Analysis of high risk factors for chromosomal aberrations in peripheral blood lymphocytes of 200 radiation workers in Hainan Province / 上海预防医学

ObjectiveTo investigate the current status and high-risk factors of chromosomal aberrations in peripheral blood lymphocytes （PBL） of radiation workers in Hainan Province. MethodsA total of 200 radiological workers who underwent occupational health examination in Hainan Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were selected to collect the occupational health examination data and the rate of PBL chromosomal aberrations. The influencing factors of PBL chromosomal aberrations were analyzed by logistic regression model. The predictive value of logistic regression prediction model on PBL chromosomal aberrations were determined by using the reciver operator characteristic （ROC） curve. ResultsA total of 20 000 cells （100 cells/person） were tested. The chromosomal aberration rate was 0.37% （74/20 000） and the PBL chromosomal aberration rate in the subjects was 6.00% （12/200）. Univariate analysis showed that PBL chromosomal aberrations in radiological workers were related to age， length of service， type of work and education （all P<0.05）， but not to gender （P>0.05）. The logistic regression prediction model was constructed based on the influencing factors， with χ2=9.413， df=9， P=0.852， suggesting a good model fit. The logistic regression prediction model predicted the area under the curve （AUC） for the occurrence of PBL chromosomal aberrations in radiation workers was 0.914 （95%CI： 0.866‒0.949）， with a cut-off value of 3.05， corresponding to a prediction sensitivity and specificity of 100.00% and 75.98%， respectively. ConclusionThe incidence of PBL chromosomal aberrations in radiological workers in Hainan Province was 6.00%， with age， working age and job type as high-risk factors and education level as a protective factor. The prediction model constructed by the above factors can provide a reliable basis for clinical prediction of PBL chromosomal aberrations in radiological workers.

Early-effectiveness of unilateral biportal endoscopic laminectomy in treatment of two-level lumbar spinal stenosis / 中国修复重建外科杂志

OBJECTIVE@#To analyze the early effectiveness of unilateral biportal endoscopy (UBE) laminectomy in the treatment of two-level lumbar spinal stenosis (LSS).@*METHODS@#The clinical data of 98 patients with two-level LSS treated with UBE between September 2020 and December 2021 were retrospectively analyzed. There were 53 males and 45 females with an average age of 59.9 years (range, 32-79 years). Among them, there were 56 cases of mixed spinal stenosis, 23 cases of central spinal canal stenosis, and 19 cases of nerve root canal stenosis. The duration of symptoms was 1.5- 10 years, with an average of 5.4 years. The operative segments were L 2, 3 and L 3, 4 in 2 cases, L 3, 4 and L 4, 5 in 29 cases, L 4, 5 and L 5, S 1 in 67 cases. All patients had different degrees of low back pain, among of which 76 cases were with unilateral lower extremity symptoms and 22 cases were with bilateral lower extremity symptoms. There were 29 cases of bilateral decompression in both segments, 63 cases of unilateral decompression in both segments, and 6 cases of unilateral decompression and bilateral decompression of each segment. The operation time, intraoperative blood loss, total incision length, hospitalization stay, ambulation time, and related complications were recorded. Visual analogue scale (VAS) score was used to assess the low back and leg pain before operation and at 3 days, 3 months after operation, and at last follow-up. The Oswestry disability index (ODI) was used to evaluate the functional recovery of lumbar spine before operation and at 3 months and last follow-up after operation. Modified MacNab criteria was used to evaluate clinical outcomes at last follow-up. Imaging examinations were performed before and after operation to measure the preservation rate of articular process, modified Pfirrmann scale, disc height (DH), lumbar lordosis angle (LLA), and cross-sectional area of the canal (CAC), and the CAC improvement rate was calculated.@*RESULTS@#All patients underwent surgery successfully. The operation time was (106.7±25.1) minutes, the intraoperative blood loss was (67.7±14.2) mL, and the total incision length was (3.2±0.4) cm. The hospitalization stay was 8 (7, 9) days, and the ambulation time was 3 (3, 4) days. All the wounds healed by first intention. Dural tear occurred in 1 case during operation, and mild headache occurred in 1 case after operation. All patients were followed up 13-28 months with an average of 19.3 months, and there was no recurrence or reoperation during the follow-up. At last follow-up, the preservation rate of articular process was 84.7%±7.3%. The modified Pfirrmann scale and DH were significantly different from those before operation ( P<0.05), while the LLA was not significantly different from that before operation ( P=0.050). The CAC significantly improved ( P<0.05), and the CAC improvement rate was 108.1%±17.8%. The VAS scores of low back pain and leg pain and ODI at each time point after operation significantly improved when compared with those before operation, and the differences between each time points were significant ( P<0.05). According to the modified MacNab criteria, 63 cases were excellent, 25 cases were good, and 10 cases were fair, with an excellent and good rate of 89.8%.@*CONCLUSION@#UBE laminectomy is a safe and effective technique with little trauma and fast recovery for two-level LSS and the early effectiveness is satisfactory.

Effects of long-term exposure to ambient PM2.5 on hypertension and role of dietary regulation / 环境与职业医学

Background The contribution of long-term ambient PM2.5 exposure to hypertension should not be ignored. However, the conclusions of whether dietary factors play a role in regulating PM2.5-related hypertension are still inconsistent. Objective To explore the correlation between long-term exposure to ambient PM2.5 and blood pressure indicators (systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure) in adults in Ningxia and a potential moderating effect of dietary factors. Methods A set of cross-sectional survey data from March, 2013 to May, 2018 was retrieved from the China Northwest Cohort-Ningxia, and the average ambient PM2.5 concentration in the previous three years was also collected to estimate the long-term exposure of the participants. Binary logistic regression model was used to validate the correlation between long-term exposure to ambient PM2.5 and hypertension in Ningxia, and linear model was used to study the correlation between long-term exposure to ambient PM2.5 and blood pressure indicators (systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure), and to explore the influence of dietary factors on ambient PM2.5-related hypertension. Results A total of 11470 participants were included in the study, 42.2% male and 57.8% female. The three-year average ambient PM2.5 concentration before the baseline survey was 37.0 μg·m−3. Each 1 μg·m−3 increase in ambient PM2.5 was associated with an increased risk of hypertension (OR=1.111, 95%CI: 1.097, 1.125), and increased systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure by 0.886 (95%CI: 0.783, 0.990), 0.570 (95%CI: 0.500, 0.641), 0.676 (95%CI: 0.600, 0.751), and 0.316 (95%CI: 0.243, 0.389) mmHg, respectively. The stratified analysis showed that the OR and 95%CI of hypertension were 1.171 (1.097, 1.254), 1.117 (1.064, 1.174), and 1.160 (1.116, 1.207) respectively for each 1 μg·m−3 increased in PM2.5 with low frequency of vegetable and fruit consumption and salty taste respectively. The OR and 95%CI of hypertension were decreased when the moderate and high frequency of vegetable and fruit intake and moderate and light taste applied, the values were 1.091 (1.062, 1.121) and 1.114 (1.097, 1.131), 1.105 (1.082, 1.129) and 1.111 (1.092, 1.13), 1.115 (1.090, 1.140) and 1.102 (1.083, 1.121) respectively. Compared with low frequency of vegetable and fruit intake and salty taste, the increase degree of ambient PM2.5 related systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure also decreased in middle and high frequency of vegetable and fruit intake and moderate and light taste. Conclusion Long-term exposure to ambient PM2.5 is significantly associated with increased risks of hypertension and blood pressure in Ningxia area. Increasing the frequency of vegetable and fruit intake and decreasing salty taste may reduce the effect of ambient PM2.5 on hypertension and blood pressure.

Developing curriculum of speciality of education and rehabilitation using WHO rehabilitation competency framework / 中国康复理论与实践

ObjectiveTo construct rehabilitation competency framework (RCF) of the speciality of education and rehabilitation (SER-RCF) based on World Health Organization RCF, to innovate the curriculum system. MethodsThe competency for undergraduate level professionals in the speciality of education and rehabilitation were analyzed to develop curriculum using RCF theory and methodology. ResultsTalent training was a kind of competency-based and outcome-based education. SER-RCF integrated the competencies and activities in the areas of professionalism, practice, learning and development, management and leadership, and research required for professional work in education and rehabilitation around core values and beliefs. It also designed the training objectives of the speciality of education and rehabilitation: to be ethical and correct, to be physically and mentally healthy, to have a solid foundation, to be sustainable, to be co-operative and enjoyable, and to be reflective and enquiring. SER-RCF played a central role in developing the curriculum system of rehabilitation, education and psychology, and practice. ConclusionReshaping the undergraduate level curriculum system of education and rehabilitation based on RCF is not only the implementation of the construction concept of new medicine and new liberal arts, but also can effectively connect with the international standard of rehabilitation higher education.

Construction of conceptual framework and approaches of music education in special education schools based on ICF / 中国康复理论与实践

ObjectiveTo apply International Classification of Functioning, Disability, and Health (ICF) to systematically analyze the functional characteristics of children with intellectual and developmental disabilities (IDD) in special education schools, and develop a theoretical framework and methodology for music education that suits the students' functional profiles. MethodsUsing the ICF's functional classification approach, the study focused on children with IDD in special education schools. It conducted a systematic analysis of the special music curriculum and students' learning behaviors from three levels: body functions, activity and participation, and environmental factors. The study then constructed function-oriented, adapted and inclusive principles, core curriculum content, and an education and evaluation system for music education.ResultsThe main functional characteristics of children with IDD were at three levels: at the body function level, students may experience impairments in Global psychosocial functions (b122), psychomotor functions (b147), energy and drive functions (b130), high-level cognitive functions (b164), attention functions (b140), control of voluntary movement functions (b760), and involuntary movement functions (b765), among others; at the music-related activity and participation level, students may experience impairments in play (d9200), sports (d9201), arts and culture (d9202), social activities (d9205), and other specified or unspecified changes in maintaining body posture (d429); at environmental factors level, there may be influenced on products and technology for education (e130), natural environment and human-made changes to the environment, unspecified (e299), immediate family (e310), friends (e320), other professionals (e360), attitudes (e4), and educational and training services, systems and policies (e585). In music teaching activities, child-centered principles were established, advocating function-oriented inclusive music education activities. The study used the ICF's method to construct music curriculum objectives and conduct function-oriented music learning activities. These activities included welcoming and warm-up activities, music appreciation activities, singing and learning songs, combining music with dance activities, music composition activities, as well as exploring instrument playing, choir, and ensemble activities for higher grades. By using the ICF's three functional levels, a comprehensive functional assessment and music learning needs assessment can be conducted for students. Based on the assessment results, a function-oriented adaptive music education program can be developed, including: setting adapted music learning objectives and developing corresponding teaching strategies based on the analysis of students' functional characteristics; establishing accessible music education environments considering the impact of the students' environment on their music participation, and providing supportive and accessible music education environments within the family and school settings; developing and implementing function-oriented music education based on the analysis and evaluation of students' music activity needs and functional characteristics, providing inclusive or individualized music education practices, and offering opportunities for special needs students to enjoy music learning activities and social interactions. By applying the ICF to the assessment of music education for students, a function-oriented music learning assessment system can be established, including diagnostic, formative, and summative assessments of music learning.ConclusionThis study systematically analyzed the functional characteristics of IDD children in special education schools based on the ICF's three levels of body function, activity and participation, and environmental factors. It constructed a function-oriented, adapted and inclusive theoretical framework, and core curriculum content for music education in special education schools. Using the ICF, the study established function-oriented music education objectives, set up accessible music education environments, developed and implemented function-oriented, adapted and inclusive music education curricula, and conducted student music learning assessments.

Construction of special music educational objectives based on ICF and Hauenstein taxonomy of educational objectives / 中国康复理论与实践

ObjectiveTo construct a special music education goal framework with functional orientation and behavioral integration. MethodsUtilizing the International Classification of Functioning, Disability, and Health (ICF) theory and the Hauenstein educational objectives taxnomony, and by analyzing the core content of the China Special Education School Compulsory Education Curriculum Standards (2016 edition), objectives for special music education were constructed. A method is established based on the ICF and the functional characteristics of special-needs children to adjust the objectives of special music education. ResultsThe framework system of special music education goals should follow the principles of functional orientation, adaptability and inclusiveness. The framework mainly composed of the goals of cognitive domain, psycho-motor domain, emotional domain and behavioral field, and the goals of each domain could be divided into five levels according to the level of development and achievement. The cognitive domain mainly focused on feeling and appreciation, which made a foundation for music learning. The psychomotor domain developed the movements, skills and related abilities of musical performance. The emotional domain focused on the impact of special music education on behaviors in terms of emotions, values, and beliefs. The behavioral domain was the synthesization of the cognitive, emotional and psychomotor domains, to enable students to use musical elements and skills to create musical works and performance. The music education objectives should be adjusted according to students' functional and developmental levels and special music learning needs. For the cognitive domain, visual support, simplification and repetition might be useful. For the psychomotor domain, visual aids, multisensory experiences and supportive technological equipment might be needed. For the emotional domain, scenario simulation, role play and music environment setting could be used to promote the connection among music and the individual and the world. For the behavioral domain, creating an inclusive environment, affirming and encouraging, and providing opportunities for creative expression might help the students apply the musical elements and techniques. ConclusionBased on the ICF theory and the Hauenstein educational objectives taxnomony theory, and referencing the China Special Education School Compulsory Education Curriculum Standards (2016 edition), this study constructed an educational objectives framework for special music. Principles for building functionally oriented, adaptive, and inclusive music education were proposed, as well as a systematic method for adjusting the objectives of special music education.

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

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

MicroRNA-34c-5p provokes isoprenaline-induced cardiac hypertrophy by modulating autophagy via targeting ATG4B

Pathological cardiac hypertrophy serves as a significant foundation for cardiac dysfunction and heart failure. Recently, growing evidence has revealed that microRNAs (miRNAs) play multiple roles in biological processes and participate in cardiovascular diseases. In the present research, we investigate the impact of miRNA-34c-5p on cardiac hypertrophy and the mechanism involved. The expression of miR-34c-5p was proved to be elevated in heart tissues from isoprenaline (ISO)-infused mice. ISO also promoted miR-34c-5p level in primary cultures of neonatal rat cardiomyocytes (NRCMs). Transfection with miR-34c-5p mimic enhanced cell surface area and expression levels of foetal-type genes atrial natriuretic factor (Anf) and β-myosin heavy chain (β-Mhc) in NRCMs. In contrast, treatment with miR-34c-5p inhibitor attenuated ISO-induced hypertrophic responses. Enforced expression of miR-34c-5p by tail intravenous injection of its agomir led to cardiac dysfunction and hypertrophy in mice, whereas inhibiting miR-34c-5p by specific antagomir could protect the animals against ISO-triggered hypertrophic abnormalities. Mechanistically, miR-34c-5p suppressed autophagic flux in cardiomyocytes, which contributed to the development of hypertrophy. Furthermore, the autophagy-related gene 4B (ATG4B) was identified as a direct target of miR-34c-5p, and miR-34c-5p was certified to interact with 3' untranslated region of Atg4b mRNA by dual-luciferase reporter assay. miR-34c-5p reduced the expression of ATG4B, thereby resulting in decreased autophagy activity and induction of hypertrophy. Inhibition of miR-34c-5p abolished the detrimental effects of ISO by restoring ATG4B and increasing autophagy. In conclusion, our findings illuminate that miR-34c-5p participates in ISO-induced cardiac hypertrophy, at least partly through suppressing ATG4B and autophagy. It suggests that regulation of miR-34c-5p may offer a new way for handling hypertrophy-related cardiac dysfunction.

To guide the preparation of blood before liver transplantation: the establishment of multiple regression equation based on R language / 中国输血杂志

【Objective】 To establish the multiple regression equation based on R language in order to guide scientific and reasonable blood preparation for clinicians before liver transplantation. 【Methods】 Basic clinical information, including gender, age and disease types, of 183 liver transplant patients were collected, and results of preoperative blood routine(MCV, MCHC, Hct, RBC, Hb and Plt), prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB), international normalized ratio(INR) and D dimer and antithrombin Ⅲ(AT Ⅲ), operation time, as well as intraoperative transfusion volume of red blood cells, plasma, cryoprecipitates and platelets were analyzed using R language analysis.The correlation between blood component transfusion volume and analysis factors was calculated by generalized linear function, and the regression equation for predicting blood preparation was obtained by Poisson regression analysis. 【Results】 Intraoperative transfusion rates of RBC, plasma, platelets and cryoprecipitates in liver transplantation patients were 85.79%(8.35±8.78 U), 100%(1 083±742.80 mL), 18.58%(0.26±0.60 treatment dose), and 12.02%(2.49±7.51 U), respectively. According to the analysis factors with good correlation, the prediction equations for the volume of each blood component were as follows: RBC: 3.348+ 1.276×Time-0.02×Hct-0.16×RBC-0.006×Hb, plasma: 6.901+ 0.826 ×Time-0.003×Hb, platelets: -1.275+ 1.866×Time-0.013 Hb+ 0.025×TT, and cryoprecipitates: -7.183+ 2.888×Time + 0.067×MCV+ 0.029×TT. 【Conclusion】 It is of great clinical significance to use R language to carry out multivariate regression analysis and establish the prediction regression equation of blood preparation before liver transplantation, which can provide scientific, reasonable and sufficient blood supply in operation.

Analysis on long-term quality of life and its influencing factors in patients with lung cancer / 中国综合临床

Objective:To explore the influencing factors of the long-term quality of life(QOL).Methods:According to the standard of diagnosis of primary lung cancer, a total of 74 patients with primary lung cancer were included in the study, who were first diagnosed by pathology and /or cytology and /or clinic from 1 January 2010 to 30 June 2016 in Tangshan Third Hospital, Heibei Province, and whose data were analyzed retrospectively.The Chinese version of FACT-L (4.0) QOL questionnaire was used to evaluate the QOL in 74 patients with primary lung cancer who survived more than three years.Multivariate regression statistical method was used to analyze the main influencing factors.Results:All patients with long-term survival lung cancer were treated by operation, their average QOL score was ( 126.62±13.29). Age, type of medical insurance and clinical stage had significant influence on QOL ( P<0.05). There was no significant difference in the total QOL scores between<50-year-old group(138.18±13.92) and ≥50-<60-year-old group(138.18±13.92, 137.04±12.82)(all P>0.05), but they were higher than that in ≥60-year-old group (115.28 ±13.11) (all P<0.05). The QOL of residents′ medical insurance patients (117.92 ±13.13) was lower than that of employees′ medical insurance patients (142.69±13.07) ( t=10.849, P=0.002). The QOL scores of stage Ⅰ and Ⅱ (140.34 ±12.88, 133.31±12.07) had no significant difference, but which were higher than that of stage III (96.84 ±13.46) ( P<0.05). Conclusion:Patients with long-term survival lung cancer after surgery could maintain a better QOL by early detection, timely surgery and constantly improving the medical security system to reduce the financial burden of patients.

Correlation analysis on liver function and serum markers of liver fibrosis in patients with fatty liver / 中国综合临床

Objective To analyze the changes of serum markers of liver function and liver fibrosis in patients with fatty liver,and to explore the relationship between them,so as to provide scientific basis for the prevention and treatment of fatty liver into hepatic fibrosis. Methods From January 1st,2015 to December 31st, 2015,one thousand three hundred and forty-six healthy cases were selected,and 361 cases of fatty liver were diagnosed by ultrasound. Liver function index of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was detected by automatic biochemical analyzer. Hyaluronic acid (HA),laminin (LN),serum type Ⅲprocollagen peptide ( PC Ⅲ) and type Ⅳ collagen ( C-Ⅳ) were detected by enzyme-linked immunosorbent assay. The correlation between liver function and serum liver fibrosis indexes was analyzed by Pearson parameter analysis. Results The liver function index ALT,AST((69. 04±18. 72) U/L,(59. 78±15. 65)U/L) in fatty liver group were higher than those in the non-fatty liver group((25. 71±10. 25) U/L,(23. 68±8. 23) U/L),the differences were statistically significant ( t＝279. 283,388. 461,P＜0. 05) . Four serum fibrosis index HA,LN, PCⅢ,C-Ⅳ in the fatty liver group were (112. 64±21. 63) μg/L,(125. 85±27. 52) μg/L,(127. 28±29. 37) μg/L,(79. 38±18. 52) μg/L,respectively,which were higher than those in the non-fatty liver group ( (53. 98 ±16. 84) μg/L,(86. 31±20. 46) μg/L,(53. 31±18. 23) μg/L,(57. 26±15. 86 ) μg/L),the differences were statistically significant ( t＝727. 724,170. 432,941. 357,71. 169,P＜0. 001) . The correlation analysis of liver function and serum liver fibrosis indexes showed that ALT and AST were positively correlated with the fibrosis indexes HA,LN,PCⅢ( correlation coefficient r＝0. 230,0. 119,0. 370;0. 363,0. 361,0. 509,P＜0. 001),and which had no significant correlation with C-Ⅳ(P＞0. 05). Conclusion Liver function and serum liver fibrosis index can be used as the important basis for monitoring and diagnosis on the progression of fatty liver disease.

Regulatory effects and mechanism about iRGD-functionalized nanomicelles on colorectal cancer multidrug resistance / 中国医师进修杂志

In recent years, conventional targeting of chemotherapeutic drugs on colorectal tumor tissue is poor in the clinical application. Due to the multidrug resistance of colorectal tumors, penetration and cytotoxicity of conventional drugs greatly reduced on tumor tissue. With the advent of tumor-penetrating peptides, a new and highly effective antitumor drug delivery system has become a research topic of international scholars. This article will briefly describe the research progress of iRGD peptides with the modified nanomicelles drug delivery system on targeted drug delivery and resistance to drug-resistant colorectal tumors in recent years. These studies show that iRGD peptide-modified nanomicelles will be a highly potential anti-drug delivery system.

Analysis of the correlation on serum sex hormones levels,neural transmitter and the patients with postpartum depression / 实用医学杂志

Objective To explore the correlation on serum sex hormones levels,neural transmitter and the patients with postpartum depression.Methods 80 cases of patients with postpartum depression were the obser-vation group,80 cases of maternal health were the control group.The scores of EPDS,HAMD,HAMA,the levels of E2,PRL,P,5-HT,DA,NE,OFQ were compared.Results The scores of EPDS,HAMD,HAMA for the ob-servation group were higher than the control group(P<0.05).There had significant difference on the levels of E2, PRL,P(P < 0.05). There had significant difference on the levels of 5-HT,DA,NE,OFQ on postpartum 2 d, 1 week for the two groups(P<0.05).It had positive correlation on EPDS,scors,PRL,P,OFQ(r=0.496,r=0.417,r=0.505,P<0.05).It had negative correlation on EPDS,E2,5-HT,DA,NE(r=-0.597,r=-0.583, r =-0.517,r =-0.422,P < 0.05). Conclusions It significantly related on serum sex hormones levels,neural transmitter and the patients with postpartum depression,and it can predict and prevent postpartum depression by early detection the levels of serum sex hormones levels,neural transmitter.

Clinical study of combined blood purification therapy for patients with multiple organ dysfunction syndrome complicated with liver failure / 中华急诊医学杂志

Objective To explore the clinical efficacy of artificial liver technique - double plasma molecular adsorption(DPMAS) combined with continuous renal replacement therapy(CRRT) in the treatment of multiple organ dysfunction syndrome(MODS) patients with liver failure. Methods From April 2014 to October 2016, in the Qinghai Provincial People's Hospital emergency ICU hospitalized MODS combined with liver failure patients were enrolled in this study. On the basis of comprehensive medical treatment, these patients were randomly(random number) divided into CRRT control group(23 cases) and DPMAS + CRRT treatment group(22 cases). Blood biochemical, coagulation index, inflammatory factor and severity score of two groups were comparied before and 72 h after treatment. Results The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood amine(NH3), creatinine(CREA), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), heart rate(HR),APACHE Ⅱ score and SOFA score in CRRT control group were statistically different before and after treatment (P<0.01). However, there was no significant difference in the levels of total bilirubin(TBIL), direct bilirubin(DBIL), bile acid(TBA), prothrombin activity(PTA) and international standardized ratio(INR) (P> 0.05); In the DPMAS + CRRT treatment group, the levels of ALT, AST, NH3, CREA, IL-6, TNF-α, HR, APACHEⅡand SOFA scores were significantly different before and after treatment (P<0.01), as well as the levels of DBIL, TBA, PTA, INR(P<0.01). There was significant differences in ALT, AST, TBIL, DBIL, TBA PTA, INR, IL-6, TNF-α, APACHE Ⅱ and SOFA scores between the two groups (P<0.05), while the levels of CREA, NH3, MAP, HR of these two groups had no significant difference (P>0.05). Conclusions Because of the combination of double plasma adsorption, besides the advantages of CRRT, DPMAS+CRRT can remove bilirubin and bile acid which can not be removed by CRRT, also improve coagulation function. The clearance efficiency of inflammatory factors is also higher, and the severity score is reduced more significantly.

Study on relationship between serum IDO level and regulatory T cells in patients with ulcerative colitis / 国际检验医学杂志

Objective To study the relationship between serum indoleamine 2 ,3-dioxygenase(IDO) and the level of regulatory T cells(Treg) in the patients with ulcerative colitis (UC) .Methods Seventy cases of UC treated in the Hainan Provincial People′s Hospital from January 2015 to February 2017 were selected as the observation group .In the same period ,70 healthy volunteers undergoing physical examination were selected as the control group .The levels of serum IDO and Treg were compared between the two groups ,the expression levels of serum IDO and Treg in of the patients with different disease activity periods and different severity de-grees of UC were observed ,and the correlation between the level of serum IDO and the Treg expression level in the patients with UC was analyzed .Results The serum IDO level in the observation group was significantly increased compared with that in the control group ,while the Treg expression level decreased which compared with the control group ,the difference was statistically significant (P<0 .05) .The serum IDO level in the pa-tients with activity period of the observation group was significantly increased compared with that in the pa-tients with remission period ,but the Treg expression level was decreased compared with that in the patients with remission period ,the difference was significant (P<0 .05) .The serum IDO and Treg expression levels had statistical difference among different disease degrees in the patients with active UC (P<0 .05) .The serum IDO level in the moderate and severe groups increased which compared with that in the mild group ,while the Treg expression level was significantly decreased compared with that in the mild group ,the difference was sig-nificant (P<0 .05) .The level of serum IDO in the severe group was significantly higher than that in the mod-erate group ,while the Treg expression level was significantly lower than that in the moderate group ,the difference was statistically significant ( P < 0 .05 ) .Conducting the correlation analysis according to the Spearman method found that there was a negative correlation between the serum IDO level and the Treg ex-pression level in the patients with UC (r= -0 .798 ,P=0 .000) .Conclusion The level of serum IDO in the pa-tients with UC is negatively correlated with the Treg expression level ,which jointly influence the occurrence and development of UC .

Evaluation of abnormality of intrarenal veins in patients of diabetic nephropathy with color Doppler ultrasonography / 中国医师进修杂志

Objective To evaluation of abnormality of intrarenal veins in the patients of diabetic nephropathy (DN) and the correlation between the intrarenal venous impedance index (VII) and renal function with color Doppler ultrasonography. Methods Sixty-four subjects with type 2 diabetic nephropathy from December 2016 to October 2017 were enrolled and divided into three groups according to glomerular filtration rate(GFR) level: GFR≥90 ml/(min·1.73 m2) as group B (25 cases), 60 ml/(min·1.73 m2)≤GFR＜90 ml/(min·1.73 m2) as group C (21 cases), GFR＜60 ml/(min·1.73 m2) as group D(18 cases), and 25 healthy volunteers were recruited as group A. Color Doppler ultrasonography was used to obtain the intrarenal VII. Results There were significant differences among A, B, C, D group of right renal segmental vein (0.41 ± 0.04, 0.36 ± 0.09, 0.29 ± 0.05, 0.19 ± 0.05; F＝81.85), right renal interlobular vein (0.41 ± 0.03, 0.35 ± 0.04, 0.29 ± 0.04, 0.22 ± 0.11; F＝96.42), left renal segmental vein (0.42 ± 0.08, 0.36 ± 0.05, 0.30 ± 0.08, 0.20 ± 0.04; F＝101.38) and left renal interlobular vein (0.40 ± 0.15, 0.36 ± 0.04, 0.30 ± 0.04, 0.20 ± 0.07; F＝95.71), all P＜0.05. The VII of group B, C and D was significantly lower than that of group A (P＜0.05). The VII of group D was lower than that of group B and C (P＜0.05), and the VII of group C was lower than that of group D(P＜0.05). There were no significant differences of the VII between the left and right kidneys (F＝0.001, P＞0.05). The VII was positively correlative with GFR (r＝0.85, P＜0.05). Conclusions The VII of the patients of DN can be obtained by color Doppler ultrasonography conveniently and non-invasively, which can reflex the renal function changes and provide a new diagnostic index for the patients of DN in diagnosis and treatment.

An exploratory study of effectiveness with ethylene oxide treatment for removing DNA contamination / 中国法医学杂志

Objective This exploratory study aimed to assess effectiveness with ethylene oxide treatment for removing DNA contamination. Methods 98 different spiked samples such as saliva, dander, skin cell, hair, blood and cartilage were conducted with ethylene oxide treatment. After extraction of samples, the dna was amplified and then the STR analysis was performed with 3130xl or 3500xl. Results A 6h EO treatment results showed that two saliva stains of 44 samples STR profile were detected; Just one hair of 54 samples treated with ethylene oxide was detected contaminating DNA with EO treatment for 8 hours. Conclusion This work suggested that it was more successful to reduce DNA contamination by using ethylene oxide treatment.

Association of perceived organizational support,job burnout and depression tendency of nurses in Zhengzhou City / 中国职业医学

OBJECTIVE: To explore the relationship among perceived organizational support,job burnout and depressive tendency in nursing staffs. METHODS: A total of 807 nurses from 7 municipal hospitals in Zhengzhou City,Henan Province were selected as the study subjects by multi-stage cluster random sampling method. The questionnaires of Perceived Organizational Support,Maslach Burnout Inventory-General Survey and Center for Epidemiological Survey-Depression Scale were used to conduct the survey. RESULTS: The total scores of perceived organizational support and job burnout were( 69. 3 ± 18. 5) and( 36. 3 ± 13. 7) respectively. The median of the total score of depression tendency was 17. 00. The total score of nurses' perceived organizational support was negatively correlated with the total scores of job burnout and depression tendency( P < 0. 01). The total score of job burnout was positively correlated with the total score of depression tendency( P < 0. 01). The degree of explanations for the change of perceived organizational support and job burnout on depression tendency were 9. 1% and 13. 1%,respectively. CONCLUSION: Perceived organizational support and job burnout play important roles in predicting depression tendency. Job burnout plays a mediating role in the relationship between perceived organizational support and depression tendency.

Quantification study of TE-MAGS magnetic bead based DNA extraction efficiency / 中国法医学杂志

Objective This study aimed to assess the efficiency and purification of the Trace DNA extraction with a quantified method for the magnetic bead-based DNA extraction as performed on the Tecan Automated systems with TE-MAGS magnetic separator. Methods Serial dilutions of standard commercial DNA 9947A were used with the total DNA contents, 0.1ng, 0.2ng,0.3ng, 0.4ng,0.5ng, 0.6ng, 0.7ng, 0.8ng, 0.9ng,1ng,diluted progressively and a 1ng DNA (standard commercial DNA 9947A) admixed with 6 common DNA-PCR inhibitors were extracted on the Automated systems and then performed via Fluorogenic probe quantitative PCR and STR genotype for the quantification analysis of recovery and purification. Results The recovery rate of standard 9947A DNA diluted with 0.1~1ng was 38.92~60.01%, and 0.3ng and more DNA could observed the full STR profiles. For the different PCR inhibitors, above 94.5% of bile acid, collagen and urea were efficient removal during the purification process, and the hemoglobin, melanin and humic acid removal efficiency were about 97.5%, 97.85%, 82.14%, respectively.Conclusion Our results suggested that The TE-MAGS magnetic bead-based DNA extraction was suitable for the extraction of trace DNA with high recovery efficiency and purification ability.

Clinical analysis of minimally invasive surgery combined with medication in the treatment of ureteral calculi / 局解手术学杂志

Objective To analyze of the efficacy of minimally invasive surgery combined with medication in the treatment of ureteral calculi.Methods From June 2013 to June 2015,124 patients with ureteral calculi which confirmed by X-ray in our hospital were collected as subjects.According to the treatment method,they were divided into control group and observation group,patients in the control group were treated with simple medication,while the observation group were treated with minimally invasive surgery combined with drug therapy.The effects of treatment and the levels of MCP-1,TFF1 and HMGB1 in urine between two groups were compared.Results The stone expulsion rate and the net rate of the observation group was higher than those of the control group,the differences were significant(P<0.05).The stone expulsion time of observation group was shorter than that of the control group,the formation rate of the observation group was lower than that of the control group,the differences were significant(P<0.05).Adverse reactions occurred in 11 cases of the observation group,in 29 cases of the control group,the incidence of adverse reactions in the observation group was lower than that in the control group,the difference was significant(P<0.05).After the treatment,17 cases of adverse drug reactions occurred in the observation group,which was more than 5 cases of adverse drug reactions in the control group,the difference was significant(P<0.05).After treatment,the levels of MCP-1 and HMGB1 in urine of two groups were decreased compared with those before treatment,the level of TFF1 was increased,the differences were significant(P<0.05);while the levels of MCP-1 and HMGB1 of the observation group after treatment were lower than those of the control group,the level of TFF1 was higher than that of the control group,the difference was significant(P<0.05).The effective rate of the observation group was 88.71％,which higher than 69.35％ of the control group,the difference was significant(P<0.05).Conclusion On the basis of medication,combined with extracorporeal shock wave lithotripsy for ureteral calculi can not only improve the therapeutic effect,but also reduce the risk of adverse reactions.