Construction， reliability and validity of a professional identity questionnaire for psychiatrists / 四川精神卫生

BackgroundDomestic researches on the professional identity of psychiatrists are still relatively rare up to now， and effective evaluation tools remain inadequate. ObjectiveTo construct a professional identity questionnaire for psychiatrists with high reliability and validity， so as to provide an effective tool for the evaluation of professional identity of psychiatrists. MethodsA self-designed questionnaire titled "Professional Identity Questionnaire" was compiled. After preliminary screening of items and expert consultation， an initial questionnaire was formed and administered to a sample of 400 psychiatrists， and the final questionnaire was assessed by item analysis， reliability analysis and validity analysis. ResultsThe Cronbach's α coefficient was 0.930 for the final questionnaire， and ranged from 0.817 to 0.920 for each dimension. The value of KMO was 0.904 （χ2=2 931.652， P<0.01）. The cumulative variance contribution rate of factors extracted from exploratory factor analysis was 68.306%. Confirmatory factor analysis showed that the integrity of fit indexes were χ2/df=1.234， GFI=0.905， NFI=0.916， RMSEA=0.036， CFI=0.983， IFI=0.983. The final version of the professional identity questionnaire for psychiatrists consisted of 23 items relating to 4 dimensions， namely， professional cognition， professional behavior， professional emotion and professional values. ConclusionThe professional identity questionnaire for psychiatrists has good reliability and validity， and can be used as an effective tool to evaluate the professional identity of psychiatrists. ［Funded by Foundation of Sichuan Research Center of Applied Psychology of Chengdu Medical College （number， CSXL-22304）； Science and Technology Guiding Plan Project of Guangyuan City （number， 22ZDYF0072）］

Canagliflozin alleviates renal fat deposition and improves renal oxygenation levels in patients with newly-diagnosed type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To evaluate the effect of canagliflozin on intrarenal fat content and oxygenation in newly-diagnosed type 2 diabetes patients.Methods:Twenty-three newly-diagnosed type 2 diabetes patients were divided into canagliflozin( n=11) and glimepiride control( n=12) groups .Both groups received MRI scanning with Dixon MRI and BOLD MRI sequence to assess patients′ intrarenal fat content, oxygenation level before treatment and 24 weeks after treatment. Fasting blood glucose, glycosylated hemoglobin, blood uric acid, blood lipids, blood pressure, weight, and other metabolic index were also tested before and after treatment. Furthermore, the relationship between body mass index(BMI) and intrarenal fat content and the correlation between changes in intrarenal fat content and improvement in renal hypoxia were analyzed. Results:No significant differences were found in baseline age, body weight, fasting blood glucose, glycosylated hemoglobin, blood lipid, and serum uric acid between the two groups. There was no significant difference in fasting blood glucose, glycosylated hemoglobin, cholesterol(CHO), low-density lipoprotein-cholesterol(LDL-C), and triglycerides(TG) levels in both groups after 12 and 24 weeks of treatment. The decrease in body weight, blood uric acid level, and diastolic blood pressure from baseline in the canagliflozin group was greater than those in the control group( P<0.05). Two groups of patients with type 2 diabetes at baseline had no obvious difference in intrarenal fat content, and the patients′ BMI showed no obvious correlation with degree of intrarenal fat accumulation. Canagliflozin treatment for 24 weeks could reduce intrarenal fat content, which was higher than that of control group. The R2 * values of renal cortex and medulla in the canagliflozin group decreased from baseline by 19.22% and 22.63% respectively( P<0.05), whereas no significant difference was seen in the glimepiride control group. The decrease of intrarenal fat content in the canagliflozin group was related to the improvement of renal cortex and medulla oxygenation. Conclusion:Canagliflozin can reduce intrarenal fat accumulation and improve renal cortical hypoxia in newly diagnosed type 2 diabetes patients with normal renal function.

Clinical features and perinatal outcomes of 48 cases of pregnancy complicated with placental cystic lesions / 中华妇产科杂志

Objective:To investigate the clinical characteristics and perinatal outcomes of pregnancy with placental cystic lesions.Methods:A retrospective study was carried out on 48 pregnant women diagnosed as pregnancy complicated with placental cystic lesions from January 2000 to January 2020 at the Women′s Hospital, Zhejiang University School of Medicine. The clinical features, pathological diagnosis and perinatal outcome were analyzed.Results:The age of 48 cases was (30±5) years, and the diagnostic gestational week of ultrasound was (24±8) weeks. Twenty-five cases in which showed a cystic mass at the fetal surface were diagnosed as placental cyst. The live birth rate was 100% (25/25) and the premature birth rate was 20% (5/25). Twenty-three cases showed “honeycomb like” cystic echo. Cystic lesions of 10 cases were located in the uterine cavity connected with the margin of the normal placenta, and finally diagnosed as hydatidiform mole and coexisting fetus (HMCF). Six cases of HMCF terminated pregnancy, and the live birth rate was 4/10, the premature delivery rate was 2/4. Cystic lesions of 13 cases were located in the placenta substance, and finally diagnosed as 4 cases of placental mesenchymal dysplasia (PMD) and 9 cases of focal chorionic edema; the live birth rate was 6/13 and the premature delivery rate was 4/6. The median hCG was lower in focal chorionic edema group [80 kU/L (60-110 kU/L)] than in the groups of HMCF [240 kU/L (180-430 kU/L)] and PMD [360 kU/L (210-700 kU/L)], and the differences were statistically significant (all P<0.01). Conclusions:For pregnancy complicated with placental cystic lesions, prenatal ultrasound should be performed to evaluate the shape, location and blood flow of the lesions. Maternal serological examination and invasive prenatal diagnosis are helpful for prenatal diagnosis and treatment. Due to the difference of perinatal outcomes, maternal and fetal complications, individualized pregnancy management should be carried out.

Construction of multi-parameter emergency database and preliminary application research / 生物医学工程学杂志

The analysis of big data in medical field cannot be isolated from the high quality clinical database, and the construction of first aid database in our country is still in the early stage of exploration. This paper introduces the idea and key technology of the construction of multi-parameter first aid database. By combining emergency business flow with information flow, an emergency data integration model was designed with reference to the architecture of the Medical Information Mart for Intensive Care III (MIMIC-III), created by Computational Physiology Laboratory of Massachusetts Institute of Technology (MIT), and a high-quality first-aid database was built. The database currently covers 22 941 medical records for 19 814 different patients from May 2015 to October 2017, including relatively complete information on physiology, biochemistry, treatment, examination, nursing, etc. And based on the database, the first First-Aid Big Data Datathon event, which 13 teams from all over the country participated in, was launched. The First-Aid database provides a reference for the construction and application of clinical database in China. And it could provide powerful data support for scientific research, clinical decision making and the improvement of medical quality, which will further promote secondary analysis of clinical data in our country.

Prenatal ultrasonic diagnosis and postpartum follow-up of fetal gallstone / 中华超声影像学杂志

Objective@#To explore the characteristics of gallstone-like echo in fetal gallbladder and its changes with gestational age, and following up its prognosis as well as the relationship with bilirubin after birth so as to provide more information for prenatal consultation about neonatal jaundice related diseases.@*Methods@#A total of 82 fetuses from January 2014 to December 2017 at Women′s Hospital of Zhejiang University School of Medicine, who had prenatal ultrasound diagnosis and follow-up results with gallstone-like echo in fetal gallbladder, were included in this study. The characteristics of gallstone-like echo in fetal gallbladder were summarized, its change with gestational age, and its association with the status of pregnant mother were analyzed. Bilirubin and the prognosis of the gallstone-like echo were followed up after birth.@*Results@#Four different types of prenatal ultrasound characteristics of gallstone-like echo in fetal gallbladder were observed: sediment-like type(n=13), full of hyperechoic type (n=19), multiple hyperechoic type (n=42), and single or scattered hyperechoic type(n=8). Of the total 82 cases, 2 fetus were induced abortion. In the 80 normal-born fetuses, the number of gallstone-like echo were reduced in 9 cases during pregnancy, the gallstone-like echo disappeared in uterus in 8 cases. During the follow up, the gallstone-like echoes disappeared at 3 days, 42 days, 1 year and 2 years after birth in the rest 72 cases, respectively. In the 80 fetuses, 20 cases of neonates with hyperbilirubinemia after birth (4 males and 16 females) including 4 cases of ABO hemolytic, 2 cases of neonatal sepsis.No abnormalities occurred in the remaining 60 neonates during the follow-up period.@*Conclusions@#Gallstone-like echo in fetus is a self-limiting disease that occurs in late pregnancy.Some neonates develop hyperbilirubinemia after birth with good prognosis. After phototherapy, the jaundice index decreased to the normal standard and the serum bilirubin content decreased.

The value of color Doppler signal at the nasal lip in the diagnosis of fetal cleft palate / 中华超声影像学杂志

Objective To evaluate the clinical value of color Doppler signal at the nasal lip in the diagnosis of fetal cleft palate . Methods Twenty fetuses diagnosed with fetal cleft lip and cleft palate by targeted ultrasonography and magnetic resonance imaging were enrolled in this study . Color Doppler was used during each ultrasound scan . All prenatal diagnoses were confirmed either by postnatal follow‐up or autopsy . T he location and degree of cleft lip and palate was also recorded . During inspiration or swallowing color signal acrossed the defects at the fetal palate was indicated cleft palate ,and no color signal acrossed the defects at the fetal palate was indicated without cleft palate . T wo dimensional ultrasound combined with color Doppler was used to diagnose cleft lip and palate in midsagittal plane or paratsagittal plane ,then compared with the results of post‐natal evaluation or abortion ,and the value of color signal at the nasal lip in the diagnosis of fetal cleft palate was analyzed . Results Twenty cases of postpartum fetus ( including post‐natal evaluation or abortion ) confirmed 15 cases of cleft lip and palate ,5 cases of cleft lip ( 2 cases with upper alveolar cleft) . For prenatal diagnosis ,5 cases of cleft lip and 15 cases of cleft lip and palate were diagnosed by two‐dimensional ultrasound ,of which 3 cases of cleft lip and palate were misdiagnosed as cleft lip ,w hereas 3 cases of cleft lip were misdiagnosed as cleft lip and palate with 2 cases combined with upper alveolar cleft . T wo‐dimensional ultrasound in the diagnosis of cleft lip and palate is consistent with postnatal results by additional evaluation of the color signal in nasolabial area in median sagittal section . In the cleft lip and cleft lip with the alveolar cleft fetuses ,the color signal in nasolabial area was undetectable during fetal respiratory‐like movement or swallowing by ultrasound .However ,it was detectable in cleft lip and palate fetuses . A total of 3 cases of simple cleft lip and 17 cases of cleft lip and palate were detected by magnetic resonance imaging( M RI) . In 2 cases of cleft lip and palate diagnosed by M RI ,no blood flow signal was detected at the nasolabial area . Conclusions The connected color signal in nasolabial area assessed by color Doppler ultrasound during fetal respiratory‐like movement or swallowing showed an promising value for prenatal diagnosis of cleft palate . Cleft palate could be ruled out if the connected color signal was undetectable in nasolabial area .

Prenatal ultrasonic diagnosis and postpartum follow-up of fetal gallstone / 中华超声影像学杂志

Objective To explore the characteristics of gallstone-like echo in fetal gallbladder and its changes with gestational age,and following up its prognosis as well as the relationship with bilirubin after birth so as to provide more information for prenatal consultation about neonatal jaundice related diseases. Methods A total of 82 fetuses from January 2014 to December 2017 at Women's Hospital of Zhejiang University School of Medicine,who had prenatal ultrasound diagnosis and follow-up results with gallstone-like echo in fetal gallbladder,were included in this study.The characteristics of gallstone-like echo in fetal gallbladder were summarized,its change with gestational age,and its association with the status of pregnant mother were analyzed.Bilirubin and the prognosis of the gallstone-like echo were followed up after birth. Results Four different types of prenatal ultrasound characteristics of gallstone-like echo in fetal gallbladder were observed:sediment-like type(n =13),full of hyperechoic type (n =19),multiple hyperechoic type (n=42),and single or scattered hyperechoic type(n =8).Of the total 82 cases,2 fetus were induced abortion.In the 80 normal-born fetuses,the number of gallstone-like echo were reduced in 9 cases during pregnancy,the gallstone-like echo disappeared in uterus in 8 cases.During the follow up,the gallstone-like echoes disappeared at 3 days,42 days,1 year and 2 years after birth in the rest 72 cases,respectively.In the 80 fetuses,20 cases of neonates with hyperbilirubinemia after birth (4 males and 16 females) including 4 cases of ABO hemolytic,2 cases of neonatal sepsis.No abnormalities occurred in the remaining 60 neonates during the follow-up period.Conclusions Gallstone-like echo in fetus is a self-limiting disease that occurs in late pregnancy.Some neonates develop hyperbilirubinemia after birth with good prognosis. After phototherapy,the jaundice index decreased to the normal standard and the serum bilirubin contentdecreased.

Ultrasound diagnosis of left inferior vena cava and double inferior vena cava in fetus / 浙江大学学报·医学版

OBJECTIVE@#To evaluate the application of ultrasonography in prenatal diagnosis of left inferior vena cava and double inferior vena cava in fetus.@*METHODS@#The clinical data and ultrasonographic findings of the fetuses with left inferior vena cava (18 cases) or double inferior vena cava (16 cases) were retrospectively analyzed.@*RESULTS@#The ultrasonographic images of left inferior vena cava showed that in the transverse view of the fetal upper abdomen the inferior vena cava and abdominal aorta were in the normal position; below the level of the hilum, the inferior vena cava was located behind the left side of the abdominal aorta; at the level of the hilum, it crossed the front of the abdominal aorta and run diagonally to the upper right, forming the right inferior vena cava and finally entered into the right atrium. The ultrasonographic images of double inferior vena cava showed that in the transverse view of the fetal lower abdomen, in front of spine there were three transections of blood vessels; in coronal plane of abdomen, the veins run on both sides of the abdominal aorta and entered to the iliac vein of the same side. In 34 cases of abnormal inferior vena cava, there were 17 cases complicated with other system abnormalities, including 13 cases of cardiac anomalies.@*CONCLUSIONS@#The left inferior vena cava and double inferior vena cava have characteristic imaging findings, and prenatal diagnosis can be made with ultrasonography. This type of congenital deformity is frequently complicated with other system abnormalities, which should be excluded in fetus, especially for heart system.

Prenatal diagnosis and management of fetal hepatic hemangioma / 浙江大学学报·医学版

OBJECTIVE@#To review the application of medical imaging in diagnosis and management of fetal hepatic hemangioma.@*METHODS@#Clinical data and imaging findings of 14 cases of fetal hepatic hemangioma, who were diagnosed prenatally and followed up in Women's Hospital of Zhejiang University School of Medicine from February 2014 to September 2018 were retrospective reviewed.@*RESULTS@#The fetal hepatic hemangiomas were single lesions in all 14 cases, and most of them were located in the right lobe of the liver (13/14). Ultrasound images were mainly hypoechoic with heterogeneity, the honeycomb-like or grid-like anechoic regions were presented in 9 lesions and circumferential blood flow was observed with low to moderate blood flow resistance index. MRI findings showed well-defined lesions with low signal intensity on T1WI, and high or slightly high signal intensity on T2WI. Among 14 cases, there were 8 cases of induced labor and 6 cases of continuing pregnancy. In 6 cases of successful delivery, 2 were treated with propranolol, 4 cases were followed-up without treatment. The growth and development of 6 children were normal. The lesions of hepatic hemangioma showed no significant changes in 3 children and were reduced in the other 3 children, of whom the lesion was complete disappeared in 1 case.@*CONCLUSIONS@#Fetal hepatic hemangiomas present relatively typical imaging characteristics, and prenatal diagnosis can be made with ultrasound and MRI. If there are no complications, the fetus with hepatic hemangioma can be delivered at full term with a good outcome.

Fetal anteroposterior renal pelvic diameter for predicting antenatal hydronephrosis requiring postnatal surgery / 浙江大学学报·医学版

OBJECTIVE@#To assess the value of fetal anteroposterior renal pelvic diameter (APD) in predicting antenatal hydronephrosis requiring surgical treatment after birth.@*METHODS@#A total of 525 cases of antenatal hydronephrosis detected by prenatal ultrasonography (ultrasound index APD ≥ 4 mm in the second trimester and APD ≥ 7 mm in the third trimester) in Zhejiang Prenatal Diagnosis Center from June 2007 to June 2018 were retrospectively analyzed. ROC curve was used to analyze the relationship between these ultrasound indicators and the requirement for surgical treatment after birth.@*RESULTS@#There were 162 cases (30.9%) diagnosed in the second trimester and 363 cases (69.1%) diagnosed in the third trimester; 131 cases were diagnosed pathologically after birth, of which 121 finally underwent surgical treatment. The area under ROC curve (AUC) of APD in middle pregnancy for prediction of requiring surgery 1-12 years after birth was 0.910; the cut-off value of APD was 8.45 mm with a sensitivity of 97.1%, specificity of 70.9%, positive predictive value (PPV) of 47.9%, and negative predictive value (NPV) of 98.9%. The AUC of APD in late pregnancy for prediction of requiring surgery 1-12 years after birth was 0.800; the cut-off value of APD was 12.25 mm with a sensitivity of 66.7%, specificity of 81.2%, PPV of 51.7%, and NPV of 89.1%.@*CONCLUSIONS@#APD in pregnancy can be used to predict whether the fetus with hydronephrosis needs surgical treatment after birth, and the prediction value of APD in the middle pregnancy is better.

LncRNA HULC promots HCC growth by downregulating miR-29 / 中华肿瘤杂志

Objective@#To explore the effects of lncRNA HULC on hepatocellular carcinoma (HCC) growth by down-regulating miR-29.@*Methods@#The expression levels of HULC and miR-29 in HCC tissues and cells were detected by real-time quantitative PCR (RT-qPCR), and the correlation analysis was performed. After HCC cells were transfected with HULC overexpressed plasmid or siRNA, the expressions of miR-29 and its target gene SETDB1 were determinate by RT-qPCR. According to the bioinformatic prediction of the miR-29 binding site in the HULC sequence, the report gene plasmids were constructed. The HCC cells were co-transfected with miR-29 mimics or miR-29 inhibitor, and the HULC targeted regulation of miR-29 was verified by dual luciferase reporter assay. The effect of miR-29 on the HULC-mediated proliferation in HCC cells was detected by cell count kit 8 (CCK-8) experiment. Expression of tumor proliferation antigen Ki-67 was detected by RT-qPCR.The Hep3B cells were inoculated in mice and miR-29 mimics and miR-29 negative control (NC) further injected into the lesions. The tumor volume was observed, and the expressions of tumor proliferation antigen ki-67 in tumor tissues were detected by immunohistochemical staining.@*Results@#The expression of HULC was significantly up-regulated while the expression of miR-29 was significantly down-regulated in HCC tissues and cells (P<0.01). The level of HULC was negatively correlated with miR-29 in tumor tissues (r=-0.754, P<0.01) and HCC cells (r=-0.865, P<0.05). The in vitro experiments showed that, compared with the blank control group, the expression of miR-29 in HULC overexpressed Huh7 cells was significantly reduced, while the mRNA level of miR-29 target gene SETDB1 was increased (P<0.01). The expression of miR-29 was significantly increased in HULC deleted Hep3B cells, while the mRNA expression of SETDB1 was decreased (P<0.01). Double luciferase reporter gene assay showed that miR-29 mimics significantly inhibited the luciferase activity of Hep3B cells transfected with HULC wide type (psi-HULC-WT) plasmid but had no effect on Hep3B cells transfected with mutant plasmid (psi-HULC-Mut). However, the miR-29 inhibitor antagonized the inhibitory effect of miR-29 mimics on luciferase activity of psi-HULC-WT (P<0.01). Cell proliferation experiments showed that, compared with the control group, the proliferation ability of miR-29 mimics overexpressed Huh7 cells was significantly reduced.After 24, 48 and 72 hours of treatment, the proliferation rates of Huh7 cells in the HULC overexpressed group were (43.87±3.82)%, (83.45±7.46)% and (123.34±8.67)%, respectively, significantly higher than (13.45±1.77)%, (23.54±1.37)% and (38.21±2.09)% of control group (P<0.05). After treatment for 48 and 72 hours, the proliferation rates of miR-29 mimics transfected Huh7 cells were (57.10±1.94)% and (73.76±3.46)%, respectively, significantly lower than (83.45±7.46)% and (123.34±8.67)% of control group (P<0.05). After treatment for 48 and 72 hours, the proliferation rates of Huh7 cells transfected with miR-29 mimics and miR-29 inhibitor group were (76.45±3.24)% and (89.37±4.37)%, respectively, significant higher than (57.10%±1.94)% and (73.76±3.46)% of the control group (P<0.05). After 48 h transfection, the expression of Ki-67 in Huh7 transfected with miR-29 mimics was significantly inhibited compared with the control group (P<0.01). However, the expression of Ki-67 mRNA was increased in Huh7 cells transfected with miR-29 inhibitor (P<0.01). The results of in vivo experiments showed that the tumor volumes of the control group, miR-29 mimics group and miR-29 mimics + miR-29 inhibitors group were (504.0±19.6) mm3, (310.0±24.3) mm3 and (483.7±21.2) mm3, respectively. Injection of miR-29 mimics reduced while miR-29 inhibitor promoted tumorigenesis ability of Huh7 in nude mice (P<0.01). The immunohistochemical staining showed that the average optical density values of Ki-67 protein in tumor tissues of the control group, miR-29 mimics group and miR-29 analogue+ miR-29 inhibitor group were 0.65±0.08, 0.36±0.07 and 0.56±0.06, respectively. The expression level of Ki-67 protein in miR-29 mimics group was significantly reduced (P<0.01) while increased in the miR-29 mimics+ miR-29 inhibitor group (P<0.01).@*Conclusion@#LncRNA HULC promotes HCC growth by down-regulating miR-29.

The value of color Doppler signal at the nasal lip in the diagnosis of fetal cleft palate / 中华超声影像学杂志

Objective@#To evaluate the clinical value of color Doppler signal at the nasal lip in the diagnosis of fetal cleft palate.@*Methods@#Twenty fetuses diagnosed with fetal cleft lip and cleft palate by targeted ultrasonography and magnetic resonance imaging were enrolled in this study. Color Doppler was used during each ultrasound scan. All prenatal diagnoses were confirmed either by postnatal follow-up or autopsy. The location and degree of cleft lip and palate was also recorded. During inspiration or swallowing color signal acrossed the defects at the fetal palate was indicated cleft palate, and no color signal acrossed the defects at the fetal palate was indicated without cleft palate. Two dimensional ultrasound combined with color Doppler was used to diagnose cleft lip and palate in midsagittal plane or paratsagittal plane, then compared with the results of post-natal evaluation or abortion, and the value of color signal at the nasal lip in the diagnosis of fetal cleft palate was analyzed.@*Results@#Twenty cases of postpartum fetus (including post-natal evaluation or abortion ) confirmed 15 cases of cleft lip and palate, 5 cases of cleft lip (2 cases with upper alveolar cleft). For prenatal diagnosis, 5 cases of cleft lip and 15 cases of cleft lip and palate were diagnosed by two-dimensional ultrasound, of which 3 cases of cleft lip and palate were misdiagnosed as cleft lip, whereas 3 cases of cleft lip were misdiagnosed as cleft lip and palate with 2 cases combined with upper alveolar cleft. Two-dimensional ultrasound in the diagnosis of cleft lip and palate is consistent with postnatal results by additional evaluation of the color signal in nasolabial area in median sagittal section. In the cleft lip and cleft lip with the alveolar cleft fetuses, the color signal in nasolabial area was undetectable during fetal respiratory-like movement or swallowing by ultrasound.However, it was detectable in cleft lip and palate fetuses. A total of 3 cases of simple cleft lip and 17 cases of cleft lip and palate were detected by magnetic resonance imaging(MRI). In 2 cases of cleft lip and palate diagnosed by MRI, no blood flow signal was detected at the nasolabial area.@*Conclusions@#The connected color signal in nasolabial area assessed by color Doppler ultrasound during fetal respiratory-like movement or swallowing showed an promising value for prenatal diagnosis of cleft palate. Cleft palate could be ruled out if the connected color signal was undetectable in nasolabial area.

Pilot research: construction of emergency rescue database / 中华危重病急救医学

Objective To construct a database containing multiple kinds of diseases that can provide "real world"data for first-aid clinical research. Methods Structured or non-structured information from hospital information system, laboratory information system, emergency medical system, emergency nursing system and bedside monitoring instruments of patients who visited department of emergency in PLA General Hospital from January 2014 to January 2018 were extracted. Database was created by forms, code writing, and data process. Results Emergency Rescue Database is a single center database established by PLA General Hospital. The information was collected from the patients who had visited the emergency department in PLA General Hospital since January 2014 to January 2018. The database included 530 585 patients' information of triage and 22 941 patients' information of treatment in critical rescue room, including information related to human demography, triage, medical records, vital signs, lab tests, image and biological examinations and so on. There were 12 tables (PATIENTS, TRIAGE_PATIENTS, EMG_PATIENTS_VISIT, VITAL_SIGNS, CHARTEVENTS, MEDICAL_ORDER, MEDICAL_RECORD, NURSING_RECORD, LAB_TEST_MASTER, LAB_RESULT, MEDICAL_EXAMINATION, EMG_INOUT_RECORD) that containing different kinds of patients' information. Conclusions The setup of high quality emergency databases lay solid ground for scientific researches based on data. The model of constructing Emergency Rescue Database could be the reference for other medical institutions to build multiple-diseases databases.

Effects of Ginkgo Bitoba extract on differentiation and bone resorption of osteoclasts and their mechanisms / 吉林大学学报(医学版)

Objective:To study the effects of Ginkgo Biloba extract (GBE)on the differentiation and bone resorption of the osteoclasts,and to clarify their mechanisms.Methods:The RAW264.7 cells were cultured in vitro,then were treated with receptor activator for nuclear factor-κB ligand (RANKL)and different concentrations of GBE. The cells were divided into blank control group (0 μg · L -1 RANKL ), RANKL group (100 μg·L -1 RANKL),RANKL + 75 mg · L -1 GBE group, and RANKL + 150 mg · L -1 GBE group.The morphology and number of osteoclasts were assessed with TRAP staining assay,and bone resorption of GBE was examined with bone resorption pits assay. Flow cytometry was applied to analyze the the apoptotic rate of RAW264.7 cells and the cell cycle; the expression levels of nuclear factor of activated T cells 1 (NFATc1 ), DC-STAMP,Casthepin K,matrix metalloprotein 9 (MMP-9),Bcl-2,Bax,P27 and Cyclin-D1 in the RAW264.7 cells were analyzed by RT-PCR method.Results:Compared with blank control group,the number of osteoclasts in RANKL group were significantly increased (P <0.01);compared with RANKL group,the number of osteoclasts in RANKL+75 mg·L -1 GBE and RANKL+150 mg·L -1 GBE groups were significantly decreased (P <0.05). Compared with blank control group,the area of bone resorption pit of bone slice in RANKL group was significantly increased (P <0.05);compared with RANKL group,the areas of bone resorption pit of bone slice in RANKL+75 mg·L -1 GBE and RANK+150 mg·L -1 GBE groups were significantly decreased (P <0.05).Compared with blank control group,the apoptotic rates of the RAW264.7 cells in 75 and 150 mg · L -1 GBE groups were increased,and the expression levels of Bcl-2 in the RAW264.7 cells were significantly decreased and the expression levels of Bax were significantly increased (P <0.05).Compared with RANKL group,the G0-G1 phase arrest of the RAW264.7 cells in RANKL+ 75 mg· L -1 GBE and RANKL 150 mg· L -1 GBE groups were shortened;the expression levels of P27 in the RAW264.7 cells were significantly decreased and the expression levels of Cyclin-D1 were significantly increased (P < 0.05).Compared with blank control group,the expression levels of NFATc1, DC-STAMP,Casthepin K and MMP-9 in the RAW264.7 cells in RANKL group were significantly increased (P <0.05);compared with RANKL group,the expression levels of NFATc1,DC-STAMP,Casthepin K and MMP-9 in the RAW264.7 cells in RANKL+75 mg·L -1 GBE and RANKL+ 150 mg·L -1 GBE groups were significantly decreased (P <0.05).Conclusion:GBE could inhibit the differentiation and bone resorption of the osteoclasts,and their mechanisms may be related to promoting the apoptosis of RAW264.7 and shortening the G0-G1 phase of the RAW264.7 cells.

Impact of home visiting based on trans-theoretical model on hip function in community patients after hip joint replacement / 现代临床护理

Objective To explore the effect of trans-theoretical-model-based home visiting on hip function in community patients after hip joint replacement. Methods We chose 65 patients after hip joint replacement from January 2015 to March 2016 in our hospital:32 patients on odd days were set as the control group, where routine home visiting was done and the other 33 on even days as the experimental group, where community visiting based on trans-theoretical model. The two groups were compared in terms of Harris hip score at discharge and 6 months after discharge. Result The Harris hip score in the intervention group was significantly higher than that in the control group 6 months after discharge (P<0.05) and the hip function of the intervention group was better than that of the control group. Conclusions Community home visiting based on theoretical model can improve the hip function of patients after hip joint replacement compared with conventional health education models. This intervention method is worthy of popularization and application in community health education.

Prenatal ultrasonographic diagnosis of fetal portal-hepatic venous shunt / 中华超声影像学杂志

Objective To evaluate prenatal sonograpic findings and clinical value in fetus with congenital portal-hepatic venous shunt.Methods The prenatal ultrasonographic characteristic of ten cases of congenital portal-hepatic venous shunt were analyzed and summarized.Results Three cases had portal vein-left hepatic venous shunt,two cases with portal vein-right hepatic venous shunt,two cases with situs inversus of left right portal vein,and three cases with multiple shunt among portal and hepatic veins.All the 10 cases with portal-hepatic venous shunt had common sonographic features,①Two-dimensional ultrasound revealed the distal hepatic veins.The hepatic vein and portal vein were both visualized on the same plane and connected by an anechoic area.②Vascular signal were noted inside the anechoic area.③Blood flow inside the anechoic area demonstrated by spectral Doppler was similar to that of the portal vein.Conclusions Prental ultrasonography is valuable in the diagnosis of fetal portal-hepatic venous shunt.

Comparison of postoperative complication rate between two kinds of mini-mally invasive treatment for malignant obstructive jaundice / 中国现代医生

Objective To compare the postoperative complication rate of two kinds of minimally invasive treatment for malignant obstructive jaundice relieved by stenting via endoscopic retrograde cholangiopancreatography (ERCP) or per-cutaneous transhepatic biliary drainage (PTBD). Methods A total of 128 patients who had received ERCP or PTBD for the palliative treatment of malignant obstructive jaundice were retrospectively assessed in our hospital from January 2008 to December 2013. According to operation method, all the patients were divided into two groups. 71 patients treated by ERCP. 57 patients treated by PTBD. Investigated the different biliary drainage methods postoperative com-plication. Results Postoperative complication after ERCP occurred in five patients, including post-ERCP pancreatitis in three patients,hemobilia in one patient and fever in one patient, the rate of complication was 7.0%. Following the PTBD, eight patients (14.0%) suffered complications, fever was observed in four patients, self-limiting hemobilia in two pa tients, bile leakage in one patient, liver abscess in one patient. The postoperative complication rate of PTBD was higher than the ERCP group (P<0.05). Conclusion ERCP is feasible for palliation of malignant obstructive jaundice and seems to have a low rate of postoperative complication.

An observation on clinical efficacy of Shenqi Fuzheng injection for treatment of patients with acute exacerbation of chronic obstructive pulmonary disease / 中国中西医结合急救杂志

Objective To investigate the clinical therapeutic effect of Shenqi Fuzheng injection for treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A prospective clinical study was conducted. Fifty-eight consecutive patients with AECOPD were admitted in Departments of Respiratory Disease and Critical Care Medicine in Zhuozhou City Hospital of Hebei Province from January 2012 to December 2013. They were randomly divided into western medicine (WM) control group (28 cases, the routine treatment of WM) and integrated traditional Chinese medicine (TCM) with WM group (30 cases, on the basis of conventional therapy, Shenqi Fuzheng injection 250 mL intravenous drip was given once a day for a therapeutic course of 10 days). The duration of mechanical ventilation, the successful rate of weaning from ventilator, the rate of using ventilator again after weaning, the length of stay in intensive care unit (ICU), and mortality were recorded respectively in the two groups. Before and after treatment, the arterial blood gas analysis, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), pulmonary function and dyspnea score were evaluated. Results Compared with the WM control group, the duration of mechanical ventilation (hours: 104±16 vs. 125±24) and the length of stay in ICU (days: 6.3±2.1 vs. 7.2±3.6) were significantly shorter, the rate of successful weaning from ventilator was obviously higher [73.3% (22/30) vs. 60.7% (17/28)], and the rate of using ventilator again after weaning was remarkably lower [13.3% (4/30) vs. 28.6% (8/28)] in the combined TCM and WM group, the differences between the two groups being statistically significant (allP 0.05). Compared with those before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC) and the ratio of FEV1/FVC were all significantly higher in the two groups after treatment, while the partial pressure of arterial carbon dioxide (PaCO2), APACHE Ⅱ score, CPIS score, residual volume/total lung capacity (RV/TLC), and the dyspnea score were all lower in the two groups after treatment, the more obvious changes in levels being after 10 days of treatment in combined TCM and WM group [pH: 7.44±0.04 vs. 7.40±0.08, PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 59.1±11.9 vs. 68.1±12.4, PaO2 (mmHg): 70.5±6.9 vs. 65.1±7.4, APACHE Ⅱ score: 14.5±4.2 vs. 17.4±2.2, CPIS score: 5.3±2.4 vs. 7.6±1.4, FEV1 (L): 1.60±0.47 vs. 1.54±0.34, FEV1/FVC: (65.33±2.65)% vs. (62.00±3.25)%, FVC (L): 1.72±0.21 vs. 1.66±0.21, RV/TLC: (42.13±1.67)% vs. (43.12±0.95)%, dyspnea scores: 1.71±0.54 vs. 2.32±0.65, allP < 0.05].Conclusion Shenqi Fuzheng injection possesses certain clinical value in treatment of patients with AECOPD, as it can obviously improve the pulmonary function and the data of arterial blood gas analyses, and effectively relieve the clinical symptoms.

Analysis on bacterial culture and drug resistance of 2 125 blood specimen / 国际检验医学杂志

Objective To analyze distribution and drug resistance of pathogenic bacteria isolated from blood specimens of inpa-tients,so as to guiding the principle of clinical use of antibacterials and improve clinical efficacy.Methods The results of bacterial culture and drug sensitivity test of 2 125 blood specimens,from November 2012 to November 2014,in the Rizhao Hospital of Tradi-tional Chinese Medicine were retrospectively analyzed.Results A total of 233 strains of pathogens were isolated(the positive rate was 10.96%),including 57 strains of gram-positive coccus(accounted for 24.46%)and 1 74 strains of gram-negative bacilli(accoun-ted for 74.68%).The coagulase-negative staphylococci and Staphylococcus aureus were most common in gram-positive coccus,the detection rate of methicillin-resistant coagulase-negative staphylococci (MRCNS)and methicillin-resistant Staphylococcus aureus (MRSA)were 84.2% and 40.0%,respectively.The rate of drug resistance of coagulase-negative staphylococci and Staphylococcus aureus to penicillin,erythromycin and clindamycin were no less than 80.0%.The Escherichia coli,Klebsiella pneumoniae and Pseud-omonas aeruginosa were most common in gram-negative bacilli,the detection rate of extended spectrum beta-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae were 35.85% and 28.13%,respectively.The sensitive rate of Escherichia coli and Klebsiella pneumoniae to imipenem were both 100.0%.Conclusion Gram-negative bacilli is the most common pathogen in this hospital and multidrug resistance is observed.Therefore,cultures of blood specimen should be timely submitted in order to guiding the rational antimicrobial application in clinic.

Clinicopathological analysis of 12 cases with extraventricular neurocytoma / 临床与实验病理学杂志

Purpose To study the clinicopathological features of extraventricular neurocytoma. Methods 12 cases of extraventricular neurocytoma were retrospectively analyzed for their clinical information and histopathological features. Results The distribution of ex-traventricular neurocytoma was as follows: cerebral hemisphere (5 cases), right thalamus (2 cases), cerebellar vermis (2 cases), saddle area (2 cases), and spinal cord (1 case). The histological features were round uniform cells, round or oval nuclei, with peri-nuclear clearing commonly seen. Neuropil-like structure, ganglion cells or ganglion-like cells, perivascular rosettes, calcification, cap-illary wall thickening and hyaline degeneration and other pathological changes were also observed. All cases showed strong immunoreac-tivity for Syn. 7 cases exhibited Ki-67 labeling index of≤2%, and other 5 cases showed 3% ~8%. 3 cases were performed with fluo-rescence in situ hybridization ( FISH) to detect loss of chromosome 1p/19q, but no loss was detected. Postoperative follow-up for 4 months to 4 years showed one case had tumor recurrence and intracranial spread in postoperative 2 years. Conclusions Extraventricu-lar neurocytoma shares similar histological features with central neurocytoma, but often more complex. Ganglion cells or ganglion-like cells, calcification, capillary wall thickening and hyaline degeneration are more frequently seen, but neuropil-like structure is less seen. Extraventricular neurocytoma needs differential diagnoses from oligodendroglioma, ependymoma, dysembryoplastic neuroepitheli-al tumor and others. Immunohistochemistry and chromosome 1p/19q loss can help in the differential diagnosis. The treatment for ex-traventricular neurocytoma is grossly total resection, with post-operative radiotherapy for subtotal resection, atypical or recurrent cases.