Clinically diagnostic value of ultrasound elastography combined with serum miR-26b-5p and COX-2 examination for early hysteromyoma / 中国医学装备

Objective:To investigate the diagnostic value of ultrasound elastography combined with serum microRNA-26b-5p(miR-26b-5p)and cyclooxygenase-2(COX-2)detection for early hysteromyoma.Methods:A total of 228 patients with suspected early hysteromyoma who were diagnosed in the 90th Hospital of the Joint Service Support Center from October 2020 to September 2022 were selected as the observation objects.Based on the results of pathological section examination as the"gold standard",all subjects were divided into a positive group(124 cases)and a negative group(104 cases),and ultrasound elasticity imaging examination was performed in both groups.The expression level of miR-26b-5p in serum was detected by real-time fluorescent quantitative polymerase chain reaction(Rt-PCR),and the level of serum COX-2 was detected by enzyme-linked immunosorbent assay(ELISA),and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic values of serum miR-26b-5p and COX-2 for hysteromyoma.The four tables were applied to analyze the diagnostic values of ultrasound elastography and the combination of ultrasound elastography,serum miR-26b-5p and COX-2 for hysteromyoma.Results:The results of pathological examination indicated that 124 cases of 228 patients were positive result of hysteromyoma and 104 cases were negative result.The results of ultrasound elastography showed that 117 cases were positive,and 111 cases were negative,and the diagnostic sensitivity,specificity and accuracy of ultrasound elastography detection were respectively 74.19%,75.96%and 75.00%.Serum miR-26b-5p level of positive group was significantly lower than that of negative group,while the COX-2 level of positive group was significantly higher than that of negative group,and the differences of them between the two groups were statistically significant(t=4.519,5.601,P<0.05),respectively.The area under curve(AUC)value of ROC curve,sensitivity,specificity and the best cut-off value of serum miR-26b-5p were respectively 0.749,95.97%,46.15%and 1.10 in diagnosing hysteromyoma.The above indicators of serum COX-2 were respectively 0.835,66.13%,84.62%and 40.58 mg/L in diagnosing hysteromyoma.The sensitivity,specificity and accuracy of ultrasound elastography combined with serum miR-26b-5p and COX-2 were respectively 93.55%,86.54%and 90.35%,the differences were statistically significant(x2=23.158,17.169,P<0.05),respectively.Conclusion:Ultrasound elastography combined with serum miR-26b-5p and COX-2 has higher effectiveness in diagnosing the early hysteromyoma.

The construction of employer's satisfaction evaluation index towards the post competency of residents / 中华医学教育探索杂志

Objective:To develop employer's satisfaction evaluation index system towards post competency of residents.Methods:Using Delphi method, the employer's satisfaction evaluation index system towards post competency of residents was formulated through a two-round expert consultation among 19 experts. SPSS 20.0 was used for statistical analysis to calculate the positive coefficient, authority coefficient and coordination degree of experts.Results:For the two rounds of the expert consultation, the questionnaire recovery rate was 95.0% and 100% respectively. The experts' authority coefficient was 0.92, and the system was ultimately determined, including 5 first-level indicators, and 32 secondary indicators. The coefficient of variation (CV) of first-level indicators was 0.00, and the Kendall's W of secondary indicators was 0.663. Conclusions:Employer's satisfaction evaluation index system towards post competency of residents is scientific and reliable, which could provide employer with systematic and objective tool to evaluate residents' post competency.

Methodological study of rapid health technology assessment of drugs ：taking antitumor drugs as an example / 中国药房

OBJECT IVE To develop a rapid health technology assessment （rHTA）methodology of drugs based on evidence integration and value judgment ，which is suitable for China ’s national conditions. METHODS The literature review was adopted to study health technology assessment （HTA）and multi-criteria decision analysis （MCDA），and then rHTA method based on China ’s condition was formulated preliminarily with anti-tumor drugs ；the method of rHTA was demonstrated by expert consultation ； finally，the feasibility of rHTA was preliminarily verified taking the drugs for the treatment of non-small cell lung cancer as an example. RESULTS Established rHTA method combined the theory and principles of HTA and MCDA ：HTA method was used to guide the collection and synthesis of literature and real-world evidence ，while MCDA made the value measurements of achievable evidences by various stakeholders from different views ；it established the working process ，evaluation dimensions ，evaluation indicators and scoring system of rHTA. The feasibility of this method was verified by the drug example of treating non-small cell lung cancer. CONCLUSIONS A set of drug-driven rHTA methodology guidance based on HTA and MCDA is established. It can quickly collect and integrate evidence ，and provide evidence support for decision makers in a short time.

Effects of moxibustion on miRNA-133b, Pitx3/TH, and neurotransmitters in the midbrain of rats with diarrhea-predominant irritable bowel syndrome / 针灸推拿医学（英文版）

Objective: To investigate the mechanism of moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), by observing the effects of moxibustion at Tianshu (ST25) and Shangjuxu (ST37) on microRNA-133b (miRNA-133b), pituitary homeobox family factor 3 (Pitx3)/tyrosine hydroxylase (TH), and neurotransmitters in the brain tissue of IBS-D rats. Methods: Healthy Sprague-Dawley rats were randomly divided into a normal group, a model group, a moxibustion group, and a Western medicine group, with 12 rats in each group. Except for the normal group, the IBS-D rat model was established by mother-offspring separation and acetic acid enema combined with restraint stress stimulation in all the other groups. No intervention was performed in the normal and model groups. Mild moxibustion was applied to both Tianshu (ST25) and Shangjuxu (ST37) in the moxibustion group. Rifaximin was given by gavage in the Western medicine group. The physical status of rats in each group was observed at different periods. After the intervention, hematoxylin- eosin staining was performed to observe the histopathological morphology of rat colon; enzyme-linked immunosorbent assay was used to measure the levels of dopamine (DA), noradrenaline (NE), and 5-hydroxytryptamine (5-HT) in plasma, colon, and midbrain tissue of rats; the relative expression levels of miRNA-133b, Pitx3 mRNA, and TH mRNA in the midbrain tissue were measured by real-time fluorescence quantitative polymerase chain reaction, and the relative expression levels of Pitx3 and TH proteins in the midbrain tissue were measured by Western blotting and immunofluorescence. Results: The body weights of rats among groups and at different time points were statistically different (P<0.01). The body weight of the normal group was higher than that of the other groups over time (P<0.01). After modeling, the minimum volume threshold of abdominal withdrawal reflex (AWR) was significantly lower (P<0.01) and the loose stool rate was significantly higher (P<0.01) in the model, moxibustion, and Western medicine groups compared with the normal group; the miRNA-133b expression in the midbrain tissue was significantly lower (P<0.01), the expression levels of Pitx3 and TH in the midbrain tissue were significantly higher (P<0.01), and the levels of DA, NE, and 5-HT in plasma, colon and midbrain tissue were significantly higher (P<0.01). After the intervention, the minimum volume threshold of AWR was significantly higher (P<0.01), the loose stool rate was significantly lower (P<0.01), the miRNA-133b expression was significantly increased (P<0.01 or P<0.05) and the expression levels of Pitx3 and TH were significantly decreased (P<0.01) in the midbrain tissue, the levels of DA, NE, and 5-HT in plasma, colon, and midbrain tissue were significantly reduced (P<0.01) in the moxibustion and Western medicine groups compared with the model group; the levels of 5-HT in the colon and midbrain tissue of the moxibustion group were significantly lower than those in the Western medicine group (P<0.05), and there was no statistical difference compared with the remaining groups (P>0.05). Linear correlation analysis showed that miRNA-133b was negatively correlated with Pitx3 (r<0, P<0.01); Pitx3 with TH, TH with DA, and NE with 5-HT were positively correlated (r>0, P<0.01).Conclusion: Moxibustion at Tianshu (ST25) and Shangjuxu (ST37) improves diarrhea symptoms and visceral hypersensitivity in IBS-D rats. The mechanism may be related to up-regulating miRNA-133b, inhibiting Pitx3/TH, and reducing neurotransmitter expression levels in the midbrain tissue.

Genetic polymorphism and antibody screening of RhD negative Chinese Han population in Jiayuguan / 中国输血杂志

【Objective】 To investigate and analyze the polymorphism of RHD gene in RhD-negative population in Jiayuguan using molecular biological technique, so as to accurately identify RhD-negative individuals, and formulate individualized transfusion strategies. 【Methods】 The RhD negative voluntary blood donors and patients (mainly pregnant women) were recruited. After informed consent, history of blood transfusion and pregnancy of them were investigated, and samples were collected for negative D confirmation, gene sequencing as well as antibody screening and identification. 【Results】 Among the 96 samples, 73 cases were RHD gene deletion, 18 RHD*01EL.01(17 RHD1227A homozygous type and 1 RHD1227A heterozygous type), 2 weak RHD*15 type (845G/A), 1 partial D type, i. e. RHD-CE(7) -D heterozygous allele, and 2 RHD*01N.16 variant. Antibody was detected out in 4 cases, among which 2 were positive for anti-D, 1 anti-D plus anti-E, and 1 anti-Dia. 【Conclusion】 The proportion of DEL gene in RhD negative Chinese Han population in Jiayuguan is slightly lower than that in general Chinese Han population. No anti-D or RHD-HDN was observed in DEL type women due to multiple pregnancy or delivery of D positive newborns.

Bibliometric analysis of papers on case management from Web of Science / 现代临床护理

Objective To search the Web of Science for the papers related to case management to understand the present situation and direction of case management. Methods Papers on case management were retrieved in the Web of Science from 1999 to 2017.The Web of Science and excel were used to analyze the publication years, research themes, journals, countries and institutes. Results Totally,970 articles were included,with a sum of cited times,12,075.The number of publications on the case management was going up. Most of the authors were from the USA and China was ranked at 7 in authorship. Most of the papers concerned the research in chronic diseases such as chronic heart failure,mental disease and HIV. Conclusions Case management has been widely researched in the developed countries.China still has a lot of room for improvement in the study.The future research should be focused on the establishment of case manager training,multidisciplinary combination,case management mode suitable for chronic disease and aging population and exploration of the mode's effectiveness.

Sarcopenia screening for older women with low body-weight and low handgrip strength is more urgently required / 中华内分泌代谢杂志

To evaluate several tests of physical performance for sarcopenia screening and assessment, by investigating physical performance and function in older women. 106 community-dwelling older women from a community in Shanghai were enrolled in this study. Physical function assessed by short physical performance battery (SPPB), timed get-up-and-go (TUG), handgrip strength, and usual gait speed were asked to perform. Total lean mass was determined by Dual energy X-ray absorptiometry, the relative appendicular skeletal muscle mass ( RASM) was defined as appendicular skeletal muscle mass/height2 . 13 individuals were diagnosed as sarcopenia according to a consensus diagnostic criteria for sarcopenia, as developed by the Asian Working Group for Sarcopenia ( AWGS) in 2014. Body mass index and handgrip strength in the sarcopenia group were significantly lower than those in the non-sarcopenia group (P=0. 026, P=0. 004 respectively), and there was no significant differences in the age, SPPB score, TUG, and usual gait speed. Linear regression analysis showed RASM was significantly positively correlated with body mass index (r=0. 842, P<0. 01), time to rise from a chair and return to the seated position five times (r=0. 203, P=0. 036),TUG(r=0. 258, P=0. 008)and grip strength (r=0. 217, P=0. 025), meanwhile, both body mass index and grip strength entered Logistic regression analysis. Low weight and low handgrip strength are independent predictive factors of sarcopenia in older women. Sarcopenia screening for older women with low body-weight and weak handgrip strength is more urgently required

Clinical Study on Tianma Gouteng Decoction Combined with Routine Western Therapy in the Treatment of Early Onset Severe Pre-eclampsia / 中国中医药信息杂志

Objective To observe clinical efficacy of Tianma Gouteng Decoction combined with Western medicine for early onset severe pre-eclampsia. Methods Sixty patients were randomly divided into treatment group with 30 cases and control group with 30 cases. Two groups were both given the routine Western therapy, while the treatment group was added with Tianma Gouteng Decoction. Indicators were observed and compared between two groups including blood pressure, 24 h UAE, D-dimer, fibrinogen and their effects on pregnancy. Results Compared with the control group, the blood pressure, 24 h UAE, fibrinogen, D-dimer, hypoproteinemia, and liver and kidney function were reduced obviously in the treatment group (P<0.05);fibrinogen and D-dimer of control group were not changed significantly;gestational weeks of treatment group were extended (15.2 ± 4.8)d, and neonatal asphyxia was 7 cases;gestational weeks of control group were extended (9.3 ± 2.2)d, and neonatal asphyxia was 11 cases. There was no significant difference about cesarean section rate between the two groups. Conclusion Tianma Gouteng Decoction combined with Western medicine for treatment of early onset severe pre-eclampsia have better clinical efficacy.

Relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains / 中华皮肤科杂志

Objective To explore the relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains. Methods The National Committee for Clinical Laboratory Standards (NCCLS)M27-A2 broth microdilution method was conducted to evaluate antifungal susceptibility of 34 clinical Candida albicans isolates in vitro. Total RNA was extracted from these Candida albicans strains and transcribed into cDNA. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of ERG4 gene. Statistical analysis was carried out by a two-sample t-test. Results The expression level of ERG4 mRNA was significantly higher in fluconazole-resistant than in -sensitive Candida albicans strains (4.20 ± 2.56 vs. 1.72 ± 1.33, t = 3.99, P < 0.05), higher in itraconazole-resistant than in -sensitive Candida albicans strains (3.60 ± 2.47 vs. 1.66 ± 1.61, t = 3.71, P < 0.05), and higher in voriconazole-resistant than in -sensitive Candida albicans strains (3.99 ± 2.72 vs. 2.07 ± 1.58, t = 2.91, P <0.05). Further more, increased ERG4 mRNA expression was also observed in isolates cross-resistant to all the three azole antifungal agents compared with those susceptible to all of them (4.49 ± 2.73 vs. 1.69 ± 1.82, t = 3.81, P < 0.05). Conclusions The overexpression of ERG4 gene may be associated with cross resistance to fluconazole, itraconazole and voriconazole in clinical Candida albicans strains, but its exact role is expected to be investigated through downregulation of the ERG4 gene.

Association between the efficacy of alendronate and serum level of vitamin D in patients with osteoporosis / 中华内分泌代谢杂志

Objective To examine the association between vitamin D and alendronate response,and to investigate the proper vitamin D levels for the efficacy of alendronate treatment of osteoporosis.Methods In this retrospective study,559 post-menopausal women with osteoporosis were devided into two groups:non-responders and responders,based on the European Study of Forsteo (EUROFORS).Demographic and clinical data including mean 25-hydroxy vitamin D (25-OHD) levels between dual-energy X-ray absorptiometry (DEXA) scans were obtained.Mean 25-OHD levels were compared between responders and non-responders and multiple logistic regression analysis was performed to identify factors associated with non-response.Results There were 437 (75.5％) responsers to alendronate therapy and 142 (24.5％) non-responders.Responders with a mean serum 25-OHD level of (59.96 ±12.56) nmol/L,obtained a more favorable result than non-responders,whose serum 25-OHD level was (47.50 ±9.92) nmol/L (P＜0.01).25-OHD level was significantly associated with response.Conclusion Patients with a mean 25-OHD ≥50 nmol/L had a substantially greater likelihood of maintaining bisphosphonate response.

Relation of body mass index to vitamin D, PTH, and bone turnover markers levels among women in Shanghai area / 中华内分泌代谢杂志

Objective To examine the relationship of body mass index (BMI) with levels of vitamin D,parathyroid hormone (PTH),and bone turnover markers among women in Shanghai area.Methods Altogether 810 Chinese women aged 45 year and older were enrolled to study the associations by multiple linear regression analyses.Bone mineral density was measured by a dual energy X-ray absorptiometry (Lunar,Prodigy,GE),Serum 25-hydroxyvitamin D [25 (OH) D],PTH,C-telopeptide of type Ⅰ collagen (CTX),osteocalcin (BGP),and bonespecific alkaline phosphatase (BSALP) were measured.Results (1) 25 (OH) D,BGP,BSALP,and CTX levels were significantly lower in obesity group than in control group ; PTH level was significantly higher in obesity group than in control group.(2) In multiple linear regression analyses,BMI was significantly associated with lower 25 (OH) D (β =-0.017,P =0.006),BGP (β =-0.077,P =0.019),and higher PTH (β =0.025,P =0.000).Conclusions (1) There were siginificant associations between higher BMI and lower 25 (OH) D among women in Shanghai.(2) Serum osteocalcin was associated not only with bone metabolism but also with energy metabolism.

Comparison of several early drug interventions in postmenopausal women with osteopenia / 中华内分泌代谢杂志

Two hundreds postmenopausal women with osteopenia, aged 45-80, were randomly divided into 4 groups, and received different drug interventions. After treatment for 12 months, the lumbar spine bone mineral density(BMD)and total hip BMD in alendronate group increased significantly(3.5% and 2.6%, both P＜0.05), the lumbar spine BMD raised 2.0% in selective estrogen receptor regulator group(P＜0.05). Bone turnover indices improved in both groups(all P＜0.05). No change in BMD or bone turnover indices was found in patients treated with active vitamin D3and calcium.

Risk factor analysis for postmenopausal osteoporosis in Shanghai / 中华老年医学杂志

Objective To investigate the risk factors for postmenopausal osteoporosis in Shanghai.Methods Five hundred postmenopausal community-dwelling women aged 45-80 years were recruited. The case-control study was performed from June 2008 to September 2008.A total number of 250 women with postmenopausal osteoporosis identified with their bone mineral density (BMD) were selected as case group, and 250 non-osteoporosis women were selected as control group. BMD was measured by dual energy X-ray absorption (DEXA). Results Univariate logistic regression analysis showed that age, eduction level, occupation, years since menopause, BMI, use of calcium,historyofnon-violencefracture,fall,diabetesmellitus,chronicgastricdiseases, gastrointestinal resection and diarrhea were related to osteoporosis.Multiple logistic regression showed that age, years since menopause and nutritional status were the risk factors for osteoporosis. ConclusionsThe occurrence of osteoporosis is related with many factors in postmenopausal women in Shanghai, and women with early menopause, low BMI and older age should pay more attention to the prevention and treatment of osteoporosis.

Resistant Mechanism and Strain Relationship of Multi-resistant Pseudomonas aeruginosa / 中华医院感染学杂志

OBJECTIVE To investigate the correlated resistant genes encoding ?-lactamases,aminoglycoside and genetic marker of integron and transposon in multi-resistant Pseudomonas aeruginosa(MRPA) isolated from clinical specimens and study their relationship by phylogenetic analysis.METHODS Twenty-one resistant genes,two integron-Ⅰ genes and one transposon genetic gene were analyzed by PCR and verified by DNA sequencing.Multi-resistant genes cluster analysis was performed by UPGMA.RESULTS The positive rates of CARB,oprD2,aac(3)-Ⅱ,aac(6′)-Ⅱ,ant(2″)-Ⅰ,intⅠ1,qacE△1-sul1 and merA in 20 strains of MRPA were 15%,100%,70%,15%,15%,85%,85% and 85%,respectively,and other genes were negative.It was classfied to three subgroup,by the multi-resistant genes cluster analysis.CONCLUSIONS MRPA isolated from clinical specimens has carried many resistant genes.The deficiency rate of oprD2 gene is very high.The positive rate of genetic mark genes about integron and transposon is very high.It may be the main multi-resistant mechanism of MRPA.Multi-resistant genes cluster analysis shows that there is clone transmission in MRPA and it can induce nosocomial infection prevalence.

Analysis of epidemiological characteristics of 11 142 injuries / 中华疾病控制杂志

Objective To study the characteristics of injuries in patients,and provide basic evidence for injury prevention and control.Methods 3 hospitals were sampled by stratified sampling,and the data of all injured patients visiting the 3 hospitals in 2006～2007 were analyzed.Results 11 142 injured patients were collected.The ratio of male to female was 1.81∶1.The average age was 34.56?16.Injured patients were mainly peasants(40.04%) and students(20.62%).Most injuries occurred at home and highway,and at 9～10AM and 3～4PM.The cause of injuries were fall(32.12%),traffic accidents(20.33%) blunt force(16.60%),and animal attacks(11.67%).Unintentionally injured patients accounted for 87.70% of all cases.Conclusions The occupation injury,traffic injury and injury to young adolescents are seriously endangering the health of peasants and students.

Effect observation of 115 children with asthma treated with salmeterol/flutieasone propionate inhalation / 中国基层医药

Objective To observe the effect of salmeterol/flutieasone propionate on children with asthma. Methods Salmeterol/flutieasone propionate inhalation of different dosages were given according to different illness condition of asthma. Investigate the effects of 180 days inhalation of SM/FP among children. Results After 180 days' treatment, the PEFam and PEFpm of those children of asthma were significantly increased. The lung function has a perceptible improvement. In addition, the daytime and noctural symptom scores and asthma symptom were improved. Moreover, the shore-acting β2 agonist was used with decreasing frequency. The effects of SM/FP inhalation were marvelous after 1 week of treatment and should make a long persisting time alter six months of treatment. Conclusion SM/FP is an effective medicine for children with asthma and should be make more widespread.

Rat diffuse axonal injury model constructed by a new experimental facility / 西安交通大学学报(医学版)

Objective To design a new experimental facility to induce rat diffuse axonal injury model. Methods Rat diffuse axonal injury was induced by a new experimental facility,which was developed to let the rat head spin 90 degree at the moment to cause shearing injury.Vital sign and behavior of rat were measured simultaneously.The rats were sacrificed at 2 h,6 h,12 h,24 h,36 h,72 h and 10 d after injury,respectively,and the brain tissues were removed to prepare paraffin section.Then silver staining and HE staining were conducted to investigate changes of axonal fibers. Results There were unconsciousness,respiratory rhythm disturbance and hyporeflexia of pupil light reflex immediately after injury,and reactiveness decrease and activity retardation still existed even after resuming consciousness.At anatomical scene,subarachnoid hemorrhage or cerebroventricular haemorrhage were widespread.At an early stage,there were swelling,collapse,and axonal retraction ball formation at cortico-medulla junction,callosum,brainstem,and cerebellar white matter under microscope.But at the later stage,gitter cell proliferation and nest-like aggregation were major pathophysiological changes at focal brain tissue. Conclusion The new experimental facility is suit able to be used to induce rat diffuse axonal injury,since it is convenient,controlable,and precise.

Optimization of total epimediumon flavone microporosity osmotic pump tablet formulation by box-behnken design and response surface methodology / 中成药

AIM:To optimize total flavone of herba epimediumon microporosity osmotic pump tablets by boxbehnken design-response surface methodology. METHODS:Osmotic agent (lactose),dosage of plastificator (dibutyl phthalate),and coating weight gain were selected as key factors of influencing total flavone delivery. Total flavones cumulatiive yield in 12 h and fitting approximation was regarded as the response. Design Expert method useful for the modeling and analysis was to optimize the response. RESULTS:Response surface surface obtained repre-sented maximum one which conformed to the zero-order delivery rate equation. CONCLUSION:Optimal excipient formulation of total epimedium flavone microporosity osmotic pump tablet consists of 0. 18 g of lactose,0. 26 ratio of dibutyl phthalate to acetyl celulose and 7. 7% of coating weight gain.