Clinical application and evaluation of health economics for non-invasive prenatal testing of fetuses in Tianjin / 中华医学遗传学杂志

OBJECTIVE@#To assess the clinical efficacy and health economic value of non-invasive prenatal testing (NIPT) for the prenatal screening of common fetal chromosomal aneuploidies.@*METHODS@#10 612 pregnant women from October 2017 to December 2019 presented at the antenatal screening clinic of the General Hospital of Tianjin Medical University were selected as the study subjects. Results of NIPT and invasive prenatal diagnosis and follow-up outcome for the 10 612 pregnant women were retrospectively analyzed and compared. Meanwhile, NIPT data for two periods were analyzed for assessing the health economic value of NIPT as the second- or first-tier screening strategy for the prenatal diagnosis of fetal trisomies 21, 18 and 13.@*RESULTS@#The NIPT was successful in 10 528 (99.72%) subjects, with the sensitivity for fetal trisomies 21, 18 and 13 being 100%, 92.86% and 100%, and the positive predictive value (PPV) being 89.74%, 61.90% and 44.44%, respectively. The PPV of NIPT for sex chromosome aneuploidies was 34.21%. Except for one false negative case of trisomy 18, the negative predictive value for trisomy 21, trisomy 13 and other chromosomal abnormalities were 100%. For pregnant women with high risk by serological screening, advanced maternal age or abnormal ultrasound soft markers, NIPT has yielded a significantly increased high risk ratio. There was no statistical difference in the PPV of NIPT among pregnant women from each subgroup. NIPT would have higher health economic value as a second-tier screening until 2019, while compared to 2015 ~ 2017, its incremental cost-effectiveness ratio as a first-tier screening had declined clearly.@*CONCLUSION@#The screening efficacy of NIPT for trisomies 21, 18 and 13 for a mixed population is significantly better than conventional serological screening, but it is relatively low for sex chromosomal abnormalities. NIPT can also be recommended for populations with relatively high risks along with detailed pre- and post-test genetic counselling. From the perspective of health economics, except for open neural tube defects, it is possible for NIPT to replace the conventional serological screening in the future as its cost continues to decrease.

Health literacy of COVID-19 and its associated factors in Inner Mongolia Autonomous Region / 中华健康管理学杂志

Objective:To investigate the status of Corona Virus Disease 2019 (COVID-19) health literacy and associated factors in Inner Mongolia Autonomous Region.Methods:Based on the multi-stage stratified sampling method, the questionnaire survey of health literacy of COVID-19 were carried out in 55 599 local residents from12 prefecture-level cities of Inner Mongolia Autonomous Region between March 10 and 15, 2020. The questionnaire in details included not only knowledge, attitude and behavior, but also mental health, their scores were calculated using Decimal method. A ≥80% of the correct answer rate of the survey content was regarded as qualified for health literacy. There were 51 722 (93.0%) valid questionnaires, according to the ratio of medical staff to non-medical staff, 32 529 questionnaires were selected for analysis. The health literacy level was defined according to the proportion of qualified people.The credibility and availability of the questionnaires were evaluated by Cronbach′s α coefficient and KMO test. The associated factors were analyzed by Pearson χ 2 test and logistic regression. Results:In Inner Mongolia Autonomous Region, the whole level of health literacy of COVID-19 was 85.7%, and their scores were (26.30±2.48). Knowledge, attitude, and behavioral literacy levels were 61.6%, 95.6%, and 96.8%, respectively. Compared with the population of 15-25 years old, the health literacy level of 46-65 years old was the highest ( OR=2.00, 95% CI: 1.78-2.24). The health literacy level of medical staff group ( OR=2.54, 95% CI: 1.30-4.95) was far higher than the non-medical staff group; the population with college or above education level ( OR=10.22, 95% CI: 9.19-11.36) was significantly higher than the population with education level below college. The degree of anxiety was negatively correlated with education level. Conclusions:The health literacy level of COVID-19 in residents in Inner Mongolia Autonomous Region is relatively high, but the level of knowledge literacy needs to be improved. The main factors affecting the health literacy of COVID-19 among Inner Mongolia residents are age, occupation and education level.

Induction of tanshinone 11 a on differentiation of human placenta-derived mesenchymal stem cells into cardiomyocytes and its mechanism / 吉林大学学报(医学版)

Objective: To investigate the induction of tanshinone [1 A (Tan fl A) on the differentiation of human placenta-derived mesenchymal stem cells (hPDMSCs) into cardiomyocytes, and to provide an experimental basis for Tan IT A as a cardiomyocytc differentiation inducer. McthodS; The hPDMSCs were treated with different concentrations of Tan Fl A (0.1.0.2.0.4.0.6.0.8.1.0. 2.0. 4.0. 6.0. 8.0. and 10. 0 mg • L ). and the nontoxic dose of Tan II A <0. 1 mg • L ) was scrccncd by MTT assay for experiment. The hPDMSCs were divided into control group. 5-aza induction (10 pmol • L ) group, and Tan Fl A induction (0. 1 mg • L ) group. After culture for 20 d. the expressions of o-sarcomeric acun (o-SCA) in the cells in various groups were detected with lmmunohistochcmastry; the positive expression rates of cardiac troponin 1 (cTnl) in the cells in various groups were detected with immunofluorescence, and the differentation rates of cardiomyocytes were calculated. The expression levels of GATA-binding protein 4 (GATA4). atnal natriuretic factor (ANF). cTnl. glycogen synthase kmase-30 (GSK-30 ) and 0-catemn in the cells were detected with Western blotting method. Results: The biological characteristics of hPDMSCs accorded with the mesenchymal stem cells. The MTT results showed that when the concentration of TanFl A was more than 0. 1 mg • L . the cell survival rates were decreased with the increase of concentrations the cells in control group showed a rapid growth trend before 12 d. and the proliferation activities of the cells began to decrease on the 12th day. Compared with control group, the cell activities in 5-aza induction group and TanFl A induction group were significantly decreased < P<0. 05). The immunohistochcmistry staining results showed that the cells in control group didn' t express a-SCA. and the cells in 5-aza induction group and TanFl A induction group expressed o-SCA. cspcaally in Tan Fl A induction group. Compared with control group, the expression levels of GAT A4 ( i - 2.937. P <0.05,4.769, P ,| , <0. 05) . ANF ( t -3.728. P <0.05 j r.-5.912, P ., ,<0.05). cTnl

Influence of five-in-one management mode on disease prevention and control of school children with asthma / 中华儿科杂志

Objective@#To investigate the influence of five-in-one management mode(standardized asthma treatment, asthma diary, peak expiratory flow (PEF) monitoring, reasonable diet and physical exercise) on disease prevention and control of school children with asthma.@*Methods@#From April to October 2018, 70 children with asthma in clinical remission were selected from Affiliated Hospital of Qingdao University using randomized controlled study design. These children were randomly divided into study group and control group, with 35 cases in each group. In the study group, 5 cases were lost to follow-up, and 30 cases were actually enrolled. In the control group, 6 cases were lost to follow-up, and 29 cases were actually enrolled. Children in the control group received routine medication and regular outpatient consultation, and children in the study group received the five-in-one asthma management model. In the first time of seeing a doctor, after 3 months and 6 months of follow-up, asthma control test score, medication compliance index score and lung function index (forced expiratory volume in 1 second (FEV1), PEF were evaluated respectively.Parental satisfaction, asthma acute episodes, weight, height and biochemical index were recorded during the 6 months of follow-up. Pulmonary function index, asthma control score and body mass index of overweight children with asthma were compared with t-test, medication compliance was compared with chi-square test, and the rank sum test was used for the comparison of the number of emergency visits of asthma attacks and parents′ satisfaction.@*Results@#A total of 59 children with asthma were included, among them 30 were in the study group (8.1±1.5) years old and 29 in the control group (9.2±1.1) years old. After 3 months of follow-up, FEV1, PEF, asthma control score in the study group were (86.3±1.5)%, (83.3±2.4)%, (24.7±2.6) points respectively; and in the control group, FEV1, PEF, asthma control score were (84.4±2.5)%, (82.2±1.9)%, (21.1±1.3) points respectively. The indicators in the study group were higher than those in the control group (t=3.62, 1.97, 6.64, P<0.05). After 6 months of follow-up, FEV1, PEF, asthma control score in the study group were (88.4±2.3)%, (85.4±2.2)%, (26.8±1.8) points respectively; and in the control group, FEV1, PEF, asthma control score were (85.5±1.9)%, (83.2±1.7)%, (22.5±1.4) points respectively. The indicators in the study group were significantly higher than those in the control group (t=5.34, 4.24, 10.41, P<0.05). During the 6-month follow up, the number of emergency visits of asthma attacks in the study group and in the control group were 0.42(0.36, 0.51) and 0.92(0.72, 1.27) respectively. The indicator in the study group was significantly lower than that in the control group (Z=3.21, P<0.05). After 3 months of follow-up, the proportions of children with good compliance in the study group and control group were 67% (20/30) and 62% (18/29), the proportions of poor compliance were 27% (8/30) and 34% (10/29), the proportions of non-compliance were 7% (2/30) and 7% (2/29). There were no statistically significant differences (χ2=0.14, 0.43, 0.00, P=0.71, 0.51, 0.97). After 6 months of follow-up, the proportions of children with good compliance in the study group and control group were 87% (26/30) and 69% (20/29), the proportion of poor compliance were 10% (3/30) and 28% (8/29), the proportion of non-compliance were 3% (1/30) and 7% (2/29), There were no statistically significant differences (χ2=2.70, 3.00, 0.39, P=0.10, 0.08, 0.53). After 6 months of follow-up, the number of great satisfaction, satisfaction and dissatisfaction in the study group were 20, 10 and 0 respectively, the satisfaction rate was 100%, meanwhile those indicators in the control group were 4, 15 and 10 respectively, the satisfaction rate was 66%, The indicator in the study group was significantly higher than that in the control group (Z=4.60, P<0.05).@*Conclusions@#The application of "five-in-one" asthma management model (standardized asthma treatment, asthma diary, PEF monitoring, reasonable diet and physical exercise) for school-age children with asthma can significantly improve lung function, as well as reduce the number of acute asthma attacks. It has a high parent satisfaction, therefore it should be recommended for clinical implementation.

Induction of tanshinone ⅡA on differentiation of human placenta-derived mesenchymal stem cells into cardiomyocytes and its mechanism / 吉林大学学报(医学版)

Objective:To investigate the induction of tanshinoneⅡA (TanⅡA) on the differentiation of human placenta-derived mesenchymal stem cells (hPDMSCs) into cardiomyocytes, and to provide an experimental basis for TanⅡA as a cardiomyocyte differentiation inducer.Methods:The hPDMSCs were treated with different concentrations of TanⅡA (0.1, 0.2, 0.4, 0.6, 0.8, 1.0, 2.0, 4.0, 6.0, 8.0, and 10.0mg·L-1) , and the nontoxic dose of TanⅡA (0.1mg·L-1) was screened by MTT assay for experiment.The hPDMSCs were divided into control group, 5-aza induction (10μmol·L-1) group, and TanⅡA induction (0.1mg·L-1) group.After culture for 20d, the expressions ofα-sarcomeric actin (α-SCA) in the cells in various groups were detected with immunohistochemistry;the positive expression rates of cardiac troponin I (cTnI) in the cells in various groups were detected with immunofluorescence, and the differentation rates of cardiomyocytes were calculated.The expression levels of GATA-binding protein 4 (GATA4) , atrial natriuretic factor (ANF) , cTnI, glycogen synthase kinase-3β (GSK-3β) andβ-catenin in the cells were detected with Western blotting method.Results:The biological characteristics of hPDMSCs accorded with the mesenchymal stem cells.The MTT results showed that when the concentration of TanⅡA was more than 0.1mg·L-1, the cell survival rates were decreased with the increase of concentration;the cells in control group showed a rapid growth trend before 12d, and the proliferation activities of the cells began to decrease on the 12th day.Compared with control group, the cell activities in 5-aza induction group and TanⅡA induction group were significantly decreased (P＜0.05) .The immunohistochemistry staining results showed that the cells in control group didn't expressα-SCA, and the cells in 5-aza induction group and TanⅡA induction group expressedα-SCA, especially in TanⅡA induction group.Compared with control group, the expression levels of GATA4 (t5-aza=2.937, P5-aza＜0.05;tTanⅡA=4.769, PTanⅡA＜0.05) , ANF (t5-aza=3.728, P5-aza＜0.05;tTanⅡA=5.912, PTanⅡA＜0.05) , cTnI (t5-aza=3.623, P5-aza＜0.05;tTanⅡA=7.153, PTanⅡA＜0.05) and GSK-3β (t5-aza=2.995, P5-aza＜0.05;tTanⅡA=5.420, PTanⅡA＜0.05) proteins in the cells in 5-aza induction group and TanⅡA induction group were significantly increased, and the expression levels ofβ-catenin (t5-aza=2.985, P5-aza＜0.05;tTanⅡA=6.951, PTanⅡA＜0.05) protein were significantly decreased;compared with 5-aza induction group, the expression levels of GATA4, ANF, and GSK-3βproteins in TanⅡA induction group were increased (P＜0.05) .Conclusion:TanⅡA can induce the differentiation of hPDMSCs into cardiomyocytes, which has better effect than 5-aza, and its mechanism may be related to inhibiting the Wnt/β-catenin signaling pathway.

Association between blood lipid indices and bone mineral density in a physical examination population / 中华健康管理学杂志

Objective This study aimed to explore the association between blood lipid indices and bone mineral density (BMD).Methods A total of 2,396 individuals (1 198 males and 1 198 females,average age 55.24±12.12 years) who underwent physical examination between April 2015 and April 2016 at the medical examination center of the Inner Mongolia Autonomous Region People's Hospital were recruited.The blood lipid indices,including high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),total cholesterol (TC),and triglycerides,were collected,and BMD at the total hip and its sub-regions was measured.The association between lipid indices and BMD was analyzed using SPSS 16.0 software,with adjustment for the covariates of age,sex,height,and weight.The association between blood lipid indices and BMD was then tested by linear regression analysis.Results Regression analysis demonstrated that in the combined sample with both sexes,HDL-C was negatively associated with total and sub-region BMD (regression coefficients,-0.11 to-0.06;all P＜0.01).LDL-C was negatively associated with femur neck BMD (regression coefficient,-0.01;P=0.01) and Ward's triangle BMD (regression coefficient,-0.01;P＜0.01).TC was negatively associated with trochanter BMD,femoral neck BMD,and Ward's triangle BMD (beta coefficients,-0.02 to-0.01;P＜0.05).In the female group,TC was positively associated with trochanter BMD (regression coefficient,0.06;P＜0.01).In the male group,both LDL-C and TC were negatively associated with femoral neck BMD (regression coefficients,-0.05 and-0.04,respectively;P＜0.05).Conclusion While blood lipid indices are associated with sub-region and total hip BMD,the association pattern and magnitude vary according to body region and sex.

Effect of VEGF165b on biological characteristics of human hepatocellular carcinoma HepG2 cells / 吉林大学学报(医学版)

Objective:To study the effect of vascular endothelial growth factor 165b (VEGF165b) on the biological characteristics of human hepatocellular carcinoma HepG2 cells,and to explore its mechanisr.Methods;The HepG2 cells were divided into blank group (treated with transfection reagent),control group (transfected with pcDNA3.0 expression vector) and pcDNA-VEGF165b group (transfected with pcNDA-VEGF165b).MTT assay was used to detect the survival rate of HepG2 cells;RT-PCR and Western blotting method were used to detect the expression levels of VEGF165b and VEGF165 mRNA and protein in the HepG2cells;Transwell chamber assay was used to measure the migration ability of HepG2 cells.Results:Compared with blank group,there was no significant changes in the expression levels of VEGF165b and VEGF165 mRNA and protein in the HepG2 cells in control group (P＞0.05).Compared with blank group,the expression levels of VEGF165b mRNA and protein in the HepG2 cells in PcDNA-VEGF165b group were significantly increased (P＜0.05),and the expression levels of VEGF165 mRNA and protein were significantly decreased (P＜0.05).There was no significant difference in the survival rates between blank group and control group (P＞0.05).The survival rate of HepG2 cells in PcDNA-VEGF165b group was lower than those in blank group and control group,but the differences were not statistically significant (P＞0.05).The cell migration experiment results showed that there was no significant difference in the migration rate between blank group and control group (P＜0.05).Compared with blank group and control group,the migration rate of HepG2 cells in PcDNA-VEGF165b group was significantly reduced (P＜ 0.05).Conclusion:VEGF165b can inhibit the expressions of VEGF165 mRNA and protein,and VEGF165b has no effect on the proliferation of hepatocellular carcinoma cells;but it can reduce the migration of hepatocellular carcinoma cells.

MRI features and pathological analysis of intracalvarium hemangioblastomas / 中国介入影像与治疗学

Objective To discuss MRI and pathological features of intracranial hemangioblastoma.Methods MRIdata of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively.Results There were 22 cases with single lesion and multiple lesions in 4 eases.And a total of 31 lesions located in the posterior cranial fossa,including 14 lesions in right cerebellar hemispheres,9 lesions in left cerebellar hemispheres,2 lesions in cerebellar inferior vermis,4 lesions in medulla oblongata,and 2 lesions in fourth ventricle.Ninteen lesions showed cystic nodular type,1 lesion was cystic type,11 lesions showed parenchymal type or partial parenchyma type.Cystic lesions showed long T1 and long T2 signal,T1WI of solid area showed slightly long T1 and slightly long T2 signal,of which 12 lesions were slightly shorter T1 signal.Solid areas significantly enhanced,cystic area had no enhancement,but cystic wall of 3 cystic nodular lesions were slightly enhanced.DWI of solid areas showed low signal.MRS showed the peak of Cho obviously increased,and the peaks of Cr and NAA obviously decreased or nearly disappeared,and the high peak of lipids and lactate were observed.Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics,MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.

The research progress of fire needling treatment for vitiligo / 国际中医中药杂志

The study of vitiligo has made a huge progress due to the development of medical technology. Some new treatment idea, methods and integrated therapies have been considered as the trending alternatives. This paper summarized the treatment of different regular treatment combined with fire needling for vitiligo in clinic.

Observation on the Effect of Lidocaine Treated in Three Different Ways on the Prevention of General Anesthesia in the Elderly Patients / 现代生物医学进展

Objective:To compare the three effects of lidocaine in the prevention of general anesthesia in elderly patients.Methods:A total of 120 elderly patients (65-85 years old) underwent anesthesia with general anesthesia (ASA) Ⅰ ～ Ⅱ were randomly divided into thyrocricocentesis group (group H),throat surface anesthesia group (Group Y),intravenous injection group (group J) and control group (group D).Group H was injected with lidocaine for surface anesthesia;group Y used laryngeal spray for laryngeal sprayed lidocaine for surface anesthesia;group J was anesthetized induction of intravenous lidocaine to prevent intubation reaction;group D the control group was not treated with lidocaine.(SBP) and heart rate (HR) were measured before and after induction (T0),tracheal intubation (T1) and 1 (T2),3 (T3) and 5 min (T4),the changes of hemodynamics related indexes were compared.Results:Compared with the same group of T0,the SBP and HR of four groups of T1 moments were significantly decreased (P ＜0.05);In the other three groups,SBP was significantly increased at T2 and T3 (P ＜0.05),HR ofT2 was significantly increased (P ＜0.05);Compared with group D,SBP and HR in group H,Y and J were significantly different at T2,T3 and T4,he difference was statistically significant (P ＜0.05);but there was no statistically significant difference between the three groups (P＞ 0.05).Conclusion:The three ways of lidocaine can be used to prevent the general anesthesia reaction in elderly patients,the effect of three ways is parallel.However,cricothyroid membrane puncture increased the patient's pain,throat spray method increased the cumbersome operation and enhanced the cost of the patient,and intravenous injection method is simple and worthy of popularization and application in clinic.

Change of serum sST2 and copeptin levels in patients with chronic heart failure and their correlation / 心血管康复医学杂志

Objective:To observe change of peripheral serum levels of soluble ST 2 (sST2 ) and copeptin in patients with chronic heart disease (CHF) ,and explore their diagnostic value for heart failure . Methods :A total of 80 CHF patients ,who hospitalized in our department of cardiology from Jun 1st ,2015 to Dec 1st ,2015 ,were selected as CHF group .Meanwhile ,another 30 patients with cardiac neurosis or arrhythmia were regarded as normal cardiac function group .According to NYHA classification ,CHF group was further divided into class II group (n= 22 ) , class III group (n=32) and class IV group (n=26) .Serum sST2 and copeptin levels were measured and compared a‐mong all groups ,and their correlation was analyzed .Results:Compared with normal cardiac function group ,there were significant rise in serum levels of sST2 [(0.27 ± 0.09) ng/ml vs .(1.18 ± 0.81) ng/ml] and copeptin [(1239.64 ± 229.98) pg/ml vs .(1987.16 ± 426.84) pg/ml] in CHF group , P< 0.01 both .Compared with class II group , there were significant rise in serum levels of sST2 [ (0.46 ± 0.17) ng/ml vs .(0.77 ± 0.18) ng/ml vs .(2.31 ± 0.29) ng/ml] and copeptin [ (1625.61 ± 522.13) pg/ml vs .(2103.15 ± 340.74) pg/ml vs .(2194.31 ± 332.97) pg/ml] in class III and class IV group ,and those of class IV group were significantly higher than those of class III group , P<0.05 or <0.01 .Pearson product‐moment correlation analysis indicated that serum sST2 level was significant posi‐tively correlated with serum copeptin level in CHF group (r=0.66 ,P=0.005) .Conclusion:Serum sST2 and copep‐tin levels are closely associated with severity of heart failure .They can be used as markers for heart failure ,which is worth extending .

MRI features and pathological analysis of intracalvarium hemangioblastomas / 中国介入影像与治疗学

Objective To discuss MRI and pathological features of intracranial hemangioblastoma.Methods MRIdata of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively.Results There were 22 cases with single lesion and multiple lesions in 4 eases.And a total of 31 lesions located in the posterior cranial fossa,including 14 lesions in right cerebellar hemispheres,9 lesions in left cerebellar hemispheres,2 lesions in cerebellar inferior vermis,4 lesions in medulla oblongata,and 2 lesions in fourth ventricle.Ninteen lesions showed cystic nodular type,1 lesion was cystic type,11 lesions showed parenchymal type or partial parenchyma type.Cystic lesions showed long T1 and long T2 signal,T1WI of solid area showed slightly long T1 and slightly long T2 signal,of which 12 lesions were slightly shorter T1 signal.Solid areas significantly enhanced,cystic area had no enhancement,but cystic wall of 3 cystic nodular lesions were slightly enhanced.DWI of solid areas showed low signal.MRS showed the peak of Cho obviously increased,and the peaks of Cr and NAA obviously decreased or nearly disappeared,and the high peak of lipids and lactate were observed.Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics,MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.

Analysis of the related factors of postpartum hemorrhage via vaginal delivery / 中国基层医药

Objective To analyze the relevant factors of vaginal delivery postpartum hemorrhage,and discussion how to prevent postpartum hemorrhage.Methods 2 417 maternal women who hospitalized vaginal delivery were selected.Preeclampsia,macrosomia,placental abruption,obesity,premature rupture of membranes,high blood pressure,gestational age,maternal age,maternal time,the number of abortion,scar uterus vaginal delivery,oxytocin induced labor,misoprostol for cervical mature,forceps midwifery,and the correlation of postpartum hemorrhage were analyzed.Results The incidence rate of postpartum hemorrhage was 15.22%.Pre -eciampsia,macrosomia,placental abruption had significant association with postpartum hemorrhage(χ2 =26.75,0.16,22.26,all P 0.05 ).Oxytocin induced labor,misoprostol for cervical mature,forceps midwifery were significantly associated with postpartum hemorrhage(χ2 =45.66,21.77,88.06,all P <0.01 ).Conclusion Prenatal maternal and neonatal weight control,prevention of preeclampsia,placental abruption occurred to prevent postpartum hemorrhage;Intrapartum avoid no indications oxytocin,misoprostol for cervical mature,forceps midwifery and reduce postpartum hemorrhage;Postpartum accurately estimated blood loss, active treatment,avoid serious complications.

Changes of sTWEAK and IL-6 levels in patients with acute coronary syndrome and its clinical signifi-cance / 心血管康复医学杂志

Objective:To explore diagnostic value of soluble tumor necrosis factor - like weak inducer of apoptosis (sTWEAK) and interleukin (IL) -6 concentrations in patients with acute coronary syndrome (ACS) .Methods:A total of 170 ACS patients hospitalized in our hospital from Jan 1st ,2014 to Jun 31st ,2014 were selected as ACS group ,mean‐while ,80 inpatients with stable angina pectoris (SAP) confirmed by coronary angiography (CAG) or coronary CT were se‐lected as SAP group ,and another 80 patients excluded for coronary heart disease (CHD) by CAG were regarded as normal control group .ACS group was further divided into ST elevation myocardial infarction (STEMI) group (n=45) ,non -STEMI (NSTEMI) group (n=52) and unstable angina pectoris (UAP) group (n=73) .Plasma sTWEAK and serum IL‐6 concentrations were compared among all groups .Results:Compared with normal control group and SAP group ,there were significant rise in concentrations of plasma sTWEAK [ (120.32 ± 10.15) ng/L vs .(123.86 ± 15.23) ng/L vs .(140.05 ± 17.51) ng/L] and serum IL‐6 [ (110.34 ± 26.01) pg/ml vs .(112.38 ± 25.74) pg/ml vs .(245.23 ± 68.58) pg/ml] (P0.05. There were no significant difference in plasma sTWEAK and serum IL‐6 concentrations among UAP group ,NSTEMI group and STEMI group , P>0.05 all .Conclusion:Plasma sTWEAK and serum IL‐6 concentrations significantly rise in ACS patients ,which possesses certain diagnostic value for ACS .

Expression and clinical significance of estrogen receptor and progesterone receptor in endometrial carcinoma in aged patients / 中国生化药物杂志

Objective To investigate expression of elderly patients with endometrial cancer of estrogen receptor and progesterone receptor and its clinical significance.Methods 45 elderly patients with endometrial carcinoma from March 2012 to June 2014 were selected as the observation group, over the same period healthy women with normal endometrium as control group, using S-P immunohistochemical method, to detect the expression of receptor and progesterone receptor in two groups.Results In observation group, estrogen and progesterone receptor positive expression rates were 60.00%, 46.67%, compared with control group(93.33%, 86.67%), was significantly lower (P<0.05).Patients with low differentiation of estrogen and progesterone receptor, positive expression rate was 37.50%, 25.00%, was lower than other two groups, but which had no difference.Estrogen, progesterone receptor positive expression rates in progress stage were 35.71%, compared with patients ( 80.65%, 74.19%) in early stage, was significantly lower (P<0.05).The positive expression rate of estrogen receptor in patients with lymph node metastasis was 66.67%, compared with the patients with no metastasis, the difference was not statistically significant.The positive expression rate of progesterone receptor was 76.67%, compared with the non metastasis group (46.67%), and was significantly lower (P<0.05).Conclusion The expression of estrogen and progesterone can reflect the biological behavior and prognosis of endometrial carcinoma in aged patients, and have important significance for clinical diagnosis and treatment.

Studies on big data in domestic libraries / 中华医学图书情报杂志

Papers on big data studies in domestic libraries were analyzed with g index and cluster analysis method with CNKI as the data source,which showed the following hotspots in studies on big data,namely innovative service, subject service and literature resource development , big data storage , big data process , big data mining and analy-sis, big data processing technology and tools.The problems waiting to be solved were pointed out.

Effect of calcitriol combined with losartan on diabetic nephropathy and influence on pulse wave velocity and ankle brachial index / 中国基层医药

Objective To evaluate the effect of calcitriol combined with losartan on diabetic nephropathy in grade Ⅲ and early Ⅳ.Methods 47 patients with diabetic nephropathy were enrolled.Patients were randomly assigned to receive losartan or both losartan and calcitriol according to randomized table for 6 months.At baseline time and after 6 months,the 24-hour urinary protein excretion,estimated glomerular filtration rate (eGFR),serum creatinine(SCr),blood pressure,fasting blood-glucose,serum calcium,serum phosphorus,pulse wave velocity(PWV) and ankle brachial index(ABI) were measured.Results The urinary protein excretion showed that there was significant decrease in the mix-treated group[(824.81 ± 307.84) g/24h vs (390.75 ± 173.51) g/24h,t =10.51,P ＜ 0.01] and the control group [(860.64 ± 313.89) g/24h vs (676.16 ± 297.71)g/24h,t =6.91,P ＜ 0.01].Furthermore,the mix-treated group had the lower proteinuria compared the group given losartan only(t =2.56,P =0.015).No significant differences were observed decrease in estimated eGFR and change in serum calcium,serum phosphorus,PWV and ABI between the two groups.Conclusion Addition of calcitriol to a renin-angiotensin system inhibitor resulted in a safe decrease in proteinuria in patients with diabetic nephropathy.

Relationship between ACE gene (I/D) polymorphism and familial essential hypertension / 心血管康复医学杂志

Objective:To explore the relationship between angiotensin converting enzyme (ACE) gene insertion/dele‐tion (I/D) polymorphism and familial essential hypertension (EH) .Methods :Fluorescent in situ hybridization stai‐ning DNA sequencing test was used to detect ACE gene I/D genotype frequency and allele frequency in 46 familial EH patients (familial EH group) ,64 EH patients without family history (non‐familial EH group) and 43 healthy people (healthy control group) .Results:In healthy control group ,non -familial EH group ,familial EH group ACE gene DD genotype frequency was 11.6% ,32.3% and 37.0% ;distribution frequency of D allele was 33.7% , 52.3% and 57.6% respectively .Compared with healthy control group ,there were significant rise in ACE gene DD genotype and D allele frequency in familial EH group and non -familial EH group (P0.05) .Conclusion:ACE gene DD genotype and D allele may be genetic predisposing genes of patients with essential hypertension ,and there is no significant difference in genetic constituent ratio between familial EH patients and non‐familial EH patients .

Compliance of antihypertensive drug use in patients with hypertension / 中华流行病学杂志

Objective To understand the compliance of antihypertensive drug use in patients with hypertension.Methods A retrospective analysis was conducted among 218 patients with hypertension to understand their drug use compliancy and influencing factors,including side effect of the drugs,drug type,educational level,economic status and drug use length.Results The factors including disease course,drug type,drug use length and drug side effects,the economy status,educational level,awareness of hypertension related knowledge and psychological reaction could significantly influence the compliance of antihypertensive drug use.Among the patients surveyed,86.67％ of them with poor drug use compliance had only an educational level less than senior high school,77.33％ had poor awareness of hypertension related knowledge.Conclusion The antihypertensive drug use compliance in patients with hypertension is directly related to the outcome of the disease in clinical treatment.It is necessary to take effective measures to improve the treatment compliance and maintain normal blood pressure level of the patients.

An investigation of the efficacy of invasive-noninvasive sequential mechanical ventilation in senile patients with severe community-acquired pneumonia / 中华危重病急救医学

ObjectiveTo investigate the efficacy of invasive-noninvasive sequential mechanical ventilation (MV) in senile patients with severe community-acquired pneumonia (CAP).Methods A prospective study was conducted. The patients with severe CAP aged≥ 75 years admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University from November 2012 to July 2014, with refusal to have tracheostomy, were enrolled. All patients meeting the diagnostic criteria of CAP and severe CAP were first admitted into the Department of Emergency, and they were found to need MV without absolute contraindication for noninvasive ventilation (NIV) in RICU. The patients were mechanically ventilated via endotracheal intubation (ETI), and they were randomly divided into invasive-noninvasive sequential MV group (sequential MV group) and conventional MV group. NIV was initiated immediately when patients matched the conditions for early extubation in the sequential MV group. Oxygen therapy (5 L/min) via a Venturi mask was provided when the indications of conventional extubation were met. The baseline data and clinical characteristics were recorded, the risk factors of death were analyzed by logistic regression analysis, and 60-day survival rate was analyzed by Kaplan-Meier curve. Results Ninety-one senile patients with severe CAP were enrolled, among them 28 patients died within 60 days, with a mortality rate of 30.77%. No significant difference in 60-day mortality was found between sequential MV group (n = 44) and conventional MV group [n = 47, 25.0% (11/44) vs. 36.2% (17/47),χ2 = 1.331,P = 0.249]. In the sequential MV group, the incidence of ventilator-associated pneumonia (VAP) was significantly decreased [27.3%(12/44) vs. 55.3% (26/47),χ2 = 7.350,P = 0.007], and the rate of ETI≥2 times was increased [59.1% (26/44) vs. 29.8% (14/47),χ2 = 5.095,P = 0.024] as compared with conventional MV group. Compared with survival group, the patients in non-survival group showed a higher incidence of cerebrovascular disease (60.7% vs. 25.4%,P = 0.002), higher acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (26.46±2.59 vs. 24.41±2.47,P = 0.001), British Thoracic Society confusion, uremia, respiratory rate, blood pressure,≥75 years (CURB-75 score, 4.00±0.47 vs. 3.68±0.53,P = 0.013), a longer total duration of MV (days: 21.18±10.02 vs. 14.56±7.62,P = 0.002), and a higher ratio of ETI≥ 2 times (53.6% vs. 33.3%,P< 0.001). It was revealed by multivariate logistic regression analysis that ETI≥ 2 times and comorbidity of cerebrovascular infarction were independent predictors of a worse outcome in the senile patients [odds ratio (OR) = 9.677, 95% confidence interval (95%CI) = 3.075 - 30.457,P< 0.001;OR = 5.386, 95%CI = 1.781 - 6.284,P = 0.003]. It was showed by Kaplan-Meir survival analysis that ETI times and concurrent cerebrovascular infarction imparted significant effects on the 60-day survival rate (χ2 = 40.805,P= 0.000;χ2 = 4.425, P = 0.035).ConclusionInvasive-noninvasive sequential MV may not improve the outcome of senile patients with severe CAP, and ETI≥ 2 times and concurrent cerebrovascular disorders drastically lowered the survival rate.