.48 ± 0.03 mg/g vs. 2.86 ± 0.06 mg/g), CVF (3.44% ± 1.45%, 2.62% ± 1.43% vs. 7.82% ± 1.95%), HWI (4.05 ± 0.02 mg/g, 3.11 ± 0.02 mg/g vs. 4.58 ± 1.05 mg/g) in the low and high dose groups of Jiawei-Danshen Yin significantly decreased respectively(P<0.05). The levels of LVEDP (10.16 ± 2.35 kPa, 6.25 ± 1.23 kPa vs. 13.15 ± 3.06 kPa) significantly decreased, HR (375.22 ± 20.36 time/min, 450.32 ± 22.13 time/min vs. 329.36 ± 22.01 time/min), LVSP (90.12 ± 6.32 kPa, 110.45 ± 10.71 kPa vs. 80.54 ± 10.35 kPa) significantly increased (P<0.05) respectively. The expression of Notch1 (0.83 ± 0.05, 1.11 ± 0.04 vs. 0.51 ± 0.06), NICD (0.72 ± 0.01, 1.06 ± 0.03 vs. 0.35 ± 0.05), Notch3 (0.62 ± 0.03, 1.20 ± 0.06 vs. 0.39 ± 0.05) in myocardial tissue significantly increased, and the expression of α-SMA (1.12 ± 0.08, 0.92 ± 0.05 vs. 1.43 ± 0.07) significantly decreased (P<0.05). Conclusions The Jiawei-Danshen Yin has a significant effect on myocardial fibrosis model rats. It can improve the anti-myocardial fibrosis ability by activating Notch signaling pathway.

Current status of professional value and influencing factors among health workers in grass-roots medical institutions in Wenzhou city / 中华全科医师杂志

Objective To survey the current status of professional value among health workers in grass-roots medical institutions of Wenzhou city and to analyze the influencing factors.Methods A survey on professional value was conducted from October to December 2017 among health workers from 14 primary medical institutions in 4 urban districts of Wenzhou City selected by stratified random sampling method.The self-designed questionnaires were used for the survey.A total of 350 questionnaires were distributed and 331 were returned,of which 302 were valid.The status and influencing factors of professional value were analyzed.Results The overall score of professional value was (96.66 ± 14.94).The univariate analysis showed that the professional value scores were associated with educational level (F=3.851),income(F=2.660),professional title(F=8.030),position(F=11.658) and specialty (F=4.667) of the health workers(all P＜0.05).The multivariate analysis showed that the gender(male:OR=0.53,95％ CI:-1.077--0.192,P=0.005),educational level (high school and below:OR=3.06,95％ CI:0.007-2.233,P=0.049),income (2 000-4 000 Yuan:OR=0.07,95％ CI:-4.783-0.627,P=0.011),professional title (no title:OR=0.27,95％CI:-2.397--0.232,P=0.017;Junior title:OR=0.31,95％CI:-2.197--0.153),P--0.024;intermediate title:OR=0.23,95％ CI:-2.533--0.366,P--0.009),position (doctor:OR=0.13,95％ CI:-3.235--0.815,P=0.001;nurse:OR=0.20,95％ CI:-2.883--0.368,P=0.011;technician:OR=0.15,95％ CI:-3.076--0.723,P=0.002)were influencing factors of professional value(all P＜0.05).Conclusion The professional values among health workers in Wenzhou grass-roots medical institutions are relatively low.The male gender,low educational level,low income,low professional title or no title and positions are influencing factors of professional value.

Changes of lipid metabolism related microRNAs expression in subclinical hypothyroidism mice model / 中华内分泌代谢杂志

Objective To obtain a non-invasive subclinical hypothyroidism ( SCH) mouse model, and to explore microRNAs profile related to lipid metabolism in the model mice. Methods C57BL/6 male mice (8 weeks) were treated with methimazole ( MMI, 0. 08 mg/kg BW/d) to construct SCH mouse model. MicroRNAs profiling analysis was performed by real-time quantitative polymerase chain reaction ( qRT-PCR) . Results Compared with the control group, the serum thyroid stimulating hormone ( TSH ) in subclinical hypothyroidism group increased significantly (P>0.01), while the serum free thyroxine(FT4) level did not show significant difference between the two groups (P>0. 05), which was in line with the diagnostic criteria of SCH. SCH mice was accompanied by dyslipidemia and liver lipid metabolism disorders. Four lipid metabolism related miRNAs, miR-33, miR-122, miR-199a-5p, and miR-375 in the liver of SCH mice were significantly decreased compared with those of control ( P>0. 05). Conclusion The noninvasive SCH model generated by MMI and miRNAs profile provide an animal model and a molecular basis for the study of SCH related lipid metabolism disorders.

Diagnostic value and characteristics of CT enterography in primary intestinal T-cell lymphoma / 中国医学影像技术

Objective To evaluate the manifestations and diagnostic value of CT enterography (CTE) in primary intestinal T-cell lymphoma (PITCL).Methods Eighteen patients with PITCL confirmed by pathology were reviewed retrospec tively.The characteristics of lesion site,amount of foci,pattern and degree of contrast enhancement,lymphadenopathy,involvement of other organs and complications were recorded.Results In all of the 18 patients with PITCL,multiple lesions were seen in 13 cases (13/18,72.22％),and solitary involvement was seen in 5 cases (5/18,27.78％).Twelve ca ses were located at jejunum/ileum,3 of them were also involved in the colon.Five cases were located only in the colon,and 1 in the duodenum.Six cases were complicated with intestinal perforation.The patients were categorized into 6 types according to the CT manifestation:infiltration type (n=7),diffuse jejunum mucosa ileum metaplasia type (n =3),luminal aneurismal dilatation type (n =3),polypoid mass type (n =2),mesentery type (n=1),mixed type (n =2).Conclusion CTE can clearly display the imaging of PITCL and it has high value for the diagnosis of PITCL.

The research on integrity and standardization of structured MRI report for rectal cancer / 实用放射学杂志

Objective To assess the integrity and standardization of structured MRI report for rectal cancer of the affiliated hospital of qingdao university,referring to National Comprehensive Cancer Network (NCCN) guidelines for colorectal cancer (Version 2015)and foreign authoritative research results,and put forward some suggestions to improve the quality.Methods A total of 110 structured MRI reports of 107 patients with rectal cancer were included in the study.The inclusion rates of 8 indexes were evaluated,including tumor site,distance from upper to lower border of tumor (DIS),tumor invasive depth (T staging),anal complex staging (A staging),nodal staging (N staging),the circumferential resection margin (CRM),extramural vascular invasion (EMVI) and metastases staging (M staging),which were compared with research results of structured reports in abroad by using Pearson chi-square test.Results There was a significant difference in the description of N staging (x2 =8.424,P＜0.05) between our research and foreign study,in 110 structured MRI reports.There was no significant difference in the description of tumor site (x2 =0.00,P＞0.05),DIS (x2 =0.041,P ＞0.05),T staging (x2 =3.256,P＞0.05) and CRM(x2 =2.957,P＞0.05) between the two groups.A staging,EMVI and M staging were not described.Conclusion Our structured MRI reports for rectal cancer basically meet international research standards.Structured MRI reports have advantages,and deserve to be further studied and promoted.

A cross-sectional survey of the knowledge on chronic obstructive pulmonary disease in physicians of tertiary hospitals in Northern China / 中华内科杂志

To investigate physicians' knowledge about chronic obstructive pulmonary disease (COPD) in tertiary hospitals in northeast China.Physicians from 77 tertiary hospitals in northeast China were surveyed with a questionnaire,which included questions such as risk factors,symptoms,exacerbations,comorbidities and diagnostic criteria of COPD.Besides cigarette smoking,air pollution and pulmonary infections,only 22.5％ (40/178) physicians recognized that the biomass fuels may induce COPD.Totally 59.0％ (105/178) physicians recognized the importance of spirometry to the diagnosis of COPD.Besides dyspnea,cough,sputum production,wheezing and chest tightness,only 23.7％ (42/177)of physicians considered that limitation of activity was an important symptom of COPD.65.5％ (116/177)physicians believed that recurrent lung infections was one of the most important comorbidities of COPD.However,less than 30％ [20.9％ (37/177)-28.8％ (51/177)] physicians were aware of the other important comorbidities.The physicians of tertiary hospitals in northeast China need to be systematically educated on COPD to meet the new guideline.

Clinical Study on Thread Embedding at the Holographic Point of the Second Metacarpal Bone for Tinnitus / 上海针灸杂志

Objective To observe the clinical efficacy of thread embedding at the holographic point Kidney of the second metacarpal bone in treating tinnitus.Method Eighty-two patients with tinnitus were randomized into a treatment group and a control group, 41 cases in each group. The treatment group was intervened by thread embedding at the holographic point Kidney of the second metacarpal bone, while the control group was by intragluteal injection with Mecobalamin 0.5 mg. The Tinnitus Handicap Inventory (THI) was compared before intervention and after 1 treatment course.Result The THI scores were significantly changed in both groups after intervention (P<0.01). The change of THI score after intervention in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Thread embedding at the holographic point of the second metacarpal bone in an effective approach in treating tinnitus.

Detection and phylogenetic tree analysis of human parainfluenza virus type 3 in children with acute respiratory tract infection from a hospital in Shanghai / 中华传染病杂志

Objective To understand the epidemiologic feature of human parainfluenza virus type 3 (HPIV-3) in Shanghai,and to provide scientific evidence for formulating prevention and control measures in the future.Methods A total of 164 nasopharyngeal aspirates samples taken from children with acute respiratory infection (ARI) were collected from Xinhua Hospital Affiliated to Shanghai Jiaotong University and sent to Shanghai Public Health Clinical Center from June 2009 to June 2010.Samples were detected for HPIV-3 by reversed transcription-polymerase chain reaction (RT-PCR).Full-length hemagglutininneuraminidase (HN) gene (1 719 bp) of five positive samples were sequenced for phylogenetic analysis.Comparison between two groups was evaluated by the precise chi-square test (two sided).Results Of 164 samples,70 samples were infected with parainfluenza virus,and HPIV-3 was detected positive in 23 samples with the positive rate of 32.86％.HPIV-3 infections were most common in spring and summer,and most of infections were mainly found in 13-36 month-old infants.Five Shanghai isolates and 36 reference sequences from different countries and areas were divided by HN gene-based phylogenetic tree into three clusters (A,B and C).Five Shanghai isolates and five Beijing isolates belonged to C3a group.The homologies of nucleotide and amino acid sequences between five Shanghai isolates and five Beijing isolates were 99.0％-99.5％ and 99.7％-100.0％,respectively.Conclusions HPIV-3 accounts for a high proportion in children with ARI in Shanghai.C3a group may be the main lineage of HPIV-3,which suggests that HPIV-3 may be of regionally correlation.

Expression of cyclin-dependent kinase 5 in cerebral cortex after subarachnoid hemorrhage in rats / 国际脑血管病杂志

Objective To investigate the expression and cellular localization of cyclin-dependent kinase 5 (Cdk5) in cerebral cortex after subarachnoid hemorrhage (SAH) in rats.Methods Fifty-two male Sprague Dawley (SD) rats were randomly divided into either a sham operation group (n =12) or a SAH group (n =40).The latter was randomly redivided into 6,12,24 h,and day 2 and 3 subgroups (n =8 in each group).A rat SAH model was induced by injecting fresh blood into the prechiasmatic cistern.Western blot and immunohistochemistry were used to detect the expression of Cdk5 in rat brain cortex.Double labeling immunofluorescence staining was used to detect the cellular localization of Cdk5 protein in cerebral cortex.Neuronal nuclear antigen labeled neurons,and glial fibrillary acidic protein labeled astrocytes.Results Western blot showed that the expression of Cdk5 protein was up-regulated at 12 hours after SAH (t =3.709,P =0.001),and it reached the peak on day 1 (t =3.475,P=0.002).Immunohistochemistry showed that the proportion of Cdk5 positive cell was also increased gradually after SAH,and the changes of time course were consistent with the results of Western blot,and it reached the peak on day 1 (t =4.320,P =0.000).Double labeling immunofluorescence showed that Cdk5 was mainly expressed in the neuronal cytoplasm in the sham operation group,and Cdk5 shifted to the neuronal nuclei in the SAH group.Cdk5 was mainly colocalized between astrocytes and neurons.Conclusions SAH up-regulates the expression of Cdk5 protein in cerebral cortex.Cdk5 may be involved in early brain injury after SAH.

The comparison of the therapeutic impacts on metabolism in hepatitis C virus and human immunodeficiency virus co-infected patients / 中华内分泌代谢杂志

To explore and compare the response of the protease inhibitors or non-nucleoside reverse transcriptase inhibitors-based therapeutic impact on metabolic indices in hepatitis C virus (HCV)/human immunodeficiency virus(HIV) co-infected patients.A randomized,open,and control approach was performed to enroll 273 cases of HCV/HIV co-infected patients on their initial visits and to choose protease inhibitors(PIs group) or non-nucleoside reverse transcriptase inhibitors (NNRTIs group) based therapy treatments for one year.Laboratory results of metabolic indices before and after the treatment were collected.After treatment,the levels of triglyceride in NNRTIs and Pls groups were (1.93 ± 0.99) mmol/L and (1.62 ± 0.93) mmol/L respectively,high density lipoprotein-cholesterol were(1.28 ± 0.55) mmol/L and (1.08 ± 0.53) mmol/L,low density lipoprotein-cholesterol were (2.60 ± 1.44) mmol/L and (2.22 ± 1.16) mmol/L,fasting plasma glucose were (5.92 ± 1.21) mmol/L and (4.79 ± 0.47) mmol/L,serum creatinine were (70.5 ± 14.6) μmol/L and (56.6 ± 8.3) μmol/L,and serum amylase were(66.9 ± 27.5) U/L and(62.7 ± 33.8) U/L respectively.The difference between the two groups was statistically significant(all P＜0.01).There is a therapeutic impact on metabolic indices in patients wtih HCV / HIV co-infection after non-nucleoside reverse transcriptase inhibitors-based regimen.

Endothelin-1 and cerebral vasospasm after subarachnoid hemorrhage / 国际脑血管病杂志

Cerebral vasospasm (CVS) is a serious complication of aneurysmal subarachnoid hemorrhage (SAH).Endothelin-1 (ET-1) is an endothelium-derived vasoconstrictor substance.A large number of clinical and basic studies have shown that cerebrospinal fluid and/or ET-1 levels in peripheral blood increases in patients with SAH and play an important role in the occurrence and development of CVS.This article reviews the research status of the role of ET-1 in the occurrence and development of CVS.

Identification of a suspected Klebsiella variicola strain isolated from a patient with severe septic shock / 中华传染病杂志

Objective To identify a suspected Klebsiella variicola strain isolated from a patient with severe septic shock. Methods Sequences of rpoB, gyrA, mdh, infB, phoE and nifH genes were obtained from the clinical isolated suspected Klebsiella variicola strain, and used for constructing phylogenectic trees. Characteristics of phylogenetic trees were used to distinguish Klebsiella variicola from Klebsiella pneumoniae. Results All target gene sequences from this clinical isolated strain constantly formed a cluster with their counterparts from other Klebsiella variicola strains. These clusters were readily differentiated from Klebsiella pneumoniae clusters. Conclusions The clinical isolated strain belongs to Klebsiella variicola class and can cause septic shock. From genetic perspective, Klebsiella variicola is distinctly different from Klebsiella pneumoniae, most of which can be isolated from normal healthy people.

Fluoroquinolone resistance among Neisseria gonorrhoeae isolates from Shanghai, China: Detection of quinolone resistancedetermining region mutations.

Background & objectives: Fluoroquinolone has a broad spectrum of antimicrobial activity, and is widely used for gonorrhoea treatment. However, its effi cacy can be compromised by the drug-resistance property of Neisseria gonorrhoeae isolates. Most resistant cases of N. gonorrhoeae are associated with mutations in the quinolone-resistance-determining-region (QRDR) within genes of gyrA and parC. This study was undertaken to describe resistance profi le of N. gonorrhoeae to fl uoroquinolones in Shanghai, P.R. of China, and also associated resistance mutations in gyrA and parC. Methods: Eighty N. gonorrhoeae isolates were collected from Shanghai Skin Disease & Sexually Transmitted Disease Hospital or DongFang Hospital during April 2005 to April 2006 in Shanghai, P.R. of China. The minimum inhibitory concentrations (MIC) of fl uoroquinolones for these isolates were determined by an agar dilution method. Mutation patterns within gyrA and parC were determined by direct sequencing or by using established restriction fragment length polymorphisms (RFLP) methods. Results: Ninety fi ve per cent (76 of 80) of isolates were resistant, 3.75 per cent (3 of 80) intermediate resistant, and 1.25 per cent (1 of 80) were sensitive to fl uoroquinolone drug ciprofl oxacin. Sequencing and RFLP analysis of gyrA and parC revealed that all resistant isolates had dual mutations of S91F and D95A/G/N in gyrA. Some isolates had an extra mutation within parC either of D86N, S87N or E91A/G. Mutation patterns for gyrA and parC were signififififi cantly (P<0.05) associated with MICs level. Interpretation & conclusions: Mutations of S91F and D95A/G/N in gyrA combined with S87N in parC was the most prevalent mutation pattern of fl uoroquinolone resistant N. gonorrhoeae isolates. This mutation pattern was associated with a high level of quinolone resistance (MIC >16.0 μg/ml) which can serve as a maker for quinolone-resistance prediction in Shanghai, P.R. of China.

Causes of Failure and Complications of Minimally Invasive Percutaneous Nephrolithotomy / 中国微创外科杂志

Objective To investigate the causes and preventive measures for failure and complications of minimally invasive percutaneous nephrolithotomy (mPCNL). Methods From January 2005 to October 2008,totally 353 cases of mPNCL were performed in our hospital. Among the cases,30 patients experienced failure of the surgery or postoperative complications. The data of the 30 patients were analyzed retrospectively in this study. Results Of the 30 cases,puncture failure occurred in 5 patients,while 2 of them were converted to open surgery,and the other 3 were treated by a second puncture successfully; Zebra wire extrusion was found in 5 cases,who were then cured by re-puncture or a second operation; in 3 patients,the wire or PCN tube was moved into the renal vein (2 cases) or the colon (1 case) without causing bleeding or intestinal fistula,the cases were cured afterwards by a second operation; 3 patients developed hydrothorax and then was cured by chest drainage; postoperative arteriovenous fistula was detected in 2 patients,who were cured by interventional therapy; in 5 days after the operation,one patient developed massive hemorrhage from the PCN tube when driving cars,and then recovered by clipping the PCN tube and hemostasis; another patient showed hemorrhage and infection due to extraction of the PCN tube,and open surgery was carried out to cure this patient. Conclusions Failure of puncture and Zebra wire extrusion are most common causes of failure of mPCNL. Whereas,post-mPCNL complications is often caused by unskillful surgeons or noncompliant patients.