Retrospective Analysis of Death Cases of Oral Diphenidol Hydrochloride Poisoning / 法医学杂志

OBJECTIVES@#To explore the characteristics of postmortem examination, chemical examination and scene investigation of deaths caused by oral diphenidol hydrochloride poisoning, and so as to provide a reference for proper settlement and prevention of such deaths.@*METHODS@#The data of 22 deaths caused by oral diphenidol hydrochloride poisoning in a city from January 2018 to August 2020 were collected, including case details, scene investigations, autopsies, chemical examinations and digital evidence. Thirty-one cases of deaths caused by oral diphenidol hydrochloride poisoning reported in previous literature were also collected.@*RESULTS@#In the 53 oral diphenidol hydrochloride poisoning death cases, 50 cases were suicide, 2 cases were accidental, while 1 case was undetermined. Fifty-two cases were found in the medical records or crime scene investigation reports with doses ranging from 775 mg to 12 500 mg, and 23 deceased were detected with postmortem blood concentrations ranging from 2.71 mg/L to 83.1 mg/L. Clinical symptoms were recorded in 6 patients, including conscious disturbance and convulsion. Among the 45 cases which were performed with external examination, 23 cases autopsied.@*CONCLUSIONS@#Most of the deceased of oral diphenidol hydrochloride poisoning were suicide. No significant correlation was found between dose and blood concentration through the retrospective analysis of cases.

Clinical Efficacy of Didangtang Combined with Gemcitabine in Postoperative Patients with Non-muscle-invasive Bladder Cancer / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Didangtang combined with gemcitabine chemotherapy in postoperative patients with non-muscle invasive bladder ctraditional chinese medicineancer （NMIBC）. Method:A total of 100 patients with NMIBC in Jiangsu Provincial Second Chinese Medicine Hospital and Jiangsu Province Hospital of Chinese Medicine from January 2015 to September 2020 were randomly divided into control group and treatment group. 50 cases in the treatment group received Didangtang combined with intravesical infusion of gemcitabine， and 50 cases in the control group received placebo combined with intravesical infusion of gemcitabine. Before and after the treatment cycle， the blood biochemistry， immune cell subsets（CD3⁺，CD4⁺ and CD4⁺/CD8⁺） were detected to assess the safety and immune function changes in treatment group. Quality of life scale for patients with bladder cancer prepared by European Organization for the Research and Treatment of Cancer （EORTC QLQ-C30） and Specificity scale for patients with superficial bladder cancer （EORTC QLQ-BLS24） were scored to assess the changes in physical， role， emotional and social functioning of the patients， symptomatic conditions such as fatigue， pain， nausea and vomiting， shortness of breath， insomnia， loss of appetite， diarrhea and constipation， as well as bladder cancer-specific symptoms such as treatment-generated problems， future concerns， bowel symptoms and urinary tract symptoms. Result:There were no differences in terms of age， sex， disease duration and tumor states. During the treatment period， both groups had no recurrence or adverse events. The traditional Chinese medicine（TCM） efficacy in the treatment group was significantly better than that in the control group（<italic>χ²</italic>= 7.23，<italic>P </italic>= 0.02）. After treatment， the number of CD3⁺，CD4⁺ ，CD8⁺ cells and the CD4⁺/CD8⁺ ratio in the treatment group were significantly higher than those in control group（<italic>P</italic><0.05）. Both groups showed significant improvements in the domains of role functioning， social functioning， and general health after treatment （<italic>P</italic><0.05）. In addition， fatigue， diarrhea， constipation， intestinal symptoms， and urinary tract symptoms in the treatment group were significantly better than those in the control group after treatment （<italic>P</italic><0.05）. Conclusion:Didangtang can reduce adverse clinical symptoms during postoperative gemcitabine infusion chemotherapy in patients with NMIBC， reduce urethral and intestinal discomfort reactions， improve immune function and enhance quality of life for patients.

Frequency and collective dose of medical radiation exposure in Hubei Province in 2018-2019 / 公共卫生与预防医学

Objective To assess the medical radiation exposure frequency and find out the main factors related to the collective dose derived from X-ray diagnosis procedures. Methods A survey of 3 178 hospitals was conducted to collect the basic information such as types of medical radiation, allocation of radiological diagnosis and treatment devices, the frequency of radiologic examinations, etc. By using a stratified sampling method，36 hospital were selected and more specific details, including 26 types of diagnostic radiologic examinations, were collected to estimate the collective dose to the population in Hubei, combining with the previous literature. Results A total number of 6 843 radiological diagnosis and treatment devices were covered and 33 771 855 medical radiologic procedures were counted in this survey. The result showed a annual frequency of 569.79 examinations per 1 000 population for all types of procedures. A large variation was revealed among different areas and the highest area was with a 4-fold frequency of the lowest area. Although tertiary hospitals accounted for 4.40% of the total hospitals, 48.42% procedures were carried out in them. The collective effective dose from X-ray diagnosis in Hubei was 65 399.55man·Sv, and the average annual effective dose was 1.10mSv, while contribution from CT scans accounted for 86.90% of the dose. Conclusion The frequency of medical radiologic procedures presented a consistent increase in Hubei province, with a uneven development among hospitals from urban and rural areas, or from different regions, or from different levels. Among all types of X-ray examinations, CT scan frequency had the fastest growth rate and accounted for the major annual collective effective dose. In order to reduce the health risk from medical radiologic exposure, CT scan need to be applied more properly and the radiation dose per single CT scan need to be limited to a reasonable level.

Protective effect and mechanism of Wangshi Baochi Pills against acute alcoholic liver/stomach injury in mice / 中国中药杂志

As a common disease worldwide, alcoholic liver injury is caused by long-term or excessive intake of alcohol and triggers cell death due to alcohol metabolism and reactive oxygen species(ROS)-mediated cytotoxicity. Wangshi Baochi(WSBC) Pills have been widely adopted in clinical practice for evacuating stasis, resolving turbidity, clearing heat, tranquilizing mind, invigorating sto-mach, promoting digestion, purging fire and removing toxin. This study aimed to investigate the efficacy of WSBC Pills in dispelling the effect of alcohol and protecting against acute alcoholic liver/stomach injury in mice, and preliminarily investigate its possible mole-cular mechanism. The results found that the preventive treatment with WSBC Pills contributed to elevating the activity of alcohol dehydrogenase(ADH) and its expression in liver and shortening the time required for sobering up of mice with acute alcoholic liver injury. The staining of liver pathological sections as well as the detection of serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) and liver ROS levels revealed that WSBC Pills protected the liver by reducing serum AST and ALT. It suppressed oxidative stress-induced liver injury by lowering liver ROS and elevating superoxide dismutase(SOD), and the liver-protecting effect was superior to that of silibinin. Western blot assay confirmed that WSBC Pills inhibited the oxidative stress by up-regulating SOD1 and NAD(P)H: quinone oxidoreductase 1(NQO-1). In addition, WSBC Pills lowered the ROS level to protect against the acute alcoholic stomach injury in mice. The findings have suggested that WSBC Pills alleviated the acute alcoholic liver/stomach injury in mice by increasing ADH and resisting oxidative stress.

Verification of doses to PTV and OAR and 2D dose distribution in IMRT for 7 accelerators in Hubei province / 中华放射医学与防护杂志

Objective To study a method to measure the doses to planned target volume (PTV) and organ at risk (OAR) and 2D dose distribution in IMRT by using TLD and radiochromic film for a verification purpose.Methods Totally 7 different types of medical linear accelerators were selected from seven hospitals in Hubei province.A polystyrene phantom provided by IAEA was CT scanned and then the scanned images were returned to the Treatment Planning System (TPS) for determining the prescribed doses to PTS and OAR and the corresponding MU.After the phantom was irradiated with 6 MV X-ray,the TLDs and films were transmitted to the secondary standard dosimetry laboratory of China CDC for measurement and estimation.Results The IAEA required the relative deviations between TLD-measured and TPS-planned doses to OAR and PTV be within ±7.0％.For PTV,the measured-to-planned deviation values for 7 accelerator were within-5.4％ to 6.5％,all consistent with the IAEA requirements.For OAR,the values for 5 accelerators were within-2.2％ to 6.7％,not consistent the requirements,whereas the values for the other 2 were-8.6％ and 8.2％ respectively,beyond the required values.The IAEA required that the 2D dose distribution 3 mm/3％ pass rate be higher than 90％.The measured values for 7 accelerators were in the range of 90.3％-98.9％,all consistent with the requirements.Conclusions It is feasible scientifically and easy to operate in practice for using TLD and film to carry out dose verification in IMRT.It would be advisable to apply this method to quality verification in IMRT in medical institutions to the extent possible.

Verification of doses to PTV and OAR and 2D dose distribution in IMRT for 7 accelerators in Hubei province / 中华放射医学与防护杂志

Objective@#To study a method to measure the doses to planned target volume (PTV) and organ at risk (OAR) and 2D dose distribution in IMRT by using TLD and radiochromic film for a verification purpose.@*Methods@#Totally 7 different types of medical linear accelerators were selected from seven hospitals in Hubei province. A polystyrene phantom provided by IAEA was CT scanned and then the scanned images were returned to the Treatment Planning System (TPS) for determining the prescribed doses to PTS and OAR and the corresponding MU. After the phantom was irradiated with 6 MV X-ray, the TLDs and films were transmitted to the secondary standard dosimetry laboratory of China CDC for measurement and estimation.@*Results@#The IAEA required the relative deviations between TLD-measured and TPS-planned doses to OAR and PTV be within ±7.0%. For PTV, the measured-to-planned deviation values for 7 accelerator were within -5.4% to 6.5%, all consistent with the IAEA requirements. For OAR, the values for 5 accelerators were within -2.2% to 6.7%, not consistent the requirements, whereas the values for the other 2 were -8.6% and 8.2% respectively, beyond the required values. The IAEA required that the 2D dose distribution 3 mm/3% pass rate be higher than 90%. The measured values for 7 accelerators were in the range of 90.3%-98.9%, all consistent with the requirements.@*Conclusions@#It is feasible scientifically and easy to operate in practice for using TLD and film to carry out dose verification in IMRT. It would be advisable to apply this method to quality verification in IMRT in medical institutions to the extent possible.

Yes-associated protein (YAP) and transcriptional coactivator with a PDZ-binding motif (TAZ): a nexus between hypoxia and cancer

Hypoxia is a common feature of solid tumors. As transcription factors, hypoxia-inducible factors (HIFs) are the master regulators of the hypoxic microenvironment; their target genes function in tumorigenesis and tumor development. Intriguingly, both yes-associated protein (YAP) and its paralog transcriptional coactivator with a PDZ-binding motif (TAZ) play fundamental roles in the malignant progression of hypoxic tumors. As downstream effectors of the mammalian Hippo pathway, YAP and/or TAZ (YAP/TAZ) are phosphorylated and sequestered in the cytoplasm by the large tumor suppressor kinase 1/2 (LATS1/2)-MOB kinase activator 1 (MOB1) complex, which restricts the transcriptional activity of YAP/TAZ. However, dephosphorylated YAP/TAZ have the ability to translocate to the nucleus where they induce transcription of target genes, most of which are closely related to cancer. Herein we review the tumor-related signaling crosstalk between YAP/TAZ and hypoxia, describe current agents and therapeutic strategies targeting the hypoxia-YAP/TAZ axis, and highlight questions that might have a potential impact in the future.

Identification of ezrin gene transcriptional regulatory region and its gRNA target site in pancreatic cancer cells / 医学研究生学报

Objectiveezrin gene is overexpressed in pancreatic cancer, and its upstream sequence plays an important role in gene expression. This study intends to knock out ezrin transcriptional regulatory region and identify its gRNA target sites for gene editing in pancreatic cancer cells.MethodsThe reporter gene expression vectors carrying the upstream segment of ezrin gene were transiently transfected into Panc-1 cells. The ezrin transcriptional regulatory regions were identified by double luciferase reporter gene detection system. Then, the online software was utilized to predict the gRNA target sites located at the upstream and downstream of ezrin transcriptional regulatory region. Two recombinant plasmids pX459-sgRNA-L and pX458-sgRNA-R contained these two sequences were constructed for gene editing. Moreover, in order to identify the targeted knockout of ezrin transcriptional regulatory region, the recombinant plasmids were co-transfected into Panc-1 cells, and the genome DNA contained gRNA target sites were amplified, subcloned and sequenced. Finally, Panc-1 cells transfected with recombinant plasmids were preliminary sorted using puromycin treatment. The cell proliferation was detected by water-soluble tetrazolium salt method.ResultsLuciferase data showed that ezrin gene fragment -1297/-1186 enhanced the transcriptional activity of SV40 promoter and ezrin promoter in Panc-1 cells. Subclonal sequencing data revealed that the recombinant plasmids carrying the gRNA target sequence of ezrin transcriptional regulatory region were co-transfected into Panc-1 cells could trigger the genomic DNA fragments, which located between gRNA-L and gRNA-R target sites. Cell proliferation assay showed that the proliferation was significantly inhibited after transfection.ConclusionThe targeted knockout of ezrin transcriptional regulatory region was achieved and the inhibition of Panc-1 cell proliferation may be related to this knockout.

Verification of positioning accuracy of MLC leaves of 7 medical linear accelerators in IMRT in Hubei province / 中华放射医学与防护杂志

Objective To verify the leaf positioning accuracy of multi-leaf collimator (MLC) in intensity modulated radiation therapy (IMRT) by using radiochromic films to provide references for IMRT quality control.Methods Medical linear accelerators of different designs,owned by 7 first-class hospitals at grade-3 in Hubei,were selected for this verification study.Five strip picket fence pattern was created by treatment planning system (TPS).Each strip was 0.6 cm wide with a 3 cm strip separation.MLC leaf positions,positioning bias and opening widths were then measured with EBT2 radiochromic films.Results According to IAEA standards,the film-measured and TPS planned MLC leaf position difference was ±0.5 mm.The difference of MCL strip position of No.5 and No.7 accelerator was 0.7 and-1.0 mm,respectively,not in line with the IAEA standards.The difference of film-measured MLC leaf position between each pairs and all pairs of leaves of 7 accelerators were all within ± 0.5 mm,in line with the IAEA requirements.As required by IAEA,the difference of opening width of MLC leave of each pair relative to the averaged widths of all pairs should be within ±0.75 mm.The filem-measured values from 7 accelerators ranged from-0.6 to 0.5 mm,all in line with the IAEA standards.Standard deviation of opening width of all leaves were required to be within 0.3 mm.The measured values from 7 accelerators ranged from 0.1 to 0.2 mm,in line with the IAEA standard.Conclusions The use of EBT2 radiochromic films to verify MLC leaf positioning accuracy is an important means of quality control owing to its simplicity and high measurement accuracy.It is recommended for verification use at a large scale.

Efficacy of ultrasound-prepositioned four-point method for right internal jugular vein catheterization in parturients at high risk of bleeding / 中华麻醉学杂志

Objective To evaluate the efficacy of ultrasound-prepositioned four-point method for right internal jugular vein ( IJV) catheterization in the parturients at high risk of bleeding. Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱparturients diagnosed as having perni-cious placenta previa, aged 25-38 yr, weighing 60-90 kg, scheduled for elective cesarean section under general anesthesia, were divided into 2 groups ( n=40 each) using a random number table method: real-time ultrasonic guidance group ( group UG ) and ultrasound-prepositioned four-point method group ( group UF) . In group UG, the right IJV catheterization was performed under real-time ultrasound guidance: mov-ing the ultrasonic probe to make the mid-line of the cross section image of the right IJV overlap with the mid-line of the ultrasonic display screen, and the intersection of the mid-line of the IJV and the horizontal line of the annular cartilage was selected as the puncture point. In group UF, the right IJV catheterization was per-formed by using ultrasound-prepositioned four-point method as follows: moving the ultrasonic probe to make the midline of the right IJV cross-sectional images overlap with the midline of the ultrasound display screen, and marking the skin where the midpoint of the probe's long-axis was located as point A;transversely mov-ing the probe to the inside so that the tangent line of its inner edge overlapped with the midline of the ultra-sonic display screen, marking the skin where the midpoint of the probe's long-axis was located as point B ( the puncture site);at the proximal cardiac end of the right IJV, making point C at 2 cm from point B, and making point D ( the indicator point, direction of the puncture needle) at 2 cm from point A. After lo-cal infiltration anesthesia was performed in point B, the puncture needle was inserted towards the point D. The success rate of puncture, success rate of catheterization, catheterization operation time and complica-tions such as hematoma, intravascular catheter insertion or hemopneumothorax were recorded. Results The success rate of total catheterization was 100％ in two groups. Compared with group UG, the catheteriza-tion operation time was significantly shortened ( P<0. 01) , and no significant change was found in the suc-cess rate of puncture at first attempt, success rate of catheterization at first attempt or intravascular catheter insertion in group UF ( P>0. 05) . Conclusion Compared with real-time ultrasound guidance, ultrasound-prepositioned four-point method produces better efficacy when used for the right IJV catheterization in the parturients at high risk of bleeding.

Expression of IL-25 and IL-33 and the count of EOS in peripheral blood of children with allergic rhinitis receiving immunotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To investigate the expression of IL-25,IL-33 and EOS in children with allergic rhinitis (AR).@*METHODS@#Ninety-four AR children receiving immunotherapy and 23 healthy people were concluded in the study. The serum levels of IL-25 and IL-33 were detected by Enzyme-linked Immunosorbent Assay (ELISA), and a count of EOS were measured.@*RESULTS@#The serum levels of IL-25 and IL-33 in the mild group were higher than control group (0.05). The serum levels of IL-25 and IL-33 in the severe group were higher than those in mild group (<0.05). The serum levels of IL-25 and IL-33 in the severe group were higher than control group (<0.05). The count of EOS in the severe group were higher than those in mild group (<0.05). The count of EOS in the severe group were higher than those in control group (<0.05). Spearman test showed the serum levels of IL-25 in the children with AR patients have positive correlation with the serum levels of IL-33 (<0.05, =0.238).@*CONCLUSIONS@#Expression of IL-25 levels, IL-33 levels and the count of EOS in patients with AR are enhanced, which shows that IL-25, IL-33 and the count of EOS are involved in the AR. If we can understand the mechanism of them, it will profound implications for treatment.

Verification of absorbed dose and single-field dosimetry of MLC-shaped IMRT photon beams in Hubei province / 中华放射医学与防护杂志

Objective To verify the absorbed dose and two-dimensional dosimetry delivered by MLC-shaped IMRT photon beams using thermoluminescent dosimeters (TLDs) and radiochromic films.Methods Different types of medical linear accelerators at 7 third-grade first-class hospitals in Hubei were selected for this audit study.Besides TLDs and films,a small polystyrene phantom measuring 15 cm × 15 cm × 15 cm,supplied by the International Atomic Energy Agency (IAEA),was also used.The TPS dose calculation were performed with 6 MV X-ray beam and by delivering 6 Gy dose to the TLDs or films at 10 cm depth for 5 cm × 5 cm field size at 90 cm SSD.After irradiation,comparations were conducted of dose derivations between TPS-calculated values and TLD-or film-measured values.The two-dimensional dosimetry audit was carried out by using 30 cm × 30 cm homogeneous solid phantoms in which a 25 cm × 25 cm film was located at 5 cm depth.A single-filed profile generated by TPS was delivered to the film,and the film was measured.And then,two-dimensional dose distribution was analyzed using the film analysis system.Results The results suggested that the relative deviations of TLD and film to TPS dose was-8.5％ and-1.9％ for accelerator 1,5.4％ and 0.5％ for accelerator 7,respectively,whereas those for other accelerators were within ± 5％.The passing rates for two-dimensional dose distribution at all accelerators were all higher than 90％.Conclusions TLD and film quality audit for IMRT can be applied for a wide range of application in view of its simplicity,reliability and postal convenience.

Monitoring EGFR T790M mutations by Blocker PCR in plasma of advanced non-small-cell lung cancer patients with EGFR-TKI acquired resistance / 复旦学报（医学版）

Objective To evaluate the feasibility of Blocker PCR assays in monitoring T790M mutations in plasma of non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) acquired resistance.Methods Blocker PCR assays were employed to identify mutations in plasma for 127 advanced NSCLC with acquired EGFR-TKI resistance.In addition,the paired tumor re-biopsy or PE samples were obtained to analyze EGFR mutations.Meanwhile,we evaluated the detection accuracy of Blocker PCR assays in comparison with the next generation sequencing (NGS).Results Among the 127 patients,40.15％ (51/127) EGFR T790M was detected in the plasma,78.44％ (40/51) coexisted with an EGFR activating mutation.Additionally,54.54 ％ (6/11) EGFR T790M was identified in re-biopsy tissues,while 43.75 ％ (14/32) were detected in the plasma.Furthermore,the concordance rate of Blocker PCR and NGS in identifying EGFR sensitizing mutations and EGFR T790M mutations was 100％.Conclusions Blocker PCR is a highly sensitive and reliable method in monitoring EGFR T790M mutations in the plasma of NSCLC patients with EGFR-TKI acquired resistance.

Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer and mediastinal lesions / 复旦学报（医学版）

Objective To investigate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in lung carcinoma and mediastinal lesions.Methods From Jan.,2015 to Dec.,2015,368 patients with hilar and/or mediastinal lymphadenopathy or mass outside the airways by CT scan or PET/CT in Department of Pulmonary Medicine,Zhongshan Hospital,Fudan University were enrolled and recieved EBUS-TBNA examination.All of their clinical data were collected.Results Retrospective analysis was performed in the 368 patients.In the 252 patients diagnosed as malignancy,232 patients were diagnosed by EBUS-TBNA,while the other 116 patients were diagnosed as benign disease.The diagnostic concordance rate was 92.9 ％.A total of 387 lymph nodes and 56 masses outside the airways were found among the 368 patients received EBUS-TBNA procedure.The sensitivity and specificity of EBUS-TBNA were 92.1 ％ and 100 ％,respectively.Conclusions EBUS-TBNA is an effective and safe method with high specificity and sensitivity in diagnosis of unknown hilar and/or mediastinal lymphadenopathy,mediastinal mass as well as lymph node staging in lung cancer patients.

Evaluation of clinical features and factors affecting prognosis in patients with secondary sepsis of acute gastrointestinal perforation / 中国中西医结合急救杂志

Objective To observe the clinical features and evaluate the risk factors affecting prognosis in patients with secondary sepsis of gastrointestinal perforation (GIP). Methods A retrospective cohort study was conducted, and the patients with GIP admitted to the Department of General Surgery of Affiliated Shuyang People's Hospital of Xuzhou Medical University from January 1, 2014 to April 30, 2017 were enrolled, according to the presence or absence of sepsis occurrence, they were divided into GIP with and GIP without sepsis groups. The difference of gender, age, the time between the onset of GIP and the occurrence of sepsis, infection situation, body temperature, heart rate, respiratory frequency, white blood cell count (WBC), systemic inflammatory response syndrome (SIRS) in accord with standard, C-reactive protein (CRP), blood sugar, mean arterial pressure (MAP), lactic acid, number of cases having undergone laparoscopic surgery, sequential organ failure score (SOFA) and quick sequential organ failure score (qSOFA), Glasgow coma score(GCS), length of stay in intensive care unit (ICU), the total length of stay in hospital were compared;the status of survival and prognosis was assessed on day 30 by the Glasgow Outcome Scale (GOS). The indicators with statistical significance in the two groups were brought into the Cox regression model to analyze the independent risk factors affecting the prognosis of the patients. Results Fifty-eight patients with GIP were enrolled in this study. Among them, 22 cases developed secondary sepsis (GIP with sepsis group, there were 50.0% cases with single organ failure and 50.0% cases with multiple-organ failure, cases only in accord with 0-1 SIRS criteria accounting for 81.8%, and the mortality of secondary sepsis being 31.8%). No sepsis occurred in 36 patients (GIP without sepsis group). In GIP with sepsis group, the age, blood glucose, lactic acid, SOFA score, qSOFA, and the length of stay in ICU were significantly higher than those of GIP without sepsis group [age (years): 68.7±15.9 vs. 56.1±17.2, blood glucose (mmol/L): 6.9±2.3 vs. 5.9±1.2, lactic acid (mmol/L): 2.9±1.3 vs. 1.2±0.7, SOFA score: 5.6±3.2 vs. 0.5±0.4, qSOFA score: 1.0±0.9 vs. 0.3±0.1, the length of stay in ICU (days): 1.0 (0-4.0) vs. 0.1 (0-2.0), all P < 0.05], while MAP, GCS, and GOS scores in GIP with sepsis group were significantly lower than those in GIP without sepsis group [MAP (mmHg, 1 mmHg =0.133 kPa): 83.6±18.7 vs. 100.0±14.3, GCS score: 12.8±3.5 vs. 14.5±0.5, GOS score: 3.5±1.9 vs. 4.9±0.2, all P < 0.01]. Cox multivariable regression analysis showed: only low MAP and low GCS score were the independent risk predictors of death outcome for GIP with sepsis, the relative risk (RR) was 0.896 [95% confidence interval (CI) = 0.815-0.984, P = 0.022] and 0.585 (95%CI = 0.395-0.866, P = 0.007) respectively. Conclusion Patients with secondary sepsis following GIP have relatively high morbidity and much more risk factors, but only low MAP and low GCS score are closely associated with its high risk of death.

Preparation of Carbon Dots and Their Application in Food Analysis as Signal Probe / 分析化学

As the new popular fluorescent carbon nanomaterials, carbon dots have not only excellent optical properties and small size characteristics, but also have good biocompatibility, low toxicity and easy to achieve the surface functional characteristics, and can replace the traditional semi-quantum dots of the better choice.Based on the unique fluorescence characteristics and high sensitivity, carbon fluorescent probe has a good potential in food analysis and testing. In this experiment, the study of fluorescent carbon dots has been reviewed in recent years. The characteristics of carbon dots are briefly introduced and the preparation methods of carbon dots are summarized. The application of carbon dot fluorescent probes in food analysis and detection is introduced and the limitations and development of carbon point application are analyzed and forecasted.

Evaluation of clinical features and factors affecting prognosis in patients with secondary sepsis of acute gastrointestinal perforation / 中国中西医结合急救杂志

Objective To observe the clinical features and evaluate the risk factors affecting prognosis in patients with secondary sepsis of gastrointestinal perforation (GIP). Methods A retrospective cohort study was conducted, and the patients with GIP admitted to the Department of General Surgery of Affiliated Shuyang People's Hospital of Xuzhou Medical University from January 1, 2014 to April 30, 2017 were enrolled, according to the presence or absence of sepsis occurrence, they were divided into GIP with and GIP without sepsis groups. The difference of gender, age, the time between the onset of GIP and the occurrence of sepsis, infection situation, body temperature, heart rate, respiratory frequency, white blood cell count (WBC), systemic inflammatory response syndrome (SIRS) in accord with standard, C-reactive protein (CRP), blood sugar, mean arterial pressure (MAP), lactic acid, number of cases having undergone laparoscopic surgery, sequential organ failure score (SOFA) and quick sequential organ failure score (qSOFA), Glasgow coma score(GCS), length of stay in intensive care unit (ICU), the total length of stay in hospital were compared;the status of survival and prognosis was assessed on day 30 by the Glasgow Outcome Scale (GOS). The indicators with statistical significance in the two groups were brought into the Cox regression model to analyze the independent risk factors affecting the prognosis of the patients. Results Fifty-eight patients with GIP were enrolled in this study. Among them, 22 cases developed secondary sepsis (GIP with sepsis group, there were 50.0% cases with single organ failure and 50.0% cases with multiple-organ failure, cases only in accord with 0-1 SIRS criteria accounting for 81.8%, and the mortality of secondary sepsis being 31.8%). No sepsis occurred in 36 patients (GIP without sepsis group). In GIP with sepsis group, the age, blood glucose, lactic acid, SOFA score, qSOFA, and the length of stay in ICU were significantly higher than those of GIP without sepsis group [age (years): 68.7±15.9 vs. 56.1±17.2, blood glucose (mmol/L): 6.9±2.3 vs. 5.9±1.2, lactic acid (mmol/L): 2.9±1.3 vs. 1.2±0.7, SOFA score: 5.6±3.2 vs. 0.5±0.4, qSOFA score: 1.0±0.9 vs. 0.3±0.1, the length of stay in ICU (days): 1.0 (0-4.0) vs. 0.1 (0-2.0), all P < 0.05], while MAP, GCS, and GOS scores in GIP with sepsis group were significantly lower than those in GIP without sepsis group [MAP (mmHg, 1 mmHg =0.133 kPa): 83.6±18.7 vs. 100.0±14.3, GCS score: 12.8±3.5 vs. 14.5±0.5, GOS score: 3.5±1.9 vs. 4.9±0.2, all P < 0.01]. Cox multivariable regression analysis showed: only low MAP and low GCS score were the independent risk predictors of death outcome for GIP with sepsis, the relative risk (RR) was 0.896 [95% confidence interval (CI) = 0.815-0.984, P = 0.022] and 0.585 (95%CI = 0.395-0.866, P = 0.007) respectively. Conclusion Patients with secondary sepsis following GIP have relatively high morbidity and much more risk factors, but only low MAP and low GCS score are closely associated with its high risk of death.

Preparation of Carbon Dots and Their Application in Food Analysis as Signal Probe / 分析化学

As the new popular fluorescent carbon nanomaterials, carbon dots have not only excellent optical properties and small size characteristics, but also have good biocompatibility, low toxicity and easy to achieve the surface functional characteristics, and can replace the traditional semi-quantum dots of the better choice.Based on the unique fluorescence characteristics and high sensitivity, carbon fluorescent probe has a good potential in food analysis and testing. In this experiment, the study of fluorescent carbon dots has been reviewed in recent years. The characteristics of carbon dots are briefly introduced and the preparation methods of carbon dots are summarized. The application of carbon dot fluorescent probes in food analysis and detection is introduced and the limitations and development of carbon point application are analyzed and forecasted.

Effect of fractional laser on the expression of SCF and c-kit in skin stem cells of guinea pig / 中华医学美学美容杂志

Objective To investigate the effect of fractional laser on the expression of stem cell factor (SCF) and c-kit receptor in body surface of guinea pig.Methods 20 guinea pigs were adopted.The back skin of each guinea pig was divided into four zones:A zone (the skin was not treated),B zone (the skin was treated by fractional laser at a low fluence:20 mJ/cm2),C zone (the skin was treated at a medium fluence:60 mJ/cm2),and D zone (the skin was treated at a high fluence:120 mJ/cm2).The immunohistochemical method was used to detect the expression of SCF and c-kit in body surface of guinea pig.The results were quantified using an HPIAS-1000 system.Results One week later,the SCF expression level in B,C and D groups was increased obviously,which showed statistical difference compared with A group (P＜0.05);the c-kit expression level in C and D groups was increased obviously,compared with A group (P＜0.05).4 weeks later,the SCF expression level in C and D groups was higher than A and B groups;furthermore the level in D group was higher than C group (P＜0.05);the c-kit expression level in D group was higher than A and B groups (P＜0.05).Conclusions The fractional laser could generate the curative effect by increasing the expression of SCF and c-kit in body surface.

Comparison of risk of death between older and non-older critical patients in ICU: a retrospective cohort study of consecutive 3 years / 中华危重病急救医学

Objective To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital.Methods A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from theregistration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed. The patients were divided into elderly group (65 years and older) and non-elderly group (15-65 years), and logistic regression analysis was performed for the risk of death in the two groups.Results During the study period, 2707 critical patients in emergency were admitted to the ICU of Shuyang People's Hospital, and patients not satisfied the inclusion criteria were excluded. Finally, a total of 2466 patients were enrolled in the analysis with the male and female ratio of 1.6 : 1, an average age of (61.8±17.3) years, a median Glasgow coma scale (GCS) score of 6 (4, 8), and with a median ICU stay of 3 (1, 6) days. In 2466 critical patients, the most common cause of critical state was spontaneous intracerebral hemorrhage (25.5%) and traumatic brain injury (17.0%), with a fatality rate of 46.0% and 39.5% within first 7 days respectively. Compared with the non-elderly patients (n = 1415), the incidences of death of the elderly patients (n = 1051) due to traumatic brain injury, cerebral infarction, heart failure/cardiovascularcrisis, and respiratory critically ill were significantly increased (9.4% vs. 4.7%, 2.9% vs. 0.8%, 5.0% vs. 2.1%, 2.5% vs. 1.0%, respectively), while the incidence of death for pesticide/drug poisoning in the elderly group was significantly lower than that in the non-elderly group (0.2% vs. 1.2%, allP < 0.01). Stepwise logistic regression analysis showed that traumatic brain injury [hazard ratio (HR) = 1.878, 95% confidence interval (95%CI) = 1.233-2.864,P = 0.003), cerebral infarction (HR = 0.435, 95%CI = 0.229-0.826, P = 0.011), heart failure/cardiovascular crisis (HR = 0.399, 95%CI = 0.238-0.668,P = 0.000), and respiratory critically ill (HR = 0.239, 95%CI = 0.126-0.453,P= 0.000) in the older patients were significantly high risk factors of death as compared with those in non-older patients.Conclusions In the general ICU, the most common cause is spontaneous intracerebral hemorrhage and traumatic brain injury in critical patients with a high fatality rate. The risk of death in elderly patients with severe traumatic brain injury, cerebral infarction, heart failure/cardiovascular crisis, respiratory critically ill is higher than that of the non-elderly patients.