Risk factors for ketoacidosis in children/adolescents with type 1 diabetes mellitus and establishment of a predictive model / 中国当代儿科杂志

OBJECTIVES@#To investigate the risk factors for diabetic ketoacidosis (DKA) in children/adolescents with type 1 diabetes mellitus (T1DM) and to establish a model for predicting the risk of DKA.@*METHODS@#A retrospective analysis was performed on 217 children/adolescents with T1DM who were admitted to General Hospital of Ningxia Medical University from January 2018 to December 2021. Among the 217 children/adolescents,169 cases with DKA were included as the DKA group and 48 cases without DKA were included as the non-DKA group. The risk factors for DKA in the children/adolescents with T1DM were analyzed, and a nomogram model was established for predicting the risk of DKA in children/adolescents with T1DM.@*RESULTS@#For the 217 children/adolescents with T1DM, the incidence rate of DKA was 77.9% (169/217). The multivariate logistic regression analysis showed that high levels of random blood glucose, hemoglobin A1c (HbA1c), blood ketone body, and triglyceride on admission were closely associated with the development of DKA in the children/adolescents with T1DM (OR=1.156, 3.2031015, 20.131, and 9.519 respectively; P<0.05). The nomogram prediction model had a C-statistic of 0.95, with a mean absolute error of 0.004 between the risk of DKA predicted by the nomogram model and the actual risk of DKA, indicating that the model had a good overall prediction ability.@*CONCLUSIONS@#High levels of random blood glucose, HbA1c, blood ketone body, and triglyceride on admission are closely associated with the development of DKA in children/adolescents with T1DM, and targeted intervention measures should be developed to reduce the risk of DKA.

Assessment of intensity of seasonal influenza activity in Beijing-Tianjin-Hebei region, 2019-2021 / 中华流行病学杂志

Objective: To explore the feasibility of moving epidemic method (MEM) in the assessment of seasonal influenza (influenza) activity intensity from the perspective of urban agglomeration, assess influenza activity intensity in the Beijing-Tianjin-Hebei region from 2019 to 2021 and evaluate the reliability of surveillance data and the effectiveness of the MEM model application. Methods: The weekly reported incidence rate (IR) of influenza and the percentage of influenza-like illness (ILI%) from 2011-2021 in Beijing-Tianjin-Hebei region were collected to establish MEM models respectively. The model fitting effect and the reliability of the two data were evaluated for the purpose of establishing an optimal model to assess the influenza activity intensity in Beijing-Tianjin-Hebei region from 2019-2021. A cross-validation procedure was used to evaluate the performance of the models by calculating the Youden's index, sensitivity and specificity. Results: The MEM model fitted with weekly ILI% had a higher Youden's index compared with the model fitted with weekly IR at both Beijing-Tianjin-Hebei region level and provincial level. The MEM model based on ILI% showed that the epidemic threshold in Beijing-Tianjin-Hebei region during 2019-2020 was 4.42%, the post-epidemic threshold was 4.66%, with medium, high and very high intensity thresholds as 5.38%, 7.22% and 7.84%, respectively. The influenza season during 2019-2020 had 10 weeks (week 50 of 2019 to week 7 of 2020). The influenza season started in week 50 of 2019, and the intensity fluctuated above and below medium epidemic level for six consecutive weeks. The high intensity was observed in week 4 of 2020, the threshold of very high intensity was excessed in week 5, and the intensity gradually declined and became lower than the threshold at the end of the influenza season in week 8. The epidemic threshold was 4.29% and the post-epidemic threshold was 4.35% during 2020-2021. Influenza activity level never excessed the epidemic threshold throughout the year, and no epidemic period emerged. Conclusions: The MEM model could be applied in the assessment of influenza activity intensity in Beijing-Tianjin-Hebei region, and the use of ILI% to assess influenza activity intensity in this region was more reliable than IR data. Influenza activity intensity in Beijing-Tianjin-Hebei region was higher during 2019-2020 but significantly lower in 2020-2021.

Study on alkaloids of endophytic Trichoderma atroviride B7 from Colquhounia coccinea var. mollis / 药学学报

Nine compounds were isolated from the crude extract of the solid culture of endophyte Trichoderma atroviride B7 of Colquhounia coccinea var. mollis by silica gel column chromatography, Sephadex LH-20 gel column chromatography, and HPLC. They were identified as atroviridanol (1), 3-oxo-3-[(2-phenylethyl) amino]-propanoic acid (2), N-(2′-phenylethyl)-acetamide (3), neoechinulin A (4), echinulin (5), gancidin W (6), N-isobutyl-3-methylbutanamide (7), 5-acetamido-1-pentanol (8), and N-2-methylpropyl-2-methylbutenamide (9) by NMR, HR-MS, and so on. Among them, compound 1 is a new compound, and compounds 2-9 are firstly isolated from Trichoderma spp.

Safety and short-term efficacy of apatinib combined with oxaliplatin and S-1 in the conversion treatment for gastric cancer with peritoneal metastasis / 中华胃肠外科杂志

Objective: To investigate the safety and short-term efficacy of apatinib combined with oxaliplatin and S-1 in the conversion treatment for gastric cancer with different types of peritoneal metastasis. Methods: A prospective study "one arm exploratory clinical study of conversion therapy of apatinib with S-1 and oxaliplatin in the treatment of advanced gastric cancer" (clinical registration ChiCTR-ONC-17010430) from medical record database was retrospectively analyzed. Patients aged 18-70 years with gastric cancer peritoneal metastasis confirmed by histology and laparoscopic exploration, and had not receive radiotherapy, chemotherapy, targeted therapy or immunotherapy before were enrolled. Before operation, the patients received 6 cycles of S-1 (80-120 mg/d, d1-d14) and oxaliplatin (130 mg/m(2), d1), and 5 cycles of apatinib (500 mg/d, d1-d21) conversion regimen. Three weeks after chemotherapy, whether the operation was performed or not depending on re-evaluation and patient preference. The main outcome were adverse reactions, and the secondary outcome were objective remission rate (ORR), disease control rate (DCR), and overall survival (OS) rate. The follow-up period was up to May 2020. Results: A total of 27 patients with gastric cancer peritoneal metastasis were enrolled in this study. There were 13 males and 14 females, with a median age of 58 (30-68) years old. There were 9 cases of P1a, 5 cases of P1b, and 13 cases of P1c. There were 14 cases with 1-5 scores of PCI (peritoneal cancer index), and 13 cases with 6 scores or above. The incidence of adverse reactions was 100%. The most common adverse reactions were hematological events including leucopenia (70.4%, 19/27) and granulocytopenia (74.1%, 20/27). Non-hematological adverse events included fatigue (51.9%, 14/27) and oral mucositis (37.0%, 10/27). One patient was withdrawn due to grade 4 thrombocytopenia. Among 26 patients with feasible efficacy evaluation, 18 (69.2%) achieved partial remission, 3 (11.5%) achieved stable disease, and 5 (19.2%) disease progression. The objective remission rate was 69.2% (18/26) and the disease control rate was 80.8% (21/26). Fourteen patients underwent surgery, including 6 patients undergoing R0 resection with the R0 resection rate of 42.9% (6/14). The postoperative pathological response rate was 64.3% (9/14). The follow-up time was 12-40 months, and the follow-up rate was 100%. The 1-year OS rate was 65.2% and the survival time was (14.0±1.7) months. The 1-year OS rates of P1a/P1b group and P1c group were 81.8% and 42.0% respectively, whose difference was statistically significant (P=0.041). The 1-year OS rates of PCI 1-5 group and PCI ≥6 group were 67.3% and 38.5% respectively, whose difference was statistically significant (P=0.022). Conclusion: In the conversion treatment of gastric cancer peritoneal metastasis, the safety of apatinib combined with oxaliplatin and S-1 is acceptable, and this regimen shows a good short-term survival efficacy in patients with P1a/P1b and PCI of 1-5.

Effects of Arsenic Disulfide Combined with Itraconazole on Proli- feration and Apoptosis and Hedgehog Pathway of Diffuse Large B-Cell Lymphoma Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of arsenic disulfide (AS@*METHODS@#The human DLBCL cell OCI-LY3 was treated with different concentrations of AS@*RESULTS@#The DLBCL cell viability was decreased significantly at 24, 48 or 72 h as cultured with itraconazole. Along with the increasing of itraconazole concentration, the DLBCL cell viability was significantly reduced as compared with that in control group, and the results showed statistically significant(r=-0.690，r=-0.639, r=-0.833, r=-0.808, r=-0.578). The inhibitory and apoptosis rates of the cells were significantly increased as compared with those of the single drug-treated group after treated by the combination of itraconazole and AS@*CONCLUSION@#Itraconazole can inhibit proliferation of DLBCL cells in a concentration-and time-dependent manner. In addition, the combination of AS

Advances in chromatography-based methods for screening active compounds from natural products / 药学学报

Natural products have been a major source of leading compounds in drug discovery. How to effectively screen active compounds from complex matrix remains an interesting topic. In this review, we comprehensively summarized advanced liquid chromatography based approaches in natural products screening, including pre-column, on-column and post-column screening methods. Their advantages, disadvantages and prospect are also discussed.

Analysis of correlation between plasma trough level and response of generic imatinib in the treatment of Chinese patients with chronic myeloid leukemia / 中华血液学杂志

Objective: To analyze the correlation between plasma trough level of generic imatinib and its metabolism and clinical outcomes in Chinese patients with chronic myeloid leukemia in chronic phase (CML-CP) . Methods: The 21 patients with CML-CP who enrolled in a clinical trial YMTN 1.0 from Oct 11(th), 2012 to May 8(th), 2013 and received generic imatinib were as study subjects. The correlation between steady plasma trough levels of imatinib and its metabolism with clinical response, age, weight and body surface area (BSA) were evaluated. Results: ①The mean steady plasma trough level of generic imatinib and its metabolism was (1 185.07±417.91) μg/L and (251.53±76.50) μg/L, respectively. ②Age, weight and BSA has no significant effects on plasma trough level of generic imatinib and its metabolism (P>0.05) . ③Patients with steady plasma trough level of generic imatinib more than 1 000 μg/L are possible to have higher major molecular response (MMR) /complete molecular response (CMR) rate than those below 1 000 μg/L (42% vs 0, P<0.05) . Conclusion: Plasma trough levels of generic imatinib varied in CML patients. The steady plasma trough levels of generic imatinib is maybe related to molecular response in CML patients.

Leucosceptroid B from glandular trichomes of Leucosceptrum canum reduces fat accumulation in Caenorhabditis elegans through suppressing unsaturated fatty acid biosynthesis / 中国天然药物

Obesity that is highly associated with numerous metabolic diseases has become a global health issue nowdays. Plant sesterterpenoids are an important group of natural products with great potential; thus, their bioactivities deserve extensive exploration. RNA-seq analysis indicated that leucosceptroid B, a sesterterpenoid previously discovered from the glandular trichomes of Leucosceptrum canum, significantly regulated the expression of 10 genes involved in lipid metabolism in Caenorhabditis elegans. Furthermore, leucosceptroid B was found to reduce fat storage, and downregulate the expression of two stearoyl-CoA desaturase (SCD) genes fat-6 and fat-7, and a fatty acid elongase gene elo-2 in wild-type C. elegans. In addition, leucosceptroid B significantly decreased fat accumulation in both fat-6 and fat-7 mutant worms but did not affect the fat storage of fat-6; fat-7 double mutant. These findings indicated that leucosceptroid B reduced fat storage depending on the downregulated expression of fat-6, fat-7 and elo-2 and thereby inhibiting the biosynthesis of the corresponding unsaturated fatty acid. These findings provide new insights into the development and utilization of plant sesterterpenoids as potential antilipemic agents.

Effect of type WIYIS-6/90 plateau oxygen generating vehicle on high altitude spot / 医疗卫生装备

Objective To evaluate the effect of type WIYIS-6/90 plateau oxygen generating vehicle on the high altitude spot. Methods Totally 20 male soldiers during field training at 4 280 m altitude were involved in this trial. They were given administration of oxygen inhalation at 2 L/min by nasal cannula. Blood pressure, heart rate, blood oxygen saturation, vital capacity, left and right hand strength, digit span and discriminative reaction time were detected before and after oxygen inhalation for 20 minutes and finished for 10 minutes. Results After oxygen inhalation for 20 minutes, blood oxygen saturation, vital capacity, left and right hand strength, digit span and correct times increased and heart rate decreased compared with before oxygen inhalation (P<0.05,or P<0.01).Stopping oxygen inhalation for 10 minutes,vital capacity and right hand strength increased and response time decreased(P<0.05,or P<0.01).Conclusion Using type WIYIS-6/90 plateau oxygen generating vehicle for oxygen supply at high altitude can improve brain-body function and promote work ability.

Discussion on WANG You-ren's Experience in Using Regulating Jueyin Method for the Treatment of Breast Hyperplasia / 中国中医药信息杂志

Senior expert WANG You-ren in Beijing Massage Hospital has unique method in treating breast hyperplasia, who believes that Jueyin system is closely related with breast hyperplasia in etiology and pathogenesis, meridians, and muscles. It is concluded as "Breast hyperplasia, related with Jueyin meridian". Guided by the treatment thoughts of internal medicine "crook may cause pain", "block may cause pain", and "not smooth may cause pain", WANG You-ren attaches importance to bone-setting, Shu and Mu acupoints simultaneous application and meridian theory in medical applications. The use of Tuina regualting Jueyin method for the treatment of breast hyperplasia is with high comfort, without local operation, with the exact efficacy and other characteristics.

Prevalence and risk factors of chronic mountain sickness in Pamirs plateau / 中国应用生理学杂志

OBJECTIVE@#To investigate the prevalence of chronic mountain sickness (CMS) and its predisposing factors in Pamirs plateau and analysis clinical feature and risk factors.@*METHODS@#Eight hundred and twenty-four individuals in Pamirs plateau were surveyed used Qinghai CMS scoring system. Demographics, BP, SaO, heart rate and specified symptoms of CMS were recorded, Hb level was estimated.@*RESULTS@#Overall CMS prevalence was 22.08%, including 21.84% mild and 0.24% moderate without severe patient. Gender, nation, age, immigration time, altitude, occupation and accommodation mode were risk factors for CMS (<0.05 or <0.01), CMS prevalence was higher than HAPC rate both in male and female (χ=90.59 and 44.13, <0.01). Multiple linear regression analysis showed age, BMI, SaO and systolic pressure correlated with CMS (<0.01).@*CONCLUSIONS@#Chronic mountain sickness prevalence in Pamirs plateau is rather high but high altitude polycythemia prevalence is low, so the disease type is high altitude deterioration. Work and exercise more reasonable to avoid overtiredness, oxygen inhalation to raise blood oxygen saturation, control blood pressure and resting therapy can improve CMS symptom and decrease prevalence.

Regional comparison and implications of China's long-term care insurance system / 中国卫生政策研究

This paper attempts to review the long-term care insurance policies which have been issued in 13 national pilot cities such as Qingdao and Haidian district,Beijing. The paper investigates the problems and challen-ges China's long-term care insurance system faces with,and put forward the construction of long-term care insurance system. The preliminary thinking on some issues, such as the relationship between welfare and marketization when the long-term care insurance has been put into practice on a trial basis,the relationship between long-term care insur-ance and medical insurance,and the specific implementation plan of the long-term insurance. According to the issued documents issued by pilot regions,it was found that there are not only differences but also similarities among the pilot cities in who are insured,who pays the insurance fee,what might be covered,what the levels of insurance are,and what kind of service will be provided. Although the long term care insurance system has been initially established in these cities, the specific implementation remains to be demonstrated, e. g. supervision and management, nursing service provision. In addition,local governments need to continuously expand the benefit range of long-term care in-surance to ensure long-term success,do good coordination and connection of long-term care insurance and pension in-surance,and reasonably allocate the medical insurance,pension,and health care resources.

Screening of microsatellite loci with polymorphism among individuals and strains of guinea pigs / 中国比较医学杂志

Objective To screen the polymorphism microsatellite markers of guinea pigs, and provide basic information for identification of genetic structure and gene mapping in guinea pigs. Methods The genomic DNA of guinea pigs was found out on foreign websites,and microsatellite sequences characterized by AC/GT were selected. A total of 400 pairs of primers were designed using software according to their flanking sequences. After two rounds of PCR and electrophoresis,with the electrophoresis bands serving as genetic markers, the polymorphic primers were screened by the evaluation of microsatellite structure of guinea pigs. Results At the first step,10 DNA samples from 5 strains of guinea pigs were taken for PCR, and 110 pairs of polymorphic microsatellite markers with 1 -3 electrophoretic bands were screened from the designed 400 pairs of primers. At the second step,60 DNA samples from 5 strains of guinea pigs were assayed by PCR and 51 pairs of polymorphic primers with high resolution electrophoresis bands were screened from the above 110 pairs of primers. Among these screened 51 primers, more than 10 pairs of primers showed accordant or mostly accordant differences among strains. Conclusions The 51 pairs of primers are polymorphic among individuals and strains, and have not been found in other reports so far.They can be used for conventional genetic detection and related studies,and some of them can be used for gene mapping of the traits in guinea pigs.

Cartilage repair using induced pluripotent stem cell derived chondrocytes in osteoarthritis / 中国组织工程研究

BACKGROUND: Stem cell-based therapy has been proposed for the treatment of osteoarthritis (OA) and induced pluripotent stem cells (iPSCs) are becoming a promising stem cell source as they have strong proliferation and differentiation potentials and no ethics problem. OBJECTIVE: To explore an effective method of iPSCs differentiating into chondrocytes and to study the therapeutic effect of iPSCs derived chondrocytes on osteoarthritis. METHODS: In this study, three steps were developed to induce human iPSCs to differentiate into chondrocytes which were then transplanted into rat OA models induced by monosodium iodoacetate (MIA). There were four groups in the experiment: control group with normal saline injection, model group with MIA injection, iPSCs group with iPSCs transplantation following MIA injection, and differentiated iPSCs group with transplantation of iPSCs derived chondrocytes following MIA injection. At 15 weeks after transplantation, micro-CT was used and histological analysis of the knee joint was performed. RESULTS AND CONCLUSION: Compared with the iPS group, the expression of chondrocyte specific genes and proteins (Col2A1, GAG and Sox9) were significantly increased in the differentiated iPSCs group after 6 days of embryoid formation and after 2 weeks of cell differentiation. At 15 weeks after cell transplantation, no immune responses were observed, micro-CT showed an improvement in subchondral bone integrity, and histological examinations demonstrated the production of articular cartilage matrix. iPSCs derived chondrocytes showed better effects on articular cartilage repair than the iPSCs. To conclude, iPSCs derived chondrocytes can be effective via transplantation approach for cartilage tissue regeneration in OA rats.

Zinc oxide nanoparticles inhibits Ca2+-ATPase1 expression induced by UVB irradiation in human lens epithelial cells / 眼科新进展

Objective To investigate the effect of ZnO nanoparticles on the expressions of plasma membrane calcium ATPasel (PMCA1) of human lens epithelial cell B-3 (HLEB-3) at both mRNA and protein levels in the presence and absence of ultraviolet B (UVB) irradiation.Methods HLEB-3 was cultured in RPMI 1640 medium,and the cytotoxic effect of different concentrations of ZnO (0 μg · mL-1,2.5 μg · mL-1,5.0μg · mL-1,10.0 μg · mL-1) on HLEB-3 was investigated in the presence and absence of UVB irradiation.DAPI staining was used to monitor the effect of ZnO on HLECB-3 nuclei,and cell apoptosis was evaluated using annexin V-FITC/PI staining in the presence and absence of UVB irradiation.In addition,the intracellular calcium ion (Ca2 +)levels were assayed using Fluo-3/AM staining,and the expression levels of both PMCA1 mRNA and protein within HLEB-3 were detected by real-time PCR and Western blot,respectively.Results DAPI staining showed that the ZnO-treated HLEB-3 displayed a concentration-dependent apoptosis,and UVB irradiation could further aggravate the cytotoxic effect of ZnO on HLEB-3.In addition,in the presence of UVB irradiation,concentration gradient of ZnO (2.5 μg · mL-1,5.0 μg · mL-1,10.0 μg · mL-1) increased the intracellular calcium ion levels [from (156.34 ±4.59) nmol · L-1 to (173.88 ±7.17)umol · L-1,(289.02 ± 9.09) nmol · L-1,(488.36 ± 48.16) nmol · L 1,respectively] and upregulated HLEB-3 apoptosis,with statistical difference (all P ＜ 0.05).Moreover,the expression level of PMCA1 in the 2.5 μg · mL-1,5.0 μg · mL-1,10.0 μg · mL-1 ZnO-treated epithelial cells was accordingly 0.75,0.57 and 0.41 as much as that in the 0μg · mL-1 ZnO-treated cells in the absence of UVB irradiation (all P ＜ 0.05),and was accordingly 0.64,0.24 and 0.09 in the present of UVB irradiation,with significant difference (all P ＜ 0.05).Conclusion Both ZnO nanoparticle and UVB irradiation can exert cosuppression effect on HLEB-3 via calcium-mediated signaling pathway,indicating it has great potential for the treatment of posterior capsular opacification with UVB irradiation.

Cryptosporidium infection in Nanjing City from 2015 to 2016 / 中国血吸虫病防治杂志

Objective To investigate the status of Cryptosporidium infection in the population in Nanjing City so as to pro-vide the evidence for the prevention and control of cryptosporidiosis. Methods A total of 100 fecal samples were collected from each of three districts(Liuhe,Qixia and Gaochun)and one hospital(Nanjing Zhongda Hospital)in 2015 and 2016 respective-ly. The fecal samples were detected for Cryptosporidium with microscopy(by using the gold amine phenol-modified acid-fast staining)and the positive samples were detected again for the molecular biology confirming by using the fluorescence quantita-tive PCR. Results During the two years,581 cases of normal population who lived in the city were surveyed and no Cryptospo-ridium infection was found. Among 202 cases of outpatients with chronic diarrhea,there were 9 Cryptosporidium positive cases with the microscope scanning method (4.46％),and among the 9 cases,7 cases showed obvious logarithmic amplification curves showing positive Cryptosporidium nucleic acid,but 2 cases without the obvious logarithmic amplification curves,and the Cryptosporidium nucleic acid positive rate was 3.47％. Conclusions Cryptosporidium infection is not found in the normal popu-lation of Nanjing City,but the Cryptosporidium infection is found in the chronic diarrhea patients. The results imply that we should strengthen the detection of Cryptosporidium in the chronic diarrhea patients,so as to provide the evidence for improving the diagnosis and treatment of cryptosporidiosis.

A Meta-analysis on percutaneous vertebroplasty with high-viscosity and low-viscosity bone cement for osteoporotic vertebral compression fractures / 中国组织工程研究

BACKGROUND: Percutaneous vertebroplasty (PVP) has been proved to be effective for osteoporotic vertebral compression fractures (OVCF); however, bone cement leakage-related complications occur frequently. OBJECTIVE: To systematically evaluate the safety and complications of PVP with high-viscosity and low-viscosity bone cement in the treatment of OVCF. METHODS: We performed a systematic search by computer in PubMed, EMBASE, Cochrane Library (December, 2016) and CNKI, CBM, VIP and WanFang databases from January, 2000 to December, 2016; meanwhile, the relevant Chinese and English orthopedic journals were retrieved manually. Randomized controlled trials (RCTs) concerning the use of high-viscosity and low-viscosity bone cement in the PVP for OVCF were collected and systematically reviewed using the method recommended by the Cochrane Collaboration. The Meta-analysis was performed by using the RevMan5.2. RESULTS AND CONCLUSION: Six relevant RCTs were included, involving 554 patients (high-viscosity bone cement was used in 278 cases and low-viscosity bone cement in 276 cases). Meta-analysis results showed that postoperative pain symptoms were alleviated in all the 554 cases, and there was no significant difference in the amount of adjacent vertebral fractures between two approaches (P > 0.05). However, there was a significant difference in the visual analog scale score, Oswestry disability index value, Cobb angle, and bone cement leakage rate between high-viscosity and low-viscosity cement groups (P < 0.05). To conclude, PVP with either high-viscosity or low-viscosity bone cement can relieve pain rapidly in OVCF patients, and both approaches are safe and effective. However, high-viscosity bone cement has a lower cement leakage rate and better outcomes in visual analog scale score, Oswestry disability index, Cobb angle and cement leakage prevention as compared with low-viscosity bone cement.

Short and long term efficacy and improvement of quality of life of patients with breast cancer after radical mastectomy by Stewart transverse incision / 中国现代普通外科进展

Objective:To explore the short,long term efficacy and improvement of quality of life of patients with breast cancer after radical mastectomy by Stewart transverse incision.Methods:Collecting 104 patients with breast cancer from May 2009 to May 2013 in the hospital,55 cases of breast cancer were treated with Stewart transverse incision (the experimental group)and 49 cases were treated with traditional vertical incision for breast cancer (the control group).All the patients were treated with adjuvant chemotherapy.To observe the skin healing of the incision in the two groups after operation.Patients were followed up for 3-48 months,compared with two groups the incidence of postoperative complications,recurrence and metastasis and improve the quality of life.Results:Compared with the control group,the healing rate of grade A was significantly improved in the experimental group,the difference was statistically significant(P＜0.05).There was significant difference between the experimental group and the control group (P＜0.05).The incidence of complications such as flap fluid and upper limb edema was lower in the experimental group than in the control group,but the difference was not statistically significant (P＞0.05).The local recurrence,remote metastasis and 4-year survival rate of the experimental group were better than the control group,but the difference was not statistically significant (P＞0.05).The quality of life of the two groups of patients,the experimental group score in all areas were higher than the control group,the difference was statistically significant (P＜0.05).Conclusion:Stewart transverse incision breast cancer radical surgery is more conducive to wound healing,postoperative local recurrence rate,incidence of complications and psychological impact on patients were significantly reduced.And effectively improve the quality of life of patients after surgery.

Improving coverage rate of medical equipment metrological verification using PDCA cycle / 医疗卫生装备

Objective To improve the coverage rate of medical equipment metrological verification to ensure medical equipment safety and efficiency.Methods PDCA cycle was used to analyze the main problems in medical equipment metrological verification from the aspects of personnel,institution,management and flow,and the solutions were put forward accordingly.A certain of verification devices were sampled after verification,and the coverage rate of medical equipment metrological verification in the hospital was estimated based on the corresponding value of the sampled devices.Results Statistical analysis on the verification devices in 3 a showed the coverage rate of verification was enhanced from 45.5％ to 97.5％.Conclusion PDCA cycle contributes to increasing the coverage rate of medical equipment metrological verification.

Reliability of Ultrasound Tissue Characterization for Quantifing Integrity of Achilles Tendon and Patellar Tendon in People without Tendinopathy / 中国康复理论与实践

@#Objective To investigate the reliability of ultrasound tissue characterization (UTC) for quantifing the integrity of achilles ten-don and patellar tendon in subjects without tendinopathy. Methods From August, 2016 to April, 2017, testers A and B quantified integrity of achilles tendon and patellar tendon of dominant legs from 43 subjects without tendinopathy by UTC in random order respectively. Tester B quantified integrity of patellar tendon of dominant legs from other 22 subjects without tendinopathy by the same way, and repeated the mea-surements the next day. Interclass correlation coefficient (ICC) and the minimum detectable different (MDD) were calculated. Results The ICC of inter-rater reliability of achilles tendon assessment was 0.492 to 0.735, MDD was 0.3%to 3.0%. The ICC of inter-rater reliability of patellar tendon assessment was 0.383 to 0.678, MDD was 0.3%to 4.4%. The ICC of intra-rater reliability of patellar tendon assessment was 0.525~0.760, MDD was 0.6%to 5.3%. Conclusion The test-retest reliability of UTC for the quantification of integrity structure of achilles tendon and patellar tendon is satisfactory with little error, the inter-rater reliability need to be improved. which is a accurate and feasible tool to quantify tendon by the same tester.