Trends and risk factors of anaemia among the nutrition improvement program for rural compulsory education students aged 6-15 years, Hunan Province / 中国学校卫生

Objective@#To investigate the prevalence of anemia among students aged 6-15 years old participated in the Nutrition Improvement Program for Rural Compulsory Education Program in 2012-2021 in Hunan Province, and to explore associated factors.@*Methods@#A cluster random sampling method was used. The survey was conducted among compulsory education students who came from counties in Hunan Province where nutrition improvement plan and key surveillance were carried out. Height and weight were measured, hemoglobin, dietary habits and health knowledge were collected.@*Results@#Since the implementation of nutrition improvement plan in 2012, the anemia rate decreased from 12.8% to 9.3%, the average hemoglobin content decreased from 133.9 g/L to 130.0 g/L. The proportion of students eating meat every day increased from 20.4% to 47.3%. Students eating three or more servings of table tennis ball size of meal increased from 21.4% to 47.3%. The proportion of students eating more than three kinds of vegetables per day was 39.1% in 2016 and 32.6% in 2019, and less than 30% in other years. The proportion of students eating three or more servings of table tennis ball size of vegetables increased from 19.5% to 39.6%, and the proportion of students eating snack less than once a day increased from 13.1% to 76.9%. The proportion of students drinking beverages less than once a day increased from 36.5% to 90.7%. Girls, older than 12 years, not eating meat every day, and who eat less than 1 serving of table tennis ball size of meat, eat less than 3 servings of table tennis ball size of vegetables and fruit at one time, and who eat less than 3 kinds of vegetables every day, and those who grow slowly had higher risk of anemia. Potential factors of anemia in students varied by survey year.@*Conclusion@#The implementation of the compulsory education has improved the nutritional status of compulsory education students in rural areas of Hunan Province, but anemia still occurs. Potential factors associated with childhood anemia are changing. Child health literacy education should adapt to the changing social and economic enviornment, as well as lifestyles. Targeted and appropriate nutritional education and intervention are greatly needed.

Seven cases of severe pneumocystis jirovecii pneumonia in children with non-human immunodeficiency virus infection and a literature review / 中国小儿急救医学

Objective:To summarize the clinical features and treatment of pneumocystis jirovecii pneumonia(PCP) in children with non-human immunodeficiency virus(HIV) infection.Methods:A retrospective study was performed on seven cases of severe PCP children with non-HIV infection who were admitted to PICU of The University of Hong Kong-Shenzhen Hospital and PICU of Xianyang Rainbow Hospital from May 1, 2015 to May 1, 2021.The risk factors, clinical manifestations, laboratory results, pulmonary radiological features, treatment and outcomes were observed.Results:Seven children with PCP, including four males and three females, aged from 13 months to 85 months[(42.4±26.8) months], were all associated with underlying diseases, and most of which was hematological malignancies.Six children had a history of using TMP-SMX for PCP prevention, but four of them stopped by themselves and infected PCP in 2 to 4 weeks.All children had hypoxic respiratory failure, whose OI was 30.6±3.4, and presented with fever, dry cough, progressive dyspnea but no lung rales in the early stage.LDH[(745.7±317.0) U/L] and β-D-glucan[(513.8±225.0) pg/mL] increased in all patients.Chest CT showed diffused interstitial changes in bilateral lung fields associated with multiple exudative lesions.Among the anti-Pneumocystis Jirovecii treatment regimens, all cases began the treatment in the first three days during the admission, five cases were treated with intravenous TMP-SMX, and two cases were treated with oral TMP-SMX + caspofungin, with a course of 21 days.All children were also treated with glucocorticoid at the same time.Three days after the treatment of PCP, two children were worsened and one of them died, while another one started to recover on the 6th day of the regimen.The remaining five cases began to show clinical improvement after 3~7 days of PCP treatment.Finally six children were cured and one was died.Conclusion:PCP infection of children without HIV has high risk of destruction in immune system.TMP-SMX can prevent PCP effectively.In the severe PCP cases, early commencement of intravenous TMP-SMX can reduce the mortality rate.In the absence of intravenous TMP-SMX, oral TMP-SMX can be used with caspofungin.

Application of Near-Infrared Fluorescence Imaging with Indocyanine Green in Totally Laparoscopic Distal Gastrectomy

Purpose@#Recently, totally laparoscopic gastrectomy has been gradually accepted by surgeons worldwide for gastric cancer treatment. Complete dissection of the lymph nodes and the establishment of the surgical margin are the most important considerations for curative gastric cancer surgery. Previous studies have demonstrated that indocyanine green (ICG)-traced laparoscopic gastrectomy significantly improves the completeness of lymph node dissection. However, it remains difficult to identify the tumor location intraoperatively for gastric cancers that are staged ≤T3. Here, we investigated the feasibility of ICG fluorescence for lymph node mapping and tumor localization during totally laparoscopic distal gastrectomy. @*Materials and Methods@#Preoperative and perioperative data from consecutive patients with gastric cancer who underwent a totally laparoscopic distal gastrectomy were collected and analyzed. The patients were categorized into the ICG (n=61) or the non-ICG (n=75) group based on whether preoperative endoscopic mucosal ICG injection was performed. @*Results@#The ICG group had a shorter operation time and less intraoperative blood loss.Moreover, significantly more lymph nodes were harvested in the ICG group than the non-ICG group. No pathologically positive margin was found and there was no significant difference in either the proximal or distal surgical margins between the 2 groups. @*Conclusions@#Near-infrared fluorescence imaging with ICG can be successfully used in totally laparoscopic distal gastrectomy, and it contributes to both the completeness of D2 lymph node dissection and confirmation of the gastric transection line. Well-designed prospective randomized studies are needed in the future to fully validate our findings.

Ater-soluble Protein Profiles of Astragalus membranaceus var. mongholicus and A. membranaceus / 中国实验方剂学杂志

Objective::Astragalus membranaceus var. mongholicus and A. membranaceus are medicinal Astragalus, which are closely related and similar in composition, but with unclear medicinal value. Water-soluble protein profiles for A. membranaceus var. mongholicus and A. membranaceus were established to explore the differences between the two kinds of Astragalus Radix. Method::The water-soluble protein components were obtained through water ultrasonic extraction and acetone precipitation. After digested with trypsin, the obtained peptides were analyzed by nano ESI-LC-MS/MS method. Proteome Discovery 1.4 software was used to identify the proteins by comparing with the legume protein database, and the different expression water-soluble proteins were analyzed by the label-free quantitative software SIEVE. Finally, relevant information for common expression proteins, including classification, molecular function, involved biological process and signaling pathway, were analyzed by bioinformatics. Result::There were 920 and 717 specific proteins identified for A. membranaceus var. mongholicus and A. membranaceus, respectively. Totally 472 proteins were found to be co-expressed, in which 21 were differentially expressed, such as PR-10 protein, NDK-1 protein, glutelin A2, and phospholipase D. There were 14 highly expressed proteins in A. membranaceus var. mongholicus and 7 highly expressed proteins in A. membranaceus. Conclusion::There are significant differences in water-soluble protein profiles for two kinds of Astragalus Radix. Specific proteins, differentially expressed proteins and common expressed proteins can provide references for the identification of A. membranaceus var. mongholicus and A. membranaceus. It also can be used to define pharmacological mechanisms and search for drug action targets.

The role of comprehensive first-aid training in improving medical students' comprehensive first-aid ability / 中华医学教育探索杂志

Objective:To explore the role of comprehensive first aid skills training in improving medical students' comprehensive first aid ability.Methods:Eighty-seven medical students were enrolled in this study, and received the training of comprehensive first aid skills developed by the emergency medicine teaching and research section of our hospital. The scores of individual first aid ability, emergency handling ability, team cooperation ability, organization and coordination ability and communication ability before and after the training were analyzed. At the same time, a questionnaire survey was conducted among students to understand their evaluation and recognition of the training. SPSS 10.0 was used for t test. Results:After the training, the total score of comprehensive first aid ability was increased significantly [(73.55±3.89) vs. (63.53±3.06)], and the scores of emergency handling ability [(10.11±1.43) vs. (8.01±1.16)], team cooperation ability [(11.38±1.21) vs. (8.15±0.99)], organization and coordination ability [(10.68±1.17) vs. (8.15±0.99)] and communication ability [(9.64±1.31) vs. (7.55±1.08)] were also significantly increased ( P<0.05). However, there was no significant difference in the scores of individual first aid ability mastery before and after training. In all, 80.46%-96.55% of the students think that the training of comprehensive first aid skills is conducive to the improvement of their comprehensive first aid ability, and all of the students are willing to use this training in the future. Conclusion:Comprehensive first aid skill training is beneficial to improve medical students' comprehensive first aid ability.

Extralevator abdominoperineal excision versus abdominoperineal excision for low rectal cancer: a meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Extralevator abdominoperineal excision (ELAPE) has become a popular procedure for low rectal cancer as compared with abdominoperineal excision (APE). No definitive answer has been achieved whether one is superior to the other. This study aimed to evaluate the safety and efficacy of ELAPE for low rectal cancer with meta-analysis.@*METHODS@#The Web of Science, Cochrane Library, Embase, and PubMed databases before September 2019 were comprehensively searched to retrieve comparative trials of ELAPE and APE for low rectal cancer. Pooled analyses of the perioperative variables, surgical complications, and oncological variables were performed. Odds ratio (OR) and mean differences (MD) from each trial were pooled using random or fixed effects model depending on the heterogeneity of the included studies. A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.@*RESULTS@#This meta-analysis included 17 studies with 4049 patients, of whom 2248 (55.5%) underwent ELAPE and 1801 (44.5%) underwent APE. There were no statistical differences regarding the circumferential resection margin positivity (13.0% vs. 16.2%, OR = 0.69, 95% CI = 0.42-1.14, P = 0.15) and post-operative perineal wound complication rate (28.9% vs. 24.1%, OR = 1.21, 95% CI = 0.75-1.94, P = 0.43). The ELAPE was associated with lower rate of intraoperative perforation (6.6% vs. 11.3%, OR = 0.50, 95% CI = 0.39-0.64, P < 0.001) and local recurrence (8.8% vs. 20.5%, OR = 0.29, 95% CI = 0.21-0.41, P < 0.001) when compared with APE.@*CONCLUSIONS@#The ELAPE was associated with a reduction in the rate of intra-operative perforation and local recurrence, without any increase in the circumferential resection margin positivity and post-operative perineal wound complication rate when compared with APE in the surgical treatment of low rectal cancer.

Analysis of risk factors of pulmonary infection in patients over 60 years of age after radical resection for gastric cancer / 中华胃肠外科杂志

OBJECTIVE@#To investigate the risk factors of postoperative pulmonary infection (PPI) in patients over 60 years of age with gastric cancer after radical gastrectomy.@*METHODS@#Clinicopathological data of 373 patients over 60 years of age who underwent radical gastrectomy at Department IV of Gastrointestinal Cancer Center, Peking University Cancer Hospital, from April 2009 to December 2016 were retrospectively collected in this case-control study. The clinicopathological characteristics of patients with postoperative pulmonary infection (including postoperative atelectasis) and those without pulmonary infection were compared. A Student t-test (reported as Mean±SD if data matching normal distribution) or Mann-Whitney U test [reported as median (quartile) if data did not conform to normal distribution] was used to analyze continuous variables. A χ² test or Fisher exact tests (reported as number and percentage) was used for categorical variables. Multivariable logistic regression was used to analyze the risk factors for pulmonary infection after operation of gastric cancer.PPI was defined as postoperative patients with elevated body temperature (>38.0 degrees centigrade) for more than 24 hours; cough and expectoration; positive sputum bacteria culture;recent infiltration, consolidation or atelectasis confirmed by chest imaging examination.@*RESULTS@#Among 373 patients, 50 cases had PPI(13.4%, PPI group), 323 cases had no PPI(86.6%, non-PPI group). There were 39 (78.0%) and 178(55.1%) patients with comorbidities (including hypertension, diabetes and cardiopulmonary disease) preoperatively in PPI and non-PPI group, respectively. The difference between two groups was statistically significant (χ²=9.325,P=0.002). The incidence of preoperative hypoalbuminemia in PPI group was also significantly higher than that in non-PPI group [10.0%(5/50) vs. 3.1% (10/323),χ²=4.098, P=0.048]. Compared to non-PPI group, the rate of total gastrectomy [54.0%(27/50) vs. 34.4% (111/323), χ²=12.501, P=0.002], postoperative wound pain [34.0%(17/50) vs. 11.8% (38/323),χ²=16.928, P<0.001], secondary operation [6.0%(3/50) vs. 0.6% (2/323), χ²=6.032, P=0.014] and the rate of gastric tube removal later than 7 days postoperatively [96.0%(48/50) vs. 84.5%(273/323),χ²=4.811, P=0.028] were significantly higher in PPI group, respectively. The postoperative hospital stay was also prolonged in PPI group [16.0(9.5) days vs. 12.0(5.0) days, U=4 275.0, P<0.001]. Multivariate logistic regression analysis showed that preoperative comorbidities (OR=4.008, 95%CI:1.768-9.086, P=0.001), abdominal infection (OR=3.164, 95%CI:1.075-9.313, P=0.037), and wound pain (OR=3.428, 95%CI:1.557-7.548, P=0.002) were independent risk factors for PPI in patients over 60 years of age with gastric cancer. Furthermore, 50 patients with pulmonary infection were classified according to the length of latency and the type of infection. The patients with PPI latency ≤ 3 days were classified as early onset (34 cases, 68.0%), and those with latency ≥ 4 days as delayed onset (16 cases, 32.0%); PPI combined with surgical infection (including anastomotic leakage, abdominal infection, duodenal stump leakage, wound infection, etc.) was classified into mixed infection group (13 cases, 26.0%), with non-surgical infection as simple infection group (37 cases, 74.0%). The results showed that the pulmonary infection occurred 0 to 12 days (median 3 days) before surgical infection in mix infection group. The incidence of previous chronic obstructive pulmonary disease (COPD) in patients with early onset was significantly higher than that in patients with delayed onset [17.6%(6/34) vs. 0, χ²=5.005, P=0.025], and the incidence of mixed infection in patients with delayed onset was significantly higher than that in patients with early onset [50%(8/16) vs. 14.7%(5/34), χ²=6.730, P=0.009],but there was no significant difference in postoperative hospital stay between the two groups[17.0(9.8) days vs. 14.0(9.5) days, U=224.0, P=0.317].@*CONCLUSIONS@#Postoperative pulmonary infection is common in gastric cancer patients over 60 years of age. Preoperative comorbidities, abdominal infection and wound pain are independent risk factors for postoperative pulmonary infection. Pulmonary infection within 3 days after operation is associated with preoperative COPD. For patients suffering from PPI after the 4th day,attentions should be paid to abdominal infection and anastomotic leakage.

Extralevator abdominoperineal excision versus abdominoperineal excision for low rectal cancer: a meta-analysis / 中华医学杂志(英文版)

Background@#Extralevator abdominoperineal excision (ELAPE) has become a popular procedure for low rectal cancer as compared with abdominoperineal excision (APE). No definitive answer has been achieved whether one is superior to the other. This study aimed to evaluate the safety and efficacy of ELAPE for low rectal cancer with meta-analysis.@*Methods@#The Web of Science, Cochrane Library, Embase, and PubMed databases before September 2019 were comprehensively searched to retrieve comparative trials of ELAPE and APE for low rectal cancer. Pooled analyses of the perioperative variables, surgical complications, and oncological variables were performed. Odds ratio (OR) and mean differences (MD) from each trial were pooled using random or fixed effects model depending on the heterogeneity of the included studies. A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.@*Results@#This meta-analysis included 17 studies with 4049 patients, of whom 2248 (55.5%) underwent ELAPE and 1801 (44.5%) underwent APE. There were no statistical differences regarding the circumferential resection margin positivity (13.0% vs. 16.2%, OR = 0.69, 95% CI = 0.42-1.14, P = 0.15) and post-operative perineal wound complication rate (28.9% vs. 24.1%, OR = 1.21, 95% CI = 0.75-1.94, P= 0.43). The ELAPE was associated with lower rate of intraoperative perforation (6.6% vs. 11.3%, OR = 0.50, 95% CI = 0.39-0.64, P < 0.001) and local recurrence (8.8% vs. 20.5%, OR = 0.29, 95% CI = 0.21-0.41, P < 0.001) when compared with APE.@*Conclusions@#The ELAPE was associated with a reduction in the rate of intra-operative perforation and local recurrence, without any increase in the circumferential resection margin positivity and post-operative perineal wound complication rate when compared with APE in the surgical treatment of low rectal cancer.

Application of laparoscopy-assisted total gastrectomy in elderly patients ≥65 years with gastric cancer / 中华胃肠外科杂志

OBJECTIVE@#To evaluate the safety and feasibility of laparoscopy-assisted total gastrectomy in gastric cancer patients over 65 years old.@*METHODS@#Clinical, pathological and follow-up data of 188 gastric cancer patients who underwent laparoscopy-assisted total gastrectomy at Department IV of Gastrointestinal Cancer Center, Peking University Cancer Hospital, from April 2009 to December 2016 were collected for a retrospective cohort study.@*INCLUSION CRITERIA@#ECOG performance score 0-1; preoperative gastroscopy discovered gastric masses, and pathological biopsy confirmed adenocarcinoma; distant metastases were excluded by image examination; preoperative cardiopulmonary function was normal; preoperative blood routine test, liver and renal function, and coagulation function were normal; laparoscopy-assisted total gastrectomy was performed.@*EXCLUSION CRITERIA@#intraoperative laparoscopic exploration indicated abdominal and/or pelvic peritoneal metastasis; free cancer cells in peritoneal cavity; conversion to laparotomy during laparoscopic surgery. Patients were divided by age into 2 groups, ≥ 65 years old group(59 cases) and 0.05). Multivariate logistic regression analysis showed that preoperative comorbidities(OR=0.223, 95%CI:0.053 to 0.944, P=0.041) was an independent risk factor for postoperative complications in patients aged ≥ 65 years old undergoing laparoscopy-assisted total gastrectomy. The median survival time was 21.3 months and the overall 5-year survival rate was 50.0%. The 5-year survival rate was 45.5% and 57.5% in patients aged ≥ 65 and < 65 years, respectively, and there was no significant difference(P=0.205).@*CONCLUSIONS@#Laparoscopy-assisted total gastrectomy is safe and effective in the treatment of gastric cancer patients ≥ 65 years old. Age is not a contraindication of laparoscopy-assisted total gastrectomy.

Interhemispheric functional connectivity for Alzheimer's disease and amnestic mild cognitive impairment based on the triple network model / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The purpose of this study was to explore the differences in interhemispheric functional connectivity in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) based on a triple network model consisting of the default mode network (DMN), salience network (SN), and executive control network (ECN). The technique of voxel-mirrored homotopic connectivity (VMHC) analysis was applied to explore the aberrant connectivity of all patients. The results showed that: (1) the statistically significant connections of interhemispheric brain regions included DMN-related brain regions (i.e. precuneus, calcarine, fusiform, cuneus, lingual gyrus, temporal inferior gyrus, and hippocampus), SN-related brain regions (i.e. frontoinsular cortex), and ECN-related brain regions (i.e. frontal middle gyrus and frontal inferior); (2) the precuneus and frontal middle gyrus in the AD group exhibited lower VMHC values than those in the aMCI and healthy control (HC) groups, but no significant difference was observed between the aMCI and HC groups; and (3) significant correlations were found between peak VMHC results from the precuneus and Mini Mental State Examination (MMSE) and Montreal Cognitive Scale (MOCA) scores and their factor scores in the AD, aMCI, and AD plus aMCI groups, and between the results from the frontal middle gyrus and MOCA factor scores in the aMCI group. These findings indicated that impaired interhemispheric functional connectivity was observed in AD and could be a sensitive neuroimaging biomarker for AD. More specifically, the DMN was inhibited, while the SN and ECN were excited. VMHC results were correlated with MMSE and MOCA scores, highlighting that VMHC could be a sensitive neuroimaging biomarker for AD and the progression from aMCI to AD.

Correlation of monitoring the renal pelvic pressure in RIRS and the morbidity of postoperative fever / 局解手术学杂志

Objective To investigate the clinical significance of monitoring the renal pelvic pressure( RPP) and regulating the manual perfusion pressure in flexible ureteroscope holmium laser lithotripsy. Methods A total of 189 patients with upper urinary tract calculi treated by RIRS in our hospital were retrospectively analyzed from August 2014 to August 2017. The renal pelvic pressure was monitored during RIRS in 136 cases( monitored group) whereas no monitoring occurred in the rest 53 cases( unmonitored group) . The monitored group was divided into two sub-groups of 49 cases named high-pressure group(the cumulative time of renal pelvis pressure upon 40 cmH2O≥1 min) and 87 ca-ses named low-pressure group respectively. The morbidity of postoperative fever ( T≥38. 5℃) was evaluated statistically between monitored group and unmonitored group,meanwhile between high-pressure group and low-pressure group. Results Postoperative fever did not correlate to age,sex,involved kidney,and postoperative urinary tract infection. Whether renal pelvic pressure was monitored or not,infection calculi, duration of operation and whether the cumulative time of renal pelvis pressure upon 40cmH2O≥1 min contributed to postoperative fever. The rate of postoperative fever in unmonitored group was higher than monitored group while the same between high-pressure group and low-pres-sure group,with statistically significant difference(P<0. 05). Conclusion Monitoring the intraoperative RRP and regulating the manual perfusion pressure during RIRS has positive significance in postoperative recovery and contribute to reducing postoperative fever.

Evaluation of the implementation of the organ-system based integrated curriculum model in medical education / 中华医学教育探索杂志

Objective Comparing the organ-system-based integrated curriculum model and tradi-tional teaching model in medical education to evaluate the effect of Integrated curriculum model. Methods The experiment group (Group A) included 45 students who had graduated in 2016 under integrated curricu-lum model, the control group (Group B) included 82 students who had graduated in the same year under traditional teaching model. Comparing the test score between two groups to see if a significant difference emerged, including general education courses, graduation examination, clinical intern examination, uninte-grated curriculum and National Medical Licensing Examination. Using SPSS 19.0 statistics, 2-Independent-sample T test. Results There were no significant difference in the scores of general education courses between the groups. The total score of graduation theory examination in group A was 54.71±8.58, which was significantly higher than group B (49.13±12.21) (P=0.008), especially in internal medicine, surgery, gyne-cology and obstetrics, the contrast of the two groups being P=0.015, P=0.022, P=0.002 respectively. The total score of OSCE in group A was 69.56±5.64, which was significantly higher than group B (65.74±5.37) (P=0.000), especially in diagnose, clinical thinking ability, interpersonal communication skills and total score, the contrast of the two groups being P=0.019,P=0.001, P=0.000 respectively. The scores of clinical Intern examination in group A were superior to group B, especially in internal medicine, surgery, gynecology and obstetrics, the contrast of the two group being P=0.029, P=0.015, P=0.003 respectively. The scores of 3 unintegrated curriculum in group A were the same with group B. The total score of National Medical Licens-ing Examination in group A was (429.690±31.197), which was significantly higher than group B (412.370± 46.858) (P=0.048), especially in Clinical medicine, Preventive Medicine, the contrast of the two groups were P=0.011, P=0.022 respectively, in the level of knowledge, comprehension, application, the contrast of the two groups being P=0.022, P=0.041 respectively. Conclusions The integrated curriculum modal has more advantages in developing students' Comprehensive ability. There is no fixed pattern of integrated curriculum, and it needs continuous evaluation and improvement to ensure the effect.

Effects of different concentrations of MgSiF6 as electrolyte for micro-arc oxidation on the bond strength between titanium and porcelain / 中华口腔医学杂志

Objective@#To investigate the effects of different concentrations of MgSiF6 as electrolyte on the bond strength between titanium and porcelain after micro-arc oxidation (MAO) treatment and screen the suitable concentration of MgSiF6 that can improve the bond strength between titanium and porcelain.@*Methods@#Four different concentrations of MgSiF6 (10, 20, 30, 40 g/L) were chosen as MAO reaction solutions. Sandblasting treatment was selected as a control group. After porcelain was fused to each specimen, titanium-porcelain bond strengths were evaluated by the three-point bending test according to ISO 9693. Scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) were adopted to evaluate the morphologies and elemental compositions of both the MAO coatings and the interfaces of the titanium-porcelain restoration.@*Results@#The surface of titanium specimen in the control group was sharp and rough, while specimens in both 10 g/L group and 20 g/L group were porous and homogeneous. However, the pores found on the specimens in the latter group were larger in diameter (approximately 1.0-2.0 μm) than those on the former one (0.2-0.5 μm). The bond strengths of the control group and the experimental groups (10, 20, 30, 40 g/L MgSiF6) were (27.08±3.16), (38.18±2.65), (44.75±2.21), (36.44±2.04), (31.04±2.59) MPa, respectively. All the experimental groups showed higher bond strengths than the control group did (P<0.05), and the bond strength of 20 g/L MgSiF6 group was significantly higher than those of the other groups (P<0.05). Besides, the interfaces between titanium and porcelain were tight and compact in the 20 g/L group, while different amounts of pores and cracks were visible in the other groups. Additionally, after the three-point bending test, few residual porcelains could be observed on the surfaces of specimens in the control group.@*Conclusions@#MAO treatment with 20 g/L MgSiF6 on titanium can improve bonding strength between titanium and porcelain.

Effects of piceatannol on rat kidney with diabetic nephropathy in early stage / 中国病理生理杂志

AIM: To observe the effect of piceatannol on the kidney of diabetic nephropathy rats in early stage, and to explore the possible mechanisms.METHODS: The rats were randomly divided into 5 groups: control group, model group, low dose of piceatannol treatment group, medium dose of piceatannol treatment group and high dose of piceatannol treatment group.The rat model of diabetic nephropathy was induced accordingly, and the rats received 20 mg/kg, 40 mg/kg or 60 mg/kg of piceatannol by gavage once a day for 4 weeks.Blood glucose was detected by glucometer.The urea nitrogen and creatinine levels in the serum were measured by urease-glutamate dehydrogenase enzymatic and inosine acid oxidase methods, respectively, and 24 h urinary microalbumin was analyzed by immune transmission turbidimetry test.Moreover, the pathological changes of the kidney tissues were observed under microscope with HE staining.The protein expression of TGF-β1 and Smad 7 and the phosphorylation levels of Smad2 and Smad3 were determined by Western blot.RESULTS: Compared with model group, piceatannol treatment significantly decreased the levels of blood glucose, blood urea nitrogen and urinary microalbumin, but had no effects on serum creatinine.Furthermore, HE staining showed that the increased mesangial cells, matrix hyperplasia and degenerated epithelial cells in model group were markedly inhibited after piceatannol treatment.Additionally, piceatannol treatment also reduced the protein expression of TGF-β1 and Smad 7, and the phosphorylation levels of Smad2 and Smad3.CONCLUSION: Piceatannol attenuates pathological progression in the kidney of diabetic nephropathy rats in early stage, which may be through inhibiting TGF-β/Smad signaling pathway.

Comparison of automatic and manual methods for preparation of leukocyte-reduced red blood cell and plasma / 医疗卫生装备

Objective To compare the leukocyte-reduced red blood cells and plasmas respectively prepared by automated blood components separator and manual method so as to provide theoretical basis for automatic and standardized flow of blood components preparation.MethodsThe prepared red blood cells and plasma were measured on the hemoglobin concentration,mean corpuscular volume (MCV),red blood cell count (RBC),haematocrit (HCT),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC),average red blood cell volume distribution width,plasma weight and protein content after the first separation,preparation time and etc.These results obtained from different methods were compared and analyzed.Results The plasma weight after the first separation which was one-off prepared were (267.57 ±16.31) g (by automatic method) and (246.06±22.48) g (by manual method) (P＜0.05) respectively.The preparation time were (66.66±9.01) s (by automatic method) and (162.33±22.00) s (by manual method) (P＜0.05) respectively.Other results had no significant difference (P＞0.05).Conclusion All blood components products in this research meet the criterion of GB 18469-2012.However,the quality and separation efficiency of products made by automatic blood component separator are obviously higher than those by manual method.

Upregulation and biological function of transmembrane protein 119 in osteosarcoma

Osteosarcoma is suggested to be caused by genetic and molecular alterations that disrupt osteoblast differentiation. Recent studies have reported that transmembrane protein 119 (TMEM119) contributes to osteoblast differentiation and bone development. However, the level of TMEM119 expression and its roles in osteosarcoma have not yet been elucidated. In the present study, TMEM119 mRNA and protein expression was found to be up-regulated in osteosarcoma compared with normal bone cyst tissues. The level of TMEM119 protein expression was strongly associated with tumor size, clinical stage, distant metastasis and overall survival time. Moreover, gene set enrichment analysis (GSEA) of the Gene Expression Omnibus (GEO) GSE42352 dataset revealed TMEM119 expression in osteosarcoma tissues to be positively correlated with cell cycle, apoptosis, metastasis and TGF-β signaling. We then knocked down TMEM119 expression in U2OS and MG63 cells using small interfering RNA, which revealed that downregulation of TMEM119 could inhibit the proliferation of osteosarcoma cells by inducing cell cycle arrest in G0/G1 phase and apoptosis. We also found that TMEM119 knockdown significantly inhibited cell migration and invasion, and decreased the expression of TGF-β pathway-related factors (BMP2, BMP7 and TGF-β). TGF-β application rescued the inhibitory effects of TMEM119 knockdown on osteosarcoma cell migration and invasion. Further in vitro experiments with a TGF-β inhibitor (SB431542) or BMP inhibitor (dorsomorphin) suggested that TMEM119 significantly promotes cell migration and invasion, partly through TGF-β/BMP signaling. In conclusion, our data support the notion that TMEM119 contributes to the proliferation, migration and invasion of osteosarcoma cells, and functions as an oncogene in osteosarcoma.

A comparative study of organ-system based integrated curriculum model and traditional teaching model in medical education / 中华医学教育探索杂志

Objective By comparing the organ system based medical integration teaching mode and traditional teaching mode to evaluate the effect of the integration of curriculum implemen-tation. Methods Through a questionnaire survey of 63 students who implement integrated curriculum and 183 students who are not implementing integrated curriculum as well as 76 teachers, we evaluate students' emotional, cognitive and motor skills, using SPSS statistical analysis, chi-square test. Results In the affective domain, most of the teachers thought the experimental class was superior to the com-mon one in learning interest, lifelong learning and independent learning, critical thinking, the contrast of the two classes were P=0.000, P=0.031 and P=0.001 respectively, all of significant difference. In the cognitive domain, the contrast of the two classes in memory, understanding and application were P=0.000, all of significant difference. The experimental class has high degree of recognition. In the psychomotor domain, more than 55.3%(42/76) of the teachers thought that the experimental class was superior to the common class. According to the students' questionnaire survey, the contrast of the two classes in clinical operation skills, Interpersonal communication skills were P=0.077, P=0.031 respec-tively. There was no statistically significant difference. Conclusions The integrated curriculum teach-ing model can greatly promote students' abilities in most areas such as interest in learning, lifelong learning awareness, clinical thinking ability; interpersonal communication skills etc. In some respects the differences remains to be further studied such as memory of knowledge, systematic knowledge, and clinical operation skills, etc.

Studies on Ultrasound-assisted Extraction Process of Total Flavonoids in Vaccinium Bracteatum Thunb. Leaves / 中国药师

Objective:To optimize the ultrasound-assisted extraction process of total flavonoids in Vaccinium bracteatum Thunb. leaves. Methods:The single factor test and orthogonal test were adopted with the content of total flavonoids as the index, and the ultra-sound-assisted extraction was optimized with the concentration of solvent, extracting time, ratio of raw material to liquid and extraction times as the factors. Results:The optimal extraction conditions were 70% ethanol with 40-fold volume, extracting 2 times with 30 mi-nutes per time. Conclusion:The extraction process is stable and feasible, and all the results are useful references for the extraction process improvement.

Detection of lymphocyte subsets in peripheral blood of patients with drug eruption and its significance / 国际检验医学杂志

Objective To analyze the changes of lymphocyte subsets in peripheral blood of patients with drug eruption . Methods 18 newly diagnosed patients were served as the drug eruption group ,and were subdivided into cephalosporin group (n=9) ,penicillin group(n=5) and Chinese medicine group(n=4) according to different sensitizing drugs .20 healthy people were taken as the control group .Flow cytometry were utilized to detect the percentages and absolute counts of T lymphocytes (CD3+ ,CD3+CD4+ and CD3+CD8+ ) ,B lymphocytes ,natural killer cell(NK) and natural killer T lymphocytes(NKT) in their peripheral blood . Results Differences of percentages of T lymphocytes (CD3+ ,CD3+ CD4+ ) ,B lymphocytes ,NKT cells between the drug eruption group and the control group showed statistical significant (P0 .05) ,while that of abso-lute counts of T and B lymphocytes of patients was statistical significant between the drug eruption group and the control group (P<0 .05) .Conclusion The percentages of CD3+ ,CD3+CD4+ lymphocytes of patients with drug eruption decrease ,while those of NKT cells increase ,which may be related to the patients′immune regulation .

CBCT image guided radiation therapy clinical application / 中国医学装备

Objective:Study the effect about cone beam CT(CBCT) image guidance sytem to improve the positioning accuracy and reducing the set-up uncertainty in precise radiotherapy. Methods:Use CBCT system to scan head and neck tumors patients (30 cases) and chest tumor patients (40 cases), including head and neck tumor patients were scaned 90 times, chest tumor patients were scaned 113 times. Setup deviation statistics about anterior and posterior, head and feet, left and right direction. Results:The patients with head and neck cancer, the maximum error of anterior-posterior is 6mm, Three directions errors which greater than 3mm all less than 10%. Patients with chest tumor position error are in the head and foot direction, greater than 5 mm up to 21.51%. Before and after the direction of the error did not exceed 5mm. The left and right direction greater than 5 mm up to 4.53%. Conclusion:It greatly enhances the precision of radiotherapy, improved the curative effect of radiotherapy by using CBCT online image guidance system for the patient position correction. Compared with EPID, patients scaned with CBCT absorb smaller cumulative dose, the image resolution is higher, image matching is more accurate. But compared with the ordinary helical CT,the resolution and scanning range also need to improve.