Comorbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021 / 中国学校卫生

Objective@#To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association ，so as to provide scientific basis for the establishment of the mechanism of Co-morbidity，Shared Etiology，and Shared Prevention of common diseases in children and adolescents.@*Methods@#A total of 139 630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September,2021. Myopia was determined using distance visual acuity examination and refractive error examination, and obesity was determined according to the BMI classification criteria for overweight, obesity screening of Chinese school age children and adolescents. Used a questionnaire, healthy lifestyles were determined according to the American Heart Association s Healthy Lifestyle Score by totaling the six scores for smoking, alcohol consumption, diet, exercise, screen time, and sleep duration.The χ 2 test was used to compare the association between group differences in the co-morbidity rate of myopia and obesity. The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity, and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity.@*Results@#The prevalence of myopia and obesity co-morbidity among students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%, higher among boys than girls ( 15.5 % vs. 11.8%), higher among those aged 10-12 years old than 7-9,13-15,and 16-18 years old (14.7%,13.7%, 13.3%, 12.0%), higher among other ethnic minorities than Han Chinese and Mongolians (15.3%, 14.0%, 12.5%), higher in urban areas than that in suburban areas(15.3%, 13.0%), and middle economic level tracts were higher than poor and good tracts (14.8%, 12.9 %, 12.6%) ( χ 2=392.37，115.73，62.80，119.02，121.60, P <0.05). Multivariable Logistic regression modeling showed that unhealthy lifestyles ( OR=1.24, 95%CI=1.19-1.29 ) and middle level of lifestyle score ( OR=1.15, 95%CI=1.10-1.19 ) students had higher prevalence of co-morbidity, and the results were statistically significant among both boys and girls, the age groups of 10- 12, 13-15, and 16-18 years old, as well as the Han and Mongolian ethnic groups (all P <0.05).@*Conclusion@#In 2021, the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.

Arterial partial pressure of carbon dioxide combined with Wells score helps predict acute pulmonary embolism / 中华急诊医学杂志

Objective:To explore the clinical value of arterial partial pressure of carbon dioxide (PaCO 2) combined with Wells score in predicting acute pulmonary embolism (PE). Methods:Patients with suspected acute PE admitted to Emergency Department of Beijing Chaoyang Hospital, Capital Medical University from January 1, 2016 to August 31, 2021 were screened. Patients with positive computed tomography pulmonary angiography (CTPA) results were classified as the PE group, and those with negative CTPA results were classified as the non-PE group. Demographic characteristics, symptoms, vital signs, underlying diseases, risk factors for venous thrombosis, arterial blood gas analysis and Wells scores were statistically analyzed and compared between the two groups, and the clinical efficacy of PaCO 2 combined with Wells score in predicting acute PE was evaluated. Results:A total of 1 869 patients with suspected acute PE were screened, and 1 492 patients were finally selected. There were 537 cases in the PE group and 955 cases in the non-PE group. The frequency of chest pain, dyspnea, unilateral lower limb edema, history of PE or deep venous thrombosis, history of surgery or immobilization within 3 months, history of fracture within 3 months, active malignant tumor, elevated Wells score and reduced PaCO 2 in the PE group was significantly higher than that in the non-PE group (all P< 0.05). The area under receiver operating characteristic (ROC) curve (AUC) of Wells score was 0.784 (95% CI: 0.758-0.810), and the sensitivity and specificity of predicting acute pulmonary embolism were 61.64% and 88.48%, respectively. The AUC of reduced PaCO 2 was 0.679 (95% CI: 0.651-0.707), and the sensitivity and specificity of predicting acute pulmonary embolism were 79.89% and 55.92%, respectively. The AUC of reduced PaCO 2 combined with Wells score was 0.837 (95% CI: 0.816-0.858), and the sensitivity and specificity of predicting acute pulmonary embolism were 74.12% and 77.07%, respectively. The AUC of reduced PaCO 2 combined with Wells score was significantly greater than the AUC of Wells score ( P<0.001) and the AUC of reduced PaCO 2 ( P<0.001). Conclusions:The efficacy of PaCO 2 reduction combined with Wells score in predicting acute PE was superior to that of either of them alone. This was a beneficial supplement to the screening of patients with acute PE, and would also help reduce the abuse of CTPA in the emergency department.

Etiologic spectrum of hand, foot and mouth disease and the genetic characteristics of the Coxsackievirus A10 and A6 in Qingdao in 2014 / 中华实验和临床病毒学杂志

Objective@#To investigate the etiology spectrum of hand foot and mouth disease (HFMD) and to analyze the molecular characteristics of Coxsackievirus A10 and A6 in Qingdao in 2014.@*Methods@#Throat swabs of HFMD cases were tested for total enteroviruses (EVs), EV-A71, CV-A16, CV-A10 and CV-A6 by multiplex real time RT-PCR. Other EV serotypes were identified through the sequences of partial VP1 gene. The full-length of VP1 gene of CV-A10 and CV-A6 were amplified and sequenced. The sequences were phylogenetically analyzed using MEGA 5.0 software package.@*Results@#A total of 1727 HFMD patients were detected in 2014 and 11serotypes of enteroviruses were identified. EV-A71(38.0%, 410/1078), CV-A16(28.8%, 311/1078), CV-A10(14.1%, 152/1078)and CV-A6(3.2%, 34/1078)were the most dominant pathogen in 2014 in Qingdao. Proportions of CV-A10 in enterovirus infected children varied dramatically in different ages(χ2=15.19, P=0.001), showing a downtrend with age. Proportion of CV-A10 in inpatients was much higher than that in outpatients(χ2=49.1, P <0.001), while 60% of those inpatients showed nervous system damage symptoms, with pathological reflex or disappearance of physiological reflex. Phylogenetic analysis of complete VP1 sequences showed that all CV-A10 strains identied in this study belonged to genotype C, 71.7% of which located in branch C5; all CV-A6 strains belonged to genotype D while 83.3% of which located in branch D5.@*Conclusions@#EV-A71, CV-A16, CV-A10 and CV-A6 were the prevalent pathogens of HFMD in Qingdao in 2014. CV-A10 was more frequently detected in lower age group with HFMD, which can cause damage to nervous system. Strains of branch C5 in genotype C were the dominant strains of CV-A10 circulated in Qingdao in 2014 while strains of branch D5 in genotype D were the major strains of CV-A6.

Efficacy of stent-assisted and non-stent-assisted coil embolization in the treatment of posterior communicating ruptured wide-necked aneurysms in acute stage / 中国医师进修杂志

Objective@#To compare the safety and efficacy of stent-assisted and non-stent-assisted coil embolization in the treatment of posterior communicating ruptured wide-necked aneurysms.@*Methods@#Data were collected from January 2014 to December 2018 in Dezhou People′s Hospital where patients with ruptured posterior communicating artery wide-necked aneurysm were treated by interventional embolization. All patients were admitted to hospital for subarachnoid hemorrhage, and the diagnosis of posterior communicating artery aneurysm of internal carotid artery was confirmed within 7 d of admission, and the patients were treated with interventional embolization. To compare the perioperative complications, mortality and clinical prognosis between stent-assisted embolization group (stent group, 45 patients) and non-stent-assisted embolization group(non-stent group, 38 patients) was analyzed.@*Results@#The incidence of ischemic complications in stent group was 20.0% (9/45), in nonstent group was 5.3% (2/38), and there was significant difference (χ2=3.892, P < 0.05). The overall complication rate in stent group was 28.9%(13/45), in non-stent group was 10.5%(4/38), and there was significant difference (χ2=4.265, P < 0.05). There was no significant difference in bleeding complications, symptomatic vasospasm, mortality and clinical prognosis between the two groups (P > 0.05).@*Conclusions@#In the acute stage of posterior communicating artery aneurysm rupture, stent-assisted embolization has a high rate of thrombotic complication, and the clinical application needs to be cautious. Both the stent-assisted and non-stent-assisted embolization have a good clinical outcome in the treatment of wide-necked posterior communicating aneurysms in the acute phase.

TAZ promoting angiogenesis and its mechanism in gastric cancer / 中国肿瘤临床

Objective: To determine the expression of TAZ and its role in angiogenesis in gastric carcinoma. Methods: Immunohistochemical staining was performed to investigate the expression of TAZ and to determine whether a direct relationship exists between TAZ and β-catenin. Transfection with TAZ overexpression plasmid in MKN28 cells was conducted to induce exogenous expression of TAZ and a TAZ knockdown plasmid was transfected into MGC803 cells to reduce TAZ levels. The effects on endothelial cell formation, proliferation, and migration were determined by Matrigel three-dimensional culture, MTT proliferation assay and Transwell migration assay. In addition, the expression of TAZ and β-catenin in transfected gastric cancer cells was detected by Western blot. Results: Immunohistochemistry showed that TAZ protein was expressed in 64 of 150 gastric cancer sample tissues (43%), TAZ was localized in the nucleus, and its expression was associated with tumor grade, TNM stage, metastasis, and microvessel density (MVD) (P<0.05). In addition, the expression frequency of β-catenin in the TAZ positive group was 67.2%, which was significantly higher than that in the TAZ negative group, and the expression of TAZ was positively correlated with β-catenin. After transfection, TAZ overexpression increased the expression of β-catenin and enhanced HUVECs tube formation, proliferation, and migration. In the MGC803 cells transfected with the knockdown plasmid, β-catenin levels were decreased and HUVECs motility was inhibited. Conclusions: TAZ may promote angiogenesis in gastric cancer by promoting β-catenin expression.

Assessment of cerebrovascular reactivity in obstructive sleep apnea hypopnea syndrome with transcranial Doppler ultrasonography / 中华老年心脑血管病杂志

Objective To investigate the value of transcranial Doppler ultrasonography(TCD)for assessing the cerebrovascular reactivity (CVR)in obstructive sleep apneahypopnea syndrome (OSAHS)patients.Methods Sixty OSAHS outpatients and inpatients admitted to our neurology department from August 2015to December 2016served as an OSAHS group,then further divided into mild group(n=15),moderate group(n=27)and severe group(n=18)according to apneahypopnea index(AHI).Meanwhile,20healthy individuals served as a control group.They underwent TCD on admission to detect their CVR,including the average velocity of cerebral artery blood flow(Vm)during calm breathing and after breath holding.The breath holding index(BHI) was calculed.The relationship between BHI and CVR was analized by pearson linear correlation analysis. Results There was no statistically significant difference in Vm during calm breathing between the OSAHS and control groups(73.64±9.87cm/s vs 72.79±8.68cm/s,P＞0.05).Both of Vm after breath holding and BHI of the OSAHS group were lower than those of the control group(88.63±6.65cm/s vs 93.26±7.12cm/s,0.71±0.16 vs 0.93±0.37,P＜0.01).Both of Vm after breath holding and BHI of the mild group were the highest,while the severe group had the lowest values and the moderate group was in between(P＜0.05).No significant correlation was found between AHI and Vm during calm breathing(r=0.197,P=0.052),while AHI was negatively correlated with Vm after breath holding and BHI(r=-0.557,P =0.011;r=-0.605,P=0.000).Conclusion TCD can detect CVR changes in OSAHS patients,whose Vm after breath holding and BHI decrease significantly.The more severe the OSAHS is,the lower the CVR is.

Diagnostic value of different puncture needles in endoscopic ultrasonography guided aspiration for pancreatic solid masses / 中华胰腺病杂志

Objective To compare the diagnostic value of two different types of puncture needles guided by endoscopic ultrasonography for pancreatic solid masses.Methods The clinical data of 176 pancreatic solid tumor patients who received endoscopic fine needle aspiration (EUS-FNA) in Shanghai Changhai Hospital from January 2018 to December 2018 was retrospectively analyzed.The acquired specimens were analyzed by cytology and histology.The patients were divided into 25G acupuncture needle group (25G group,63 cases) and 22G acupuncture needle group (22G group,113 cases) according to the type of acupuncture needle.The satisfaction score of specimen,the positive rate of puncture and diagnostic accuracy of malignant masses were compared between the two groups.Results The satisfaction of specimen in 25G group (44.6 ± 18.8) was higher than 22G group (20.5 ± 18.1),and the differences were statistically significant (P =0.047).The positive rates of puncture were 79.3％ and 85.8％,respectively,and the differences were not statistically significant (P =0.267).Thirty nine of 176 patients underwent surgical resection.Thirty three cases of malignant were diagnosed pathologically.The accuracy of 25G and 22G group was 81.3％ and 86.9％,respectively,and the differences were not statistically significant.Conclusions The accuracy and positive rate of 25G and 22G needle in the diagnosis of pancreatic solid masses are comparable,but compared with 25G needle,22G needle can obtain more tissue specimen.

Efficacy of stent-assisted and non-stent-assisted coil embolization in the treatment of posterior communicating ruptured wide-necked aneurysms in acute stage / 中国医师进修杂志

compare the safety and efficacy of stent-assisted and non-stent-assisted coil embolization in the treatment of posterior communicating ruptured wide-necked aneurysms. Methods Data were collected from January 2014 to December 2018 in Dezhou People′s Hospital where patients with ruptured posterior communicating artery wide- necked aneurysm were treated by interventional embolization. All patients were admitted to hospital for subarachnoid hemorrhage, and the diagnosis of posterior communicating artery aneurysm of internal carotid artery was confirmed within 7 d of admission, and the patients were treated with interventional embolization. To compare the perioperative complications, mortality and clinical prognosis between stent-assisted embolization group (stent group , 45 patients) and non-stent-assisted embolization group(non-stent group , 38 patients) was analyzed. Results The incidence of ischemic complications in stent group was 20.0% (9/45), in non-stent group was 5.3% (2/38), and there was significant difference (χ2＝3.892, P < 0.05). The overall complication rate in stent group was 28.9%(13/45), in non-stent group was 10.5%(4/38), and there was significant difference (χ2＝4.265, P < 0.05). There was no significant difference in bleeding complications, symptomatic vasospasm, mortality and clinical prognosis between the two groups (P >0.05). Conclusions In the acute stage of posterior communicating artery aneurysm rupture, stent-assisted embolization has a high rate of thrombotic complication, and the clinical application needs to be cautious. Both the stent-assisted and non-stent-assisted embolization have a good clinical outcome in the treatment of wide-necked posterior communicating aneurysms in the acute phase.

Etiology and clinical analysis of central nervous system infection caused by Coxsackievirus B5 in severe hand, foot and mouth disease in Qingdao City, 2013-2014 / 中华预防医学杂志

Objective@#To illuminate the gene characteristics and clinical characterization of Coxsackievirus B5 (CV-B5) strains isolated from patients with sevre hand, foot and mouth disease (HFMD) in Qingdao city.@*Methods@#A total of 1 844 patients of HFMD were consecutively admitted to Qingdao Women and Children's Hospital from 2013 to 2014. Information of the study population described above was collected retrospectively. The samples were collected from at least 1 site (throat swab, cerebrospinal fluid), which viral nucleic acid extracted and the entire VP1 gene sequences of CV-B5 isolates were amplified and sequenced, then the homology and phylogeny analysis were conducted by MEGA7.0. The prototype Faulkner strain and other VP1 amino acid sequences were derived from the GenBank database.@*Results@#A total of 8 CV-B5 positive cases were obtained, including 4 males and 4 females; 6 severe hospitalized cases and 2 outpatients. The age of 6 hospitalized patients ranged from 3 to 48 months, with a median of 26 months. For the six inpatients, fever, convulsions vomiting, diarrhea and rash were the main clinical manifestation, and all combined with viral encephalitis. Compared with the prototype strain Faulkner, in the VP1 region,the nucleotide and the amino acid homologies was 77.3%-78.8% and 95.5%-97.0% respectively. Five out of the six severe cases with substitution of serine (S) to asparagine (N) at amino acid site 95 in the VP1 region. The sequences of 8 CV-B5 strains were classified into genogroup D.@*Conclusion@#Hand, foot and mouth disease associated with CV-B5 virus infection can result in nervous system involvement and the main complication was viral encephalitis. The CV-B5 strains associated with severe hand, foot and mouth disease had high nucleotide homology and present a certain regional aggregation.

Genetic characteristics of CV-A12 VP1 region and clinical manifestations of CV-A12-associated se-vere hand, foot and mouth disease in Qingdao / 中华微生物学和免疫学杂志

Objective To investigate the molecular characteristics of coxsackievirus A12 ( CV-A12) and to understand the clinical manifestations of severe hand, foot and mouth disease (HFMD) caused by CV-A12 in Qingdao. Methods Throat swabs of HFMD, herpangina and influenza-like cases from 2011 to 2016 were detected for enteroviruses ( EVs) in Qingdao. Human rhabdomyosarcoma ( RD) and human la-ryngeal carcinoma (Hep-2) cells were used for virus proliferation and CV-A12 strains were identified through a semi-nest RT-PCR. The full-length of VP1 gene of CV-A12 strains was sequenced and phylogenetically an-alyzed using MEGA7. 0 software package. Clinical data of severe HFMD cases positive for CV-A12 were col-lected and analyzed. Results CV-A12-positive HFMD, herpangina and influenza-like cases accounted for 0. 3％(18/6798), 1. 2％(2/169) and 0. 1％(1/676) in Qingdao, respectively. Most of the HFMD caused by CV-A12 in children were mild before 2013 (84. 6％, 11/13), while hospitalized severe cases with neurological symptoms (100％, 5/5) became more common after 2013. Phylogenetic analysis of the VP1 region revealed that CV-A12 strains worldwide could be divided into two genotypes, A and B. All of the CV-A12 strains successfully sequenced in Qingdao from 2011 to 2016 belonged to genotype B, and 88. 9％(16/18) of them belonged to subgenotype B2. All hospitalized severe cases of CV-A12-caused HFMD after 2013 were associated with strains in branch B2b of subgenotype B2. Conclusion CV-A12 was one of the pathogens causing HFMD, herpangina and influenza-like illness in children in Qingdao. Strains of genotype B2 were the predominant CV-A12 strains circulating in Qingdao in recent years. CV-A12-caused HFMD might complicated by nervous system damage.

The value of immunohistochemical indicators in staging and grading of non-muscle in-vasive bladder cancer / 中国肿瘤临床

Objective:To evaluate the staging and grading valut of Ki-67,TP53,Cyclin D1,HER-2 in non-muscle invasive bladder cancer (NMIBC).Methods:Retrospective analysis was performed on the clinicopathologic characteristics of 184 Ta,T1 stage NMIBC patients who underwent transurethral resection of the bladder(TURBT)at the Tianjin Medical University Cancer Institute and Hospital from January 2015 to December 2016.The expression of Ki-67,TP53,Cyclin D1 and HER-2 was evaluated by immunohistochemical assay.Then,the association between immunohistochemical indicators expression,staging and grading of NMIBC were assessed by univariate analysis.The independent factors of staging and grading in NMIBC were assessed by multivariate Logistic analysis,and their sensitivity and specificity were compared. Results:Univariate analysis showed a positively correlation between tumor size and T1 and G3 of NMIBC(P<0.05).The high expression of Ki-67 and HER-2 was positively correlated with tumor staging and grading(P<0.05)in T1,G3 NMIBC tissues.The high expression of CyclinD1 was negatively correlated with tumor staging and grading(P<0.05)in Ta stage tissues.Logistic multivariate analysis showed that high expression of Ki-67 and low expression of Cyclin D1 were independent predictors of T1 in NMIBC.High expression of Ki-67,high expression of HER-2 and low expression of Cyclin D1 were independent predictors of G3 in NMIBC.The Ki-67 expression had high sensitivity and specificity for predicting tumor staging and grading in NMIBC.The sensitivity were 81.40%(48/59)and 76.80%(96/125),and the specificity were 76.83%(63/82)and 86.30%(88/102),respectively.Conclusions:Detection of Ki-67 expression could predict staging and grading in NMIBC,and provide the basis for appropriate treatment.

Fabrication and application of two-dimensional code slice specimen in histology / 中华医学教育探索杂志

Two-dimensional code technology is widely used in daily life,and its application is relatively rare in medical education.Students organized write the Chinese and English slices' information by the way of extracurricular teaching activities,and two-dimensional code transformed from slices' information as label was pasted onto slice to made slice specimen with two-dimensional code.The students can quickly and accurately read the slice information by scanning the two-dimensional code.This practice can stimulate students' interest in learning and creative ability.It not only creates convenient conditions for the opening of the histology experiment and the independent study of the students,but also provides a way of thinking for the information management of the experimental teaching.

Effect of postoperative compression cryotherapy at different durations on patients with shoulder joint arthroscopy / 中国实用护理杂志

Objective To explore the effects of postoperative compression cryotherapy at different durations on patients underwent shoulder joint arthroscopy. Methods Sixty patients underwent shoulder joint arthroscopy were divided into 3 study groups by random digits table method: group 1 (20 cases), group 2(20 cases),group 3(20 cases).The study populations with routine care were offered compression cryotherapy at different durations:group1 was managed with 30 mins postoperative cryotherapy every 8 h within 24 h, group2 with the same treatment within 48 h, group 3 within 72 h. Visual Analogue Scale (VAS)was used to assess preoperative as well as postoperative pains,and perimeters of three parts(20 cm and 25 cm above lateral epicondyle of humerus,and armpit)were measured to assess swelling at different durations-preoperatively and 24,48,72 h after operation. Results There was no significant difference in the scores of VAS at 24 h after operation among three groups(P>0.05).The score of VAS at 48 h after operation in group 1,group 2,group 3 was(3.65±1.23),(2.65±1.50),(1.80±1.11)points,and there was significant difference(F=6.838,P=0.002),a further comparison,there was significant difference between the two groups(P<0.05).The score of VAS at 72 h after operation in group 1,group 2,group 3 was(3.50± 1.10),(2.65±1.50),(2.05±1.10)points,and there was significant difference(F=10.366,P=0.000),a further comparison, there was significant difference between the two groups (P<0.05). There was no significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus, and armpit at 24 h after operation among three groups(F=1.208, 2.097, 0.427, P>0.05). There was significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus,and armpit at 48 h after operation among three groups(F=15.577, 17.128, 5.109, P<0.05), a further comparison, there was significant difference between group 1 and group 2, group 1 and group 3(P<0.05), but there was no significant difference between group 2 and group 3(P>0.05).There was significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus,and armpit at 72 h after operation among three groups(F=24.159, 20.963, 8.496, P<0.05), a further comparison, there was significant difference between the two groups (P<0.05). Conclusions 72 h postoperative compression cryotherapy for patients underwent shoulder joint arthroscopy can be the most statistically significant factor to alleviate pain and swelling effectively,beneficial to early functional exercise and shoulder joint recovery.

Application of mean difference method in students' self-and peer-assessment / 中华医学教育探索杂志

Objective To explore an effective evaluation method for students' self-and peer-assess-ment. Methods The students of 6 groups participating in extracurricular teaching activities were selected as research subject. Traditional method (final score = mean score of group/2 + teacher's score/2) and mean difference method [final score=teacher's score-(mean difference of group-mean difference of all groups)] were used to calculate final score of each group, and effect of two methods were compared. Results Scores of most groups were higher than the teacher's scores, and high scores were given by group 3 in self- and peer-assessment. The final score of all groups were higher than teacher's scores in traditional method. Compared with teacher's scores, final scores increased significantly in group 1, 4, 5 below mean difference, final score decreased significantly in group 2, 3 above mean difference, and final score did not differ in group 6 equal to mean difference in mean difference method. Conclusion The mean difference method can reflect the effect of student's self- and peer-assessment, and guide student to make objective and accurate evaluation. It is a more reasonable and scientific evaluation method for self-and peer-assessment.

Effects of Angelicae Sinensis Radix and Angelicae Sinensis Radix Polysaccharides on Immune Function Injury Induced by X Ray in SD Rats / 中国中医药信息杂志

Objective To investigate the protective effects of Angelicae Sinensis Radix and Angelicae Sinensis Radix polysaccharides on immune function injury induced by X rays in SD rats. Methods Forty SD rats were randomly divided into control group, model group, Angelicae Sinensis Radix Decoction group, Angelicae Sinensis Radix polysaccharide group and positive medicine group. After routine feeding for 14 day, each administration group was given relevant medicine for gavage, while control group and model group were given the same amount of distilled water for gavage, once a day for 7 d. From the 8th day, except for the control group, the rats in the rest of groups were subjected to whole-body X ray irradiation, continuous exposure to 2 d; the total absorbed dose was 6 Gy. The rats were killed by femoral artery after irradiate 3 d. The WBC count, RBC, HGB, and PLT in peripheral blood were observed by blood routine test; the number of nucleated cells in the bone marrow was observed by nucleated cell count method; the pathological changes of spleen were observed by HE staining under microscope; the contents of IFN-γ and IL-4 in serum were detected by ELISA. Results Compared with the control group, the spleen index WBC, number of bone marrow nucleated cells and serum contents of IL-4 and IFN-γ in model group was significantly lower (P<0.05), The contents of RBC and HGB increased (P<0.05). Compared with the model group, WBC, number of bone marrow nucleated cells, and the contents of IL-4 and IFN-γ in serum of each administration group increased significantly (P<0.05); RBC and HGB decreased significantly (P<0.05). Conclusion Angelicae Sinensis Radix and Angelicae Sinensis Radix polysaccharides have protective effects on the immune function injure induced by X ray in SD rats.

Reliability and validity of four-level and three-district triage standards in emergency department: a randomized sampling cross-sectional study of 1106 adult patients / 中华危重病急救医学

Objective To evaluate the reliability and validity of three-district and four-level triage standards in adult emergency department.Methods A randomized sampling cross-sectional study was conducted. A total of 1106 emergency adult patients admitted to the Second Xiangya Hospital of Central South University in Hunan Province from December 2015 to April 2016 were enrolled. The triage was independently performed by 12 nurses according to the emergency triage criteria. Based on the shift style, 2 nurses were assigned to each shift as the triage guider and assistant respectively, who did the triage for every patient independently. The clinical data were recorded as follows: the demographic data, emergency information (triage time, emergency way, complaints, vital signs, and conscious state), triage information (triage level, admitted department), waiting time, treatment time, destination and outcomes. The reliability of three-district and four-level triage standards was analyzed by Spearman correlation, and the receiver operating characteristic curve (ROC) was plotted to evaluate its validity.Results ① A total of 254 patients were enrolled for reliability evaluation in the first 2 weeks of the study. The overall internal consistency rate ofthe triage instructors and the triage assistants was 72%, the total Kappa value was 0.686 [95% confidence interval (95%CI) = 0.608-0.757,P < 0.001]. ② Validity analysis showed that in the 1125 emergency patients collected during the study, a total of 1106 patients were finally enrolled in the analysis excluding the patients who refused to accept the treatment, whose data was incomplete and who was diagnosed as prehospital death. With the increase of three-district and four-level triage level, a significant increase was showed in the waiting time of patients, the treatment time, and the retention rate; on the contrary, the salvage rate, the hospitalization rate, hospitalization time, emergency mortality, in-hospital mortality and total mortality rate were decreased [the waiting time of patients from triage level 1 to 4 (minutes) was 1.00 (1.00, 1.75), 1.00 (1.00, 5.00), 8.00 (2.00, 23.00), 10.00 (4.50, 28.00), the treatment received time (minutes) was 1.00 (1.00, 10.00), 6.00 (1.00, 23.00), 48.00 (25.00, 105.00), 87.00 (41.00, 140.00), the retention rate was 4.76%, 10.94%, 55.91%, 42.86%, the salvage rate was 95.24%, 87.94%, 20.81%, 0%, the hospitalization rate was 57.14%, 70.98%, 53.62%, 20.41%, the hospitalization time (days) was 19.50 (9.75, 28.00), 11.00 (8.00, 17.00), 12.00 (8.25, 17.00), 10.50 (8.75, 15.25), the emergency mortality was 19.05%, 6.92%, 1.41%, 0%, the in-hospital mortality was 16.67%, 15.09%, 6.25%, 0%, and the total mortality rate was 28.57%, 17.63%, 4.76%, 0%, allP < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of three-district and four-level triage standards for identifying patients needed an immediate intervention (triage level 1 to 2) was 0.854 (95%CI = 0.831-0.878), and the sensitivity and specificity were 78.62% and 89.89%, respectively, the misdiagnosis rate was 10.11%, and the missed diagnosis rate was 21.38%.Conclusion The three-district and four-level triage standards were proved to be a reliable and valid instrument, which can distinguish the severity of the disease and help nurses to triage patients correctly.

Picroside Ⅱ plays a neuroprotective effect by inhibiting cyto C/caspase-9/caspase-3 signal pathway following ischemia/reperfusion injury in rats / 中国药理学通报

Aim To investigate the neuroprotective effect of picroside Ⅱ(PIC)on cyto C/caspase-9/caspase-3 signal pathway following ischemia/reperfusion(I/R)injury in rats.Methods Atractyloside(Atr)was selected as negative control,cyclosporin A(CsA)was selected as positive control,and PIC was selected as the treatment medicine.The I/R model was made by inserting a monofilament suture into internal carotid artery for 2 h,and then reperfused for 24 h.The cerebral infarction volume was detected by TTC staining,and the expression of cyto C,caspase-9 and caspase-3 were determined by immunohistochemical assay and Western blot.Results In model group,the cerebral infarct volume was obviously large;the expression of cyto C,caspase-9 and caspase-3 was increased significantly more than that in sham group(P<0.05).In PIC group,the cerebral infarct volume was significantly improved;the expression of cyto C,caspase-9 and caspase-3 was significantly decreased than that in model group(P<0.05).In Atr+PIC group,the rat infarction volume was reduced,and the expression of cyto C,caspase-9 and caspase-3 was significantly decreased than that in Atr group(P<0.05).Conclusion The mechanism of PIC inhibiting neuron apoptosis in focal cerebral I/R rats might be through down-regulating the expression of cyto C,caspase-9 and caspase-3.

Study on the risk of HIV transmission by heterosexual contact and the correlation factors / 中南大学学报(医学版)

OBJECTIVE@#To understand the associated factors on human immunodeficiency virus (HIV) transmission via heterosexual contact and to provide evidence for decision-maker for prevention of HIV.
@*METHODS@#Questionnaire survey was conducted in 250 HIV-positive persons to understand their socio-demographic characteristics and sexual behavior. Meanwhile, 431 persons who had heterosexual contact with the HIV carriers were traced to their HIV infection status. The factors associated with continued HIV transmission were reviewed by case-control analysis.
@*RESULTS@#Among the 432 persons, 59 were HIV-positive because of heterosexual contact. The secondary attack rate and the growth rate was 13.7% (59/431) and 0.236 (59/250), respectively. The factors associated with the spread of HIV included: the degree of knowledge on HIV/AIDS, psychological reflection after infection, the condition for condom usage among spouses, and regular sexual partners or non regular sexual partners.
@*CONCLUSION@#The secondary attack rate and the growth rate of HIV transmission by heterosexual contact are high. Improvement of the knowledge about HIV/AIDS prevention and control, enhancement of psychological education and promotion of condom usage can reduce the risk for continued HIV transmission.

Characteristics of HIV's sexual behavior and their effect on the secondary transmission rate / 中南大学学报(医学版)

OBJECTIVE@#To analyze the sexual behavior characteristics of the sexually transmitted HIV-positive people and to estimate the secondary transmission rate.
@*METHODS@#Field investigation and literature review were conducted among sexually transmitted HIV-positive people to collect general information during the last 6 months before notification of HIV infection. A mathematical model was used to estimate the secondary transmission rate.
@*RESULTS@#A total of 769 HIV-positive people were recruited for the study, 186 of them were women, 286 were men who have sex with women (MSW), 242 were men who have sex with men (MSM) and 55 were men who have sex with men and women (MSMW). During 6 months, the average sex partner among these 4 groups were 2.29, 1.61, 3.32 and 4.10, respectively; the sexual behavior frequency were 26.03, 20.97, 14.77 and 25.51, respectively; the rates of non-use of condom were 74.14%, 73.53%, 59.60% and 72.06%, respectively; the secondary transmission rate were 0.0095, 0.0151, 0.1759 and 0.1985, respectively. Under constant conditions of other factors, the secondary transmission rates decreased by 30.13%-82.00%, 23.00%-49.51%, and 16.10%-19.09%, respectively, if there was a reduction in 1 sex partner, 1 time/month for the sexual frequency and 20% of rate for non-use of condom.
@*CONCLUSION@#The HIV secondary transmission from MSMW HIV-positive people to general population was the highest. Change in sexual behavior of the HIV-positive people can decrease the HIV secondary transmission rate significantly.

Characteristics of stem cell spheres of the renal carcinoma cell lines SN12C and 786-O grown in serum-free culture medium / 中国肿瘤临床

Objective:This study aims to determine the suitable cell line to be used in isolating cancer stem cells by comparing the characteristics of tumor stem cells in renal cell carcinoma cell lines SN12C and 786-O. Methods:The rate of sphere formation in SN12C and 786-O cells was determined in serum-free medium (SFM). The expression levels of CD133, CD44, Nanog, and Oct3/4 were investi-gated through flow cytometry. Moreover, the tumorigenicity of spheroid cell that originated from SN12C and 786-O cells was investi-gated in vivo by using a tumor model. Results:The average time of sphere formation in SFM was shorter in SN12C than in 786-O (5 days vs. 7 days). Moreover, the expression levels of CD133, CD44, Nanog, and Oct3/4 in SN12C and 786-O significantly differed (P<0.05). When transplanted in nude mice, 786-O spheres were less tumorigenic than SN12C spheres. Conclusion:SN12C spheres possess the main defining characteristics of renal cancer stem cell;thus, SN12C is the more suitable cell line to be used to isolate cancer stem cells compared with 786-O.