Anesthesiologists′ proficiency and training needs in flexible bronchoscope-guided awake fiberoptic intubation in China: a nationwide prevalence survey / 中华麻醉学杂志

Objective:To investigate the Chinese anesthesiologist′s proficiency, training experience and needs of flexible bronchoscope-guided awake flexible bronchoscopy intubation (AFBI) using a questionnaire method.Methods:The cluster sampling was used, and self-designed questionnaires that addressed 54 questions in 5 categories were distributed through WeChat and online platforms. The survey took one month, and the answers were automatically recorded by the WeChat server.Results:A total of 1 250 anesthesiologists participated in the survey in 30 provinces of China, 9 of them were not anesthesiologists, and 1 241 (99.28%) questionnaires were validated. In the valid questionnaires, 52.70% (654) of the anesthesiologists were from tertiary hospitals, and 74.78% (928) of the anesthesiologists were attending physicians or above, only 7.57% (94) of the anesthesiologists had sufficient confidence in AFBI. Twenty-five point two two percent (313) of the anesthesiologists preferred fiberoptic intubation as the first tool when dealing with the anticipated difficult airway. Forty-eight point one one percent (597) of the anesthesiologists had implemented AFBI. Among them, 80.74% (482) had experienced unsuccessful AFBI practices. Eight hundred and ninety-four anesthesiologists had received AFBI training, and the most common AFBI training strategy was theoretical lectures. In addition, the degree of satisfaction regarding the theoretical lectures quality, technical training, clinical practice relativity and non-technical skills training was 21.47% (192), 14.32% (128), 12.3% (110) and 17.90% (160), respectively. The degree of satisfaction with all the 4 training elements mentioned above was 7.27% (65).Conclusions:The awareness and practice of Chinese anesthesiologists in terms of clinical application of AFBI to treat difficult airways need to be strengthened at present, and the lack of high-quality AFBI training may be the key.

A nationwide multicenter study on clinical laboratory construction in China / 中华医院管理杂志

Objective To investigate the status of clinical laboratory construction in China and evaluate its completeness,adequacy and effectiveness.Methods An electronic investigation on laboratory construction was conducted in March 2019.The questionnaires were synchronously distributed to 14 055 laboratories covering 31 provincial administrative units in China.Excel 2010 and SPSS 20 were used for analysis of four main indicators:gross area,total equipment value,human resource,and testing items.Descriptive statistics were demonstrated and comparisons of the indicators among different types of laboratories were checked with the Kruskal-Wallis test.Results A total of 9 966 valid questionnaires were returned,with an effective recovery of 70.9％.The overall median of the four indicators were respectively:gross area(344.5 square meters),total equipment value (RMB 4.15 million),staff number(12) and testing item number(160).The difference of all four indicators among various types of laboratories was significant (P ＜ 0.05).Conclusions The construction of laboratories in primary hospitals and private hospitals is not satisfying,especially the equipment and human resource.More attention on the awareness to improve clinical laboratory construction for further quality improvement and patient safety is needed.

A nationwide multicenter study on clinical laboratory construction in China / 中华医院管理杂志

Objective@#To investigate the status of clinical laboratory construction in China and evaluate its completeness, adequacy and effectiveness.@*Methods@#An electronic investigation on laboratory construction was conducted in March 2019. The questionnaires were synchronously distributed to 14 055 laboratories covering 31 provincial administrative units in China. Excel 2010 and SPSS 20 were used for analysis of four main indicators: gross area, total equipment value, human resource, and testing items. Descriptive statistics were demonstrated and comparisons of the indicators among different types of laboratories were checked with the Kruskal-Wallis test.@*Results@#A total of 9 966 valid questionnaires were returned, with an effective recovery of 70.9%. The overall median of the four indicators were respectively: gross area(344.5 square meters), total equipment value(RMB 4.15 million), staff number(12) and testing item number(160). The difference of all four indicators among various types of laboratories was significant(P<0.05).@*Conclusions@#The construction of laboratories in primary hospitals and private hospitals is not satisfying, especially the equipment and human resource. More attention on the awareness to improve clinical laboratory construction for further quality improvement and patient safety is needed.

Status analysis of 15 quality indicators at clinical laboratorieis of 8029 medical institutions in China / 中华医院管理杂志

Objective To investigate the 15 quality indicators at medical institutions in China , and to explore the model of quality specifications .Methods Online questionnaires were sent to 8029 clinical laboratories ,with the results analyzed by SPSS 20 .The 25th percentile ,50th percentile ,and 75th percentile of the distribution ,according to the level of the hospital ,were regarded as the optimum , appropriate and minimum quality specifications for each quality indicator ,respectively .Results As shown in the median ,sigma values of most indicators were greater than 3 .The defect percentages of test uncovered by internal quality control (IQC)and test uncovered by inter-laboratory comparison were 47.46％ and 85.73％ ,respectively ,both too poor to calculate the sigma values. The turnaround time (TAT )differed greatly among the subjects.The longest time of pre-examination TAt and Intra-laboratory TAT were clinical immunity. The minimum quality specifications for the quality indicators were from 3σ to 6σ.Conclusions Laboratories should strengthen their IQc and inter-laboratory comparison with continuing education training to realize the continuous quality improvement .

Analysis of 15 quality indicators in clinical laboratory in Zhejiang province / 中华检验医学杂志

Objective To establish and apply the procedure of survey on quality indicator in clinical laboratory and to analyze the status in quo of the 15 quality indicators in Zhejiang province .Methods A network platform for the survey on quality indicator in clinical laboratory was designed and developed by our center.The online questionnaires that should be reported back within one month were assigned to 473 laboratories.The developed software and SPSS 13.0 were used for statistical analysis .13 indicators expressed in rate were further evaluated with sigma scales .The 25th percentile, 50th percentile, and 75th percentile of the distribution of each quality indicator were regarded as the minimum , appropriate and optimum quality specifications, respectively.Results Totally 444 laboratories submitted the survey results.The overall sigma levels of 10/13 indicators were all >3, of which the inappropriate CV of internal quality control and unacceptable performances in EQA were still less than 3σin 15.8%and 9.2%of the laboratories.The rates of quality indicators in different scales of laboratories and diverse disciplines were significantly different .Pre-analytical TAT in routine examination for clinical chemistry and immunology was 50 min, on average.And the time for routine examination of blood , urine and stool was 30 min.Pre-analytical TAT in emergency examination for all four disciplines were all between 10 and 15 min. Intra-analytical TAT for clinical immunology was the longest , which was 154 min for routine examination and 40 min for emergency examination, respectively.The optimum quality specifications for 8 indicators were 6σ, while the minimum quality specifications were less than 1σfor 4 indicators.Conclusions According to the results of our survey, the pre-analytical quality indicator perform better than that of Intra-analytical and post-analytical phase.The laboratory should strengthen the laboratory information system technology construction to ensure the reliable data collection and long-time monitoring.

Cohort study of effects on lung function of coke oven workers exposured to coke oven emissions / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>Through comparative study on pulmonary function damage of coke oven workers exposed to coke oven emissions with the same group before and after five years, and further explore the relationship between the coke oven emissions and injury in pulmonary function of coke oven worker.</p><p><b>METHODS</b>Select a coking plant in Shanxi 165 coke oven workers (exposed group) and 52 auxiliary workers (control group) for the study, using a uniform questionnaire to collect workers' personal information. Fixed workplace air samples collected periodically. Air samples of benzo (a) pyrene concentrations was measured by high pressure liquid chromatograph. Pulmonary function of research object was measured by portable spirometer respectively in 2009 and 2013, and comparative analysis on it.</p><p><b>RESULTS</b>The concentration of B(a)P was no significant difference in the same area between 5 years in 2009-2013. Compared with 2009, 2013 control workers lung function index and the abnormal rate had no significant difference (P > 0.05). But FVC%, FEV1.0%, MVV%, VC% and FEF25% of exposed workers in 2013 was significantly lower than in 2009, FVC%, FEV1.0%, VC% and FEF25% pulmonary dysfunction rate in 2013 was also significantly higher than in 2009, difference was statistically significant (P < 0.05). Workers emerging pulmonary function abnormalities mainly distributed in furnace roof and side. furnace roof group FVC%, FEV1.0%, VC% additional abnormal number (rate) was significantly higher than furnace floor and the control group (P < 0.05), and furnace side groop was significantly higher than the control group, the difference was statistically significant (P < 0.05). Multivariate Logistic regression analysis showed that after 5 years FVC%, FEV1% and VC% of abnormal lung function emerging adjusted OR of furnace roof workers were 7.939, 5.966 and 4.956. For abnormal of FVC%, FEV1%, VC% and MVV%, the contacting coke seniority is a risk factor. There is a positive interaction between contacting coke seniority and furnace roof (P < 0.05).</p><p><b>CONCLUSION</b>Coke oven workers lung function damage associated with exposureing to coke oven emissions, coke oven emissions exposure level and exposure time are the main factors of coke oven workers in lung function damage, there is a positive interaction between the two factors.</p>

Treatment for lumbar disc herniation with percutaneous transforaminal endoscopic discectomy and discussing the relative problems / 国际外科学杂志

Objective To investigate the efficiency,decision of intra-operative puncture route,treatment of perioperative complications and discuss the other relative problems of the treament for lumbar disc herniation with percutaneous transforaminal endoscopic discectomy.Methods To excise the nucleus pulpesus under percutaneous transforaminal endoscopic discectomy,use the Macnab standard,visual analogue scale and infrared thermal imaging to estimate the efficiency.Results Among followed-up of 208 patients,182 patients were excellent and good outcome,23 patients favorable,2 patients fair,0 patient poor.The leg and back VAS was a significant improvement 1 week post-operation compared with pre-operation (P ＜ 0.05),but no statistical difference among 3 months,6 months,12 months and 1 week post-operation (P ＞ 0.05).The infrared thermal imaging point out that the legs skin temperature of D-value was a significant improvement post-operation compared with pre-operation (P ＜ 0.05).Conclusions The method excised the nucleus pulpesus,and provided the spine maximum protection about the stability and flexibility.Intra-operative puncture route of individuation design can reduce the complications of intervertebral foramen perioperative,and the key to improve the effectiveness.

Relationship between HSP70 gene polymorphisms and susceptibility to lung function injury of cock-oven workers / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>In this study, we investigate the relationship between HSP70 and lung function injury. To study on the feasibility of HSP70 genes polymorphisms as biological marker of the damage of pulmonary dysfunction susceptibility.</p><p><b>METHODS</b>183 cock-oven workers were selected as exposure groups and 143 workers unexposed workers were selected as control groups. We investigated their general information with uniform questionnaire. Pulmonary dysfunction indicators were determined using portable spirometer. HSP70-1 G190C, HSP70-2 A1267G, HSP70- hom T2437C genotypes were analyzed by using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The haplotypes were calculated using PHASE 2.0 software.</p><p><b>RESULTS</b>VC%, FVC%, MVV%, FEV(1.0%) in exposed group were lower than in non-exposure group, the difference were significantly (P < 0.05). VC%, FVC%, MVV%, FEV1.0% in exposed group with HSP70-1, HSP70-2, HSP70-hom genotypes were lower than in non-exposure group (P < 0.05); FVC% in exposed group with HSP70-hom T/C genotypes were lower than that with HSP70-hom T/T genotypes, MVV% were lower than that with HSP70-hom T/T, C/C genotypes. There's no difference in pulmonary dysfunction index of HSP70-1, HSP70-2 genotypes (P>0.05), but significant difference between the exposed group with HSP70-1, HSP70-hom genotypes; The adjust OR (95%CI) of exposed group with HSP70-1 G/C genotypes and HSP70-homT/C genotypes were 2.516 (1.012 ∼6.252) and 2.284 (1.033∼5.053). Exposed group with CGT haplotype pulmonary dysfunction were significantly higher than in non-exposure group (P < 0.05).</p><p><b>CONCLUSION</b>Coke oven exposure may increase pulmonary dysfunction injury, Coke oven workers who have the HSP70-1 G/C genotypes, HSP70-hom T/C genotypes and CGT haplotypes may increase the susceptibility of pulmonary dysfunction. There must be some relationship between HSP70-1, HSP70-hom gene polymorphisms and lung function injury of Cock-oven Workers.</p>

Effect of tumor necrosis factor receptor associated factor 6 gene silencing by small interfering RNA on proliferation of odontoblast cells / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of small interfering RNA (siRNA)-mediated inhibition of tumor necrosis factor receptor associated factor 6(TRAF6) gene on murine odontoblast-like cell line, MDPC-23 cell and the effect of TRAF6 on MDPC-23 cell proliferation.</p><p><b>METHODS</b>The vectors expressing siRNA against TRAF6 were constructed and introduced into MDPC-23 cell with lipofectin , and the cell line with stable expression of siRNA of TRAF6 was obtained by G418 screening and colony culture. Reverse transcription-PCR (RT-PCR) and Western blotting were performed to detect the expression of TRAF6. The proliferation of transfected MDPC-23 cell was investigated through methabenzthiazuron (MTT) and flow cytometry (FCM) assay.</p><p><b>RESULTS</b>The positive single colony was screened out, and was found to express siRNA against TRAF6 effectively because both TRAF6 mRNA and protein relative expression were significantly decreased in the experimental group (pSUPER-TRAF6siRNA: mRNA 0.163 ± 0.008, protein 0.215 ± 0.006) compared with controls (pSUPER: mRNA 0.778 ± 0.017, protein 0.964 ± 0.007 (P < 0.001). The A value of treated pSUPER-TRAF6siRNA cells (3 d: 0.46 ± 0.03, 5 d: 1.35 ± 0.06) was increased compared with controls (P<0.01). The result of proliferation index (PrI) was also increased compared with controls [pSUPER- TRAF6siRNA: (24.1 ± 2.2)%; pSUPER (11.2 ± 1.0)%; control (10.5 ± 0.7)%, P < 0.01].</p><p><b>CONCLUSIONS</b>The transcription and expression of TRAF6 gene were inhibited. The proliferation ability was increased in MDPC-23 cells by the constructed pSUPER-TRAF6siRNA vector. It may further influence the formation and repair of dentin, and may be involved in the regulation of normal tooth eruption and process of dentin repair after injury.</p>

Assessment of mitochondrial DNA ND2 gene C5178A polymorphism for cerebral-cardiovascular complications in patients with type 2 diabetes mellitus / 中华检验医学杂志

Objective To assess the relationship between mitochondrial DNA (mtDNA) ND2 gene C5178A polymorphism and complications of cardio-cerebral-vascular in patients with type 2 diabetes mellitus (T2DM).Methods This is a case-control study.448 unrelated patients with T2DM were collected from Zhejiang Provincial People's Hospital from 2010 to 2011,including 274 males and 174 females.Direct nucleotide sequencing analysis was used to screen mtDNA ND2 gene C5178A genotyping in ）patients.Meanwhile,detailed clinical and laboratory information for all of study subjects were collected.Body mass index (BMI),blood pressure,blood lipid,blood glucose and incidence rate of cerebral infarction were compared between 5178C patients and 5178A patients.Furthermore,according to the genotyping results,we 2analyzed whether these differences exist in patients with different gender by using t test or x2 test.Results 348 out of 448 patients with T2DM were C carriers and the remaining patients were A carriers.There're significant differences between T2DM patients with 5178A and T2DM patients with 5178C on systolic pressure (124.6 mm Hg ± 9.0 mm Hg vs 127.8 mm Hg ± 10.7 mm Hg,t =2.700,P =0.007)and HDL (1.3 mmol/L ± 0.2 mmol/L vs 1.2 mmol/L ± 0.3 mmol/L,t =2.968,P =0.003).Moreover,the incidence of cerebral infarction in T2DM patients with 5178A (8.0％,8/100) was much lower than that with 5178C (21.0％,73/348 ; x2 =8.832,P =0.003).No statistical gender difference was found in the distribution of C5178A (P ＞ 0.05).Our results also revealed that the female T2DM patients with 5178A had a lower serum triglyceride (1.5 mmol/L ±0.8 mmol/L; t =2.601,P =0.011) and lower systolic pressure (123.6 mm Hg±6.6 mm Hg; t =2.887,P =0.004) than that with 5178C (1.8 mmol/L ± 1.0 mmol/L and 128.0 mm Hg ± 9.0 mm Hg,respectively).Furthermore,cerebral infarction was more common in female T2DM patients with 5178C (21.3％,29/136; x2 =5.232,P =0.022) than that with 5178A (5.3％,2/38).Similarly,male T2DM patients with 5178A had a much lower incidence rate of cerebral infarction (9.7％,6/62; x2 =3.946,P =0.047) than that with 5178C (20.7％,44/212).In contrary,the serum concentration of HDL was higher in male T2DM patients with 5178A (1.4 mmol/L ±0.2 mmol/L;t=3.511,P =0.001) than that with 5178C (1.2 mmol/L±0.3 mmol/L).Conclusions The polymorphism site mtDNA C5178A correlates with cerebral-cardiovascular complications in patients with type 2 diabetes mellitus.mtDNA 5178A allele may protect T2DM patients from developing cerebral-cardiovascular diseases through regulation of blood pressure and lipid metabolism.

Relationship between the T3394C mutation of the mitochondrial DNA ND1 gene and type 2 diabetes mellitns in the elderly Chinese Han people in Zhejiang / 中华老年医学杂志

ObjectiveTo explore the relationship between the T3394C mutation of the mitoehondrial DNA ND1 gene and type 2 diabetes mellitus (T2DM) in the elderly. MethodsDirect sequencing of PCR product was applied to study the T3394C mutation of mitochondrial DNA in 340 unrelated individuals in T2DM patients (90 cases of elderly patients, 250 cases of non-elderly patients) and 265 normal controls (130 cases of elderly controls, 135 cases of non-elderly controls) from Zhejiang province. The mutation was analyzed by DNASTAR and Antheprot 5.0 softwares. ResultsThe T3394C mutation of mitochondrial DNA was found in 5 of 90 elderly T2DM patients (5.6%),1 of 130 elderly controls(0.8%), and 2 of 250 non-elderly T2DM patients (0.8%). The incidence of the mutation was significantly different between the elderly T2DM patients and elderly controls(P＜0.05), as well as between the elderly T2DM patients and non-elderly T2DM patients(P＜0.05). The T3394C mutation caused the change of the ND1 protein secondary structure. ConclusionsThe T3394C mutation of the mitochondrial DNA ND1 gene may contribute to the pathogenesis of T2DM in the elderly with other genetic and environment factors.

Preliminary study on blood proteome processing and mass spectrometry standards / 基础医学与临床

Objective To study the influence of sampling,handling,shipping and storage on low-molecular-weight serum proteome profiling.Methods Serum samples instantly separated and aliquoted,some stored at-80 ℃ for up to 6 months,others stored at 4 ℃ or room temperature(25 ℃) for 2 to 72 hrs.The variations of protein profiling under these conditions on WCX magnetic beads were studied.Profiling influenced by hemolysis,multi freeze-thaw cycles,storage conditions.Results Different handling procedures and storage conditions have different effects on serum profiling.Serum stored at-80 ℃ up to 6 months,stored at 4 ℃ or 25 ℃ for 2 h or one freeze-thaw cycle,had little effects on serum proteomic analysis.If serum diluted into 9 mol/L urea buffer at room temperature,the result is stable for 24 hours.Statistics analysis shows that 35.9% peaks have significant changes(P

Detection of CEA negative colorectal cancer and prognostic biomarkers of colorectal cancer / 基础医学与临床

ObjectiveTo study serum proteomic fingerprints of colorectal cancer during onset and progression and to screen tumor markers related to prognosis.Methods Serum from colorectal cancer patients, non-cancer patients, and healthy control were profiled using WCX ProteinChip or magnetic beads and analyzed by mass spectrometry. Results Seven protein peaks were found related to colorectal cancer. Several peaks were closely related to lymph node metastasis, distal organ metastasis and decreased after surgery. The diagnostic model composed of 3398.3、5477.1、8453.9 u can detect CEA negative colorectal cancer in 100%. Conclusion Protein fingerprinting technology (PFT) in conjunction with bioinformatics can significantly identify novel biomarkers in the serum of colorectal cancer patients with potential values for prognostic evaluation, detection of CEA negative colorectal cancer and changing its progression.

Serum nitric oxide level in the patients with oral squamous cell carcinoma and its change after operation / 中国癌症杂志

Purpose:To study the serum nitric oxide level and changes before and after operation in patients with oral squamous cell carcinoma.Methods:Serum NO and nitric oxide synthase(NOS) in 41 patients with oral squamous cell carcinoma,31 cases of benign diseases and 20 healthy coutrol were measured by chemical photometry.Results:In oral squamous cell carcinoma group,the serum NO and NOS level were significantly higher than in benign diseases and healthy control group ( P