Study on the current status of postgraduates training in public health and preventive medicine in China in 2016 / 中华预防医学杂志

To investigate the current status of postgraduates training in public health and preventive medicine in China. In this study, a questionnaire survey was conducted among directors of enrollment and teaching in 22 universities with postgraduate admission qualifications in corresponding disciplines nationwide. In 2016, full-time postgraduates were mainly academic masters. In addition to the graduate entrance examination, the common enrollment mode in colleges was to enroll a high qualified student with recommendations from relevant experts or institutions and an exemption from entrance examination (20/22). The emphasis on training contents between academic and public health master was different. Currently, the scale of public health postgraduate enrollment in public health and preventive medicine in China is stable, and the training program is reasonable, but there is an issue of monotonous model and uneven distribution of enrollment.

Application experience of integrated nursing mode for extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident / 中华烧伤杂志

Objective@#To explore the application experience of integrated nursing mode in the treatment of extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident.@*Methods@#On August 2nd, 2014, 35 extremely severe burn patients involved in the August 2nd Kunshan factory aluminum dust explosion accident were admitted to Wuxi Third People′s Hospital, including 18 males and 17 females, aged 21-50 years. According to the characteristics of the wounded, the situation of the nursing staff, and the characteristics of the nursing work, the integrated nursing mode was constructed and implemented to improve overall nursing quality. The standardized management measures such as cluster management of facilities and equipments in wards, improving and unifying nursing system, standardized training, drawing up " Nurses Compulsory Reading" , optimizing nursing shift handover and so on were taken. Professional quality control groups such as continuous renal replacement therapy (CRRT) group, static therapy group, airway group, and burn group were established, and standardized writing nursing group, wound nursing group, psychological nursing group, and enteral nutrition nursing group were set up under burn group. The treatment outcomes of patients and effects of nursing management, nursing methods, and specialty nursing were recorded.@*Results@#Twenty-seven patients survived the shock period, infection period, and recovery period smoothly. The success rate of rescue was 77.14%. During the treatment, the ward was in good order. The implementation rate of disinfection and isolation system, the completion rate of shift handover, the standard rate of intravenous therapy, the implementation rate of bed head elevation, the correct rate of posture placement, and the success rate of CRRT were all 100%. Successful turn over of rotating bed without interruption of CRRT for 24 hours was implemented in two patients. In many cases, the single filter for hemodialysis continuously run for more than 72 hours. The airway mucosa of patients healed around 20 days after injury. No adverse nursing events such as tracheal cannula detachment/blockage, respiratory distress, atelectasis, lung consolidation, aspiration by mistake, rotating bed rollover, ear chondritis, nasal septal pressure ulcer, vacuum sealing drainage (VSD) catheter blockage, VSD dressing leakage, severe abdominal distension/diarrhea, non-planned extubation/blockage of various intravenous treatment catheters implanted into deep veins and arteries were observed.@*Conclusions@#The integrated nursing mode significantly optimizes the nursing work process in the treatment of extremely severe mass burns, clarifies the duties of nursing staff, and improves the quality of nursing. This mode is worthy of taking reference by other burn treatment units.

Investigation on the current status of the cultivation of the master of public health (MPH) in colleges in China / 中华预防医学杂志

In order to understand the status of the cultivation of the masters of public health (MPH) in colleges in China and improve the cultivation model, an electronic questionnaire survey were conducted among 22 schools of public health in colleges. The result showed that the size and the enrolment scale of Chinese MPH students were relatively small, and the training objectives were still unclear. There was no obvious difference between the curriculum setting for MPH and academic master degree. The practical skill-oriented courses and emergency response ability of public health practice were insufficient. The cultivation model of MPH should be improved in future.

Analysis of the contradiction between the supply and demand of Chinese graduate students′ emergency professional ability in public health and preventive medicine in China / 中华预防医学杂志

In order to underst and the status of health emergency personnel training development and raising coping measures, electronic questionnaire surveys were conducted among 22 colleges and universities in different region of China. The result showed that colleges universities in China invested less in the training of emergency personnel. It is different and emphasized particularly for the cultivation of emergency professional ability among different types of public health students. Universities and employer hold relative evaluation of students′ emergency professional ability with distinct regional differences.

Tumor necrosis factor-alpha and procalcitonin level variations in the serum and their effects on organ function in patients with severe acute pancreatitis during infected stage

To investigate the changes of tumor necrosis factor-alpha [TNF-alpha] and procalcitonin [PCT] in the serum and their effects on organ function in patients with severe acute pancreatitis [SAP] during infected stage, aiming to provide a reference to individual treatment. 32 patients with SAP during infected stage admitted to the Digestive Department of The Second Affiliated Hospital of Zhengzhou University from April 2014 to May 2015 and also 30 volunteer normal people were recruited in this study. And 26 patients detected with positive pathogenic bacteria were grouped into group A and another 6 patients with negative pathogenic bacteria into group B and 30 normal people into group C. And TNF-alpha and PCT level in the serum and the liver, kidney and lung function and the relationship between them of all the included people were compared and analyzed. the serum TNF-alpha level detected in the bile, urine and the surface of wound in group A was much higher than that in group B [P<0.05]; and there was no significant difference in PCT between group A and group B; and TNF-alpha and PCT level in the serum in group A and group B were remarkably higher than group C [P<0.05]. In addition, the organ function [the liver, kidney and lung] in the patients with high TNF-alpha level [High TNF-alpha group] was significantly different from the patients with low TNF-alpha level [Low TNF-alpha group] [P<0.05]. And various organ functional indexes increased significantly in the patients with high PCT level [P<0.05]. There were two kinds of TNF-alpha level [high level and low level] in the patients during SAP general infection stage, and the high level may reduce various organ function, the low level can contribute to the regular inflammatory response. And there is a high PCT level in the early SAP infection stage, which can be used to predict the patients' condition

Preliminary study on expression profiles of plasma circulating microRNAs in patients with sepsis and healthy control people / 实用医学杂志

Objective To identify the circulating miRNAs which can be used to evaluate the diagnosis and prognosis of sepsis by microarray and quantitative real-time PCR,and to predict target genes of miR-519c-5p by bioinformatics analysis. Methods Three sepsis patients,3 septic shock patients and 3 normal controls were enrolled in this study. Plasma RNA was extracted,and was used for hybridized by miRCURY LNATMmicroRNA Array.The signals were scanned and used to conduct differential expression profilings and cluster analysis.Further-more,we performed qRT-PCR to confirm the expression of miRNAs chosen from microarray screening. We used the miRanda and Targetscan databases to predict target genes of the concerned miRNAs and used KEGG database to analyze the related pathways. Results Fifty-seven and 11 miRNAs were observed significantly upregulated in sepsis and septic shock patients,respectively(fold change≥2.0;P<0.05).qRT-PCR results showed that miR-519c-5p was significantly upregulated in patients with sepsis or patients with septic shock compared with the healthy normal controls(P<0.05).Twenty-nine target genes of miR-519c-5p were predicted by the bioinformatics analysis,and 7 potential target genes participate in the sepsis-related pathways.MiR-519c-5p might be a potential positive regulator for the critical cell cycle control gene of MAP2K4,contributing to the vascular endothelial cells apoptosis via MAPK signaling pathway. Conclusions We demonstrated that the plasma level of miR-519c-5p can be used for the diagnosis of sepsis and miR-519c-5p may be a potential therapeutic target for sepsis.

Bacteriological analysis and treatment strategy in patients with biliary sepsis / 中华肝胆外科杂志

Objectives To access the bacteriology in patients with sepsis due to biliary tract infection to provide a basis for empirical selection of proper antibiotic treatment.Methods This is a single-center retrospective study on 214 patients with biliary tract infection admitted from August 2014 to July 2016 to the surgical intensive care units (ICU) of The First Affiliated Hospital of Sun Yat-sen University.To study the demographic information,sequential organ failure assessment (SOFA),usage of antibiotics before ICU and duration of ICU were analyzed.Bile,peritoneal drainage and blood samples were collected.Results 47 septic shock patients and 25 septic patients due to biliary tract infection were enrolled in the trial.The two groups (the shock group vs.the sepsis group) had a significant difference in the duration of ICU stay [(6.4 ± 4.6) d vs.(2.3 ± 1.8) d,P ＜ 0.05].48 strains of pathogens were isolated from the bile samples.The major pathogens were Escherichia coli (E.coli) (n =23,47.9％),Enterococcus faecalis (n =8,16.7％) and Enterococcus faecium (n =2,4.2％).80 strains of pathogens were isolated from the peritoneal drainage culture samples.E.coli,pseudomonas aeruginosa,and Klebsiella pneumoniae ranked the top 3 species,accounting for 26.3％,11.3％ and 7.5％,respectively.The sensitivity of E.coli isolated from bile to amikacin,imipenem and panipenem were all over 90.0％.Conclusions E.coli was the principal gram-negative bacterium in biliary infection induced sepsis.Early administration of carbapenemes may reduce the occurrence of septic shock in these patients.

Investigation of inductive effect of triptolide on cytochrome P450 s in rat hepatocytes and HepG2 cells and possible mechanism / 中国药理学通报

Aim Toinvestigatingtheinductionof CYPs in hepatocytes or HepG2 cells by triptolide(TP) andthepossiblemechanism.Methods AfterTPtreat-ment,the expression of CYPs in rat primary hepato-cytes or human HepG2 cells was detected by real-time PCR and Western blot assays.Specific inhibitors or gene knockdown method were employed to analyze the possiblemechanism.Results Theexpressionof CYP1A2,2C7,2C11,2C12,2D2,2E1 and 3A1 in rat primary hepatocytes was induced by TP.The fold was 19,2,31,3,21,88 and 34 at 50 nmol·L-1, respectively while at 100 nmol·L-1 it was 20,5,30,23,61,83 and 38,respectively.In HepG2 cells,the expression of human CYP1A1,2B6,2C9,2C19, 2D6,2E1 and 3A4 was also induced by TP.The ac-tivities of nuclear receptor PXR and CAR were inhibi-ted.TP upregulated p53 expression,and the induction of several CYPs caused by TP was blocked when p53 wasinhibited.Conclusions TPinducesCYPsexpres-sion in rat hepatocytes and HepG2 cells.Nuclear re-ceptors may not be involved in TP induced CYPs, while the mechanism may partly attribute to p53.

The emerging roles of the DDX41 protein in immunity and diseases

RNA helicases are involved in almost every aspect of RNA, from transcription to RNA decay. DExD/H-box helicases comprise the largest SF2 helicase superfamily, which are characterized by two conserved RecA-like domains. In recent years, an increasing number of unexpected functions of these proteins have been discovered. They play important roles not only in innate immune response but also in diseases like cancers and chronic hepatitis C. In this review, we summarize the recent literatures on one member of the SF2 superfamily, the DEAD-box protein DDX41. After bacterial or viral infection, DNA or cyclic-di-GMP is released to cells. After phosphorylation of Tyr414 by BTK kinase, DDX41 will act as a sensor to recognize the invaders, followed by induction of type I interferons (IFN). After the immune response, DDX41 is degraded by the E3 ligase TRIM21, using Lys9 and Lys115 of DDX41 as the ubiquitination sites. Besides the roles in innate immunity, DDX41 is also related to diseases. An increasing number of both inherited and acquired mutations in DDX41 gene are identified from myelodysplastic syndrome and/or acute myeloid leukemia (MDS/AML) patients. The review focuses on DDX41, as well as its homolog Abstrakt in Drosophila, which is important for survival at all stages throughout the life cycle of the fly.

High risk factors of blood infection in voluntary donors in China: A single-centre retrospective study / 中华器官移植杂志

Objective To analyze the high risk factors of blood infection in Chinese citizens' organ donation,provide the basic evidence for early protection,increase the success rate of donor distribution,and expand the Chinese organ donation pool.Methods A retrospective study was performed on 70 cases of donation recruited during October 2014 to January 2016.The incidence of blood infection in these donors was analyzed.The univariate analysis and multivariate logistic regression analysis were used to find out the high risk factors influencing the donor blood infection.Finally,the donor blood infection assessment model and the receiver operating characteristic (ROC) curve were established to assess the sensitivity and specificity.Results The overall infection rate was 64.3％ (45/70).The pulmonary,blood,and urinary tract infection rate was 42.9％,31.4％ and 1.4％ respectively.The total length of hospital stay (＞10 days) (P =0.017),oxygenation index (＜ 233.5 ± 107.0) (P =0.046),aspartate aminotransferase (＞196.9 ± 329.1 U/L) (P =0.044),and valley alanine aminotransferase (＞95.0 ± 78.1 U/L) (P =0.026) were four risk factors for predicting the donor blood infection.The multivariate logistic regression analysis revealed that the total length of stay ＞10 days along with the donors' oxygenation index (＜233.5 ± 107.0) was independent risk factor for predicting the blood infection.The donor blood infection model was:0.193 + 1.753 hospital stay (＞10 days)-0.007 oxygenation index.The sensitivity and specificity were 0.682 and 0.75 (P ＜0.001) respectively.Conclusion For a long-term stay in ICU,the rate of blood infection for donors was much higher,at this time,the most effective antibiotics should be chosen.Besides,improving donor oxygenation index and liver function can reduce the incidence of infection.

A comparative study of retinopathy of prematurity during different times in a single tertiary neonatal center / 中国新生儿科杂志

Objective To study the incidence and risk factors of retinopathy of prematurity (ROP) in a single tertiary center during different times(Phase 1:2009 to 2011;Phase 2:2012 to 2014). Methods From 2009 to 2014, fundus examinations were performed on premature infants admitted to NICU of our hospital. The incidence and risk factors of ROP were compared between the two phases. Results During Phase 1,68 (11. 1% ) cases were diagnosed with ROP among 614 premature infants. During Phase 2, 121 (15. 2% ) cases were diagnosed with ROP among 794 premature infants. The incidences of ROP between the two phases were significantly different (P <0. 05). During Phase 1 and 2, 10 (14. 7% ) infants and 12 (9. 9% ) infants were diagnosed with Grade 3 and above or threshold ROP, respectively. The incidence of Grade 3 and above or threshold ROP between the two phases were also significantly different (P < 0. 05). Logistic analysis demonstrated that gestational age(GA), birth weight (BW), duration of oxygen therapy and mechanical ventilation(MV) were independent risk factors during hase 1, whereas GA, MV and blood transfusion were independent risk factors during Phase 2. Pulmonary surfactant (PS) was protective factor of ROP in both two groups. GA in Phase 2 was significant lower than Phase 1 (P <0. 05), while duration of oxygen therapy, incidence of MV, PS and blood transfusion were higher in Phase 2 ( P < 0. 05) . Conclusions The incidence of ROP has increased. Reducing the incidence of preterm delivery, duration of oxygen therapy, incidence of MV and blood transfusion has important role in preventing ROP. Reducing the use of MV and the oxygen concentrations, appropriate PS therapy and focusing on early ophthalmic screening are important preventing severe ROP.

Isolation, cultivation and identification of human skin microvascular endothelial cells / 中国组织工程研究

BACKGROUND:Currently, the enzymatic digestion combined with magnetic activated cel sorting for isolating microvascular endothelial cel s are cumbersome and do harm to cel s. Therefore, how to simplify the isolation and culture of human dermal microvascular endothelial cel s to obtain highly purified endothelial cel s in vitro becomes a hotspot. OBJECTIVE:To explore a simple and effective cultivation method of microvascular endothelial cel s from diabetic patient skins in vitro, and to detect the cel growth. METHODS:Diabetic patients with chronic foot wounds after amputation were enrol ed to col ect the limb proximal skin and topical skin around the wound superficial dermal tissue. Human dermal microvascular endothelial cel s were obtained using adherent method and trypsin method, fol oewd by purified utilizing trypsin digestion and repeated attachment method when passage culture. RESULTS AND CONCLUSION:Human dermal microvascular endothelial cells were obtained successfully, Primary cultured endothelial cells completely adhered to the wall at 24 hours, entered the logarithmic phase at the 10th day, and the cell concentration reached 80%at the 12th-13th day. While the passage cells grew more actively than primary cells, and fully covered the bottom in a“cobblestone”arrangement after 5-7 days of culture. Immunohistochemical staining showed that cultured cells were positive for FVIII and CD31-associated antigens with 100%positive rate. MTT assay showed that cell growth curves of 2, 4, and 5 generations of dermal microvascular endothelial presented the invertedSshape. These results suggest that abundant highly purified human dermal microvascular endothelial cells can be obtained through the adherent method and a small amount of short-term trypsin method.

Protective effect of myeloid-derived suppressor cells in mice with sepsis / 实用医学杂志

Objective To investigate whether myeloid-derived suppressor cells (MDSCs) have a protective effect in septic mice. Methods The model of caecal ligation and puncture (CLP) was performed to induce polymicrobial sepsis in mice. The changes of MDSCs in spleens at different times after operation were studied. In order to observe the influence of MDSCs on the inflammatory factors and survival of septic mice, MDSCs were injected into the peritoneal cavities of mice after CLP. Results MDSCs accumulated in spleens of septic mice progressively. MDSCs could increase anti-inflammatory cytokine production, decrease the level of inflammatory factors, and improve the survival rate of mice with sepsis. Conclusion MDSCs can attenuate the inflammation and improve the survival rate of mice with sepsis, suggesting that intraperitoneal injection of MDSCs may provide a new direction for the treatment of sepsis.

Recent advances in the study of mechanism of APOBEC3G against virus / 药学学报

APOBEC3 is a class of cytidine deaminase, which is considered as a new member of the innate immune system, and APOBEC3G belongs to this family. The research about APOBEC3G is a new direction of innate immune defense mechanism against virus. APOBEC3G has the restrictive activity on many viral replications, which deaminates dC to dU in the viral genome and then induces extensive hypermutation. APOBEC3G can also interrupt viral replication at several phases such as reverse transcription, replication, nucleocapsid and so on by non-deamination mechanisms. However, virus can encode viral proteins to counteract the restriction activity of APOBEC3G. Elucidation of the antagonistic interaction between APOBEC3G and the virus will be contributed to development of new antiviral drugs in the future.

Role of hypoxia-inducible factor-1α in hypoxia-induced pulmonary hypertension of neonatal rats and its association with pulmonary vascular remodeling / 中华围产医学杂志

Objective To investigate the serum concentration and the lung tissue expression level of hypoxia-inducible factor-1α (HIF-1α) in neonatal rats with hypoxia-induced pulmonary hypertension (HPH),and the role of HIF-1α in pathogenesis of HPH and pulmonary vascular remodeling.Methods Eighty neonatal Wistar rats were randomly assigned into normoxia and hypoxic group,forty in each group.HPH models were established on rats in hypoxic group.On the 3rd,7th,14th and 21st day after modeling,ten rats in each group were taken to measure the mean pulmonary arterial pressure (mPAP).Meanwhile,serum HIF-1α concentration were determined by enzyme-linked immunosorbent assay,while expression of HIF-1α in lung tissue were detected by immunohistochemistry and real time polymerase chain reaction.After hematoxylineosin and Van Gieson staining,morphological changes of pulmonary arterioles of rats in both groups were observed by optical microscope.Intima-media thickness/external diameter ratio (MT) and medial wall cross sectional area/vessel total cross-sectional area ratio (MA) were determined.Wilcoxon rank sum test,t-test,Ridit analysis,Pearson correlation and Spearman rank correlation test were applied for statistical analysis.Results mPAP in both groups kept increasing as the time went on.mPAP in hypoxic group were higher than that innormoxiagroup[(8.59±1.57) mmHgvs (6.14±1.02) mmHg,(11.63±2.56) mmHgvs (8.33±0.76) mmHg,(15.29±2.88) mmHgvs (10.92±2.74) mmHgand (18.04±2.69) mmHgvs (12.17±1.64) mmHg on the 3rd,7th,14th and 21st day after hypoxia modeling (t=4.14,3.91,3.48 and 5.89,all P＜0.05).Serum concentration,expressions of mRNA and immune response intensity of HIF-1α in hypoxic group were higher than those in normoxia group on the 3rd,7th and 14th day after hypoxia [serum concentration:(805.67±19.52) μg/molvs (204.34±83.21) μg/mol,(906.29±24.24) μg/molvs (548.93±11.78) μg/mol and (939.25±28.57) μg/mol vs (674.44± 17.41) μg/mol,t=6.43,4.11 and 2.34,respectively,all P＜0.05; relative expressions of HIF-1α mRNA:0.98±0.35 vs 0.23±0.16,1.30±0.49 vs 0.69±0.13 and 1.45±0.76 vs 0.64±0.21,respectively,t=4.56,2.72 and 4.63,all P＜0.05; immune response intensity of HIF-1α (average Ridit value):0.318 vs 0.183,0.303 vs 0.198 and 0.374 vs 0.176,respectively,u=3.26,2.73 and 3.91,all P＜0.05].MT and MA in hypoxic group were higher than those in normoxia group [MT:52.71％ (45.91％-63.23％) vs 47.42％ (41.14％ 56.17％),61.28％ (52.25％-68.63％) vs 50.22％(43.79％ 58.40％) and 65.24％ (56.02％-71.28％) vs 53.78％ (48.02％-64.58％) at 7,14 and 21st day respectively,u=2.08,4.54 and 4.37; MA:60.89％ (54.04％ 66.21％) vs 55.19％ (50.32％-63.59％),66.09％ (58.52％-72.58％) vs 59.77％ (53.55％-67.09％) and 68.25％(62.02％-74.51％)vs 61.40％(50.74％-70.55％),respectively,u=2.16,2.27 and 3.18,all P＜0.05].There were positive relations between HIF-1α and mPAP (r=0.294),as well as MT and MA (r=0.548 and 0.265,all P＜0.05).Conclusions HIF-1α may play a role in the pathogenesis of HPH.Pulmonary vascular remodeling occurred after seven days of hypoxia induction and may be exacerbated as the hypoxic time is prolonged,which might be prevented with early interventions.

Quantitative detection and the significance of K-ras12 and K-ras13 mutations in peripheral blood of the population with high risk of pancreatic cancer / 中华消化杂志

Objective To explore the clinical significance of the detection of K-ras12 and K-ras13 mutations in the peripheral blood of population with high risk group of pancreatic cancer.Methods From May 2010 to November 2011,a total of 160 patients with clear diagnosis and high risk of pancreatic cancer were collected.Among those patients,36 cases were finally diagnosed as pancreatic cancer,36 cases were chronic pancreatitis (CP),six cases were autoimmune pancreatitis (AIP),16 cases were other malignant tumor,13 cases were pancreatic benign tumor,13 cases were bile duct stones and 40 cases were other benign diseases.Fasting peripheral venous blood was collected in all selected candidates.The condition of K-ras12 and K-rasl3 mutation was detected by peptide nucleic acid-mediated real time fluorescen quantitative polymerase chain reaction.Mann-Whitney U test was performed to compare the mutation between the two groups.Chi-square test was used to compare the rates.According to the receiver operator characteristic (ROC) curve,the mutation positive decision value and the mutation positive rate of K-ras12 and K-ras13 were calculated.Results There were significant differences in K-ras12 mutation between pancreatic cancer group (1154(2207)) and other benign diseases (476(973)),CP group (446(808)),bile duet stones group (357(568)) (U=502,446 and 117,all P＜0.05).There were no significant differences in K-ras13 mutation between pancreatic cancer group and other benign diseases,CP group,bile duct stones group (all P＞0.05).When the mutation positive decision value of K-ras12 was set as mutation copy over 1000,the positive mutation rate of pancreatic cancer and non-pancreatic cancer was 55.6％ (20/36) and 25.0％ (31/124),respectively.When the area under the ROC curve of K-ras12 was 0.664,there was differential diagnostic value in identifying pancreatic cancer and non-pancreatic cancer (P=0.003).When the area under the ROC curve of K-ras13 was 0.522,there was no differential diagnostic value in identifying pancreatic cancer and non-pancreatic cancer (P=0.695).There was significant difference in K-ras13mutation between smokers and non-smokers (943 (1510) and 571 (964)).Conclusion K-ras12mutation in peripheral venous blood may be used for pancreatic cancer screening.

Significance of quantitatively detecting K-ras codon 12 and 13 mutations in the tissues of pancreatic cancer and related pancreatic diseases / 中华胰腺病杂志

ObjectiveTo investigate the clinical significance of quantitative detection of K-ras codon 12 and 13 mutations in the tissues of pancreatic cancer and related pancreatic diseaaes. Methods One hundred and thirty samples from surgically removed pancreatic tissue with a conclusive pathological diagnosis (105 cases of pancreatic ductal adenocarcinoma,8 cases of pancreatic adenosquamous carcinoma of the pancreas,2 cases of pancreatic mucinous adenocarcinoma,3 cases of pancreatic endocrine carcinoma,6 cases of duodenal and papillary adenocarcinoma and 6 cases of benign pancreatic diseases ) were collected.Quantitative detection of K-ras codon 12 and 13 mutations was performed by the method of peptide nucleic acidmediated PCR clamping with two different fluorescence labeled probes.Mutation number ＞ 100 copies was used as the criteria to calculate the positive mutation rate.ResultsThe median and quartile of K-ras codon 12mutations of pancreatic ductal adenocarcinoma,adenosquamous carcinoma of the pancreas,pancreatic mucinous adenocarcinoma,pancreatic endocrine carcinoma,duodenal and papillary adenocarcinoma and benign pancreatic diseases were 4062 (495,10800),238 (45,8420),15 (9,21),3 (3,16),2283 (73,5037)and 21(8,56),and the positive mutation rates were 84.8％ (89/105),50.0％ (4/8),0,0,66.7％ (4/6)and 16.7％ (1/6).The quantity of K-ras codon 12 mutation in pancreatic ductal adenocarcinoma was not statistically different from those of adenosquamous carcinoma,duodenal and papillary adenocarcinoma,but it was significantly higher than those in pancreatic mucinous adenocarcinoma,pancreatic endocrine carcinoma,and benign pancreatic diseases (P ＜0.05).The area under ROC of K-ras codon 12 mutation in pancreatic ductal adenocarcinoma was 0.727.The sensitivity and specificity of the K-ras codon 12 mutation for the diagnosis of pancreatic ductal adenocarcinoma were 84.8％,64.0％,respectively.The quantity of K-ras codon 12 was associated with survival of patients with pancreatic ductal adenocarcinoma.The quantity of K-ras codon 13 mutations and the positive mutation rates in pancreatic ductal adenocarcinoma was not statistically different from other pancreatic diseases.ConclusionsThe quantity of K-ras codon 12 mutation has good differential diagnostic and prognostic prediction value for pancreatic ductal adenocarcinoma.

Clinical analysis of caspofungin treatment for invasive fungal disease in advanced age patients / 中华老年医学杂志

Objective To evaluate the efficacy and safety of caspofungin in the treatment of invasive fungal disease (IFD) in advanced age patients. Methods A retrospective analysis of the clinical data was conducted. IFD patients who had received caspofungin treatment in elderly wards were included. Results From January 2007 to August 2009, 29 IFD patients aged 80-100 years (mean 89 ) were treated with caspofungin. Except that one patient dead on the first drug administration day, there were 28 evaluable patients, 13 were cured (46.4%), 6 were markedly improved (21.4%), 3 progressed (10.8%) and 6 dead (21.4%). The overall effective rate was 67. 8%. Of 13cured patients, 12 were Candida bacreremia, 1 was Candida albicans disease of lung. Of 6 dead patients, 2 were Candida bacteremia, 1 was Candida albicans disease of lung and 3 was suspected of lung IFD. One patient performed that alanine aminotransferase was increased, considering drug-related impairment of liver function. Conclusions Caspofungin is effective and safe in the treatment of IFD in advanced age patients.

Qualitative research in work shift pattern of ICU nurses / 中国实用护理杂志

Objective To explore the psychological experience of ICU nurses who had worked follow different work patterns, and find the most appropriate staffing model. Methods A phenomenological approach of qualitative research was conducted in 5 ICU nurses by intensive interview,then the data collected were read, analyzed, reflected,finally the theme was got. Results In the work pattern of shifted every 12 hours, with low work frequency and strong feeling of fatigue. In the work pattern of shifted every 8 hours, with high work frequency and the disadvantage of nurse- patient relationship. In the short-time continuous APN work pattern, with continuous management of patients' condition, promotion of nurse-patient relationship, improvement of doctor-nurse relationship, comparatively stable biological clock. Conclusions The short-time continuous APN work pattern can concentrate nurses' work and rest time, relieve the press that caused by the shifted work, at the same time, promote the patients',patients' family and doctors' satisfaction degree with nursing work, increase nurses' effect in the ICU team, guarantee the quality of care, eventually ensure the patients' safety.

The study on screening the differences of serum proteins in ulcerative colitis / 中华消化杂志

Objective To search for the differences of serum proteins expression in ulcerative colitis (UC) by proteomics method and to preliminary explore the potential biological markers of ulcerative colitis. Method The serum of 30 ulcerative colitis patients and 30 healthy individuals were collected. The equal amounts of proteins in pooled serum were separated by two-dimensional gel electrophoresis (2-DE) and then compared and analyzed by image analysis software to recognize the differences of protein expression. Some spots of proteins with different expression were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).Result There was no statistic significant in age, weight index, smoking and alcohol taking between UC group and control (P ＞ 0.05 respectively). Thirty-nine proteins with significant different expression between UC patients and healthy individuals were preliminary screened out. Nine of those spots were selected, after analyzed by MALDI-TOF-MS, it was found that the expression of haptoglobin, heat shock factor protein 2, receptor tyrosine kinase, aldehyde reductase,apolipoproteinC-Ⅲ, pericentriol material 1 increased in ulcerative colitis patients, keratinl, filamin A interacting protein 1 and tropomyosin 3 decreased. Conclusions With proteomics 2-DE and spectrometry methods, nine UC associated serum proteins were screened out and identified, which provide new molecular markers for the research of UC biological behavior.