Time series analysis and prediction model of percentage of influenza-like illness （ILI） cases in Shanghai / 上海预防医学

ObjectiveTo predict the incidence trend of influenza-like illness proportion （ILI%） in Shanghai using the seasonal autoregressive integrated moving average model （SARIMA）， and to provide an important reference for timely prevention and control measures. MethodsTime series analysis was performed on ILI% surveillance data of Shanghai Municipal Center for Disease Control and Prevention from the 15th week of 2015 to the 52nd week of 2019， and a prediction model was established. Seasonal autoregressive integrated moving average （SARIMA） model was established using data from the foregoing 212 weeks， and prediction effect of the model was evaluated using data from the latter 36 weeks. ResultsFrom the 15th week of 2015 to the 52nd week of 2019， the average ILI% in Shanghai was 1.494%， showing an obvious epidemic peak. SARIMA（1，0，0） （2，0，0） 52 was finally modeled. The residual of the model was white noise sequence， and the true values were all within the 95% confidence interval of the predicted values. ConclusionSARIMA（1，0，0） （2，0，0） 52 can be used for the medium term prediction of ILI% in Shanghai， and can play an early warning role for the epidemic and outbreak of influenza in Shanghai.

Comparison of 7 methods for sample size determination based on confidence interval estimation for a single proportion / 南方医科大学学报

OBJECTIVE@#To compare different methods for calculating sample size based on confidence interval estimation for a single proportion with different event incidences and precisions.@*METHODS@#We compared 7 methods, namely Wald, AgrestiCoull add z2, Agresti-Coull add 4, Wilson Score, Clopper-Pearson, Mid-p, and Jefferys, for confidence interval estimation for a single proportion. The sample size was calculated using the search method with different parameter settings (proportion of specified events and half width of the confidence interval [ω=0.05, 0.1]). With Monte Carlo simulation, the estimated sample size was used to simulate and compare the width of the confidence interval, the coverage of the confidence interval and the ratio of the noncoverage probability.@*RESULTS@#For a high accuracy requirement (ω =0.05), the Mid-p method and Clopper Pearson method performed better when the incidence of events was low (P < 0.15). In other settings, the performance of the 7 methods did not differ significantly except for a poor symmetry of the Wald method. In the setting of ω=0.1 with a very low p (0.01-0.05), failure of iteration occurred with nearly all the methods except for the Clopper-Pearson method.@*CONCLUSION@#Different sample size determination methods based on confidence interval estimation should be selected for single proportions with different parameter settings.

Comparative Study of PD-L1 Expression in Different Sites of Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#The expression of programmed cell death ligand 1 (PD-L1) as a biomarker for immunotherapy in non-small cell lung cancer (NSCLC) is routinely detected in clinical pathology department. However, the spatial heterogeneity of PD-L1 expression in intrapulmonary tumors and extrapulmonary metastases is still a challenge for the clinical testing. This study aims to explore the differences of PD-L1 expression in test samples obtaining from different sites of NSCLC. This study may contribute to the detection strategy of PD-L1 in patients with advanced lung cancer.@*METHODS@#One hundred and thirty-one cases of consecutively detected PD-L1 (22c3 assay, Dako) staining in metastatic NSCLC and 972 cases of non-paired intrapulmonary NSCLC were collected. The discrepancies of tumor proportion score (TPS) of PD-L1 expression in intrapulmonary samples and extrapulmonary metastatic samples of different sites were compared.@*RESULTS@#The positive expression rate of PD-L1 in extrapulmonary metastatic NSCLC (TPS ≥ 1%) was 61.83%, and the TPS was significantly higher than that in intrapulmonary tumors (P=0.03). The PD-L1 scores of the specimens obtained from different sites were significantly different (P=0.007). The positive rates of PD-L1 in liver and adrenal metastases were 85.71% and 77.78% respectively, and their TPS were significantly higher than that of the intrapulmonary samples (P<0.05). The positive rates of PD-L1 in lymph node, bone, brain, soft tissue, and pleural metastases was 40.00%-66.67%, with no significant differences compared to intrapulmonary tumors. The analysis of histological subtype and sample type showed that the PD-L1 score of extrapulmonary samples of adenocarcinoma subtype or surgical specimen was significantly higher than that of intrapulmonary tumors. The analysis of clinicopathological parameters showed that the PD-L1 positive expression or high expression were significantly correlated with male patients, smoking history, and epidermal growth factor receptor (EGFR) wild type.@*CONCLUSIONS@#The expression of PD-L1 in metastatic NSCLC is generally higher than that in intrapulmonary tumor, and the positive rate of PD-L1 expression was discrepant in different sites of specimen. The differences of PD-L1 score between extrapulmonary metastatic samples and intrapulmonary samples may be associated with different metastatic sites, histological subtype, and specimen type.

O Efeito Direto do Índice de Massa Corporal nos Resultados Cardiovasculares entre Participantes sem Obesidade Central pela Estimativa por Máxima Verossimilhança Direcionada / The Direct Effect of Body Mass Index on Cardiovascular Outcomes among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation

Resumo Fundamento: O índice de massa corporal (IMC) é o índice mais usado para categorizar uma pessoa como obesa ou não-obesa, e está sujeito a limitações importantes. Objetivo: Avaliar o efeito direto do IMC nos desfechos cardiovasculares em participantes sem obesidade central. Métodos: Esta análise incluiu 14.983 homens e mulheres com idades entre 45-75 anos do Estudo de Risco de Aterosclerose em Comunidades (ARIC). O IMC foi medido como obesidade geral e a circunferência da cintura (CC), a relação cintura-quadril (RCQ) e circunferência do quadril como obesidade central. A estimativa de máxima verossimilhança direcionada (TMLE, no acrônimo em inglês) foi usada para estimar os efeitos totais (TEs) e os efeitos diretos controlados (CDEs). A proporção de ET que seria eliminada se todos os participantes fossem não obesos em relação à obesidade central foi calculada usando o índice de proporção eliminada (PE). P<0,05 foi considerado estatisticamente significativo. As análises foram realizadas no pacote TMLE R. Resultados: O risco de desfechos cardiovasculares atribuídos ao IMC foi significativamente revertido com a eliminação da obesidade na RCQ (p <0,001). A proporção eliminada dos efeitos do IMC foi mais tangível para participantes não obesos em relação à CC (PE = 127%; IC95% (126,128)) e RCQ (PE = 97%; IC95% (96,98)) para doença arterial coronariana (DAC), e RCQ (PE = 92%; IC95% (91,94)) para acidente vascular cerebral, respectivamente. Com relação ao sexo, a proporção eliminada dos efeitos do IMC foi mais tangível para participantes não obesos em relação a RCQ (PE = 428%; IC95% (408.439)) para DAC em homens e CC (PE = 99%; IC95% (89,111)) para acidente vascular cerebral em mulheres, respectivamente. Conclusão: Esses resultados indicam diferentes efeitos potenciais da eliminação da obesidade central na associação entre IMC e desfechos cardiovasculares em homens e mulheres. (Arq Bras Cardiol. 2021; 116(5):879-886)

Background: Body mass index (BMI) is the most commonly used index to categorize a person as obese or non-obese, which is subject to important limitations. Objective: To evaluate the direct effect of BMI on cardiovascular outcomes among participants without central obesity. Methods: This analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities Study (ARIC). BMI was measured as general obesity, and waist circumference (WC), waist-to-hip ratio (WHR) and hip circumference as central obesity. Targeted maximum likelihood estimation (TMLE) was used to estimate the total effects (TEs) and the controlled direct effects (CDEs). The proportion of TE that would be eliminated if all participants were non-obese regarding central obesity was computed using the proportion eliminated (PE) index. P <0.05 was considered statistically significant. Analyses were performed in the TMLE R package. Results: The risk of cardiovascular outcomes attributed to BMI was significantly reversed by eliminating WHR obesity (p<0.001). The proportion eliminated of BMI effects was more tangible for non-obese participants regarding WC (PE=127%; 95%CI (126,128)) and WHR (PE=97%; 95%CI (96,98)) for coronary heart disease (CHD), and WHR (PE=92%; 95%CI (91,94)) for stroke, respectively. With respect to sex, the proportion eliminated of BMI effects was more tangible for non-obese participants regarding WHR (PE=428%; 95%CI (408,439)) for CHD in males, and WC (PE=99%; 95%CI (89,111)) for stroke in females, respectively. Conclusion: These results indicate different potential effects of eliminating central obesity on the association between BMI and cardiovascular outcomes for males and females. (Arq Bras Cardiol. 2021; 116(5):879-886)

Morphological aspects of epididymal microscopy and rete testis in greater Rhea Americana / Aspectos morfológicos da microscopia do epitélio do epidídimo da Rhea americana

ABSTRACT: The purpose of this research was to study the histology and describe the microscopy findings of the epididymis epithelium of greater Rhea americana at three time periods: November 2005 (n=14), December 2006 (n= 20), and May 2007 (n= 20), to observe and compare the differences that occurred. We studied the epididymis from 54 rheas, bred in Santa Maria, Rio Grande do Sul, Brazil. The epididymis were collected during commercial slaughter and fixed in bouin. Optical microscopy was used to measure the cellular structure, types of cells, tubules, and stereological values like the epididymis epithelium diameters, lumen, thickness, and relative volume of the tissue structure. Additionally, electron microscopy was studied. In December 2006 and May 2007, the means of the epididymis tubular diameter were: 79.1 and 58.1 µm, epithelium thickness: 24.0 and 52.2 µm, and lumen diameter: 55.0 and 5.8 µm, respectively. Regarding the volumetric proportion, we reported the following values: epithelium volume 36.2 and 80.4%, lumen without spermatozoon 19.6 and 3.0%, lumen with spermatozoon 5.4 and 0.0%, interstitium 35.4 and 12.0%, blood vessels 3.5 and 4.6%, structures in cellular superficies 1.4 and 0%, lamina 1.4 and 3.2%, and artifacts 0.3 and 1.3%, respectively. The epididymis ducts had a circular form in transverse sections with spermatozoon only in November 2005 and December 2006. The Rhea's epididymis morphology was found to be similar to ostriches, roosters, and Japanese quail. Here, we present data from stereological microscopy (tubular diameter, epithelium thickness, and lumen diameter), volumetric proportion (epithelium, lumen without spermatozoon, lumen with spermatozoon, interstitium, blood vessels, structures in cellular superficies; cilium, estereocilium, and lamina) in this species during the repose and sexual activity period (reproductive season).

RESUMO: O objetivo desta pesquisa foi estudar a histologia e descrever os achados microscópicos do epitélio epidídimo de ema em três períodos: novembro/2005 (n = 14), dezembro/2006 (n = 20) e maio/2007 (n = 20), para observação e comparação das diferenças que ocorreram nesses tempos distintos. Estudamos o epidídimo de 54 animais, criados em Santa Maria, RS. Durante o abate comercial, os epidídimos foram coletados e fixados em Bouin. A microscopia óptica mede a estrutura celular, tipos de células, túbulos e valores estereológicos, como os diâmetros do epitélio do epidídimo, lúmen, espessura, volume relativo da estrutura do tecido. Em dezembro/2006 e maio/2007, as médias do diâmetro tubular do epidídimo foram: 79,1 e 58,1µm, espessura do epitélio: 24,0 e 52,2µm, diâmetro do lúmen: 55,0 e 5,8µm, respectivamente. Em relação à proporção volumétrica, encontramos os seguintes valores: volume epitelial 36,2 e 80,4%, lúmen sem espermatozoide 19,6 e 3,0%, lúmen com espermatozoide 5,4 e 0,0%, intestínio 35,4 e 12,0%, vasos sanguíneos 3,5 e 4,6%, estruturas celulares superfícies 1,4 e 0%, lâmina 1,4 e 3,2%, artefatos 0,3 e 1,3%, respectivamente. Os ductos do epidídimo apresentaram forma circular em cortes transversais com espermatozoide apenas em novembro/2005 e dezembro/2006. A morfologia do epidídimo de Rhea foi semelhante ao avestruz, galo e codornas japonesas. Apresentamos dados de microscopia estereológica (diâmetro tubular, espessura do epitélio, diâmetro do lúmen), proporção volumétrica, em porcentagem (epitélio, lúmen sem espermatozóide, lúmen com espermatozoide, intestório, vasos sanguíneos, estruturas em superfícies celulares - cílio - estereocílio, lâmina e artefatos) nesta espécie nos períodos de repouso e atividade sexual (estação reprodutiva).

Efficacy of precision treatment in multidrug-resistant pulmonary tuberculosis based on proportion method for drug susceptibility test / 中华传染病杂志

Objective:To explore the precision treatment effect of multidrug-resistant pulmonary tuberculosis (MDR-PTB) based on the proportion method for drug susceptibility test, and to provide a scientific basis for formulating MDR-PTB treatment plan.Methods:One hundred and eighty patients with MDR-PTB treated in Shenzhen Center for Chronic Disease Control from January 5, 2016 to April 30, 2018 were enrolled. The initial treatment plan after diagnosis was six months of amikacin (AM), pyrazinamide (Z), levofloxacin (LFX), ethambutol (E), prothionamide (PTO) and 18 months of Z, LFX, E, PTO. According to whether proportion method for drug susceptibility test for 10 commonly used drugs was implemented, patients were divided into precision treatment group and empirical treatment group. In the precision treatment group, the treatment plans were adjusted according to the results of the drug susceptibility test. The treatment plans and disease outcomes of the two groups of patients were retrospectively analyzed. Chi-square test was used for statistical analysis.Results:Among the 180 patients, there were 113 patients in the precision treatment group and 67 patients in the empirical treatment group. The drug resistance rates of the precision treatment group from low to high were: capromycin (CM) (0, 0/113), AM (2.65%, 3/113) and kanamycin (KM) (2.65%, 3/113), para-aminosalicylic acid (PAS) (7.96%, 9/113), PTO (11.50%, 13/113), ofloxacin (OFX)(38.05%, 43/113), E (39.82%, 45/113), and streptomycin(S) (76.99%, 87/113). In the precision treatment group, the drugs were adjusted for 104 person-times according to the proportion method for drug susceptibility test during the treatment, from low to high: AM (3 person-times), PTO (13 person-times), LFX (43 person-times) and E (45 person-times). The treatment success rate of the precision treatment group was 78.8%(89/113), which was higher than that of the experience treatment group (52.2%(35/67)), the difference was statistically significant ( χ2=13.805, P=0.000 2). In the precision treatment group and empirical treatment group, there were no statistically significant differences of alanine aminotransferase elevated (32.3%(31/96) vs 34.0%(18/53)), serum creatinine elevated (4.2%(4/96) vs 5.7%(3/53)), and white blood cell count decreased (24.0%(23/96) vs 22.6%(12/53)) (all P>0.05). Conclusion:The traditional treatment plan based on the proportion method for drug susceptibility test has a high success rate in the treatment of MDR-PTB, which is still a worthy choice.

A preliminary validation of the "lung surface intersegmental constant proportion landmarks" in identifying intersegmental planes during segmentectomy / 中国胸心血管外科临床杂志

@#Objective     To verify the feasibility and accuracy of the "lung surface intersegmental constant proportion landmarks", developed by our center, in identifying intersegmental planes during pulmonary segmentectomy. Methods    We prospectively enrolled the patients who planned to receive thoracoscopic segmentectomy in West China Hospital of Sichuan University and The Third People's Hospital of Chengdu from September 2021 to October 2021. We took a relatively objective and feasible method, intravenous injection of indocyanine green, in identifying intersegmental planes as standard control. We intraoperatively judged the consistency between "lung surface intersegmental constant proportion landmarks" and intravenous injection of indocyanine green in identifying intersegmental planes. We discerned main landmarks of intersegmental plane by the constant proportion segment module, which was built based on the "lung surface intersegmental constant proportion landmarks", as well as distinguished the planes with discrepant fluorescence by peripheral intravenous indocyanine green injection. When the distance between the landmarks determined by the "ung surface intersegmental constant proportion landmarks" and the segmental boundaries displayed by indocyanine green  fluorescence staining was ≤1 cm, the landmarks were judged to be consistent with the planes with discrepant fluorescence. As long as one of the landmarks was judged to be consistent, the method was considered to be feasible and accurate. Results 聽 聽 A total of 21 patients who underwent thoracoscopic segmentectomy were enrolled, with 5 male and 16 female patients. The median age was 55 years, ranging from 34 to 76 years. A total of 11 patients received left-side surgery, while 10 patients received right-side surgery. In the operations of 21 pulmonary segmentectomies, at least one intersegmental landmark determined by the "lung surface intersegmental constant proportion landmarks" was consistent with the intersegmental plane determined by indocyanine green fluorescence staining in each patient. Conclusion 聽 聽The intersegmental landmarks determined by the "lung surface intersegmental constant proportion landmarks" are consistent with that determined by indocyanine green fluorescence staining. The method of "lung surface intersegmental constant proportion landmarks" is feasible and accurate in identifying intersegmental planes during pulmonary segmentectomy.

Analysis of the Relationship Between the Quality of Small Biopsy Specimens of Non-small Cell Lung Cancer and the Mutation Rate of EGFR Gene / 中国肺癌杂志

BACKGROUND@#Epidermal growth factor receptor (EGFR) is the gene with the highest mutation rate in non-small cell lung cancer (NSCLC) patients, and the accurate evaluation of its mutational status can facilitate patients receiving targeted drug therapy and thereby prolong patients' survival. The gene testing platform has adequacy requirements for the specimen quality in order to obtain accurate examination results. It has been reported that the number and proportion of tumor cells in samples will affect the detection rate of EGFR gene mutation. The present study aims to analyze the relationship between the quality of small biopsy specimens of NSCLC and the mutation rate of EGFR gene with amplification refractory mutation system (ARSM) test.@*METHODS@#After collecting the clinical characteristics of 299 cases small biopsy of lung adenocarcinoma, DNA concentration of the specimens and the mutational status of EGFR gene, the number and proportion of tumor cells in HE stained sections evaluated using light microscopy, the relationship between specimen quality and the mutation rate of EGFR gene were analyzed.@*RESULTS@#The mutation rates of EGFR for the groups with tumor cell number ≤500 and >500 were 40.7% (11/27) and 43.8% (119/272) respectively, without significant difference (P=0.764). The mutation rates for the groups with DNA concentration ≤20.4 ng/μL and >20.4 ng/μL were 42.7% (64/150) and 44.3% (66/149) respectively, without significant difference (P=0.776). The mutation rates for the groups with tumor cells proportion ≤30% and >30% were 29.4% (20/68) and 47.6% (110/231) respectively, demonstrating significant difference (P=0.008). Multivariate Logistic analysis showed that male, thyroid transcription factor-1 (TTF-1) negative, smoking history and tumor cell proportion less than 30% were main factors that contributes to the low detection rate of EGFR gene mutation.@*CONCLUSIONS@#After meeting the minimum requirements for detection, the EGFR mutation rate is affected by the proportion of tumor cells in the sample. Therefore, it is necessary to re-evaluate the tumor cell proportion in the last section after the genetic test section. For samples with lower tumor cell proportion, enriching tumor cells through microdissection and other methods is recommended for a more accurate detection result. For specimens that cannot be enriched with tumor cells, circulating tumor DNA (ctDNA) test can be performed as a supplement. If the result is still negative, another biopsy should be considered to obtain enough tumor specimens for molecular testing.

Estado actual de Melongena melongena (Mollusca: Gastropoda) en la bahía de Cispatá, Caribe Colombiano / Current status of Melongena melongena(Mollusca: Gastropoda) in Cispatá Bay, Colombian Caribbean

RESUMEN Objetivo. Evaluar el estado actual de Melongena melongena en la bahía de Cispatá, Caribe Colombiano a través de los aspectos poblacionales de la especie. Materiales y métodos. Se establecieron tres sectores de muestreo, conforme con la zonificación de los manglares en la bahía. Para la recolección del material biológico se ubicó un transecto lineal de 4 x 20 m perpendicular al área del manglar con dos replicas a una distancia de 50 m. Para la determinación del sexo, se tomó una submuestra de 10 individuos con tallas superiores a la estimada para la madurez sexual de la especie. A las conchas se les midió la longitud total, con el fin de diferenciar las tallas de hembras y machos. En cada sector, la temperatura del agua y salinidad fueron registradas in situ, empleando un medidor multiparámetro Extech EC170, mientras la trasparencia del agua se calculó mediante el disco Secchi. Resultados. Se registraron un total de 1.149 individuos de M. melongena, obteniendo la mayor abundancia el sector Caño Salado (522), seguido de Las Cagás (458) y finalmente Amaya (169). El 63% de los individuos se encontraron en un intervalo de talla entre 41-61 mm. La proporción sexual fue 1:1.2 (H:M). Las tallas registradas en hembras fueron de 55 a 92 mm y en machos de 54 a 77 mm. Conclusiones. M. melongena en la bahía de Cispatá está presentando signos evidentes de recuperación en la última década, debido a que la mayoría de los individuos registrados han alcanzado la talla media de madurez sexual.

ABSTRACT Objective. Evaluate the current status of Melongena melongena in Cispata Bay, Colombian Caribbean through the population aspects of the species. Materials and methods. Three sampling sectors were established, according to the zoning of the mangrove in the bay. For the collection of the biological material a linear transect of 4 x 20 m was located perpendicular to the area of the mangrove with two replicas at a distance of 50 m. For the determination of sex, a subsample of 10 individuals with sizes greater than that estimated for the sexual maturity of the species was taken. The shells were measured in total length, in order to differentiate the sizes of females and males. In each sector, the water temperature and salinity were measured in situ using an Extech EC170 multiparameter while water transparency is calculated using the Secchi disk. Results. A total of 1,149 individuals of M. melongena were recorded, obtaining the highest abundance in the Caño Salado sector (522), followed by Las Cagás (458) and finally Amaya (169). 63% of the individuals were in a size range between 41-61 mm. The sex ratio was 1:1.2 (H:M). The sizes recorded in females were from 55 to 92 mm and in males from 54 to 77 mm. Conclusions. M. melongena in Cispatá Bay is showing evident signs of recovery in the last decade, because most of the registered individuals have reached the average size of sexual maturity.

India Diverges in Gender Proportion in COVID-19: A Health Management Study

The primary objective of this study was to investigate the male and female proportion for variouscountries and India. The secondary aim of the study was to identify the multiple influencing factorsthat are playing a role in the male to female ratio and how India differs from other countries. For thisstudy, we have used the available data and reports from various countries, health organisations andWHO from Dec 2019 to May 2020 for comparison and interpretation. There are multiple influencersfor women getting less infected by COVID-19. There are biological reasons such as chromosomesand oestrogen; lifestyle reasons such as smoking and drinking habits, and controlled food habits;social causes such as working hard in rural areas, less exposure to the crowd and minimalinternational travelling opportunities; cultural reasons such as less social gathering, default socialdistancing system and also there is an assumption that Indian women are culturally more disciplined.It is vital to understand gender-based differences in the human immune systems and how it affects thespread of the virus. Knowing the steps and precautionary measures can help us to prevent the spreadof coronavirus. Prevention is always better than cure. By following the advisories from WHO andother nation’s health organisation, making a collaborative effort, we all should be able to managebetter.

Ingredients changes in Rehmanniae Radix processing based by HPLC-ELSD specific chromatogram / 中国中药杂志

To establish the HPLC-ELSD specific chromatogram analysis method of Rehmanniae Radix and Rehmanniae Radix Prae-parata, and analyze and compare their chemical compositions, so as to reveal the change regularity of compositions during the proces-sing. By HPLC-ELSD method, the chromatographic column for Prevail Carbohydrate ES(4.6 mm ×250 mm, 5 μm) was adopted, with acetonitrile(A)-water(B) as mobile phase for gradient elution, and the evaporative light-scattering detector was used. A total of 23 batches of Rehmannia Radix samples, and 25 batches of Rehmanniae Radix Praeparata samples and processing dynamic samples were compared. The established method had a great repeatability, precision and stability. Eight common chromatographic peaks were extracted from 23 batches of Rehmanniae Radix samples, 8 common peaks were extracted from 25 Rehmanniae Radix Praeparata, and 7 chromatographic peaks were identified. The composition ratio of Rehmannia Radix was changed greatly during the processing. When the simila-rity≥0.95 and the fructose peak area was more than 2 times of stachyose tetrahydrate or more than 20 times of raffinose, the processing degree conformed to the requirements of empirical identification. The three main oligosaccharides of Rehmanniae Radix were sucrose that was heated to generate fructose and glucose, stachyose tetrahydrate that was heated to generate melibiose, sucrose and fructose, and stachyose tetrahydrate that was heated to generate manninotriose. The change in the index of proportion between monosaccharides and oligosaccharides can be used as the quantitative criterion for the processing quality of Rehmanniae Radix Praeparata.

Evaluación del nivel de inglés en los programas de enfermería en Colombia: 2011-2016 / Evaluation of the English level in Colombian nursing programs: 2011-2016

Objetivo: evaluar si se cumplió la meta del Gobierno de Colombia para el 2014 de que el 20 % de los graduandos de programas de enfermería de las instituciones colombianas de educación superior se clasifiquen en nivel intermedio o superior en inglés. Metodología: se emplearon los resultados del módulo de inglés de la base de datos de las pruebas Saber Pro del Instituto Colombiano para la Evaluación de la Educación (2011-2016). Los niveles de calificación de este módulo son adaptados del Marco Común Europeo de Referencia. Para inferir respecto al logro de la meta de la política se realizaron pruebas de proporciones paramétricas y no paramétricas. Adicionalmente, se hicieron ajustes sobre el valor p. Resultados: ningún programa cumplió estadísticamente con la meta. Sin embargo, cuando solo se realizó la prueba de comparación de proporciones paramétrica y no paramétrica (sin corrección por hacer múltiples comparaciones), el programa de la Universidad del Valle, sede Cali, sí la cumplió. Conclusión: la meta propuesta por el Programa de Fortalecimiento al Desarrollo de Competencias en Lenguas Extranjeras para el 2014 no se cumplió en el caso de los estudiantes de enfermería evaluados; solo el 2,36 % alcanzó el nivel B+ ese año. Además, se encuentran rezagados respecto a los programas de medicina, economía y administración de empresas

Objective: To determine if universities' nursing programs reached the goal established in 2014 by the Colombian government of having 20% of higher education graduates reaching an intermediate or superior level in English. Methods: The research used a descriptive and statistical approach (parametric and non-parametric tests) using the data of nursing students in Higher Education Institutions who took Saber Pro test (2011 -2016). The grades of this module are adapted to the Common European Framework of Reference for Languages. In order to make inferences in respect to the achievement of the government's goal, parametric and non-parametric proportionality tests were carried out. Additionally, adjustments were made to the p-value to avoid the bias that results from generating a joint conclusion from joining results of an individual test. Results: No nursery program met the statis-tical goal. However, Universidad del Valle's nursing program met the goal if only the parametric and non-parametric proportion comparison tests (without correction for multiple comparisons) are considered. Conclusion: Overall, the goal of the Program for the Strengthening of the Development of Competency in Foreign Languages by 2014 was not met by nursing students: just 2.36% of them achieved an intermediate or higher level of English in 2014. In addition, nursing students fall behind student in medicine, economics and business administration programs

Assessment of facial analysis measurements by golden proportion / Avaliação das medidas de análise facial pela proporção áurea

Abstract Introduction: The face is the most important factor affecting the physical appearance of a person. In facial aesthetics, there is a specific mathematical proportion, which is called golden proportion, used to measure and analyse facial aesthetic qualities in population. Objectives: The aim of this study was to measure the facial soft tissue proportions which would help to constitute a standard for facial beauty and diagnose facial differences and anomalies and to compare these proportions to the golden proportion. Methods: One hundred and thirty-three (133) Turkish patients 18-40 years of age (61 females, 72 males) were involved in the study. Analysis of the photographs was performed by the same physician, and a software programme was used (NIH Image, version 1.62). Facial proportions were measured and differences from the golden proportions were recorded and grouped as normal (1.6-1.699), short (<1.6) and long (>1.699). Results: According to the facial analysis results, the trichion-gnathion/right zygoma-left zygoma was assessed: 33.1% of the patients were in normal facial morphology, 36.8% were in long facial morphology and 30.1% were in short facial morphology, according to this proportion. The trichion-gnathion/right zygoma-left zygoma proportion was significantly higher in males than females (p < 0.001). Statistically significant difference was noted in gender groups, according to the trichion-gnathion/right zygoma-left zygoma and the right lateral canthus-left lateral canthus/right cheilion-left cheilion proportions (p = 0.001, p = 0.028). Conclusion: Facial proportion assessments in relation to the golden proportion showed that a statistically significant difference was observed between gender groups. Long facial morphology was observed more in males (51.4%); normal (41%) and short (39.3%) facial morphology were more common in females. The measurements and proportions for facial balance in our study population showed that the facial width and height proportions deviated from the golden proportion.

Resumo Introdução: A face é o aspecto mais importante da aparência física de uma pessoa. Na estética facial, existe uma proporção matemática específica, chamada de proporção áurea. A proporção áurea é usada para medir e analisar as qualidades estéticas da face na população. Objetivo: Medir as proporções dos tecidos moles faciais que contribuem para o padrão da beleza facial, auxiliar a percepção e o diagnóstico das diferenças e anomalias faciais e comparar essas proporções com a proporção áurea. Método: Foram incluídos no estudo 133 pacientes turcos com 18 a 40 anos (61 mulheres, 72 homens). A análise das fotografias foi realizada pelo mesmo médico e um programa de software foi usado (NIH Image, versão 1.62). As proporções faciais foram medidas e as diferenças das proporções áureas foram registradas e agrupadas como normais (1,6-1,699), curtas (< 1,6) e longas (> 1,699). Resultados: De acordo com os resultados da análise facial, avaliou-se a proporção do tríquion-gnátio/zigoma direito-zigoma esquerdo e 33,1% dos pacientes apresentaram morfologia facial normal, enquanto 36,8% tinham morfologia facial longa e 30,1% morfologia facial curta, segundo essa proporção. A proporção do tríquion-gnátio/zigoma direito-zigoma esquerdo foi significantemente maior em homens do que em mulheres (p < 0,001). Uma diferença estatisticamente significante foi observada entre os sexos, de acordo com a proporção do tríquion-gnátio/zigoma direito-zigoma esquerdo e do canto lateral direito-canto lateral esquerdo/ângulo cantal direito- ângulo cantal esquerdo (p = 0,001, p = 0,028). Conclusão: A avaliação da proporção facial em relação à proporção áurea mostrou que houve diferença estatisticamente significante entre os sexos. A morfologia facial longa foi mais observada no sexo masculino (51,4%), a morfologia facial normal (41%) e a curta (39,3%) foram mais comuns no sexo feminino. As medidas e proporções para o equilíbrio facial em nossa população estudada mostraram que as proporções de largura e altura faciais se desviaram da proporção áurea.

Comparative Evaluation of Golden Proportion, Recurring Esthetic Dental Proportion and Golden Percentage in Himachal Demographic

Aim:The purpose of this study was to comparatively evaluate the validity of Golden Proportion, Recurring Esthetic Dental (RED) proportion and Golden Percentage in maxillary anterior teeth in population of Himachal Pradesh.Methods and Materials:Dentulous stone casts of maxillary arch were made of the subjects who met the inclusion criteria. Conditions for inclusion criteria included that the individuals:1) should be of Himachaliorigin with agreeable smiles 2) have well aligned anterior dentition 3) should be between age group of 20-40 years Total of 200 students representing Himachal Pradesh population were included. Measurements were done for the spaces in the grids using the digital caliper. Results:1)The Golden Proportion ratio of 1.3 and 1.4 were more commonly observed in 27.5% and 40% respectively than 1.618 which was observed in 5.5% under study of the population. 2)A Paired sample t-test showed there was no significant gender based difference in Lateral/Central incisor Red Proportion.(P-value>0.05) except for the Canine/Lateral Red Proportion. (P-value<0.05). 3)The Golden Percentage for males in central and lateral incisors and canine was 22.48%, 15.96% and 11.08% respectively. The mean value for females in central and lateral incisors and canine was 22.72%, 16.25% and 10.97% respectively. Conclusions:Golden percentage could be used for aesthetic correction and was found to be more applicable in the population included in this study. Golden percentage could be used for aesthetic correction and are more applicable to natural dentition in the population of Himachal Pradesh.

Proportion of pulmonary valve annulus: A new predictive index for transannular patch in repair of tetralogy of Fallot / 中国胸心血管外科临床杂志

@#Objective To investigate if the ratio of pulmonary valve annulus, which is the proportion of pulmonary valvular annulus size to total size of aortic valvular annulus and pulmonary valvular annulus, can better guide the choice of surgical approach than the value of z. Methods A retrospective analysis was made for 254 patients who underwent total correction of tetralogy of Fallot in Guangdong General Hospital between January 2016 and January 2018. There were 154 males and 100 females with an average age of 14.60±18.76 years. The patients were categorized into two groups, a transannular patch group (TAP, n=164) and a non-TAP group (n=90). The sizes of pulmonary and aortic valvular annulus were evaluated in each group, and the cutoff value of proportion of pulmonary valvular annulus for TAP was calculated. Results Both proportion of pulmonary valvular annulus and z-scores were smaller in the TAP group than those in the non-TAP group (0.29±0.06 vs. 0.36±0.06, P<0.001; –4.04±2.13 vs. –2.06±1.84, P<0.001, respectively). In receiver operating characteristics analyses, proportion of pulmonary valvular annulus and the z-score cutoff values were 0.353 (area under the curve 0.781, 95%CI 0.725–0.831) and –2.13 (area under the curve 0.766, 95%CI 0.709–0.817), respectively, demonstrating that the proportion of pulmonary valvular annulus was a more powerful diagnostic tool as a predictor of TAP. Conclusion Our results suggest that the proportion of pulmonary valvular annulus is an effective predictor for TAP and can be easily applied to clinical practice.

Role of the proportion of dominant follicles in patients with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer / 中华医学杂志(英文版)

Background@#There is no absolute consensus for the best time for triggering. The aim of this study was to investigate the effect of different proportion of dominant follicles (PDF) on the human chorionic gonadotropin (HCG) day for the clinical outcomes in patients with polycystic ovary syndrome (PCOS) of different ovarian stimulation protocols.@*Methods@#A total of 371 cycles of the gonadotropin-releasing hormone (GnRH) agonist long protocol and 347 cycles of GnRH antagonist protocol from January 2014 to December 2016 were included in this retrospective study. Based on the PDF on the day of the HCG administration, the included patients were divided into three groups: Group A (low PDF), PDF <20%; Group B (medium PDF), 20%≤ PDF ≤40%; Group C (high PDF), PDF >40%. The measurements regarding ovarian stimulation characteristics, fertilization rate, top quality embryo rate, clinical pregnancy rate, and ovarian hyperstimualtion syndrome (OHSS) rate were compared in different PDF groups with different protocols.@*Results@#In both the GnRH antagonist protocol and GnRH agonist long protocol, the characteristics such as mean age, anti-Mullerian hormone, antral follicle count (AFC), and body mass index were comparable between groups. The number of oocytes retrieved decreased statistically significantly as the PDF and rate of matured oocytes increased. In the GnRH agonist long protocol, the rate of normally fertilized oocytes was highest in Group A (59.74 ± 31.21 vs. 49.70 ± 37.95, 49.67 ± 36.62; F = 3.743, P = 0.025). There were no significant differences in the rate of top-quality embryos and the clinical pregnancy rate between the groups. The clinical pregnancy rate was similar in the three groups (63.6%, 62.5%, 67.5%, respectively, χ2 = 0.989, P = 0.911). The moderate and severe OHSS rate increased statistically significantly when the PDF increased, which was highest in group C (1.4%, 3.1%, 6.7%, respectively, χ2 = 12.014, P = 0.017). In the GnRH antagonist protocol, there were no significant differences in the rate of top-quality embryos, the rate of normally fertilized oocytes, the clinical pregnancy rate, and the moderate and severe OHSS rate between the groups. The clinical pregnancy rate in Group C was higher than that in Group A (57.9% vs. 46.6%, χ2 = 10.850, P = 0.093).@*Conclusions@#In the GnRH antagonist protocol, PDF on the HCG day of less than 20% may be unfavorable to the clinical pregnancy rate in PCOS. In the GnRH agonist long protocol, delaying the HCG trigger timing has no good effect on clinical pregnancy and the risk of OHSS might increase in patients with PCOS.

Analysis of esthetic factors and evaluation of esthetic perception for maxillary anteriors of dental students / 대한치과보철학회지

PURPOSE: This research is to investigate factors that affect dental aesthetics and analyze whether individual perception affects and difference of genders affects the esthetic factors. MATERIALS AND METHODS: Seventy dental students of Chonnam University aged from 25 to 35 years old without periodontal problems were included. Maxillary dental cast for participants were made, and standardized photo was taken with a digital camera. Maximum visual width and the position of gingival zenith of maxillary anterior teeth and maximum height of the maxillary central incisors were measured by a measurement program and the shape of central incisor was categorized. Questionnaire was conducted to evaluate esthetic perception. SPSS program was used to perform statistical analysis. RESULTS: The average visual width ratio of right maxillary anteriors was 1.38:1:0.78 and 1.41:1:0.81 for the left which differ from the golden ratio. The width to height ratio for right and left central incisor was 0.84 and 0.83 respectively. The gingival zenith position was determined to be: mostly, central incisors and canines were located in the distal side, lateral incisors were located in the center. The visual width ratio of right maxillary anterior teeth, ratio of width to height of central incisor, gingival zenith position, crown morphology and amounts of gingival exposure upon smiling were not significantly different between genders, and facial patterns and these dental esthetic factors were not related to aesthetic perception. CONCLUSION: Even though participants had the visual width ratio of maxillary anteriors or ideal width to ideal height of central incisors that did not agree with the golden ratio, they had high satisfaction for dental esthetics. Esthetic perception depends more on subjective judgements of participants than objective indices.

Trend of disease spectrum of hospitalized children in Anhui provincial children’s hospital from 2013 to 2017 / 中华疾病控制杂志

@# Objective To investigate the composition of the disease spectrum of hospitalized children in Anhui Provincial Children's Hospital, so as to provide scientific basis of the strategy to refine pediatric medical resources and health care. Methods Totally 268809 patients from 2013 to 2017 was analyzed and compared with the 2003-2007 data. Results Compared to 2003-2007, the number of hospitalized children and involved diseases increased significantly in 2013-2017. The proportion of common diseases such as respiratory system (28.73% vs 26.49%), digestive system (12.68% vs 10.78%), and nervous system (6.22% vs 3.72%)) significantly decreased; while the proportion of injury and poisoning (2.13% vs 7.4%), infectious diseases, parasites (7.15% vs 10.69%), tumors (2.65% vs 4.12%), and blood immunity (1.42% vs 3.19%) increased. Respiratory diseases remain the first ranking disease in hospitalized children (26.49%), with pneumonia as the first ranking single disease among it. The top 5 hospitalized children in 2013-2017 were pneumonia, bronchitis, hernia, respiratory infections, and neonatal pneumonia. Conclusions The absolute number and capacity of services have been greatly improved in the hospital. While constantly improving the level of diagnosis and treatment of common diseases, we should pay more attention to the injury poisoning, mental and behavioral diseases and infectious diseases in children.

Optimization of the Best Proportion of Astragalus membranaceus Injection Combined with Erigeron breviscapus Injection against Cerebral Ischemia-reperfusion Injury in Rats by Baseline Geometric Proportion Increasing and Decreasing Design / 中国药房

OBJECTIVE： To screen the best proportion of Astragalus membranaceus injection combined with Erigeron breviscapus injection against cerebral ischemia-reperfusion injury in rats. METHODS： Male SD rats were randomly divided into sham operation group， model group and administration group [different A. membranaceus injection-E. breviscapus injection proportion groups， being A（0 ∶ 10）， B（2 ∶ 8）， C（4 ∶ 6）， D（6 ∶ 4）， E（8 ∶ 2）， F（10 ∶ 0）groups， set by baseline geometric proportion increasing and decreasing design]， with 8 rats in each group. Except for sham operation group， reperfusion injury model of middle cerebral artery occlusion were induced by modified suture method in rats. The each administration group was given relevant medicine intraperitoneally once immediately after inducing model， and then given again after 24 hours （medication interval between the two injections of 30 min）. Constant volume of normal saline was given to rats in sham operation group and model group. Forty-eight hours after reperfusion， Longa scoring method was used to evaluate neurological impairment of rats， and neurological impairment score was recorded. Serum content of MDA and activity of SOD were measured by colorimetry assay. TTC assay was used to detect cerebral infraction， and cerebral infarction rate was calculated. Kim’s formula was used to calculate the synergistic index （q） of rats in administration groups. RESULTS： Compared with sham operation group， neurological impairment score and serum content of MDA were increased significantly in model group， while activity of SOD was decreased significantly （P＜0.01）. The area of cerebral infarction increased significantly， and the rate of cerebral infarction increased significantly （P＜0.01）. Compared with model group， neurological impairment scores and serum contents of MDA were decreased significantly in group A， B， C， D and E； neurological impairment score of group C was significantly lower than those of group A and F； serum contents of MDA in group B， C， D and E were significantly lower than that of group F （P＜0.05 or P＜0.01）. Activities of SOD in group A， B， C， D and E were increased significantly， and group C was significantly higher than group F （P＜0.05 or P＜0.01）. The cerebral infarction area of rats in each administration group was reduced to varying degrees. The cerebral infarction rates of rats in group B， C， D and E were significantly reduced， and group C and D were significantly lower than group F， while group C was significantly lower than group A （P＜0.05 or P＜0.01）. The q values of group B， C， D and E were 0.90， 1.30， 1.00， 0.70 （neurological impairment score） and 0.79， 1.27， 0.98， 0.82 （cerebral infarction rate）. CONCLUSIONS： Different ratios of A. membranaceus injection and E. breviscapus injection have certain protective effects on cerebral ischemia-reperfusion injury model rats， can relieve their neurological deficits， alleviate their oxidative stress and reduce their cerebral infarction areas. The effect of the combination of the two drugs is better than that of single use， and the optimum ratio is 4 ∶ 6.

Study on Improvement Effects of Different Proportions of Total Ginsenoside of Ginseng ，Total Glucosides of Moutan Cortex and Paeonol Containing Serum on HUVEC Injury Induced by H 2O2 / 中国药房

OBJECTIVE： To study improvement effects of different proportions of total glucosides of ginseng （TGG）， total glucosides of moutan cortex （TGM） and paeonol containing serum on the injury of human umbilical vein endothelial cells （HUVEC） injury induced by hydrogen peroxide （H2O2）， screen the optimal proportion and investigate its mechanism. METHODS： The rats were randomly divided into blank group （distilled water）， TGG group （TGG， 2.025 g/kg）， TGM group （TGM， 4.05      g/kg） and paeonol group （paeonol， 1.08 g/kg）， with 12 rats in each group. They were given relevant medicine twice a day for consecutive 7 days. 1 h after last medication， the blood samples were collected via abdominal aorta to prepare drug containing serum. Using survival rate of HUVEC as evaluation indexes， different proportions of TGG， TGM and paeonol containing serum as factors， L9（34） orthogonal test was designed to optimize the optimal proportion of 3 kinds of drug containing serum. HUVEC were divided into blank group， model group， TGG group， TGM group， paeonol group and optimal proportion group. Except that blank group were treated with relevant medium， other group were treated with 1.2 mmol/L H2O2 to induce HUVEC injury， and then TGG group （volume fraction of drug containing serum was 0.000 5％）， TGM group （volume fraction of drug containing serum was 0.000 5％）， paeonol group （volume fraction of drug containing serum was 1％） and optimal proportion group were intervened with drug containing serum. The levels of LDH， NO and ET-1 in cells were detected by microplate method and ELISA. RESULTS： The optimal proportion of drug containing serum were TGG 0.000 5％， TGM 0.000 5％ and paeonol 1％. Compared with blank group， the levels of LDH and ET-1 were higher in model group （P＜0.01）， while NO level was lower （P＜0.05）. Compared with model group， the levels of NO were higher in TGG group， TGM group and optimal proportion group （P＜0.01）， while the levels of LDH and ET-1 were lower （P＜0.05 or P＜0.01）. Compared with TGG group， TGM group and paeonol group， the level of LDH was lower in optimal proportion group （P＜0.05 or P＜0.01）， while the level of NO was higher （P＜0.05 or P＜0.01）. CONCLUSIONS： TGG and TGM combined with paeonol can significantly improve HUVEC injury induced by H2O2， and the mechanism of which may be associated with the decrease of LDH and ET-1 and the increase of NO.